Personality disorder - cluster C

psychiatric rotation

1. Personality disorder cluster c Hamad Emad Hamad Dhuhayr

2. Contents Cluster C personality disorders Avoidant personality disorder Dependent personality disorder Obsessive-compulsive personality disorder

3. Cluster C personality disorders Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder , dependent personality disorder and obsessive-compulsive personality disorder . It's not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed.

4. Avoidant personality disorder is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and a hypersensitivity to negative evaluation . Prevalence: 0.5-1% of population Sex ratio: M=F Comorbidity: Social phobia, depression , anxiety Family: Cluster C disorders

5. Treatment Psychotherapy - Individual and group therapy, typically interpersonal (IPT), is the treatment of choice Medication - Antidepressants and anxiolytics are often useful for accompanying depression and anxiety

6. Physician-patient Interaction Unconditional respect and concern are very helpful Avoid implications of rejection Be aware that even a limited personal interaction may be very important, and its loss very distressing

7. Dependent personality disorder a strong need to be taken care of by other people . This need to be taken care of, and the associated fear of losing the support of others, often leads people with Dependent Personality Disorder to behave in a " clingy " manner; to submit to the desires of other people . Prevalence: 2.5-27% of population Sex ratio: F>M Comorbidity: Mood and anxiety disorders, adjustment disorders Family: Cluster C disorders

8. Treatment Psychotherapy - Dynamic, behavior, group, and family therapies are all used successfully Medication - Anxiolytics are often helpful. Antidepressants may be used with comorbid depression.

9. Physician-patient Interaction Physicians should take an active role in treatment planning, with clear explanations and recommendations. Patients may need encouragement to make decisions about treatment plans. Family involvement is often helpful.

10. Obsessive-compulsive personality disorder preoccupied with rules, regulations, and orderliness. This preoccupation with perfectionism and control is at the expense of flexibility, openness, and efficiency . Prevalence: 1% of population Sex ratio: M:F=2:1 Comorbidity: Slight increase in mood and anxiety disorders Family: Obsessive-compulsive personality disorder

11. Treatment Psychotherapy - Psychoanalytic, behavioral, and group therapies are often useful Medication - Serotonin-specific reuptake inhibitor (SSRI) antidepressants may be useful

12. Physician-patient Interaction Thorough explanations and specific, detailed information are valued Uncertainty is rarely tolerated Treatment options should be presented with clear risk-benefit analyses.

13. OCD vs. OCPD

14. these central features: -- social inhibition and hypersensitivity to criticism and rejection (avoids social and occupational activities that involve significant interpersonal contact due to insecurities and anxieties) these central features: -- preoccupation with orderliness, perfectionism, and control (preoccupied with details, rules, lists, organization, or schedules to the extent that the major point of the activity is lost) these central features: -- submissive and clinging behavior related to excessive needs to be taken cared of (urgently and indiscriminately seeks another relationship when a close relationship ends)

15. References &