Personality change due to another medical condition

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Overview

Personality disorders present with symptoms which corresponds to other psychiatric illnesses as well. It makes imperative to employ the [DSM-5] criterion to make the diagnosis of PD. Additionally, many patients with PDs also suffer from co-morbid conditions like mood disorders, substance abuse and organic brain lesions which have overlapping symptoms and signs with PDs. This requires a complete long history including duration of symptoms and developmental history and essential investigations.

Differential Diagnosis

• Another mental disorder due to another medical condition

• Depressive disorder due to brain tumor

• Chronic medical conditions associated with pain and disability
• Delirium or major neurocognitive disorder
• Other mental disorders

• Bipolar disorder
• Conduct disorders
• Delusional disorder
• Depressive disorder
• Panic disorder
• Schizophrenia

• Other personality disorders
• Substance use disorders

Diagnostic Criteria

DSM-V Diagnostic Criteria for Personality Change Due to Another Medical Condition

“

A.A persistent personality disturbance that represents a change from the individual’s previous characteristic personality pattern. Note:In children, the disturbance involves a marked deviation from normal development or a significant change in the child’s usual behavior patterns, lasting at least 1 year. AND B.There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct patho physiological consequence of another medical condition. AND C.The disturbance is not better explained by another mental disorder (including another mental disorder due to another medical condition). AND D.The disturbance does not occur exclusively during the course of a delirium. AND E.The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify whether: Labile type: If the predominant feature is affective lability. Disinhibited type: If the predominant feature is poor impulse control as evidenced by sexual indiscretions, etc. Aggressive type: If the predominant feature is aggressive behavior. Apathetic type: If the predominant feature is marked apathy and indifference. Paranoid type: If the predominant feature is suspiciousness or paranoid ideation. Other type: If the presentation is not characterized by any of the above subtypes. Combined type: If more than one feature predominates in the clinical picture.

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References

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