psychiatric rotation

1. PERSONALITY DISORDER
CLUSTER C
Hamad Emad Hamad Dhuhayr

2. Contents
 Cluster C personality disorders
 Avoidant personality disorder
 Dependent personality disorder
 Obsessive-compulsive personality disorder

3. Cluster C personality disorders
 Cluster C personality disorders are characterized by anxious, fearful thinking or
behavior.
 They include avoidant personality disorder, dependent personality disorder and
obsessive-compulsive personality disorder.
 It's not necessary to exhibit all the signs and symptoms listed for a disorder to be
diagnosed.

4. Avoidantpersonalitydisorder
 is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and
a hypersensitivity to negative evaluation.
 Prevalence: 0.5-1% of population
 Sex ratio: M=F
 Comorbidity: Social phobia, depression, anxiety
 Family: Cluster C disorders

6. Treatment
 Psychotherapy - Individual and group therapy,
typically interpersonal (IPT), is the treatment of
choice
 Medication - Antidepressants and anxiolytics
are often useful for accompanying depression
and anxiety

7. Physician-patient Interaction
 Unconditional respect and concern are very
helpful
 Avoid implications of rejection
 Be aware that even a limited personal
interaction may be very important, and its loss
very distressing

8. Dependent personality disorder
 a strong need to be taken care of by other people.
 This need to be taken care of, and the associated fear of losing the support of others,
often leads people with Dependent Personality Disorder to behave in a "clingy"
manner; to submit to the desires of other people.
 Prevalence: 2.5-27% of population
 Sex ratio: F>M
 Comorbidity: Mood and anxiety disorders, adjustment disorders
 Family: Cluster C disorders

10. Treatment
 Psychotherapy - Dynamic, behavior, group, and
family therapies are all used successfully
 Medication - Anxiolytics are often helpful.
Antidepressants may be used with comorbid
depression.

11. Physician-patient Interaction
 Physicians should take an active role in
treatment planning, with clear explanations and
recommendations.
 Patients may need encouragement to make
decisions about treatment plans.
 Family involvement is often helpful.

12. Obsessive-compulsive personality disorder
 preoccupied with rules, regulations, and orderliness.
 This preoccupation with perfectionism and control is at the expense of flexibility,
openness, and efficiency.
 Prevalence: 1% of population
 Sex ratio: M:F=2:1
 Comorbidity: Slight increase in mood and anxiety disorders
 Family: Obsessive-compulsive personality disorder

14. Treatment
 Psychotherapy - Psychoanalytic, behavioral, and group
therapies are often useful
 Medication - Serotonin-specific reuptake inhibitor (SSRI)
antidepressants may be useful

15. Physician-patient Interaction
 Thorough explanations and specific, detailed
information are valued
 Uncertainty is rarely tolerated
 Treatment options should be presented with clear risk-
benefit analyses.

16. OCD vs. OCPD

17. these central features:
-- social inhibition and hypersensitivity to criticism and
rejection (avoids social and occupational activities that
involve significant interpersonal
contact due to insecurities and anxieties)
these central features:
-- preoccupation with orderliness, perfectionism, and control
(preoccupied with details, rules, lists, organization, or
schedules to the extent that the major point of the activity is
lost)
these central features:
-- submissive and clinging behavior
related to excessive needs to be
taken cared of (urgently and
indiscriminately seeks another
relationship when a close relationship
ends)

18. References
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