{"id":4296,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/personalitydisordersadults\/"},"modified":"2023-09-01T13:46:29","modified_gmt":"2023-09-01T12:46:29","slug":"personalitydisordersadults","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/mentalhealthadult\/personalitydisordersadults\/","title":{"rendered":"Personality Disorders (Adults)"},"content":{"rendered":"\n<title>Personality Disorders (Adults)<\/title>\n\n\n\n<h3 class=\"wp-block-heading\">Major Type of Personality Disorder <\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><div align=\"justify\">Paranoid personality disorder is a pattern of \ndistrust and suspiciousness such that others&#8217; motives are interpreted as\n malevolent<\/div><\/li>\n\n\n\n<li><div align=\"justify\">Schizoid personality disorder is a pattern of \ndetachment from social relationships and a restricted range of emotional\n expression <\/div><\/li>\n\n\n\n<li><div align=\"justify\">Schizoid personality disorder is a pattern of acute\n discomfort in close relationships, cognitive or perceptual distortions,\n and eccentricities of behaviour <\/div><\/li>\n\n\n\n<li><div align=\"justify\">Antisocial personality disorder is a pattern of disregard for, and violation of, the rights of others <\/div><\/li>\n\n\n\n<li><div align=\"justify\">Borderline personality disorder is a pattern of \ninstability in interpersonal relationships, self-image and affects, and \nmarked impulsivity <\/div><\/li>\n\n\n\n<li><div align=\"justify\">Histrionic personality disorder is a pattern of excessive emotionality and attention seeking <\/div><\/li>\n\n\n\n<li><div align=\"justify\">Narcissistic personality disorder is a pattern of grandiosity, need for admiration and lack of empathy <\/div><\/li>\n\n\n\n<li><div align=\"justify\">Avoidant personality disorder is a pattern of \nsocial inhibition, feelings of inadequacy and hypersensitivity to \nnegative evaluation <\/div><\/li>\n\n\n\n<li><div align=\"justify\">Dependent personality disorder is a pattern of \nsubmissive and clinging behaviour related to an excessive need to be \ntaken care of. <\/div><\/li>\n\n\n\n<li><div align=\"justify\">Obsessive-compulsive personality disorder is a pattern of preoccupation with orderliness, perfectionism and control <\/div><\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>\u200bIf a person is committed to learning ways to reduce emotional dysregulation and improving distress tolerance, adult mental health may offer time-limited assessment to develop a formulation, which can help patients&#8217; understanding of their difficulties and direct them towards better ways of coping and managing risk.&nbsp; This may be enough for some people who are not otherwise wanting or currently able to engage in more intensive therapy. The steps below are recommended:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Treat any anxiety and depression:\n<ol class=\"wp-block-list\">\n<li>People should be offered standard talking treatments for anxiety\/depression if they have clear symptoms of this as well as any emotional dysregulation.<\/li>\n\n\n\n<li>A trial of antidepressants may also be helpful, but these should be ceased if there is no benefit, and also people should be warned about the risk of worsening suicidal ideation in some people in the first couple of weeks.<\/li>\n\n\n\n<li>Pathways exist for complex trauma via the&nbsp;<a href=\"https:\/\/services.nhslothian.scot\/riverscentre\/Pages\/default.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Rivers Centre<\/a>: Survive and Thrive groups, Drop-in Advice Clinic \u2013 see the next section<\/li>\n<\/ol>\n<\/li>\n\n\n\n<li>If the person is committed to learning ways to reduce emotional dysregulation and improving distress tolerance, then there are a variety of options available\n<ol class=\"wp-block-list\">\n<li>A short time-limited assessment \/intervention can be helpful in developing a formulation, which can help patients&#8217; understanding of their difficulties and direct them towards better ways of coping and managing risk\u2013 this may be enough for some people who are not otherwise wanting or currently able to engage in more intensive therapy.<\/li>\n\n\n\n<li>Patients may access the above option without a formal diagnosis by Psychiatry, which in itself may not always be as helpful as a formulation-based approach. Some patients may benefit from a diagnosis (for example if their level of risk is sufficient to consider a referral to the DBT Team). A diagnosis requires both the presence of a range of symptoms AND significant impact on many areas of a person&#8217;s life. A diagnosis cannot be made if only traits are present. Note that no guidelines recommend medication as a primary treatment for personality disorders.<\/li>\n\n\n\n<li>DBT (Dialectical Behavioural Therapy) may be provided for patients with a diagnosis of Emotionally Unstable Personality Disorder who are at most risk or serious self harm\/death, but these referrals are made by Mental Health Services after assessment.<\/li>\n\n\n\n<li>The emergence of clear psychotic symptoms or sustained \/ pervasive depressive symptoms in someone with a diagnosis of personality disorder should be assessed and treated., and so should be referred by the guidance for these symptoms found in other headings.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a rel=\"noreferrer noopener\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Personality-Disorder-in-Scotland.-Raising-awareness-expectations-hope.pdf\" target=\"_blank\">Personality Disorder in Scotland. Raising awareness, expectations, hope<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Personality Disorders (Adults) Major Type of Personality Disorder<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4125,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[338],"class_list":["post-4296","page","type-page","status-publish","hentry","category-personalitydisordersadults"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/mentalhealthadult\/personalitydisordersadults\/\" rel=\"tag\">Personality Disorders (Adults)<\/a>","rttpg_excerpt":"Personality Disorders (Adults) Major Type of Personality Disorder","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4296","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4296"}],"version-history":[{"count":3,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4296\/revisions"}],"predecessor-version":[{"id":11005,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4296\/revisions\/11005"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4125"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4296"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4296"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}