Chapter 26
Personality Disorders
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, Chapter 26: Personality Disorders
ICD-10 classification
1. Paranoid personality disorder.
2. Schizoid personality disorder.
3. Dissocial personality disorder.
4. Emotionally unstable personality disorder.
A. Impulsive type.
B. Borderline type.
5. Histrionic personality disorder.
6. Anankastic personality disorder.
7. Anxious (avoidant) personality disorder.
8. Dependent personality disorder.
ICD-10 criteria
A personality disorder is a severe disturbance in the character and behavioural tendencies of the individual,
usually involving several areas of the personality, and nearly always is associated with considerable personal
and social disruption.
Personality disorder tends to appear in late childhood or adolescence and continues into adulthood.
Diagnostic guidelines
o Personality disorders are characterised by markedly disharmonious attitudes and behaviour, involving
usually several areas of functioning (e.g. affectivity, arousal, impulse control, ways of perceiving and
thinking, and style of relating to others).
o The abnormal behaviour pattern is enduring, of long standing and not limited to episodes of mental
illness.
o The abnormal behaviour pattern is pervasive and clearly maladaptive to a broad range of personal and
social situations.
o The above manifestations always appear during childhood or adolescence and continue into adulthood.
o The disorder leads to considerable personal distress but this may only become apparent late in its course.
o The disorder is usually but not invariably associated with significant problems in occupational and social
performance.
Note: fewer people with a personality disorder make contact with psychiatric services compared with those with
schizophrenia and depression. The probability of someone with a personality disorder withdrawing from
treatment is higher compared with those with schizophrenia and depression.
Comparison between ICD-10 and DSM-V classification of personality disorders
ICD-10 DSM-V Cluster Main characteristics
(9 types of personality (10 types of personality
disorder) disorder)
Paranoid. Paranoid. A (‘Mad’). Odd and eccentric.
Schizoid. Schizoid.
Schizotypal.
Dissocial. Antisocial. B (‘Bad’). Dramatic, emotional and erratic.
Emotionally
unstable, impulsive type.
Emotionally Borderline.
unstable, borderline type.
Histrionic. Histrionic.
Narcissistic.
Anankastic. Obsessive compulsive. C (‘Sad’). Anxious and fearful.
Anxious (avoidant). Avoidant.
Dependent. Dependent.
Note: people with schizotypal personality disorder may develop schizophrenia. Schizotypal personality disorder is
more common in relatives of people with schizophrenia.
Epidemiology
General community
o Prevalence of all personality disorders: ~ 10%.
o Gender distribution: males > females.
Primary care
o Prevalence of a primary diagnosis of any personality disorder: 5-8%.
o Prevalence of a co-morbid diagnosis of any personality disorder in people with another primary
224
Personality Disorders
223
, Chapter 26: Personality Disorders
ICD-10 classification
1. Paranoid personality disorder.
2. Schizoid personality disorder.
3. Dissocial personality disorder.
4. Emotionally unstable personality disorder.
A. Impulsive type.
B. Borderline type.
5. Histrionic personality disorder.
6. Anankastic personality disorder.
7. Anxious (avoidant) personality disorder.
8. Dependent personality disorder.
ICD-10 criteria
A personality disorder is a severe disturbance in the character and behavioural tendencies of the individual,
usually involving several areas of the personality, and nearly always is associated with considerable personal
and social disruption.
Personality disorder tends to appear in late childhood or adolescence and continues into adulthood.
Diagnostic guidelines
o Personality disorders are characterised by markedly disharmonious attitudes and behaviour, involving
usually several areas of functioning (e.g. affectivity, arousal, impulse control, ways of perceiving and
thinking, and style of relating to others).
o The abnormal behaviour pattern is enduring, of long standing and not limited to episodes of mental
illness.
o The abnormal behaviour pattern is pervasive and clearly maladaptive to a broad range of personal and
social situations.
o The above manifestations always appear during childhood or adolescence and continue into adulthood.
o The disorder leads to considerable personal distress but this may only become apparent late in its course.
o The disorder is usually but not invariably associated with significant problems in occupational and social
performance.
Note: fewer people with a personality disorder make contact with psychiatric services compared with those with
schizophrenia and depression. The probability of someone with a personality disorder withdrawing from
treatment is higher compared with those with schizophrenia and depression.
Comparison between ICD-10 and DSM-V classification of personality disorders
ICD-10 DSM-V Cluster Main characteristics
(9 types of personality (10 types of personality
disorder) disorder)
Paranoid. Paranoid. A (‘Mad’). Odd and eccentric.
Schizoid. Schizoid.
Schizotypal.
Dissocial. Antisocial. B (‘Bad’). Dramatic, emotional and erratic.
Emotionally
unstable, impulsive type.
Emotionally Borderline.
unstable, borderline type.
Histrionic. Histrionic.
Narcissistic.
Anankastic. Obsessive compulsive. C (‘Sad’). Anxious and fearful.
Anxious (avoidant). Avoidant.
Dependent. Dependent.
Note: people with schizotypal personality disorder may develop schizophrenia. Schizotypal personality disorder is
more common in relatives of people with schizophrenia.
Epidemiology
General community
o Prevalence of all personality disorders: ~ 10%.
o Gender distribution: males > females.
Primary care
o Prevalence of a primary diagnosis of any personality disorder: 5-8%.
o Prevalence of a co-morbid diagnosis of any personality disorder in people with another primary
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