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Rethinking personality disorder

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firemonkee57

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People with personality disorder have difficulty interpreting the world, themselves, and the people around them. This condition manifests as problems with cognition, emotions, and behaviour, which often affect the ability to form interpersonal relationships. It is probably the most common psychiatric disorder, and almost certainly the most underdiagnosed. Popular opinion holds that the disorder is permanent, unchanging, and largely untreatable, leading the term to become more common as a pejorative label for so-called difficult patients than as an actual diagnosis. The Lancet Series on Personality disorder challenges this opinion.

The problem lies in the classification of the disorder. Current definitions are largely categorical (eg, borderline personality disorder); however, in view of the high prevalence of people diagnosed with non-specific personality disorder or with as many as ten comorbid personality disorders, this model simply does not seem appropriate. Instead, the Series authors argue for a system that accounts for variation within the disorder. They propose a core diagnosis based on severity (ie, the extent to which the disorder affects the life of the individual) and a secondary set of traits describing the patient's behaviour, thus providing guidance for treatment selection.

Despite the disorder often first manifesting in childhood or adolescence, the existing criteria do not allow diagnosis before the age of 18 years. This prevents health professionals from identifying and helping children and adolescents with the disorder at the time when such interventions could have the greatest effect. Furthermore, the Series describes how good outcomes can be achieved with straightforward good clinical practice by any medical practitioner with some psychiatric training.

Ultimately, doctors need to lead the way in destigmatising the disorder. They are among the most likely group to come into contact with people with personality disorder and, to give the best standard of care possible, they should be able to identify it without passing judgment, and make use of the lessons learned from existing research to deliver the most appropriate treatment.


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Section in bold done by me.
 
SarahD

SarahD

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"Ultimately, doctors need to lead the way in destigmatising the disorder. They are among the most likely group to come into contact with people with personality disorder and, to give the best standard of care possible, they should be able to identify it without passing judgment, and make use of the lessons learned from existing research to deliver the most appropriate treatment."

This last bit makes me laugh. Doctors are the ones who treat patients with personality disorders the most badly. They are the ones who stigmatise them. I know some people report having good treatment but I have witnessed some very behaviour - from doctors, not the patient (when I was in hospital).

I also have a friend with BPD and the way she is treated is appalling.

They (doctors) need to start with themselves, as far as reducing stigma goes.
 
SomersetScorpio

SomersetScorpio

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People with personality disorder have difficulty interpreting the world, themselves, and the people around them.
I find that statement in itself to be problematic.
Who says I have difficulty in interpreting the world, myself or other people?
I think i've got a really good insight into these things. It's other moronic people who unfortunately take up the majority of the population that have the problem. :unsure:
 
Darkred

Darkred

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I find that statement in itself to be problematic.
Who says I have difficulty in interpreting the world, myself or other people?
I think i've got a really good insight into these things. It's other moronic people who unfortunately take up the majority of the population that have the problem. :unsure:
Completely agree with you.
 
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|||ME|||

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Jun 1, 2012
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People with personality disorder have difficulty interpreting the world, themselves, and the people around them.
I find that statement in itself to be problematic.
Who says I have difficulty in interpreting the world, myself or other people?
...
Yes, there's something very awkward and uncomfortable about people who haven't lived a life that creates severe distress and difficulties judging the world views and interpretations of those who have as "disordered" rather than as a perfectly understandable reaction to having a different experience of the world than them.
 
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