Personality Disorders

Warning

Introduction

We all have different personality traits; a person may be given a diagnosis of a personality disorder when these traits are extreme, maladaptive and interfere with relationships, work and daily functioning.

The most commonly seen personality disorder is emotionally unstable personality disorder (EUPD), also known as Borderline Personality Disorder (BPD).

ICD-11 defines severity of personality disorder ranging from Personality Difficulty to Severe Personality Disorder.

Signs and symptoms

  • Problems with self identity and interpersonal relationships
  • Intense experience of emotions resulting in maladaptive expression of these emotions
  • Occurs across a range of different relationships and settings
  • Associated with distress and effect on personal, social and occupational functioning.

These experiences can lead to people presenting in crisis with symptoms of:

  • Self harm
  • Suicidal thoughts or acts
  • Self destructive behaviour

Assessment

You are most likely to see people with a diagnosis of personality disorder when they present in crisis. In crisis, a risk assessment is vital. This would involve assessment of risk to self and others. It is important to try to find out what is causing the distress at this moment and explore the feelings related to this in a sensitive manner.

Treatment

Treatment for personality disorders focuses upon psychological therapies such as Dialectical Behavioural Therapy (DBT), Mentalisation-Based Therapy (MBT) and psychotherapy.

Psychological therapies aim to help people identify, validate and cope with their emotions in more healthy ways.

Medications are not used to treat personality disorders but can be used for managing symptoms relating to the diagnosis of a personality disorder and any co-existing mental illness.

Last reviewed: 21/02/2024

Next review date: 21/08/2024

Author(s): Core Trainee in Psychiatry, NHS Fife & Medical Education Fellow, NHS Lothian.

Author email(s): mypsych@ggc.scot.nhs.uk.

Reviewer name(s): Medical Education Fellow, NHS Lothian.