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Personality Disorders Workup

  • Author: David Bienenfeld, MD; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych(UK)  more...
 
Updated: Feb 15, 2016
 

Approach Considerations

The following tests can be used in the diagnosis of personality disorders:

  • Toxicology screen - Substance abuse is common in many personality disorders, and intoxication can lead patients to present with some features of personality disorders.
  • Screening for HIV and other sexually transmitted diseases - Patients with personality disorders often exhibit poor impulse control, and many act without regard to risk; such behavior can lead to infection with a sexually transmitted disease
  • CT Scanning - Computed tomography (CT) scanning with appropriate blood work can be carried out if organic etiology is suspected
  • Radiography - Radiography can be indicated for injuries from fighting, motor vehicle accidents, or self-mutilation

Psychological testing

Psychological testing may support or direct the clinical diagnosis.[11, 9] The Minnesota Multiphasic Personality Inventory (MMPI) is the best-known psychological test. The Eysenck Personality Inventory and the Personality Diagnostic Questionnaire are also used. None of these has been reliably validated against DSM-5 diagnoses.

The Structured Clinical Interview for DSM-5 (SCID-5) can also be used to aid in diagnosis.

 
 
Contributor Information and Disclosures
Author

David Bienenfeld, MD Professor, Departments of Psychiatry and Geriatric Medicine, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Chief Editor

Iqbal Ahmed, MBBS, FRCPsych(UK) Faculty, Department of Psychiatry, Tripler Army Medical Center; Clinical Professor of Psychiatry, Uniformed Services University of the Health Sciences; Clinical Professor of Psychiatry, Clinical Professor of Geriatric Medicine, University of Hawaii, John A Burns School of Medicine

Iqbal Ahmed, MBBS, FRCPsych(UK) is a member of the following medical societies: Academy of Psychosomatic Medicine, American Neuropsychiatric Association, American Society of Clinical Psychopharmacology, Royal College of Psychiatrists, American Association for Geriatric Psychiatry, American Psychiatric Association

Disclosure: Nothing to disclose.

Acknowledgements

Jerry Balentine, DO Professor of Emergency Medicine, New York College of Osteopathic Medicine; Executive Vice President, Chief Medical Officer, Attending Physician in Department of Emergency Medicine, St Barnabas Hospital

Jerry Balentine, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American College of Physician Executives, American Osteopathic Association, and New York Academy of Medicine

Disclosure: Nothing to disclose.

Michael S Beeson, MD, MBA, FACEP Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine and Pharmacy; Attending Faculty, Akron General Medical Center

Michael S Beeson, MD, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy ofSciences,and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Robert Harwood, MD, MPH, FACEP, FAAEM Program Director, Department of Emergency Medicine, Advocate Christ Medical Center; Assistant Professor, Department of Emergency Medicine, University of Illinois at Chicago College of Medicine

Robert Harwood, MD, MPH, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Council of Emergency Medicine Residency Directors, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association; 2013. 645-684.

  2. McCrae RR, John OP. An introduction to the five-factor model and its applications. J Pers. 1992 Jun. 60(2):175-215. [Medline].

  3. American Psychiatric Association. A Message From APA President Dilip Jeste M.D. on DSM-5. Psychiatric News. December 1, 2012. Available at http://www.psychnews.org/files/DSM-message.pdf. Accessed: Dec 10, 2012.

  4. Friborg O, Martinussen M, Kaiser S, Overgård KT, Rosenvinge JH. Comorbidity of personality disorders in anxiety disorders: A meta-analysis of 30 years of research. J Affect Disord. 2012 Sep 20. [Medline].

  5. Walsh Z, Shea MT, Yen S, Ansell EB, Grilo CM, McGlashan TH, et al. Socioeconomic-Status and Mental Health in a Personality Disorder Sample: The Importance of Neighborhood Factors. J Pers Disord. 2012 Sep 17. [Medline].

  6. Raine A, Lencz T, Bihrle S, LaCasse L, Colletti P. Reduced prefrontal gray matter volume and reduced autonomic activity in antisocial personality disorder. Arch Gen Psychiatry. 2000 Feb. 57(2):119-27; discussion 128-9. [Medline].

  7. Lyons-Ruth K, Holmes BM, Sasvari-Szekely M, Ronai Z, Nemoda Z, Pauls D. Serotonin transporter polymorphism and borderline or antisocial traits among low-income young adults. Psychiatr Genet. 2007 Dec. 17(6):339-43. [Medline]. [Full Text].

  8. Stein DJ. Borderline personality disorder: toward integration. CNS Spectr. 2009 Jul. 14(7):352-6. [Medline].

  9. Samuels J. Personality disorders: epidemiology and public health issues. Int Rev Psychiatry. 2011 Jun. 23 (3):223-33. [Medline].

  10. Suominen KH, Isometsä ET, Henriksson MM, Ostamo AI, Lönnqvist JK. Suicide attempts and personality disorder. Acta Psychiatr Scand. 2000 Aug. 102(2):118-25. [Medline].

  11. Shedler J, Westen D. Refining personality disorder diagnosis: integrating science and practice. Am J Psychiatry. 2004 Aug. 161(8):1350-65. [Medline]. [Full Text].

  12. Hopwood CJ, Donnellan MB, Ackerman RA, Thomas KM, Morey LC, Skodol AE. The Validity of the Personality Diagnostic Questionnaire-4 Narcissistic Personality Disorder Scale for Assessing Pathological Grandiosity. J Pers Assess. 2012 Oct 26. [Medline].

  13. Stoffers JM, Völlm BA, Rücker G, Timmer A, Huband N, Lieb K. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2012 Aug 15. 8:CD005652. [Medline].

  14. Britton R. Narcissistic disorders in clinical practice. J Anal Psychol. 2004 Sep. 49(4):477-90; discussion 491-3. [Medline].

  15. Goodman G, Edwards K, Chung H. Interaction structures formed in the psychodynamic therapy of five patients with borderline personality disorder in crisis. Psychol Psychother. 2012 Dec 3. [Medline].

  16. Beck AT, Freeman A. Cognitive Therapy of Personality Disorders. London, England: Guilford Press; 1990.

  17. Livesley WJ. A practical approach to the treatment of patients with borderline personality disorder. Psychiatr Clin North Am. 2000 Mar. 23(1):211-32. [Medline].

  18. Kavoussi RJ, Coccaro EF. Divalproex sodium for impulsive aggressive behavior in patients with personality disorder. J Clin Psychiatry. 1998 Dec. 59(12):676-80. [Medline].

  19. Soloff PH. Psychopharmacology of borderline personality disorder. Psychiatr Clin North Am. 2000 Mar. 23(1):169-92, ix. [Medline].

  20. Binks CA, Fenton M, McCarthy L, Lee T, Adams CE, Duggan C. Pharmacological interventions for people with borderline personality disorder. Cochrane Database Syst Rev. 2006 Jan 25. CD005653. [Medline].

  21. Simeon D, Baker B, Chaplin W, Braun A, Hollander E. An open-label trial of divalproex extended-release in the treatment of borderline personality disorder. CNS Spectr. 2007 Jun. 12(6):439-43. [Medline].

  22. Herpertz SC, Zanarini M, Schulz CS, Siever L, Lieb K, Möller HJ. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of personality disorders. World J Biol Psychiatry. 2007. 8(4):212-44. [Medline].

  23. Lieb K, Völlm B, Rücker G, Timmer A, Stoffers JM. Pharmacotherapy for borderline personality disorder: Cochrane systematic review of randomised trials. Br J Psychiatry. 2010 Jan. 196(1):4-12. [Medline].

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