Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • paranoia
  • odd thinking
  • restricted range of emotions
  • anger and irritability
  • excessive emotionality and unstable mood states
  • anxiety and tension
  • impulsive behaviors
  • grandiosity
  • evidence of self harm (e.g., scars, burns)

Risk factors

  • history of abuse
  • family history of schizophrenia
  • negative parenting interactions
  • emotional/disruptive disorder in childhood

Diagnostic investigations

Investigations to consider

  • suicide risk screening questions
  • Standardized Assessment of Personality-Abbreviated Scale (SAPAS)
  • Millon Clinical Multiaxial Inventory-III (MCMI-III)
  • Structured Clinical Interview for DSM-IV Axis II Personality Disorders
  • MRI/CT scan of brain
  • urine drug screen
  • The Primary Care Evaluation of Mental Disorders (PRIME-MD)
  • Patient Health Questionnaire-9 (PHQ-9)
  • Mood Disorder Questionnaire
  • Generalized Anxiety Disorder-7 (GAD-7) and GAD-2
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Michael J. Schrift

Director, Geriatric Psychiatry and Neuropsychiatry Division

Director, Geriatric Psychiatry Fellowship Training Program

Associate Professor

Department of Psychiatry and Behavioral Sciences

Northwestern University Feinberg School of Medicine

Chicago

IL

Disclosures

MJS declares that he has no competing interests.

Dr Michael J. Schrift would like to gratefully acknowledge Dr Crystal T. Clark, and the late Dr Maria Devens, previous contributors to this monograph. He would also like to acknowledge Dr Eric Gausche, who contributed the psychopharmacology sections for the initial version, and Dr Richard Stringham, who reviewed and approved information on the use of imaging and laboratory tests in the diagnosis section in the initial version. MD is an author of references cited in this monograph. CTC declares that she has no competing interests. EG and RS declare that they have no competing interests.

Peer reviewers VIEW ALL

Consultant Psychiatrist and Visiting Professor

Halliwick Psychotherapy Unit

St Ann’s Hospital

London

UK

Disclosures

AWB declares that he has a bias towards the use of mentalization in the treatment of personality disorder.

Director

Borderline Personality Disorder Initiative

Semel Institute

UCLA

Los Angeles

CA

Disclosures

RLK declares that she has no competing interests.

Medical Director

Opioid Treatment Program

Dayton Veterans Affairs Medical Center

Dayton

OH

Disclosures

JT declares that he has no competing interests.

Department of Psychiatry and Psychotherapy

Medical University of Vienna

Vienna

Austria

Disclosures

DW has received lecture fees from CSC Pharmaceuticals, GlaxoSmithKline, and Pfizer, and has served as a consultant for GlaxoSmithKline.

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