Module Components

• Overview
• Learning Activities

Topics

• Epidemiology
• Diagnoses
• Differential Diagnoses
• Treatment
• Pediatric Considerations

NDNP 870 - Diagnosis and Management 1: Differential Diagnosis of Mental Disorders Across the Lifespan

Module 9: Personality Disorders, Oppositional and Conduct Disorders

Treatment

Medications are considered adjunct to psychotherapy for personality disorders. Always treat the primary comorbid diagnoses. Avoid tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) due to overdose risk.

https://usercontent2.hubstatic.com/9101539_f1024.jpg

PMHNP-patient interactions:

• Cluster A —
  • These patients rarely seek treatment. When they seek treatment, be respectful, honest, and provide clear explanations
• Cluster B —
  • Antisocial-set behavioral limits when necessary. Portray a streetwise approach without being punitive.
  • Borderline—explain care truthfully and simply. Remove anxiety. Ask the patient to keep a diary of symptoms that are hard to characterize, such as weakness, dizziness, and headaches. Have the patient take ownership of his/her symptoms rather than transferring responsibility to the provider.
  • Histrionic- provide emotional support but resist a close, interpersonal relationship
  • Narcissistic—the patient has emotional transitions, such as over idealizing the provider to devaluing him or her. Avoid being defensive about mistakes.
• Cluster C —
• Avoidant—avoid criticism of the patient
• Dependent—set limits concerning the care being provided
• Obsessive-compulsive—share control of treatment with patient, allowing the individual to actively participate in decisions regarding care. Avoid being defensive and authoritarian.

  http://emedicine.medscape.com/article/294307-treatment#d10