Nicholas Morcos, MD; Roy Morcos, MD, FAAFP Personality disorders: Department of Psychiatry, University of Michigan Health System, Ann Arbor A measured response (Dr. N. Morcos); St. Elizabeth Boardman Hospital, Mercy Health, Ohio (Dr. R. Morcos) Improving your understanding of these disorders will help you identify specific diagnoses, ensure appropriate
[email protected]. edu treatment, and reduce frustration during office visits. The authors reported no potential conflict of interest relevant to this article. ersonality disorders (PDs) are common, affecting up PRACTICE to 15% of US adults, and are associated with comorbid RECOMMENDATIONS medical and psychiatric conditions and increased utili- ❯ Maintain a high index of P 1,2 zation of health care resources. Having a basic understand- suspicion for personality ing of these patterns of thinking and behaving can help family disorders (PDs) in patients who appear to be “difficult,” physicians (FPs) identify specific PD diagnoses, ensure appro- and take care to distinguish priate treatment, and reduce the frustration that arises when these diagnoses from primary an individual is viewed as a “difficult patient.” mood, anxiety, and Here we describe the diagnostic features of the disorders psychotic disorders. C in the 3 major clusters of PDs and review an effective approach ❯ Refer patients with PDs for to the management of the most common disorder in each clus- psychotherapy, as it is ter, using a case study patient. considered the mainstay of treatment—particularly for borderline PD. B Defense mechanisms offer clues ❯ Use pharmacotherapy that your patient may have a PD judiciously as an adjunctive Personality is an enduring pattern of inner experience and treatment for PD.