Textbook of Psychiatry
H15 Personality disorders
Personality disorder: the way a person deals with things results in significant problems for
the patient himself or others, or in social dysfunction.
In some cases, patients seek psychotherapeutic help for problems of this kind, but in general
most patients present with symptoms such as anxiety, depression, sleep disorders, eating
disorders or problems with work or relationships the burden exceeds the personality’s
tolerance.
A personality disorder is a predisposing factor for the development of another psychiatric
disorder in stressful circumstances. Specific personality disorders also make individuals
vulnerable to specific stressors.
The DSM-5 identifies 10 specific personality disorders, grouped into 3 clusters:
Cluster A: eccentric personality disorder
o Paranoid
o Schizoid
o Schizotypal
Cluster B: Dramatic personality disorders
o Antisocial
o Borderline
o Histrionic
o Narcissistic
Cluster C: anxious personality disorders
o Avoidant
o Dependent
o Obsessive-compulsive
, Syndromes:
The classification criteria for the specific personality disorders overlap, so individuals often
meet the criteria for more than 1 personality disorder at a time.
The severity is determined by the symptoms and the individual’s life situation.
Cluster A personality disorders:
These patients display eccentric, odd behaviour: they are introverted, withdraw from social
life and have limited emotional expression. They often display symptoms in the area of
perception or thought content. Their social functioning is much more severely impaired by
this abnormal behaviour than that of patients in the other clusters.
Paranoid personality disorder:
Patients may give the impression of being on edge, anxious, insecure, irritable or
angry. Although they appear emotionless and cold, they are more likely to be
vulnerable, anxious and labile inside, manifested in hostility, stubbornness and
sarcasm.
Schizoid personality disorder:
These patients have lonely hobbies and jobs. They give the impression of being
socially inept, they do not understand jokes and prefer to remain in the background.
They appear to experience and display less emotion than the average person. They
rarely get angry and often remain passive, even in the face of unpleasant events.
Schizotypal personality disorder:
These patients often stand out by virtue of their unusual use of language, strange
clothes, unkempt appearance and lack of observance of social conventions. They
appear to have little if any interest in relationships or contacts with others and
become tense and suspicious if others try to come closer emotionally. They often feel
H15 Personality disorders
Personality disorder: the way a person deals with things results in significant problems for
the patient himself or others, or in social dysfunction.
In some cases, patients seek psychotherapeutic help for problems of this kind, but in general
most patients present with symptoms such as anxiety, depression, sleep disorders, eating
disorders or problems with work or relationships the burden exceeds the personality’s
tolerance.
A personality disorder is a predisposing factor for the development of another psychiatric
disorder in stressful circumstances. Specific personality disorders also make individuals
vulnerable to specific stressors.
The DSM-5 identifies 10 specific personality disorders, grouped into 3 clusters:
Cluster A: eccentric personality disorder
o Paranoid
o Schizoid
o Schizotypal
Cluster B: Dramatic personality disorders
o Antisocial
o Borderline
o Histrionic
o Narcissistic
Cluster C: anxious personality disorders
o Avoidant
o Dependent
o Obsessive-compulsive
, Syndromes:
The classification criteria for the specific personality disorders overlap, so individuals often
meet the criteria for more than 1 personality disorder at a time.
The severity is determined by the symptoms and the individual’s life situation.
Cluster A personality disorders:
These patients display eccentric, odd behaviour: they are introverted, withdraw from social
life and have limited emotional expression. They often display symptoms in the area of
perception or thought content. Their social functioning is much more severely impaired by
this abnormal behaviour than that of patients in the other clusters.
Paranoid personality disorder:
Patients may give the impression of being on edge, anxious, insecure, irritable or
angry. Although they appear emotionless and cold, they are more likely to be
vulnerable, anxious and labile inside, manifested in hostility, stubbornness and
sarcasm.
Schizoid personality disorder:
These patients have lonely hobbies and jobs. They give the impression of being
socially inept, they do not understand jokes and prefer to remain in the background.
They appear to experience and display less emotion than the average person. They
rarely get angry and often remain passive, even in the face of unpleasant events.
Schizotypal personality disorder:
These patients often stand out by virtue of their unusual use of language, strange
clothes, unkempt appearance and lack of observance of social conventions. They
appear to have little if any interest in relationships or contacts with others and
become tense and suspicious if others try to come closer emotionally. They often feel
