Schizophrenic disorders are a class of disorders marked by delusions, hallucinations, disorganized

speech, and deterioration of adaptive behavior. People with schizophrenic disorders often display
some of the same symptoms seen in people with severe mood disorders; however, disturbed thought
lies at the core of schizophrenic disorders, whereas disturbed emotion lies at the core of mood
disorders.
schizophrenia is an extremely costly illness for society, because it is a severe, debilitating disorder that
tends to have an early onset and often requires lengthy hospital care (Buchanan & Carpenter, 2000).
GENERAL SYMPTOMS:
There are a number of distinct schizophrenic syndromes, but they share some general characteristics
that we will examine before looking at the subtypes.
Sylvia was first given a diagnosis of schizophrenia at age 15. From case history of Sylvia psychiatrist
conclude following general symptoms of schizophrenia:
Deterioration of personal hygiene.
Hears voices talking to her.
argumentative, aggressive, and emotionally volatile.
innumerable fights.
highly irrational thoughts
Delusions and Irrational Thought

Personality disorders

Personality is vital to defining who we are as individuals. It involves a unique blend of

traits — including attitudes, thoughts and behaviors — as well as how we express
these traits in our interactions with others and with the world around us.

Personality disorders may cause distorted perceptions of reality, abnormal behaviors

and distress across various aspects of life, including work, relationships and social
functioning. Additionally, people with a personality disorder may not recognize their
troubling behaviors or the negative effect they have on others.

What are the types of personality disorders?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is

the standard reference publication for recognized mental illnesses, organizes the 10
types of personality disorders into three main clusters (categories). Each cluster has
different symptoms in common.

Cluster A personality disorders

Cluster A personality disorders involve unusual and eccentric thinking or behaviors.

These include:

Paranoid personality disorder: The main feature of this condition is paranoia,

which is a relentless mistrust and suspicion of others without adequate reason for
suspicion. People with paranoid personality disorder often believe others are trying to
demean, harm or threaten them.
Schizoid personality disorder: This condition is marked by a consistent pattern
of detachment from and general disinterest in interpersonal relationships. People with
schizoid personality disorder have a limited range of emotions when interacting with
others.

Schizotypal personality disorder: People with this condition display a consistent

pattern of intense discomfort with and limited need for close relationships.
Relationships may be hindered by their distorted views of reality, superstitions and
unusual behaviors.

Cluster B personality disorders

Cluster B personality disorders involve dramatic and erratic behaviors. People with
these types of conditions display intense, unstable emotions and impulsive behaviors.
Cluster B personality disorders include:

Antisocial personality disorder (ASPD): People with ASPD show a lack of

respect toward others and don’t follow socially accepted norms or rules. People with
ASPD may break the law or cause physical or emotional harm to others around them.
They may refuse to take responsibility for their behaviors and/or display disregard for
the negative consequences of their actions.

Borderline personality disorder (BPD): This condition is marked by difficulty

with emotional regulation, resulting in low self-esteem, mood swings, impulsive
behaviors and subsequent relationship difficulties.

Histrionic personality disorder: This condition is marked by intense, unstable

emotions and a distorted self-image. For people with histrionic personality disorder,
their self-esteem depends on the approval of others and doesn’t come from a true
feeling of self-worth. They have an overwhelming desire to be noticed by others, and
may display dramatic and/or inappropriate behaviors to get attention.

Narcissistic personality disorder: This condition involves a consistent pattern of

perceived superiority and grandiosity, an excessive need for praise and admiration and
a lack of empathy for others. These thoughts and behaviors often stem from low self-
esteem and a lack of self-confidence.

Cluster C personality disorders

Cluster C personality disorders involve severe anxiety and fear. They include:

Avoidant personality disorder: People with this condition have chronic feelings
of inadequacy and are highly sensitive to being negatively judged by others. Though
they would like to interact with others, they tend to avoid social interaction due to the
intense fear of being rejected.

Dependent personality disorder: This condition is marked by a constant and

excessive need to be cared for by someone else. It also involves submissiveness, a
need for constant reassurance and the inability to make decisions. People with
dependent personality disorder often become very close to another person and spend
great effort trying to please that person. They tend to display passive and clinging
behavior and have a fear of separation.

Obsessive-compulsive personality disorder (OCPD): This condition is

marked by a consistent and extreme need for orderliness, perfectionism and control
(with no room for flexibility) that ultimately slows or interferes with completing a
task. It can also interfere with relationships.

This is a separate condition from obsessive-compulsive disorder (OCD), which is

classified as an anxiety disorder. While people with OCD usually are aware that
OCD is causing their behavior and accept they need to change, people with OCPD
usually have little, if any, self-awareness of their behaviors.

People might have mixed symptoms of more than one personality disorder.

Who do personality disorders affect?

Anyone can have a personality disorder. But different types of personality disorders
affect people differently.

Most personality disorders begin in the teen years when your personality further
develops and matures. As a result, almost all people diagnosed with personality
disorders are above the age of 18. One exception to this is antisocial personality
disorder — approximately 80% of people with this disorder will have started to show
symptoms by the age of 11.

Antisocial personality disorders are more likely to affect people assigned male at
birth. Borderline, histrionic and dependent personality disorders are more likely to
affect people assigned female at birth.

How common are personality disorders?

Approximately 9% of adults in the U.S. have some type of personality disorder, and
about 6% of the global population has a personality disorder.
Borderline personality disorder (BPD) and antisocial personality disorder are the
most frequently diagnosed personality disorders.

What causes personality disorders?

Personality disorders are among the least understood mental health conditions.
Scientists are still trying to figure out the cause of them.
So far, they believe the following factors may contribute to the development of
personality disorders:
Genetics: Scientists have identified a malfunctioning gene that may be a factor in
obsessive-compulsive personality disorder. Researchers are also exploring genetic
links to aggression, anxiety and fear, which are traits that can play a role in
personality disorders.
Brain changes: Researchers have identified subtle brain differences in people with
certain personality disorders. For example, findings in studies on paranoid
personality disorder point to altered amygdala functioning. The amygdala is the part
of your brain that’s involved with processing fearful and threatening stimuli. In a
study on schizotypal personality disorder, researchers found a volumetric decrease
in the frontal lobe of their brain.
Childhood trauma: One study revealed a link between childhood traumas and the
development of personality disorders. People with borderline personality disorder,
for example, had especially high rates of childhood sexual trauma. People with
borderline and antisocial personality disorders have issues with intimacy and trust,
both of which may be related to childhood abuse and trauma.
Verbal abuse: In one study, people who experienced verbal abuse as children were
three times as likely to have borderline, narcissistic, obsessive-compulsive or
paranoid personality disorders in adulthood.
Cultural factors: Cultural factors may also play a role in the development of
personality disorders, as demonstrated by the varying rates of personality disorders
between different countries. For example, there are remarkably low cases of
antisocial personality disorders in Taiwan, China and Japan, along with significantly
higher rates of cluster C personality disorders.

What are the symptoms of personality disorders?

Each of the 10 types of personality disorders has its own specific signs and
symptoms.
But, in general, personality disorders involve problems with:
Identity and a sense of self: People with a personality disorder generally lack a clear
or stable image of themselves, and how they see themselves often changes
depending on the situation or the people they’re with. Their self-esteem may be
unrealistically high or low.
Relationships: People with a personality disorder struggle to form close, stable
relationships with others due to their problematic beliefs and behaviors. They may
lack empathy or respect for others, be emotionally detached or be overly needy of
attention and care.
Another distinguishing sign of personality disorders is that most people who have
one often have little to no insight or self-awareness of how their thoughts and
behaviors are problematic.

Diagnosis
If your doctor suspects you have a personality disorder, a diagnosis may be
determined by:
 Physical exam. The doctor may do a physical exam and ask in-depth
questions about your health. In some cases, your symptoms may be linked to
an underlying physical health problem. Your evaluation may include lab tests
and a screening test for alcohol and drugs.
  Psychiatric evaluation. This includes a discussion about your thoughts,
feelings and behavior and may include a questionnaire to help pinpoint a
diagnosis. With your permission, information from family members or others
may be helpful.
 Diagnostic criteria in the DSM-5. Your doctor may compare your symptoms
to the criteria in the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5), published by the American Psychiatric Association.
Diagnostic criteria
Each personality disorder has its own set of diagnostic criteria. However, according
to the DSM-5, generally the diagnosis of a personality disorder includes long-term
marked deviation from cultural expectations that leads to significant distress or
impairment in at least two of these areas:
 The way you perceive and interpret yourself, other people and events
 The appropriateness of your emotional responses
 How well you function when dealing with other people and in relationships
 Whether you can control your impulses
Sometimes it can be difficult to determine the type of personality disorder, as some
personality disorders share similar symptoms and more than one type may be
present. Other disorders such as depression, anxiety or substance abuse may further
complicate diagnosis. But it's worth the time and effort to get an accurate diagnosis
so that you get appropriate treatment.

Treatment

The treatment that's best for you depends on your particular personality disorder, its
severity and your life situation. Often, a team approach is needed to make sure all of
your psychiatric, medical and social needs are met. Because personality disorders are
long-standing, treatment may require months or years.
Psychotherapy
During psychotherapy with a mental health professional, you can learn about your
condition and talk about your moods, feelings, thoughts and behaviors. You can
learn to cope with stress and manage your disorder.
Psychotherapy may be provided in individual sessions, group therapy, or sessions
that include family or even friends. There are several types of psychotherapy — your
mental health professional can determine which one is best for you.
You may also receive social skills training. During this training you can use the insight
and knowledge you gain to learn healthy ways to manage your symptoms and
reduce behaviors that interfere with your functioning and relationships.
Family therapy provides support and education to families dealing with a family
member who has a personality disorder.
Medications
There are no medications specifically approved by the Food and Drug Administration
(FDA) to treat personality disorders. However, several types of psychiatric
medications may help with various personality disorder symptoms.
 Antidepressants. Antidepressants may be useful if you have a depressed
mood, anger, impulsivity, irritability or hopelessness, which may be
associated with personality disorders.
 Mood stabilizers. As their name suggests, mood stabilizers can help even out
mood swings or reduce irritability, impulsivity and aggression.
 Antipsychotic medications. Also called neuroleptics, these may be helpful if
your symptoms include losing touch with reality (psychosis) or in some cases
if you have anxiety or anger problems.
 Anti-anxiety medications. These may help if you have anxiety, agitation or
insomnia. But in some cases, they can increase impulsive behavior, so they're
avoided in certain types of personality disorders.
Hospital and residential treatment programs
In some cases, a personality disorder may be so severe that you need to be admitted
to a hospital for psychiatric care. This is generally recommended only when you can't
care for yourself properly or when you're in immediate danger of harming yourself
or someone else.
After you become stable in the hospital, your doctor may recommend a day hospital
program, residential program or outpatient treatment.