Categorization and description of personality disorder

The classification of personality disorder has been developed in relative isolation from investigations of management. The consequence is a sad example of clinical inutility; the standard descriptions of ICD-10 and DSM-IV appear to have face validity but are shown to be extremely limited when discussing specific treatments. Thus a specific question 'What are the different management strategies for dependent and histrionic personality disorder?' is met with a deafening silence from all those who wish to quote from evidence-based practice rather than making ex cathedra statements. A large part of the problem of deciding on the treatment of individual personality disorders follows from the degree of overlap between the various personality disorders and other mental state disorders. This is discussed below in the section on comorbidity, but covers a much greater area than the presence of several disabilities at a single point in time.

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