PERSONALITY-DISORDERS - GUIDELINES FOR DIAGNOSIS AND TREATMENT

Personality disorders manifest themselves in chronic and inflexible patterns of reaction to various individual or social life conditions. ICD-10 and DSM-III-R give several different definitions for specific personality disorders. They are characterized by problems in social adaptation, by specific cognitions and especially by typical disorders of affect. Under an etiological perspective it can be said that disorders in the regulation of affect lead to problems in social interaction and to specific cognitive schemata and finally to unspecific but far-reaching adaptation disorders. There are several promising developments in the treatment of personality disorders. These are special psychotherapeutic treatments for special types of disorder, which are backed by empirical data on their efficacy; An example is the dialectic cognitive therapy for borderline disorders. There is also an increasing number of publications on the treatment of personality disorders with psychotropic drugs. Serotonin reuptake inhibitors are recommended for disorders of impulse control and depression, or MAO inhibitors for anxious avoidant personality disorders. Therapists who treat personality disorders need generally high therapeutic skills because the interactional problems of the patients will also be present in the therapist-patient encounter.