Personality disorders and therapeutic approaches

Abstract

Introduction: the diagnosis and classification of Personality Disorders are a controverse and complex area of debate because it is often questioned the advantage of separating them in different clusters or using a dimensional classification and also because some wonder if a Personality Disorder is itself a disease and if so how prejudicial can the diagnosis be. Functional impact is a crucial aspect of these diagnosis and it should be a major component of evaluation and therapeutical approach. Objective: review the characteristics of the different Personality Disorders, identify the maladaptive traits in order to better adapt its therapeutical approach and analyze which one of the latter is more efficient. Methods: a systematic review was made using PubMed. The MeSH term used was “Personality Disorder”. Results: The borderline Personality Disorder is the one with more evidence in the literature, being antipsychotics the major pharmacological approach used with efficacy found for olanzapine, risperidone, haloperidol, thiothixene and also the antidepressant fluoxetine. In Personality Disorders of Cluster C and Narcissistic Personality Disorder, it was seen that a cognitive and psychodynamic approach lead to medium or high positive results, although it is clear that these subtype of Personality Disorders benefits more with this approach. Conclusion: the evidence suggests that comorbid or latent with Personality Disorders are associated with worse treatment adhesion when consider Axis 1 disorders. It was found that, generally, there is not enough information to make viable and strong conclusions in terms of pharmacological approaches and that the majority of the studies are related to the borderline Personality Disorder.