Personality Disorders: Diagnosis And Therapy

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Personality Disorders: Diagnosis And Therapy
Personality Disorders: Diagnosis And Therapy
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Personality Disorders: Diagnosis & Therapy

The diagnosis of personality disorders is not easy and difficult to make because they show up in a variety of ways. The diagnosis is therefore a suspected diagnosis that can only be confirmed during the course of treatment.

Personality disorders are generally treatable, although the therapy is often long-lasting and demands a certain stamina from those affected.

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  • How is a personality disorder diagnosed?
  • How is personality disorder treated?
  • Whom can I ask?
  • How are the costs going to be covered?

How is a personality disorder diagnosed?

Diagnosis requires knowledge, experience and sensitivity and is usually carried out by psychiatrists or psychotherapists. Clinical psychologists can also be called in to make a diagnosis. A well-founded diagnosis makes it easier to find the right form of treatment in order to lead a more balanced life. In Austria, personality disorders are diagnosed using the ICD-10 (International Classification of Diseases). Other diagnostic schemes (e.g. OPD, DSM-V) can be used to supplement and improve understanding.

According to the ICD-10, the diagnostic criteria for a personality disorder include:

  • The persistent behavioral patterns characteristic of the respective personality disorder deviate significantly from cultural values ​​in the areas: cognition, affectivity (emotional expression and feeling), impulse control, satisfaction of needs and interpersonal relationships.
  • The resulting behavior is inflexible, inappropriate, or inexpedient in many situations.
  • There is personal suffering. The influence on the environment can also be disadvantageous.
  • The characteristics of the personality disorder are long-lasting and began in later childhood or adolescence. However, it is also possible that personality disorders only show up in old age - also in connection with coping with the symptoms of old age.
  • The behavior pattern is not caused by or a consequence of another mental disorder. It may be that certain mental illnesses occur in parallel or are in the foreground.
  • An organic cause or a clear dysfunction of the brain is excluded as a reason.

A medical examination is necessary to rule out physical illnesses (e.g. of the brain). In a detailed discussion - often also with relatives - the life and medical history is recorded in detail. Personality disorders increase the risk of suffering from other psychiatric illnesses and the risk of suicide.

How is personality disorder treated?

Those affected often find it difficult to seek help. Many also fail to recognize that they need support themselves. Often people first seek counseling or therapy in their social environment, because they cannot cope with the behavior of their loved ones or develop their own emotional problems as a result. The treatment takes some time and is possible in principle.

Pillars of therapy

Psychotherapy (including psychoeducation - promoting understanding of the disorder, training how to deal with it, etc.) as well as sociotherapy, (re) learning social skills, ensuring basic social needs, rehabilitation, are among the pillars of therapy. Among other things, an individual attempt is made to try out or learn new behavior and perspectives.

In group psychotherapy, above all differences between self-perception and perception of others can be made visible, social interaction can be lived in a protected environment and mutual understanding can be promoted.

Depending on the severity of symptoms or other illnesses / disorders, medically prescribed medication may be necessary (e.g. to relieve anxiety). Among other things, antidepressants, mood stabilizers or sometimes antipsychotics are used. These drugs can be used in the context of personality disorders, for example against fear, impulse breakthroughs and possible delusional thinking and distorted ways of thinking and perceiving.

Note Your doctor or pharmacist will inform you about effects, side effects and interactions.

The problems with which those affected have to struggle (difficulties regarding closeness / distance, trust, etc.) are usually reflected in a more difficult treatment path. It is not uncommon for therapy to be discontinued. An essential basis is the trusting relationship that is slowly being built up with the professional helpers.

psychotherapy

Various methods have developed within psychotherapy that deal with personality disorders in particular, e.g. transference-focused psychodynamic psychotherapy (TFP) or special approaches to behavioral schema therapy. Which approach is used also depends on the type of personality disorder. The treatment of the emotionally unstable personality (borderline type) is best researched. This includes dialectical behavioral therapy (DBT) and mentalization-based therapy (MBT). For more information, see Emotionally Unstable Personality Disorder: Therapy.

Concomitant illnesses (e.g. addictions, depression, etc.) are taken into account in the treatment.

Whom can I ask?

If you suspect you have a personality disorder, would like to help someone around you or if you need emotional support as a relative, a specialist in psychiatry or a psychotherapist is your first choice. Specialized child and youth psychiatrists are also available for young people under the age of 18. You can also contact a clinical psychologist. For relatives, for example, HPE (help for relatives of the mentally ill) also offers information and support. Under Health Search you will find helpful information on searching for a doctor or therapist as well as searching for self-help groups (also for relatives).

How are the costs going to be covered?

The costs for the medical examination are covered by social insurance. For more information about visiting a doctor, see Doctor's Visit: Costs and Deductibles. You can find information on the costs of hospital stays and rehabilitation under What does the hospital stay cost? as well as under Rehabilitation & Cure.

A full assumption of costs for psychotherapy is possible in own or contractually bound institutions of the health insurance carriers as well as in institutions that are subsidized by the public purse. In these cases, there is the option of paying a deductible. Otherwise, you have the option of applying for a subsidy from the health insurance company if you are undergoing psychotherapy with a resident psychotherapist. If this is approved, the health insurance provider will reimburse you for part of the fee paid to the psychotherapist. However, the health insurance carriers only provide a subsidy if there is an illness-related disorder.You can find more information on "Psychotherapy on sickness certificate", cost subsidies and addresses of resident psychotherapists under Psychotherapy: Offers & Addresses.

Clinical-psychological diagnosis is a service provided by the health system, the costs of which are borne by the health insurance carriers. With a medical or psychotherapeutic referral, patients can take advantage of a psychological examination by a contract psychologist for clinical-psychological diagnostics. You have to bear the costs for treatment or advice from resident clinical psychologists, as this is not a benefit from health insurance.

You can also find more information about costs at:

  • Prescription fee: This is how drug costs are covered
  • Health Professions AZ.

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