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Personality disorders are ego-syntonic behaviors that begin in childhood or adolescence and are classified into 3 clusters: A, B, and C. They can considerably interfere with a patient’s adherence to medical treatment for a variety of reasons. It is important to rule out organic causes of a mental disorder (e.g., endocrine hormone imbalances, medication adverse effects, alcohol and/or substance use, other mental health co-morbidities) before ascribing a personality disorder to a patient. Cluster A includes paranoid, schizoid, and schizotypal personality disorders, which can be behaviorally described as being distrustful and/or detached from society.
Last updated: Feb 17, 2023
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Key features
Risk factors
Management
Clinical associations
Key features
Risk factors
Management
Clinical associations
Key features
Risk factors
Management
Clinical associations
Cluster A disorder | Paranoid | Schizoid | Schizotypal |
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Key features |
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Defense mechanism Defense mechanism Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. Psychotherapy | Projection | Isolation of affect | N/A |
Differentials | Delusional disorder Delusional disorder In delusional disorder, the patient suffers from 1 or more delusions for a duration of 1 month or more, without any other psychotic symptoms or behavioral changes and no decline in functioning abilities. Delusional Disorder |
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Management | Psychotherapy Psychotherapy Psychotherapy is interpersonal treatment based on the understanding of psychological principles and mechanisms of mental disease. The treatment approach is often individualized, depending on the psychiatric condition(s) or circumstance. Psychotherapy (first line) with low-dose pharmacotherapy for applicable symptoms (e.g., anxiolytics, mood stabilizers) | Psychotherapy Psychotherapy Psychotherapy is interpersonal treatment based on the understanding of psychological principles and mechanisms of mental disease. The treatment approach is often individualized, depending on the psychiatric condition(s) or circumstance. Psychotherapy (first line) with low-dose pharmacotherapy for applicable symptoms (e.g., anxiolytics, mood stabilizers) | Psychotherapy Psychotherapy Psychotherapy is interpersonal treatment based on the understanding of psychological principles and mechanisms of mental disease. The treatment approach is often individualized, depending on the psychiatric condition(s) or circumstance. Psychotherapy (first line) with low-dose pharmacotherapy for applicable symptoms (e.g., anxiolytics, mood stabilizers, second-generation antipsychotics Second-Generation Antipsychotics Second-generation antipsychotics (SGAs) are also called atypical antipsychotics. Medications in this class include aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lumateperone, lurasidone, olanzapine, paliperidone, pimavanserin, quetiapine, risperidone, and ziprasidone. Second-Generation Antipsychotics) |
Epidemiology | ♂>♀ | ♂>♀ (slightly) | ♂>♀ (slightly) |
Example | A man believes that his neighbors are sneaking into his house at night and are working together to get him kicked out of the neighborhood. | A man lives in a remote village and has no known friends or family. | A young man believes that the crystals he sells have magical healing properties and that the spirit gods are helping him find his fortune. |