Management of personality disorder

Abstract

Personality disorder is a conceptually flawed diagnosis applied to a group of patients whose cognitive style and behaviour contribute to distress in themselves and others. Logically, management should (a) be based on cognitive-behavioural principles, (b) avoid rejecting responses by the therapist, and (c) use drugs as additional treatment for specific symptoms such as depression, anxiety and paranoia. Patients diagnosed as personality disorder carry a high risk of suicide and may develop additional mental disorders; these problems require careful clinical supervision. Personality disordered offenders can benefit from a number of non-punitive therapeutic options, following principles derived from cognitive therapy and the therapeutic community.