Cluster A - Personality Disorders

Disorder
Paranoid
Personality

Etiology
Prevalence: 0.052.5%
Men>Women

Higher incidence
in family members
of schizophrenias

Schizoid
Personality

Prevalence: 7%
Men>Women

NO increased
incidence of
schizoid personality
in families w/

history of

schizophrenia

Presentation
Long standing
suspiciousness, hostility,
irritability
Distrust of others always
right, challenges loyalty
of friends
Jealous
Hypersensitive
Poor self-image
Question fidelity of
significant other
Patients have a formal
manner and seemed
surprised to need
psychiatric help
Lifelong withdrawal
Occurs in early childhood
Aloof/removed affect
There is no thought
disorder or delusional
thinking
Ability to recognize reality
Limited eye contact
Results in unemotional
parenting
Exaggerated intimacy
but only with one person
Patients appear ill at
ease, rarely tolerate eye

Diagnosis
4 or more of:
Suspicion that others are
deceiving them
Reluctance to confide in
others
Interpretation of benign
remarks as threatening
or demeaning
Persistence of grudges
Perception of attacks of
his/her character
Recurrence of suspicions
regarding fidelity of
spouse or lover
4 of More:
Neither enjoying nor
desiring close
relationships
Choosing solitary
activities
Little interest in sexual
activity
Taking pleasure in few
activities
Few close friends
Indifference to praise or
criticism
Detached

Treatment
Psychotherapy
Not group
Pharmacotherapy
Anti-anxiety agents
Diazepam (Valium)
controls anxiety and
agitation
Anti-Psychotics
Haloperidol (Haldol)
manages severe
agitation

Psychotherapy
Patients tend toward
introspection but
often are agreeable
w/ therapist
Group settings
patient often silent
for long periods but
become involved.
Pharmacotherapy
Small dosages of
antipsychotics,
antidepressants and
psychostimulants.
SSRIs make pt less

contact. Affect is
constricted. Occasionally
are unusual figures of
speech.
Disorder
Schizotypal
Personality

Etiology
Prevalence: 3%

Presentation
Signs and Symptoms:
Very odd and magical
thinking
Ideas of reference
Interpersonal deficits
Decreased concentration
Other Signs:
Peculiar mannerisms
eccentric
Speech is hard to follow
NOT psychotic
Severe social anxiety
Chronic in nature and can
progress to
schizophrenia

sensitive to rejection

Diagnosis
5 of More:
Ideas of reference

Magical thinking
Unusual perceptual
experiences

Suspiciousness
Inappropriate of
restricted affect

Odd or eccentric
appearance or behavior
Few close friends
Odd thinking or speech
Excessive social anxiety

Treatment
Pharmacotherapy
Antipsychotics useful in
dealing with ideas of
reference, illusions,
and other symptoms
Antidepressants should
there be a depressive
component
Paranoid more
aggressive in verbal
behavior