Biological substrates of personality and personality disorders

Many investigators have concluded that there appears to be a high genetic component in the aetiology of schizoid, depressive, psychopathic, and introversive traits. Personality disorders and major psychiatric disorders

Personality disorders have been considered as belonging to the spectrum of major psychiatric disorders. However, it must be remembered that external events, such as brain damage (organic personality disorders), or the psychological impact of a catastrophic event may also lead to personality changes. Severe psychiatric disorders may have a repercussion on the personality of the patient, and other illnesses may also have this effect. For example, chronic pain (of organic nature) can be accompanied by a profound personality change (algogenic psychosyndrome). Hypochondria or dissociative symptoms and traits may become relevant only after the patient has suffered an illness, or a problem related to diagnosis or treatment, or a problem involving the patient-physician relationship.

According to the hypothesis of a spectrum of disorders, personality disorders can often be treated by the same method as those applied to the major psychiatric disorders to which they are related. Patients with anxious or avoidant personality disorder may respond to anxiolytic medication, patients with borderline personality disorder may respond to lithium and antidepressives, patients with schizotypal personality disorder may respond to antipsychotic agents, and patients with disorders characterized by poor impulse control may respond to antidepressives with a selective serotonergic action.

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