Personality disorder overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Personality disorder, formerly referred to as a Character Disorder is a class of mental disorders characterized by rigid and on-going patterns of thought and action (Cognitive modules). The underlying belief systems informing these patterns are referred to as fixed fantasies. The inflexibility and pervasiveness of these behavioral patterns often cause serious personal and social difficulties, as well as a general impairment of functioning.
Causes
The causes of personality disorders are unknown. However, many genetic and environmental factors are thought to play a role.
Personality change due to other medical conditions
Differential Diagnosis
- Severe head trauma
- Depressive disorder
- Brain tumor
- Unspecified stimulant-related disorder[1]
Epidemiology and Demographics
Prevalence
The prevalence of personality change due to another medical condition is unknown.[1]
Risk Factors
- Central nervous system neoplasms
- Head trauma
- Cerebrovascular disease
- Huntington's disease
- Epilepsy
- Infectious conditions with central nervous system involvement (e.g., HIV),
- Hypothyroidism,
- Hypoadrenocorticism
- Hyperadrenocorticism), and
- Autoimmune conditions with central nervous system involvement (e.g., systemic lupus erythematosus)[1].
Natural History, Complications and Prognosis
Poor prognostic factors include:
- Substance use disorder
- Depressive personality disorder
- Brain tumor
Diagnosis Criteria
DSM-V Diagnostic Criteria for Borderline Personality Disorder[1]
- 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 pathophysiological 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.
OR
- Disinhibited type: If the predominant feature is poor impulse control as evidenced by sexual indiscretions, etc.
OR
- Aggressive type: If the predominant feature is aggressive behavior.
OR
- Apathetic type: If the predominant feature is marked apathy and indifference.
OR
- Paranoid type: If the predominant feature is suspiciousness or paranoid ideation.
OR
- Other type: If the presentation is not characterized by any of the above subtypes.
OR
- Combined type: If more than one feature predominates in the clinical picture.
OR
- Unspecified type
Coding note: Include the name of the other medical condition (e.g., 310.1 [F07.0] person ality change due to temporal lobe epilepsy). The other medical condition should be coded and listed separately immediately before the personality disorder due to another medical condition (e.g., 345.40 [G40.209] temporal lobe epilepsy; 310.1 [F07.0] personality change due to temporal lobe epilepsy).