Psyche mixed personality disorder. Treatment of personality disorders

Personality disorders

Personality disorders are characterized by persistent disturbances in thoughts, feelings, and actions. Many people have their own characteristics. However, sometimes someone's behavior and personality characteristics are so different from the generally accepted ones that it causes irritation. Problems arise from which both people with personality disorders and their environment suffer. If a personality disorder puts a lot of pressure on daily life, there is a need for qualified psychological help.

Personality disorders are relatively inflexible patterns of perceiving other people and responding to events that impair a person's ability to socialize.

Medications do not change personality traits, while psychotherapy can help people recognize their problems and change their behavior.
Each person has characteristic perceptual patterns (personality traits) associated with other people and events. For example, some people react to anxious situations by asking someone for help, while others prefer to deal with problems on their own. Some people underestimate the severity of the problem, while others exaggerate it. Regardless of their usual response style, mentally healthy people will try an alternative approach if their first response is ineffective.

People with a personality disorder are rigid and tend to respond inappropriately to problems, to the point of being unable to build relationships with family members, friends, and colleagues. Typically, personality disorders begin in adolescence or early adulthood and do not improve over time. Personality disorders vary in severity. Mild personality disorders are more common than severe ones.

Most people with a personality disorder are unhappy with their lives and have relationship problems at work or in social situations. Many also suffer from mood disorder, anxiety, substance abuse, or eating disorders.

People with a personality disorder do not know that their thoughts and behaviors are inappropriate, and therefore they rarely seek help on their own. They may come in for chronic tension created by a personality disorder, anxiety symptoms, or depression, and tend to believe that the problems are caused by other people or circumstances beyond their control.

Until recently, many psychiatrists and psychologists believed that treatment did not help people with personality disorders. Nevertheless, some types of psychotherapy, in particular psychoanalysis, have now been shown to help manage personality disorders.

According to the DSM (Diagnostic Statistical Manual of Mental Illness), there are 10 major types of personality disorders, which are grouped into three blocks (Cluster A, B, and C). Read more on types of personality disorder.

Consequences of personality disorders

People with a personality disorder are at high risk of developing addiction (alcohol or drug addiction), suicidal behavior, reckless sexual behavior, hypochondria, and opposition to society's values.
- People with a personality disorder may have inappropriate, overly emotional, abusive, or irresponsible parenting styles that lead to psychiatric disorders in children.
- People with a personality disorder are prone to mental breakdowns as a result of stress (during a crisis, a person encounters difficulties in performing the most ordinary tasks).
- People with a personality disorder may develop psychiatric comorbidities (such as anxiety, depression, or psychosis).
- People with a personality disorder often do not have enough contact with a therapist or doctor because they deny responsibility for their behavior, are distrustful, or feel overly needy.

Treatment of personality disorders

Medications
Medication is sometimes used to reduce anxiety, depression, and other distressing symptoms. Drugs such as selective serotonin reuptake inhibitors (SSRIs) are prescribed for depression and impulsivity. Anticonvulsants reduce impulsivity and outbursts of anger. Other drugs such as risperidone Risperdal are used to combat depression and feelings of depersonalization in people with borderline personality disorders.

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People with personality disorders often have other mental health problems, especially depression and substance abuse (alcoholism, drug addiction, substance abuse, etc.).

When and why do personality disorders occur?

Personality disorders most often begin to manifest during adolescence and continue into adulthood.

Personality disorders can be mild, moderate, or severe, and may have periods of "remission" where they may decrease significantly or not at all.

Types of personality disorders.

Several different types of personality disorders are recognized. They can be grouped into one of three groups - A, B or C - which are listed below.

Cluster A personality disorders.

A person with Cluster A Personality Disorders tends to have difficulty communicating with other people, and usually most people would find their behavior strange and eccentric. They can be described as living in a fantasy world of their own illusions.

An example is paranoid personality disorder, when a person against the background of "exemplary behavior" becomes extremely distrustful and suspicious.

Cluster B personality disorders.

A person with cluster B personality disorders tries to regulate their feelings and often oscillates between the positive and negative opinions of others. This can lead to behaviors that are described as dramatic, unpredictable, and disturbing.

A prime example is borderline personality disorder, where a person is emotionally unstable, has impulses to harm themselves, and has intense, unstable relationships with others.

Cluster C personality disorders.

A person with cluster C personality disorders struggles with persistent and overwhelming feelings of anxiety and fear. Such people can rarely show patterns of behavior, most people with this class will have antisocial and withdrawn behavior.

An example is avoidant personality disorder, where a person is painfully shy, feels socially stifled, inadequate, and extremely sensitive. A person can and often wants to be a good family man, but lacks the confidence to form close relationships.

How many people have a personality disorder?

Personality disorders are common mental health problems.

It is estimated that approximately one in 20 people has a personality disorder. However, many people have only minor changes that are more likely to show up only during times of stress (such as bereavement). Other people with more serious problems will need specialist help for a long time.

Prognosis of the course of personality disorder.

Most people who are treated recover from the personality disorder over time.

Psychotherapeutic or medical treatments provide significant relief and can often be recommended even to people with mild form personality disorders as just some kind of support. It depends on the severity of the disease, and on the presence of other current problems.
Some people with mild or moderate degree personality disorders, specific psychotherapy is shown, which helps a lot.

However, there is no single approach or any single psychotherapeutic techniques that could suit everyone, so treatment should be selected taking into account the individual characteristics of personality development. It is very important that the therapy of personality disorders be carried out by a qualified psychotherapist.

Learn more about treating personality disorders.

All people have their own special characters. People's personalities may be similar, but they will never be the same. Some personal characteristics differ so much from the supposed norm and from the generally accepted rules of behavior that they cause irritation, misunderstanding and discomfort of others. Some character traits can cause problems that affect not only the originals themselves, but also their close and distant environment.

Personality disorders are conditions that last a lifetime, decreasing or increasing in their manifestations, depending on the external environment and concomitant diseases. Such character disorders put unpredictable pressure on daily life, when the need for qualified help necessarily arises. The task of a psychotherapist is to understand, understand and determine the path to compensation for a special personality and its adaptation. There are different ways: psychological and pedagogical, pharmacological and complex.

As already mentioned, personality disorder is one of the types mental illness associated with problems of perception of situations, people, including oneself.

There are many specific types of personality disorders. These mental disorders, sometimes considered personality traits - unhealthy ways of thinking and behaving, no matter what the situation, lead to significant problems and restrictions in relationships, communication with other people, work and school.

In most cases, a person is not able to understand that he has a personality disorder, because the way of thinking and behavior seems natural to himself, and he most often blames others for certain problems that arise in the process of interpersonal contact.

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Personality disorder is a mental disorder that begins to manifest itself in childhood and adolescence. It is characterized by the suppression of some personality traits and the vivid manifestation of others. In particular, schizoid personality disorder is an unwillingness to start social contacts, lack of warm emotional contacts, but at the same time, excessive enthusiasm for non-standard hobbies. For example, such patients can build their own theories of maintaining a healthy lifestyle. In general, personality disorders come in many forms and types. The treatment of personality disorder in the Israeli clinic "IsraClinic" is carried out with the help of psychotherapy and drug therapy, methods and drugs are selected individually. Want to know more about personality disorder? Make an appointment with IsraClinic specialists.

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You can often hear that overly emotional or eccentric people are called psychopaths. About true meaning this term is seldom thought of. Psychopathy is a serious violation, determined by the excessive severity of one of the personality traits with the underdevelopment of others. In the Western classification, we will use the term “personality disorder” more than “psychopathy”. And this diagnosis includes many dissimilar disorders.

Personality disorders are a complex of deeply rooted rigid and maladaptive personality traits that cause specific perceptions and attitudes towards oneself and others, reduced social adjustment, and, as a rule, emotional discomfort and subjective distress.

The reasons why they occur most often in adolescence or even in childhood, and each type of personality disorder has its own characteristic age of formation. From the beginning of their appearance, these maladaptive personality traits are no longer defined in time and permeate the entire period. adulthood. Their manifestations are not limited to any aspect of functioning, but affect all spheres of the personality - emotional-volitional, thinking, style of interpersonal behavior.

The main symptoms of a personality disorder are:

• The totality of pathological character traits that manifest themselves in any environment (at home, at work);
• The stability of pathological features that are detected in childhood and persist until the period of maturity;
• Social maladaptation, which is the result of pathological character traits, not due to adverse environmental conditions.

Personality disorders occur in 6-9% of the population. Their origin is in most cases ambiguous. The following causes play a role in their development: pathological heredity (primarily alcoholism, mental illness, personality disorders in parents), various exogenous organic effects (craniocerebral trauma and other non-severe brain damage under the age of 3-4 years, as well as pre- and perinatal disorders), social factors (unfavorable conditions of upbringing in childhood, as a result of the loss of parents or upbringing in incomplete family, with parents who do not pay attention to children, patients with alcoholism, asocial personalities with incorrect pedagogical attitudes).

In addition, the following features of neurophysiological and neurobiochemical functioning are often noted: the presence of bipolar symmetrical theta waves on the EEG, indicating a delay in brain maturation; in patients with a high level of impulsivity, an increase in the level of some sex hormones (testosterone, 17-estradiol, estrone) is found; an increased level of monoamine oxidase correlates with a general decrease in the level of social activity of patients.

There are many. One of the main ones is the cognitive classification of personality disorders (the other is psychoanalytic), in which 9 cognitive profiles and corresponding disorders are distinguished. Let's consider the most characteristic.

paranoid personality disorder

paranoid personality disorder. A person suffering from this disorder has a tendency to attribute evil intentions to others; a tendency to form overvalued ideas, the most important of which is the idea of ​​the special significance of one's own personality. The patient himself rarely seeks help, and if his relatives send him, then when talking with the doctor, he denies the manifestation of personality disorders.

Such people are overly sensitive to criticism, constantly dissatisfied with someone. Suspicion and a general tendency to distort facts, by misinterpreting neutral or friendly actions of others as hostile, often leads to unfounded thoughts of conspiracies that subjectively explain events in the social environment.

Schizoid personality disorder

Schizoid personality disorder is characterized by isolation, uncommunicativeness, inability to warm emotional relationships with others, reduced interest in sexual communication, a tendency to autistic fantasy, introverted attitudes, difficulty in understanding and mastering generally accepted norms of behavior, which manifests itself in eccentric actions. Those suffering from schizoid personality disorder usually live by their unusual interests and hobbies, in which they can achieve great success.

They are often characterized by a passion for various philosophies, ideas for improving life, schemes for building a healthy lifestyle through unusual diets or sports activities, especially if this does not require direct dealing with other people. Schizoids may have enough high risk addiction to drugs or alcohol for the purpose of obtaining pleasure or improving contacts with other people.

antisocial personality disorder

Antisocial personality disorder is characterized by a gross discrepancy between behavior and prevailing social norms that draws attention to itself. Patients may have a specific superficial charm and impress (more often on doctors of the opposite sex).

The main feature is the desire to continuously enjoy, avoiding work as much as possible. Starting from childhood, their life is a rich history of antisocial acts: lying, absenteeism, running away from home, involvement in criminal groups, fights, alcoholism, drug addiction, theft, manipulation of others in own interests.. The peak of antisocial behavior occurs in late adolescence (16-18 years).

Histrionic Personality Disorder

Hysterical personality disorder is characterized by excessive emotionality and the desire to attract attention, which manifest themselves in various life situations. The prevalence of hysterical personality disorder in the population is 2-3%, with a predominance in women. Often it is combined with somatization disorder and alcoholism. We list the main features characteristic of this disorder: the search for the attention of others to oneself, inconstancy in attachments, capriciousness, an irresistible desire to always be in the center of attention, to arouse sympathy or surprise (no matter for what reason). The latter can be achieved not only by extravagant appearance, boasting, deceit, fantasy, but also the presence of "mysterious diseases" in them, which can be accompanied by pronounced vegetative paroxysms (spasms, a feeling of suffocation during excitement, nausea, aphonia, numbness of the extremities and other sensitivity disorders). The most unbearable thing for patients is indifference on the part of others, in this case even the role of a “negative hero” is preferred.

Obsessive Compulsive Personality Disorder

People with obsessive-compulsive personality disorder tend to be preoccupied with order, striving for perfection, control over mental activity and interpersonal relationships, to the detriment of their own flexibility and productivity. All this significantly narrows their adaptive capabilities to the outside world. Patients are deprived of one of the most important mechanisms of adaptation to the outside world - a sense of humor. Always serious, they are intolerant of anything that threatens order and perfection.

Constant doubts about making decisions, caused by the fear of making a mistake, poison their joy from work, but the same fear prevents them from changing jobs. In adulthood, when it becomes apparent that their professional success does not match the initial expectations and efforts made, the risk of developing depressive episodes and somatoform disorders is increased.

Anxious (avoidant, avoidant) personality disorder

Anxious (avoidant, avoidant) personality disorder is characterized by limited social contacts, a sense of inferiority, and increased sensitivity to negative evaluations. Already in early childhood these patients are characterized as overly timid and shy, they distort the attitude towards themselves, exaggerating its negativity, as well as the risk and danger Everyday life. They find it difficult to speak in public or simply address someone. Loss of social support can lead to anxiety-depressive and dysphoric symptoms.

narcissistic personality disorder

The most clearly manifested in people from adolescence are ideas about their own greatness, the need for admiration from others and the impossibility of experiencing. A person does not allow that he can become an object of criticism - he either indifferently denies it, or becomes furious. It should be emphasized the features that occupy a special place in the mental life of a person with a narcissistic personality disorder: an unreasonable idea of ​​​​one's right to a privileged position, automatic satisfaction of desires; propensity to exploit, use others to achieve their own goals; envy of others or belief in an envious attitude towards oneself.

Therapy of disorders associated with characterological deviations is purely individual. When choosing a therapeutic effect, as a rule, not only diagnostic and typological characteristics are taken into account, but also the structure of a personality disorder, the possibilities of self-analysis and the subjective mediation of psychopathology, behavior and reaction patterns (aggressive and auto-aggressive tendencies), the presence of comorbid personal and mental pathology, readiness to to cooperation and a sufficiently long therapeutic alliance with the doctor (which is especially important in individuals who avoid, crave recognition and dissocial).

Numerous studies indicate the effectiveness of psychotherapy for personality disorders, as well as social, environmental and pedagogical influences that harmonize behavior and contribute to the achievement of stable adaptation. Psychopharmacological agents as a method of correcting personality disorders is a relatively new concept. Psychopharmacotherapy in this case does not pursue the goal of complete relief of symptom complexes that are formed within the dynamics of personality disorders, its tasks are limited to the correction of pathocharacterological manifestations that hypertrophy to the level of psychopathological formations. Accordingly, the treatment of personality disorder is carried out on an outpatient basis, has a supportive character.

Timely and correctly selected psychotherapeutic and pharmacological treatment improves the quality of life of a person with such a difficult fate and "leaves no room for therapeutic pessimism."

Techniques for the treatment of personality disorders

For various personality disorders, specialists, as a rule, carry out treatment in several ways - drug and psychotherapeutic treatment, while an integrated approach gives top scores than using only one of the methods. The fact is that patients with a personality disorder usually suffer from internal tension and anxiety: any situation that is common for healthy people can cause severe stress in patients with a personality disorder, so the use of exclusively pharmacological treatment will not give proper results - it does not relieve all manifestations of symptoms .

For example, SSRI is used for and aroused states, the use of anticonvulsants can reduce arousal and manifestations of anger. In particular, a drug such as "Risperidone" can be prescribed to patients with depression, as well as to those who have an initial stage of personality disorder.

In psychotherapy, the main task is to relieve stress and isolate the patient from the source of stressful situations. This subsequently reduces other manifestations of symptoms - reduced anxiety, suspicion, outbursts of anger and depression. However, the most difficult task for a specialist in such disorders is to establish a trusting relationship between the patient and the doctor. It is successful interaction that can bring results, since the treatment of personality disorders is a long process.

Male personality disorder

It is impossible to unequivocally state that men are characterized by one or another type of disorder: in practice, men have the most different kinds personality disorders. In particular, it is not uncommon to have paranoid and schizoid personality disorder, which are classified as category A, and borderline and antisocial disorder are also common.

With the paranoid type, the following symptoms are manifested:

• lack of normal relations with other people;
• constant suspicion of loved ones and relatives;
• envy;
• emotional coldness;
• isolation and excessive seriousness.

Schizoid personality disorder is manifested by the following symptoms:

• indifference to others;
• unsociableness;
• avoidance of noisy parties and events;
• lack of social contacts;
• emotional coldness;
• callousness.

Borderline personality disorder manifests itself in:

• impulsiveness;
• frequent depression;
• a tendency to self-directed destructive behavior - for example, such patients are able to threaten a hunger strike, suicide or other injuries in order to achieve what they want;
• lack of healthy criticism, the ability to idealize a significant person;
• eccentric behavior.

In borderline personality disorder, a man in a relationship is able to resort to manipulation to get a woman to be with him. For example, defiantly hang yourself or cut your veins, trying to "put pressure on pity." You should know that such behavior clearly indicates a mental disorder.

Antisocial personality disorder manifests itself:

• indifference;
• irresponsibility;
• deceit;
• neglect of the safety of loved ones;
• aggression;
• irascibility;
• inability to behave within the framework of established cultural and social norms.

It should be noted that this type of disorder is typical for criminals, people with this disorder often go to jail. They absolutely cannot understand why to follow the rules and moral principles, and often go to crime, neglecting their future and the safety of loved ones. We emphasize that any type of personality disorder requires long-term therapy. As a rule, this is a combination of drug treatment and psychotherapy. In some cases, occupational therapy or other supportive psychotherapy may be recommended. This is a very serious condition and it can take months to see progress in treatment.

Personality disorder in women

For women, hysterical and narcissistic personality disorder is most characteristic. In the first case, the following symptoms will appear:

• inappropriate behavior;
• sexual disorders;
• the need to be the center of attention;
• theatrical speech;
• over-dramatization of situations;
• idealization of relationships;
• tendency to attribute to casual acquaintances serious intentions;
• impulsiveness;
• eccentric behavior, vivid emotions.

Symptoms of narcissistic personality disorder include:

• envy;
• the tendency to regard oneself as the center of the universe;
• dreams of power;
• using other people for your own benefit;
• the need for a special attitude towards oneself;
• the desire to win praise and recognition from others.

In women, personality disorder is treated in the same way as in men, usually with a combination of pharmacotherapy and psychotherapy. All drugs and methods are selected individually by a psychiatrist. Note that, as in the case of male patients, long-term treatment is required, for several months.

Personality disorder in children

Children usually have anxiety and dependent personality disorder. This is due to the negative situation at home, at school or other environment of the child, violence, moral humiliation.

Children with anxiety disorder:

• low self-esteem;
• clumsiness;
• frequent anxiety;
• exaggeration of problems;
• isolation;
• inability to build social contacts.

A child with dependent personality disorder will exhibit the following symptoms:

• the role of the victim in any situation;
• passivity;
• avoidance of responsibility;
• difficulties at school in terms of academic performance;
• sensitivity to any criticism;
• tearfulness;
• isolation;
• loneliness;
• strong self-doubt.

Treatment in case of a personality disorder in children is selected with great care - it is gentle pharmacotherapy, long-term work with a psychologist, constant supervision of a psychiatrist, as well as additional psychotherapeutic techniques (hippotherapy, sports therapy, Snoezelen therapy, and others).

General Prevention Techniques for Various Personality Disorders

There is no set standard for the prevention of personality disorders because each person is different. However, there are general recommendations from psychiatrists. First of all, avoid the negative impact of stressful situations. If a person does not control his emotions and reactions, you can consult a psychologist and get psychological tools to adequately respond to stress and resolve conflicts.

At the same time, there are prerequisites for the development of a personality disorder, as a rule, they are associated with a person's psychotype, formed in childhood and adolescence, as well as past traumatic situations. In this case, it is necessary to be observed by a psychiatrist and psychotherapist for a supportive course of psychotherapy.

organic personality disorder It is a permanent brain disorder caused by a disease or injury that causes a significant change in the behavior of the patient. This condition is marked by mental exhaustion and a decrease in mental functions. Disorders are detected in childhood and are able to remind of themselves throughout life. The course of the disease depends on age and critical periods are considered dangerous: puberty and menopause. Under favorable conditions, a stable compensation of the individual with saving the ability to work can occur, and in the event of negative influences (organic disorders, infectious diseases, emotional stress), there is a high probability of decompensation with pronounced psychopathic manifestations.

In general, the disease has a chronic course, and in some cases it progresses and leads to social maladaptation. With appropriate treatment, it is possible to improve the patient's condition. Often, patients avoid treatment without recognizing the fact of the disease.

Organic disorders due to the huge number of traumatic factors are very common. The main causes of disorders include:

- injuries (craniocerebral and damage to the frontal or temporal lobe of the head;

- brain diseases (tumor, multiple sclerosis);

- infectious lesions of the brain;

- encephalitis in combination with somatic disorders (parkinsonism);

- cerebral palsy;

- chronic manganese poisoning;

- the use of psychoactive substances (stimulants, alcohol, hallucinogens, steroids).

In patients suffering from epilepsy for more than ten years, an organic personality disorder is formed. It is hypothesized that there is a relationship between the degree of impairment and the frequency of seizures. Despite the fact that organic disorders have been studied since the end of the century before last, the features of the development and formation of symptoms of the disease have not been fully identified. There is no reliable information about the influence of social and biological factors on this process. The pathogenetic link is based on brain lesions of exogenous origin, which lead to impaired inhibition and the correct correlation of excitation processes in the brain. At present, the most appropriate approach is integrative approach in the discovery of the pathogenesis of mental disorders.

An integrative approach involves the influence of the following factors: socio-psychological, genetic, organic.

Symptoms of Organic Personality Disorder

The symptoms are characterized by characterological changes, expressed in the appearance of viscosity, bradyphrenia, torpidity, sharpening of premorbid features. The emotional state is marked either by dysphoria or unproductive euphoria; later stages are characterized by apathy and emotional lability. The threshold of affect in such patients is low, and an insignificant stimulus can provoke an outburst of aggressiveness. In general, the patient loses control over impulses and impulses. A person is not able to predict his own behavior in relation to others, he is characterized by paranoia and suspicion. All his statements are stereotypical and are marked by characteristic flat and monotonous jokes.

At later stages, organic personality disorder is characterized by dysmnesia, which can progress and transform into dementia.

Organic personality and behavioral disorders

All organic behavioral disorders occur after a head injury, infections (encephalitis) or as a result of a brain disease (multiple sclerosis). There are significant changes in human behavior. Often the emotional sphere is affected, and the ability to control impulsiveness in behavior is also reduced in a person. The attention of forensic psychiatrists to the organic disorder of a person in behavior is caused by the lack of control mechanisms, an increase in self-centeredness, as well as a loss of social normal sensitivity.

Unexpectedly for everyone, previously benevolent individuals begin to commit crimes that do not fit into their character. Over time, these people develop an organic cerebral state. Often this picture is observed in patients with trauma to the anterior lobe of the brain.

An organic personality disorder is taken into account by the court as a mental illness. This disease is accepted as a mitigating circumstance and is the basis for referral for treatment. Often problems arise in antisocial individuals with brain injuries that exacerbate their behavior. Such a patient, due to an antisocial stable attitude to situations and people, indifference to the consequences and increased impulsivity, can appear very difficult for psychiatric hospitals. The case can also be complicated by depression, anger of the subject, which are associated with the fact of the disease.

In the 70s of the 20th century, the term "episodic loss of control syndrome" was proposed by researchers. It was suggested that there are individuals who do not suffer from brain damage, epilepsy, psychosis, but who are aggressive due to a deep organic personality disorder. At the same time, aggressiveness is the only symptom of this disorder. Most of the people with this diagnosis are men. They have prolonged aggressive manifestations that go back to childhood, with an unfavorable family background. The only evidence in favor of such a syndrome is EEG anomalies, especially in the temples.

It has also been suggested that there is an abnormality in the functional nervous system leading to increased aggressiveness. Doctors have suggested that severe forms of this condition are due to brain damage, and they are able to remain in adulthood, as well as find themselves in disorders associated with irritability, impulsivity, lability, violence and explosiveness. According to statistics, a third of this category had an antisocial disorder in childhood, and in adulthood most of them became criminals.

Diagnosis of organic personality disorder

Diagnosis of the disease is based on the identification of characterological, emotional typical, as well as cognitive changes in personality.

The following methods are used to diagnose an organic personality disorder: MRI, EEG, psychological methods (Rorschach test, MMPI, thematic apperceptive test).

Organic disorders of the brain structures (trauma, disease or brain dysfunction), the absence of memory and consciousness disorders, manifestations of typical changes in the nature of behavior and speech are determined.

However, for the reliability of the diagnosis, a long-term, at least six months, observation of the patient is important. During this period, the patient should show at least two signs in an organic personality disorder.

The diagnosis of organic personality disorder is established in accordance with the requirements of the ICD-10 in the presence of two of the following criteria:

- a significant decrease in the ability to carry out purposeful activities that require a long time and not so quickly leading to success;

- altered emotional behavior, which is characterized by emotional lability, unjustified fun (euphoria, easily turning into dysphoria with short-term attacks of aggression and anger, in some cases a manifestation of apathy);

- drives and needs that arise without taking into account social conventions and consequences (anti-social orientation - theft, intimate claims, gluttony, non-compliance with the rules of personal hygiene);

- paranoid ideas, as well as suspicion, excessive concern for an abstract topic, often religion;

- change in tempo in speech, hypergraphia, over-inclusion (inclusion of side associations);

- changes in sexual behavior, including a decrease in sexual activity.

Organic personality disorder must be differentiated from dementia, in which personality disorders are often combined with memory impairment, with the exception of dementia in Pick's disease. More precisely, the disease is diagnosed on the basis of neurological data, neuropsychological examination, CT and EEG.

The effectiveness of the treatment of organic personality disorder depends on an integrated approach. It is important in the treatment of a combination of drug and psychotherapeutic effects, which, when used correctly, enhance the effect of each other.

Drug therapy is based on the use of several types of drugs:

- anti-anxiety drugs (Diazepam, Phenazepam, Elenium, Oxazepam);

- antidepressants (clomipramine, amitriptyline) are used in the development depression, as well as exacerbation of obsessive-compulsive disorder;

- neuroleptics (Triftazine, Levomepromazine, Haloperidol, Eglonil) are used for aggressive behavior, as well as during an exacerbation of paranoid disorder and psychomotor agitation;

- nootropics (Phenibut, Nootropil, Aminalon);

— Lithium, hormones, anticonvulsants.

Often, medications affect only the symptoms of the disease, and after discontinuation of the drug, the disease progresses again.

The main goal in the application of psychotherapeutic methods is to ease the psychological state of the patient, help in overcoming intimate problems, depression, obsessive-compulsive states and fears, and the assimilation of new patterns of behavior.

Help is provided both in the presence of physical and mental problems in the form of a series of exercises or conversations. Psychotherapeutic influence using individual, group, family therapy will allow the patient to build competent relationships with family members, which will provide him with emotional support from relatives. Placing a patient in a psychiatric hospital is not always necessary, but only in cases where he poses a danger to himself or to others.

Prevention of organic disorders includes adequate obstetric care and rehabilitation in the postnatal period. Proper upbringing in the family and at school is of great importance.

Personality disorder, the reaction of the army to this deviation

Every young man is familiar with the spring and autumn conscription and the troubles associated with them, including the medical board, where not only his physical but also his mental health is assessed. The military enlistment office provides a deferment or exemption from conscription for those who are diagnosed. The army assumes rather harsh conditions for the psyche, which can be dangerous for an already unhealthy person.

Personality disorder

Pathological state of mind

Personality disorder, or psychopathy, is pathological condition psyche, which is manifested by inadequate behavior, causing both the patient and the people around him to suffer. People with a personality disorder do not develop delusions or hallucinations, but there is a rather specific set of symptoms that are characteristic of each type of psychopathy.

There are several types of personality disorders in the army:

• Schizoid. Differs in extremely stingy emotions, difficulty in establishing emotional contact with others up to its complete impossibility (but it can be strong affection to animals). Moreover, such patients are often distinguished by an extraordinary mind.
• paranoid. Patients are distinguished by unreasonable suspicion and suspiciousness, they constantly suspect others of wanting to harm them. Not able to forgive insults and show tolerance.
• Hysterical. Attention is drawn to excessive expressiveness, theatricality of behavior, simulated emotions. The patient experiences a constant need for attention, and feels discomfort in its absence.
• Emotionally unstable (excitable psychopathy). In such patients, the ability to control their emotions is weakened or completely absent. Reactions of discontent or anger are violent and destructive, which is why relationships with loved ones are sharply conflicted.
• Dissocial (antisocial). It involves the patient's rejection of social norms, aggressive behavior, complete indifference to his own safety and the safety of others. Patients are irresponsible about their duties and do not feel regret about this.
• Anancaste (obsessive-compulsive). Unlike the previous one, the patient is overly conscientious and responsible. Planning your activities takes a lot of time and effort, so the result may not be achieved. Such patients have no flexibility in matters of morality, they are constantly insecure.
• Anxious (avoidant). Extreme self-doubt and sensitivity to criticism, due to which patients avoid any responsibility and rarely achieve authority.
• Dependent personality disorder. It is similar to the previous type in that patients avoid responsibility, but at the same time they are not self-sufficient, in relations with others they take a leading position, often humiliated in order to be accepted.
• Narcissistic. Such patients are convinced of their uniqueness, importance and influence, and demand from others undeserved admiration for their imaginary achievements. Often they are not able to show sympathy, because they are convinced that those around them envy them.

Personality disorders in the military

Personality disorders in the army are very diverse and make significant adjustments to the life of the patient and his loved ones.

Article 18: exemption from conscription

A profound personality disorder can be a reason for exemption from military draft. When a conscript passes a medical examination, experts carefully study his personal file, reviews from places of study and work, after which they come to the conclusion about his mental adequacy.

If a young person is found to be unfit or partially fit for military service due to mental inadequacy, this is indicated in his military ID. Article 18, which refers to personality disorder and, as a consequence, exemption from conscription, has two sections.

Article 18a indicates that the recruit has severe mental illness, in which he is not able to control his behavior. Such a conscript cannot adapt in society, his pathological reactions are dangerous for himself and those around him, so military service is completely impossible for him.

Article 18b implies that young man less serious disorders:

• Personality disorders
• Violation of sexual preferences
• Disorders of hobbies and habits
• Recurrent affective breakdowns and transient behavioral disturbances

  Personality disorder can be dangerous

  These violations may not cause any noticeable inconvenience most of the time, but they are dangerous in unpredictable breakdowns. Deliberate display of symptoms of a personality disorder is not considered a disease and does not give rise to a deferment from the army.

  The presence of article 18 on a military ID means that the conscript is not fit or is limited to being drafted, but the same article can become an obstacle to obtaining a driver's license or working in government and financial organizations.

  Personality and behavior disorders: types, treatment

  Every fifteenth inhabitant of our planet suffers from a personality disorder. Moreover, he himself hardly perceives his condition as a disease that requires an appeal to specialists. He will justify all his actions and consider his behavior normal. Treatment denies, and the consequences are unpredictable.

  Personality disorder: adaptation difficulties

  Personality disorder is a maladaptive pattern of behavior caused by a persistent mental disorder that is not associated with a somatic or neurological disease. This pathology is difficult to correct, because the patient does not believe that he needs treatment. There is no motivation, which is a catalyst for positive changes. The individual himself does not seek to get rid of the violation and does not make good contact with psychotherapists.

  Late appeal to specialists leads to the fact that the patient gets an appointment with a psychiatrist already in the stage of deep neglect of the disease. It can be difficult to relieve symptoms and cure.

  The first signs of the disease are actively manifested in adolescence. Before this period, individual episodes are possible, but only after the period of puberty can we talk about the problem. Individuals with cognitive personality disorder do not understand why others talk about any of their problems. After all, they believe that behavior and actions are normal.

  People with personality disorders are poorly perceived in society. They often have difficulties in personal communication. But at the same time, patients do not feel pangs of remorse and have no sympathy for others. After a certain time, their relationship with the world is built not according to the principle of personal adaptation to society, but according to the scheme, when the society is forced to accept or not accept a problematic person. The lack of motivation and desire to be treated exacerbates the problem, since not every doctor can find an approach to such a patient, relieve the symptoms of exacerbation and help get rid of the problem.

  Specific personality disorders

  IN Soviet time overly emotional individuals were often called psychopaths. Such a characterization and classification was not inherent in Western psychiatry. Psychopathy is a serious violation of a behavioral nature, in which, against the background of the underdevelopment of a number of personality traits, one clearly dominates. This includes a number of deviations.

• Paranoid - the patient is dominated by overvalued ideas. He attaches special importance to his personality. But he treats others with hostility, suspecting them of malicious intent. A person with a pathology does not recognize its presence. When relatives or friends pay attention to a cognitive deviation and try to take him to a specialist, he will assure that everything is in order with him and deny the existence of a problem. Very sensitive to criticism.
• Schizoid - this diagnosis is characterized by introversion, isolation, a decrease in interest in life's things. The patient does not perceive the accepted norms of social behavior, often behaves eccentrically. Schizoid personality disorders are associated with a great passion for some kind of activity in which the individual succeeds. For example, he may be pathologically addicted to various health systems, to the point of attracting other people to his interests. Experts believe that in this way a certain asociality is replaced. Also, such patients may have problems with alcohol, drugs or other types of addiction.
• Dissocial - a characteristic feature of such a personality disorder is the defiant cognitive behavior of the patient in order to obtain the desired. With all this, such patients are able to win over people, including doctors. This type is especially pronounced in late adolescence.
• Hysterical - the main goal of such patients is to draw attention to their person in any way, including defiant behavior. The diagnosis is more typical for women. Atypical capriciousness, inconstancy of desires, extravagance, deceit are observed. In order to attract attention, the patient invents non-existent diseases for himself, the symptoms of which can be given out autonomic system and difficult to remove.
• Obsessive-compulsive - patients with this type of personality disorder pathologically strive for order and perfection. They have no sense of humor, they try to be perfect in everything. When the set ideal goals are not achieved, they can fall into depressive states.
• Anxious - such a personality disorder is characterized by the cultivation of a personal inferiority complex. Patients are in a state of perpetual anxiety and uncertainty. From childhood, such patients are shy and timid. Often suspect others of hostility. They are prone to depression.
• Narcissistic - a deviation in which a person manifests narcissism from childhood, a desire to be constantly admired. Such a patient does not accept criticism: he reacts to it either with resentment or with aggression. Indifferent to the feelings of other people, prone to exploiting them to achieve their own goals.

Different forms of psychopathy require an individual approach to treatment. Personality disorders should not be confused with character accentuation. In the latter case, a person also has behavioral features, but they lie within the upper limit of the norm. In addition, it is adapted to social conditions. The classification of classical psychopathy is inappropriate here. Diagnosis and types are different.

Causes that cause personality and behavioral disorders

All specific personality disorders are usually divided into three clusters. Their classification:

• types of psychopathy cluster A: paranoid and schizoid;
• Cluster B psychopathy: hysterical, asocial, narcissistic;
• types of psychopathy cluster B: obsessive-compulsive, depressive.

The causes of cluster A psychopathy are considered to be genetic and hereditary. The fact is that among the relatives of patients who have a personality disorder, as a rule, there is at least one with schizophrenia.

A hereditary predisposition to pathologies can also be traced in cluster B and C psychopathy. The first option can also be aggravated by problems with alcohol: in families of people who drink, children often develop with disorders.

There is a version that cognitive specific personality disorders may be associated with hormonal disorders in the body. If a person has elevated levels of testosterone, estrone and estradiol, the consequences of this are manifested in the form of aggression. In addition, he does not produce enough endorphins, which, in turn, leads to depressive disorders.

The social factor also plays an important role in the formation of the psychotype. For active children space matters. If they are forced to be brought up in conditions closed space, small-sized areas, this leads to the appearance of hyperactivity. Anxious babies from birth can become balanced if they are raised by emotionally stable parents. A calm mother can help a child become confident, and an anxious one can not remove, but increase his personal anxiety state.

Character traits become noticeable already in early childhood. In adolescence, they can already develop as a personality disorder. Cognitive impairment is manifested in a decrease in memory, increased fatigue. Pathologies of the nervous system are observed more often in people with an asocial temperament.

Mixed personality disorder

This type of psychopathy has been studied less than others. The classification has no special criteria. The patient manifests forms of one or the other type of disorders that are not persistent. Therefore, this type of disorder is also called mosaic psychopathy. But it is also difficult for a person with a mixed type of disorder to get along in society because of the peculiarities of their behavior.

Instability of character is often the basis that contributes to the development of various types of addiction. Mixed personality disorder may be accompanied by alcoholism, drug addiction, gambling addiction.

Mosaic psychopathy can combine symptoms of the schizoid and paranoid types. Such people do not know how to build social contacts in society, they are obsessed with overvalued ideas. With the predominance of paranoid symptoms, patients suffer from increased suspicion. They are prone to scandals, threats, like to write angry complaints about everyone and everything.

Specialists are alarmed if signs (classification) of several disorders coexist in one patient: schizoid, hysterical, asthenic, excitable. In this case, there is a high risk of developing schizophrenia.

Brain injuries or complications after a number of diseases can lead to mosaic types of pathology. This mixed personality disorder is considered acquired. If we consider the situation in detail, it will look like this: a person already has an innate tendency to mosaic psychopathy, which, due to certain circumstances, is superimposed by organic pathology.

Mosaic disorder requires specific treatment only when symptoms worsen, or if there is organic build-up. Then neuroleptics, tranquilizers, vitamins can be prescribed by a specialist.

Infantile personality disorder

With this type of psychopathy, signs of social immaturity are pronounced. A person is not able to withstand stressful situations and relieve tension. In difficult circumstances, he does not control his emotions in the same way as children do. Infantile personality disorders for the first time clearly declare themselves in adolescence. The hormonal storms that occur at this time with a person cause changes in the psycho emotional sphere. As you get older, the diagnosis can only progress. It is possible to finally talk about the presence of the disease only after reaching 16-17 years. In stressful circumstances, the patient manifests himself immature, poorly controls aggression, anxiety, fear. Such a person is not hired for military service, they are denied employment in law enforcement agencies. Permits to carry weapons or obtain a driver's license are decided on a limited and strictly case-by-case basis, according to an assessment of signs and condition.

transient personality disorder

This diagnosis refers to borderline conditions, when the symptoms of deviation are difficult to attribute to any type of personality disorder. The main causes of psychopathy are long-term stressful situations.

Transient personality disorder has its own characteristics:

• disorientation;
• hallucinations;
• rave;
• inhibition of verbal and motor functions.

Even one of the symptoms may already signal a disorder. This diagnosis is special in that the disease does not last too long: sometimes only a day, and sometimes a month. It suddenly arises and just as it passes. Sometimes a person can go to sleep with a disturbance, and get up in a normal emotional state with residual effects in the form of increased anxiety or sleep disturbances. With each new stress, a spontaneous return of pathology is possible.

Such a diagnosis does not pass without a trace. In the event that there are signs of delirium or hallucinations, such a person requires special treatment, because his condition can also threaten those around him. In the period between exacerbations, the patient experiences emotional burnout, in which nerve cells are also destroyed. Therefore, even for preventive purposes, it is recommended to take vitamins and herbal remedies.

As historical examples show, partial transient personality disorder is not a benign condition. Many of the famous serial killers and maniacs had this diagnosis. They led a normal life, had families, work, but during the period of exacerbations they committed crimes. When Western experts studied the brains of executed criminals, they did not find significant changes in it. All its parts corresponded to the norm of a healthy person. But only stressful conditions could lead to the appearance of signs of a personality disorder, which entailed antisocial acts. Perhaps, if during the period when the first signs of the disease appeared, there would have been a person nearby who noticed this and helped to contact a specialist, such consequences could have been avoided. Being face-to-face with continuous stressful situations, the psyche simply could not stand it. The mechanism of the development of the disease was launched.

Treatment for personality disorders

When a person is diagnosed with psychopathy, he rarely agrees with him. The peculiarity of this disease is that the patient does not see problems in himself, but looks for them in others. Treatment in this case is always difficult. According to statistics, only one in five of them agree to accept help.

Treatment of psychopathy is carried out individually. It includes sessions of psychotherapy and, if necessary, the use of medicines. In difficult cases, when the antisocial behavior of the patient poses a threat to others, treatment can be carried out in a hospital.

Disputes among specialists are caused by the treatment of borderline conditions. Some believe that the patient needs help only during exacerbations, while others insist on constant support. In any case, the treatment of psychopathy has been going on for many years. With the patient's tendency to impulsive acts that can threaten life and health, psychotropic drugs are connected.

Organic personality disorder in humans

The consequence of a violation of brain activity due to illness or due to brain damage is a significant change in human behavior. This disease is called an organic personality disorder in humans and is accompanied by exhaustion of the psyche, a decrease in the function of thinking. Most often, the disease is detected in adolescence and in the course of his life he can repeatedly remind himself of himself.

The most dangerous for the course of the disorder are puberty and menopause. Conditions favorable to this contribute to the formation of a stable, compensated personality that retains ability to work.

If there are some circumstances aggravating the course of the disease: organic disorders, frequent emotional stress, then decompensation is possible, with bright subsequent manifestations of psychopathy.

Most often, the disease is chronic, periodically progressive, and sometimes leading to the inability of the individual to adapt to his social environment.

There are a number of main causes of organic personality disorder, these include, in particular, a vast number of traumatic factors:

• Damage due to traumatic brain injury.
• Brain tumors, multiple sclerosis.
• Infectious lesion of the human brain.
• Diseases of the vascular system.
• Associated with disorders internal systems encephalitis organism.
• Varieties of cerebral palsy.
• Use of psychoactive substances: steroids, hallucinogens.

Patients who have been suffering from epileptic seizures for over 10 years may feel the influence of an organic personality disorder in humans. There is a hypothesis fixing the relationship between the number of seizures and the severity of the personality disorder.

Not fully identified distinctive features development of disease symptoms. There is no definite information on the influence of biological and social factors on the development of symptoms.

As vivid symptoms of an organic personality disorder, the following are revealed: inhibition of the course of mental processes (bradyphrenia), difficulty in the consistent flow of thoughts (torpidity), emphasis on premorbid personality traits. At the level emotional state there is a gloomy dislike for others, accompanied by irritability (dysphoria), or an empty-high spirits.

Late stages of the disease are marked by apathy and instability of the emotional state. Usually, a minor stimulus is enough for the patient to fall into a state of passion, or to provoke an explosion of aggressiveness in him.

A person loses control over his own intentions, he cannot predict personal behavior in relation to the people around him, and shows unmotivated suspicion towards them. In terms of statements, their uniformity is observed with a predominance of flat jokes.

The later stages of the course of this disorder are characterized by a decrease in the ability to remember information (dysmnesia), which can develop into a degradation of mental ability (dementia).

The diagnosis of the disorder is preceded by the identification of personality changes at the level of cognitive abilities, emotional intelligence, and psychopathic disorders. As a method of diagnosing an organic personality disorder, methods based on the use of MRI - magnetic resonance imaging, EEG - electroencephalograms of the brain, psychological methods: Rorschach test, thematic apperceptive test.

In the process of research, organic lesions of brain structures, the absence or presence of damage to the memory function, typical changes are identified and fixed. behavioral signs and speech disorders.

The diagnosis can be established in accordance with the international classifier of diseases (ICD-10), if at least two of the following signs are observed simultaneously:

• drastically reduced real ability to implement purposeful activity;
• distortion of emotional behavior, resulting in emotional inconstancy, characterized by mood swings from unmotivated fun to equally unmotivated aggression, sometimes alternating with complete apathy;
• the emergence of antisocial needs associated with sexual intemperance, a tendency to steal, non-compliance with personal hygiene;
• the presence of crazy ideas, suspiciousness and suspicion;
• reduced rate of speech, writing style accompanied by excessive verbosity (hypergraphia).

  A clear differentiation must be made between organic personality disorder and dementia, since the latter has a memory impairment, except for Pick's disease. Neuropsychological research contributes to the final diagnosis of the disease.

  Methodology for the treatment of organic disorder

  A clear methodology for the treatment of an organic disorder is quite important. A flexible combination of psychotherapeutic treatment and intervention is needed medicines. With cross-stimulation of the body, the action of these channels is enhanced.

  As drug therapy are used Various types medications, these include:

• drugs that lower the anxiety threshold;
• drugs used in the treatment of depression;
• psychotropic drugs focused on the treatment of psychotic disorders (neuroleptics) associated with aggressive behavior;
• drugs that improve memory, learning ability, activating brain activity- nootropics;
• hormonal medications.

However, often used medicines remove only the manifestations of the disease, which, after their cancellation, begins to progress again. That is to say, the role of the drugs is actually reduced to the relief of symptoms and alleviation of the patient's morbid condition, offering him new behaviors for their assimilation and practice.

The patient should be provided with psychotherapeutic assistance to build a balanced relationship with patients own family so that they can provide support, and he could take it at the proper level. It is far from always shown that a patient is placed in a hospital - a psychiatric clinic, but only if he is dangerous both for himself and for others.

What is an organic personality disorder? Main symptoms and treatment

An organic personality disorder is a pronounced change in the patient's usual behavior, the cause of which is diseases with a change in the structure of the brain. Organic personality disorder can be manifested by disturbances in the emotional sphere, changes in vital needs and priorities. Often this pathology is accompanied by a decrease in the ability to think and learn, sexual disorders.

Diseases that are caused by some obvious structural changes in the brain (or other organ) are considered organic. These changes can usually be identified using imaging techniques (X-ray, CT and MRI, ultrasound).

In the case of congenital organic changes in the brain, signs of the disease are detected in early childhood and persist throughout life. The course of organic pathology of the brain is variable, asymptomatic periods and exacerbations are possible. Especially often exacerbations occur during strong hormonal changes - in adolescence and during menopause.

In the absence of concomitant pathology and favorable living conditions, long-term (from several years to decades) compensation with sufficient social adaptation and working capacity can occur. However, for any negative influences(infections, injuries, stresses), a severe relapse with psychopathological manifestations and subsequent deterioration of the condition is possible.

Organic disorder of personality and behavior in most cases proceeds stably. Cases of continuous progression with subsequent maladjustment and a pronounced personality defect are described. Continuous treatment contributes to long-term stabilization and even some improvement in the condition. A number of patients may refuse treatment, denying the presence of the disease.

Causes of Organic Personality Disorder

The causes of organic personality disorders are extremely diverse. Among the main ones:

• traumatic brain injury of any localization,
• tumors and cysts
• epilepsy,
• degenerative diseases of the brain (multiple sclerosis, Alzheimer's disease, etc.),
• brain infections,
• encephalitis,
• cerebral palsy,
• poisoning with neurotoxic substances, in particular manganese,
• cerebrovascular pathology,
• substance abuse.

Long-term (more than ten years) epilepsy with frequent convulsive seizures leads to the appearance of an organic personality disorder. There are a number of studies proving the relationship between the frequency of seizures and the severity of mental pathology.

Organic personality disorders have been known and researched for over a century. However, there is still no exact information about their pathogenesis and development. Impact not fully explored social factors and features of the premorbid state during this class of disorders. The main mechanism for the development of the disease is considered to be a violation normal ratio and the mechanics of the processes of excitation and inhibition in the brain due to its damage.

IN Lately An integrative approach to the pathogenesis of this class of diseases is gaining popularity, which, in addition to organic factors, takes into account the genetic characteristics of the patient and his social environment.

According to ICD-10, organic personality disorder has the following symptoms.

First of all, the presence of general criteria for psychiatric illness due to brain damage is mandatory:

• confirmed data on the presence of a disease or brain injury,
• preserved consciousness and memory,
• absence of other mental disorders.
• Emotional disturbances that can be manifested by euphoria, irritability, anger, apathy, the appearance of flat or inappropriate witticisms in speech, attacks of aggression, frequent fluctuations in emotions, their instability and changeability.
• cognitive disorders. More than others, an organic personality disorder is characterized by the presence of paranoid ideas or excessive suspicion, a tendency to divide people into “good” and “bad”, pathological enthusiasm for one occupation.
• Changes in speech, in particular viscosity, slowing down, excessive thoroughness, a tendency to use colorful adjectives.
• Decreased ability for long-term purposeful activities, including professional ones. This is especially noticeable in relation to activities that require a lot of time, the result of which does not appear immediately.
• Sexual disturbances - changes in preferences or increased libido.
• Disinhibition of drives, including those of an antisocial nature - the patient may develop hypersexuality, aversion to personal hygiene, a tendency to gluttony, he may participate in illegal acts.

Depending on the predominant combination of symptoms, the following types of organic personality disorder are distinguished:

Diagnosis of organic personality disorder

To establish the diagnosis of organic personality disorder, it is necessary to identify a combination of emotional, cognitive and characterological changes with organic brain damage.

Diagnostics is carried out using the following methods:

• neurological examination,
• psychological research (testing and conversation with a psychologist),
• functional study of the brain (electroencephalography),
• visualization of brain structures (CT and MRI).

During the examination, a search is made for damage and dysfunctions of the brain, changes in behavior and drives, speech disorders, the safety of memory and the level of consciousness are checked.

For the final confirmation of the diagnosis, a long-term, for at least six months, observation of the patient by a specialist - a neurologist or a psychiatrist - is necessary. During this period, the presence of three or more diagnostic features of an organic personality disorder is confirmed according to the ICD-10 criteria described above.

Treatment of organic personality disorder

Treatment of personality disorders of an organic nature is necessarily complex. It includes the prescription of drugs and methods of psychotherapy. In the right combination, these tools enhance the effect of each other.

For the medical treatment of organic personality disorders, the following groups of drugs are used:

• antidepressants to correct the emotional state or in the presence of obsessive-compulsive symptoms;
• tranquilizers to eliminate psychomotor agitation;
• antipsychotics of different groups - to reduce the degree of aggression, with motor arousal, to reduce paranoid symptoms;
• nootropics and antihypoxants are indicated for organic personality disorders of any etiology in order to slow the progression of symptoms;
• anticonvulsants if necessary;
• lithium preparations as long-term maintenance therapy.

Most medications require a life-long intake, since when they are canceled, the symptoms of the disease reappear.

Goals of psychotherapeutic treatment:

• increasing the subjective psychological comfort of the patient,
• improving the quality of life,
• fight against depression
• elimination of sexual disorders,
• treatment of obsessive-compulsive conditions,
• teaching the patient socially acceptable behavior patterns.

Psychotherapy is carried out in the form of a series of personal conversations with a psychiatrist, followed by exercises aimed at mastering new behaviors. Family, group and individual psychotherapy is used. Working with the patient's family is especially effective, as a result of which it is possible to improve relations with relatives and provide their support to the patient.

Hospitalization of the patient in a specialized institution is carried out with the threat of suicide or high aggressiveness of the patient with a danger to others.

There is no complete prevention of organic personality disorders. It is important to pay great attention prevention of injuries during childbirth, industrial and domestic injuries, medical examination of the population in order to timely detect pathology for early treatment. After identifying the disease, it is necessary to create conditions for stabilizing the condition, to work with the environment of the patient.

Pathologies related to human activity in the mental plane include a personality disorder, the symptoms of which can only be determined with a detailed acquaintance with the disease. To understand what kind of condition it is, you need to pay attention to the behavior of the patient and, if they are detected, consult a doctor. Better yet, take preventive measures to eliminate a serious disease.

Mental illness is a whole cluster of disorders to which the ailment we are describing is directly related. To understand more competently in this matter, you need to start with the usual examples for us. To begin with, each of us is an individual with a certain normal type thinking, perception of reality, environment, attitude to various kinds of situations, time, space, etc. As soon as it comes teenage years, until recently, an unintelligent child is already able to show his personal character traits, has his own style of behavior. Despite the fact that with age certain features are activated or fade away, they still accompany a person until the last moment of life. But this is an example ordinary person not suffering from mental illness. In the case of a patient, a personality disorder is a rigidity, maladaptation of traits that cause a malfunction in its functioning. Sick people from time to time undergo psychological protection for no reason or irritating factors, which is why such people remain maladaptive, with an immature type of thinking, and so on, almost all their lives.

According to international standards, there is a code “Personality Disorder ICb 10”, since the problem affects all areas human life, and only an experienced specialist is able to identify ten types of disorders, three specific clusters of illness, based on clinical indicators.

Personality disorder affects all areas of human life

Personality disorder: symptoms and signs

Let us first study the signs of mental deviation. A person suffering from a disorder can hide his features for a long time, which is called frustration in medicine and at certain moments show his anger, aggression towards others. A large number of patients are worried about their lives, they almost always have problems with employees, relatives, friends. Pathology is often accompanied by mood swings, anxiety, panic attacks, excessive use of psychotropic, sedatives Moreover, there is a failure in eating behavior.

Important: experts pay attention to the fact that in severe forms of the disease, a person can fall into deep hypochondria, is capable of violent actions, self-destructive actions.

In the family, the patient can behave very contradictory, be too emotional, tough or conniving, allow family members anything that leads to the development of somatic and physical pathologies in children.

For reference: studies have shown that approximately 13% of the total population of the planet suffers from PD, and the pathology of an antisocial nature is more common among men than among women (ratio 6 to 1), the borderline condition is more common in women (ratio 3 to 1).

Symptoms of personality deviations

Provoking factors of the disease can occur in childhood, adolescence. At first, they can definitely be considered, but with the stage of maturation, already in future life, there is no specific definition. The manifestation of signs is not observed in specific aspects, but relates to all spheres of human activity - emotional, mental, interpersonal, volitional. The main symptoms of the disease include:

• pathology in the character manifests itself totally: at work, at home, among friends;
• pathology in the personality remains stable: it begins in childhood and pursues all life;
• due to problems with behavior, character, etc., there is social maladaptation regardless of the environment.

Personality disorder can be identified by a number of symptoms

Personality disorder: types

According to the psychoanalytic classification, doctors distinguish a number of disorders and the most characteristic of them are:

socialized conduct disorder

In this case, a person (a child, a teenager and older) seeks to draw the attention of others with their inconsistency with generally accepted social norms of behavior. Persons with such a pathology always have a certain charm, special manners, strive to impress others. Their main feature character - to receive benefits without investing any physical effort. Literally from childhood, they are accompanied by a continuous series of wrong deeds: absenteeism from school, running away from the garden, at home, constant lies, fights, joining gangs, criminal groups, theft, drug use, alcohol, manipulation of loved ones. The peak of pathology most often falls on the pubertal period from 14 to 16 years.

Unsocialized conduct disorder

This type of behavior is accompanied by persistent dissociation, aggression, disruption of relationships with peers and relatives. Domestic psychiatry calls the type "deviant", the symptoms of which are manifested:

• Affective excitability - irritability, fits of anger, aggression (fights, humiliation, insults) predominate in the character. With prohibitions and restrictions, a protest reaction arises - refusal to attend school, teach lessons, etc.
• Mental instability - excessive suggestibility, dependence on the pleasures received from external conditions, a tendency to deceive.
• Violation of desires - vagrancy, running away from home, aggression, sadistic inclinations, violation of sexual behavior (preversion).
• Impulsive-epileptoid - a tendency to protracted outbursts of affective behavior, a long exit from a state of anger, revenge, stubbornness.

Personality disorder of organic etiology

Psychopathy is an organic disorder that occurs as a result of previous brain diseases:

• traumatic brain injury;
• infectious diseases: encephalitis, meningitis;
• excessive alcohol consumption;
• taking drugs;
• abuse of psychotropic drugs;
• neoplasms in the brain;
• atherosclerosis, diabetes, hypertension;
• autoimmune pathologies;
• powerful intoxication.

According to experts, the disorder often becomes a companion of epilepsy, approximately 10% of the total number of patients suffer from mental disorders.

Important: the listed provoking factors can cause serious damage to the human psyche, so it is necessary to consult a doctor in time for adequate treatment in order to prevent mental disorders.

seasonal personality disorder

Many of us are familiar with seasonal depression, especially during those times of the year when there is little sun, it rains, the sky is overcast. But do not confuse this state with affective human behavior, repeated at certain times of the year. In people with SAD, the problem also arises from a lack of sunlight, the main supplier of the hormone of cheerfulness, joy, energy. But at the same time, they absolutely cannot cope with a behavior disorder, which is expressed in such signs as:

• long sleep;
• feeling of brokenness;
• desire to sleep during the daytime;
• early awakening;
• low mood;
• drop in self-esteem;
• feeling of hopelessness, despair;
• tearfulness;
• inability to cope with everyday activities, activities;
• irascibility;
• attacks of aggression, anger, irritability;
• tension, anxiety.

With an affective disorder, it is difficult for a seasonal person to endure any stress, even minor troubles, he does not control not only social, but also eating, sexual behavior, which leads to an increase in body weight, sexual problems.

Tearfulness is one of the symptoms of a personality disorder.

Pathology can occur at any age, but more often it affects people aged 18 to 30 years.

Personality and behavior disorder in adulthood

In this case, the pathology can be expressed in different ways, it all depends on what clinical manifestations accompany a person throughout life. The individual characteristics of the individual, how his relationship with others have developed, is important. Many traits are acquired not only in early age but also in later stages. Symptoms such as mixed, long-lasting, refer to protracted and deeply rooted behaviors, as a person managed to survive a lot of serious situations, and the psyche developed a response.

A factor in the development of disorders in advanced age is also a number of diseases inherent in the aging body.

Important: a personality disorder is a very serious diagnosis, and for it you can miss a more dangerous illness - schizophrenia, so you need to urgently contact a specialist and undergo a thorough examination.

Personality disorder and work

For persons with PD of certain types, it is necessary to select work taking into account the characteristics of behavior. With the right choice, work helps a person to realize himself, adapt with society, meet financial needs, and most importantly, switch from frustration to more positive activities. Employment includes several stages:

1. Protected- the patient works under the constant supervision of a doctor or social worker, simplified work, gentle mode.
2. Transition- work with the usual mode, but the control by the social worker or doctor continues.
3. General grounds- work at the usual place, with training at the enterprise, control is maintained.

Not a single specialist will give universal recommendations regarding the employment of a person with PD. It all depends on individual abilities and the severity of the symptoms of the disease.

Work and labor are not at all prohibited in personality disorders, but, on the contrary, are shown

With complex forms of disorders, doctors do not recommend getting a job, attending educational institutions until effective treatment has been completed and the diagnosis has been eliminated.

How to Treat a Personality Disorder

To eliminate symptoms such as anxiety, panic, depression and others, medication is being taken. The number of drugs includes psychotropic, neuroleptic drugs, serotonin inhibitors. Risperidone is used to exclude depresonalization.

Psychotherapy is aimed at correcting inadequate signs, but it is worth remembering that the treatment will be lengthy. The cognitive-behavioral method allows the patient to pay attention to his behavior, and not the consequences caused by his actions. The specialist can force the patient to obey his orders, for example, stop screaming, speak quietly, calmly, control himself during the moments of attacks. Of no small importance is the participation of relatives of the patient, who should also know the diagnosis of "personality disorder", what it is, communicate with a specialist and develop a certain demeanor. Positive results can be expected after 5-6 months of continuous exposure to the patient. The optimal duration of treatment is from 3 years.

How to be diagnosed with a personality disorder

In Russia, free medical and advisory assistance is provided to people with PD. There is no record of patients with this diagnosis, as in the past. After appropriate treatment, patients are under dynamic examination in the dispensary for some time, that is, it is necessary to visit doctors within six months. To remove the diagnosis is mainly sought by persons wishing to find a job as a driver, security guard. If the patient does not visit a doctor for five years, then his card is transferred to the medical archive, from where it can be claimed by law enforcement agencies, the personnel department, etc.

Removal of the diagnosis is possible after a successful treatment course

It is theoretically possible to remove the diagnosis only after 5 years, but only if the patient has been under observation for a year, and the doctor canceled the treatment. For premature removal of the diagnosis, it is necessary to contact a psychiatric clinic, undergo an examination, and obtain the approval of the commission. Some people with PD, feeling completely healthy, are confident in the positive decision of doctors, but the latter, in turn, may draw the opposite conclusion.