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8/10/2019 PERSONALITY DISORDERS & REPERTORIAL APPROACH
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PERSONALITY DISORDERS & REPERTORIAL APPROACH
Dr S.K.PANDEY, READER
DEPT. OF REPERTORY
NEHRU HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL
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As per aphorism 215 of Organon of Medicine, all the so-called mental
& emotional diseases are nothing more than corporeal diseases inwhich the symptoms of derangement of the mind and disposition
peculiar to each of them is increased, whilst the corporeal symptoms
decline(more or less rapidly),till it at length attains the most striing
one sidedness, almost as though it were a local disease in thein!isi"le su"tle organ of the mind or disposition# $r %ahnemann has
classified mental diseases into four types(Aphorisms
21,221,22',225)
1#Mental diseases appearing with the decline of corporeal diseases
which threatens to "e fatal(Aphorism-21 omato-psychic type)
2 Mental diseases appearing suddenly as an acute disease in patients
ordinary calm state caused "y some eciting factors(Aphorism-221)
* Mental diseases of dou"tful origin(Aphorism-22')
' Mental diseases arising from prolong emotional cause-(Aphorism-
225+sycho- somatic- type)
n modern medicine personality disorder, as defined in the
$iagnostic and tatistical Manual of the American +sychiatric
Association, ourth .dition, /et 0e!ision ($M--/0), is anenduring pattern of inner eperience and "eha!ior that differs
maredly from the epectations of the indi!iduals culture, is
per!asi!e and inflei"le, has an onset in adolescence or early
adulthood, is sta"le o!er time, and leads to distress or impairment#+ersonality disorders are a long-standing and maladapti!e pattern of
percei!ing and responding to other people and to stressfulcircumstances# /en personality disorders, grouped into * clusters
(i#e#, A, 3, 4), are defined in the $M--/0#1
0.6.748
ndi!iduals may ha!e more than one personality disorder# /he
following are pre!alences for specific personality disorders in the
general population9
+aranoid personality disorder - :#5-2#5;
chi
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%istrionic personality disorder - 2-*;
7arcissistic personality disorder - =ess than 1;
A!oidant personality disorder - :#5-1;
O"sessi!e-compulsi!e personality disorder - 1;
MO0/A=/8> MO03$/8
+atients with personality disorders are at higher ris than the
general population for many (Ais ) psychiatric disorders# Mooddisorders are a particular ris across all personality diagnoses# ome
co mor"idities are more specific to particular personality disorders
and clusters#
4luster A9 +A0A7O$ +.0O7A=/8 $O0$.0 may appear as a
prodrome to delusional disorder or fran schi
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4luster A9 4%O$ +.0O7A=/8 $0O$.0 is slightly more
common in males than in females#
4luster 39 A7/O4A= +.0O7A=/8 $O0$.0 is * times more
pre!alent in men than in women# 3orderline personality disorder is *times more common in women than in men# Of patients with
narcissistic personality disorder, 5:-B5; are male#
4luster 49 O3..-4OM+6=. +.0O7A=/8 $O0$.0 is
diagnosed twice as often in men than in women#
AC.
+ersonality disorders generally should not "e diagnosed in children
and adolescents "ecause personality de!elopment is not complete
and symptomatic traits may not persist into adulthood# /herefore,
the rule of thum" is that personality diagnosis cannot "e made until
the person is at least 1D years of age# 3ecause the criteria fordiagnosis of personality disorders are closely related to "eha!iors of
young and middle adulthood, $M--/0 diagnoses of personality
disorders are notoriously unrelia"le in the elderly population
+A0A7O$ +.0O7A=/8 $O0$.0
ndi!iduals with this disorder display per!asi!e distrust and
suspiciousness# 4ommon "eliefs include the following9
Others are eploiting or decei!ing the person#
riends and associates are untrustworthy#
nformation confided to others will "e used maliciously#
/here is hidden meaning in remars or e!ents others percei!e as
"enign#
/he spouse or partner is unfaithful#
REPERTORIAL APPROACH
87/%. 0.+.0/O08
M7$ .4/O7
Adapta"ility, loss of
Admonition
$ogmatic
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E.7/F 0.+.0/O08
M7$ .4/O7
$elusions, critici
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ndifference
+aranoia
E.7/F 0.+.0O08
M7$ .4/O7
Apathy (+age no#-G)
.stranged from society (+age no#-*G)
uite (+age no#-B:)
olitude (+age no#-D1)
6nfriendly (+age no#-G1)
3340
M7$ .4/O7
Anthropho"ia, a!ersion to others (+age7o-1G2)
A!ersion to, family, certain persons (+age no#-1G*)
Awwardness (+age no#-1G*)
3enum"ed (+age no#-1G*)
4ompany, a!ersion to (+age no#-1G5)
$epression (+age no#-1GD)
oolish, silly a"surd (+age no#-2:2)
ntrospecti!e, intro!erted, a"sor"ed (+age no#-2:G)
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6nsocial (+age no#-22:)
4%O/8+A= +.0O7A=/8 $O0$.0
+eople with this disorder ehi"it mared eccentricities of thought,perception, and "eha!ior# /ypical eamples are as follows9
deas of reference (i#e#, "elie!ing that pu"lic messages are directed
personally at them)
Odd "eliefs or magical thining
ague, circumstantial, or stereotyped speech
.cessi!e social aniety that does not diminish with familiarity
diosyncratic perceptual eperiences or "odily illusions
REPERTORIAL APPROACH
87/%. 0.+.0/O08
M7$ .4/O7
Admonition
Aloof
Aniety
E.7/F 0.+.0/O08
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M7$ .4/O7
uite (+age no#-B:)
olitude (+age no#-D1)
3340
M7$ .4/O7
3enum"ed (+age no#-1G')
%eadstrong (+age no#-2:*)
magination, fancies (+age no#-2:B)
deas, fied (+age no#-2D')
A7/O4A= +.0O7A=/8 $O0$.0
Antisocial personality disorder9 ndi!iduals with antisocialpersonality disorder display a per!asi!e pattern of disregard for and
!iolation of the rights of others and the rules of society# Onset mustoccur "y age 15 years & includes following features9
0epeated !iolations of the law
+er!asi!e lying and deception
+hysical aggressi!eness
0ecless disregard for safety of self or others
4onsistent irresponsi"ility in wor and family en!ironments
=ac of remorse
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ome person with antisocial disorder are terrorists & some terrorists
suffer from Antisocial personality disorder# Many terroristsdemonstrate diagnostic feature of A+$ without possessing the
actual disorder# /errorists are not "orn terrorists# Most people
"elie!e in something "igger than life#
REPERTORIAL APPROACH
87/%. 0.+.0/O08
M7$ .4/O7
A"usi!e
Adulterous
Anger
Antisocial
3rutality
4orrupt
$esire, to ill
$estructi!eness
Misanthropy
0age
0aes
E.7/F 0.+.0/O08
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n the meantime, the international community adopted a series of
sectoral con!entions that define and criminali
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precipitously in those two countries for a decade "efore declining
eKually dramatically# Other countries, such as 4anada and /he7etherlands, ha!e pro!en to "e more resistant, and ha!e
eperienced only a few isolated terrorist incidents#
n general, democratic countries ha!e pro!ided more fertile ground
for terrorism "ecause of the open nature of their societies# n such
societies citi
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inally, some terrorists are moti!ated "y !ery specific issues, such as
opposition to legali
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/he 6## $epartment of tate has designated se!en countries as
state sponsors of terrorism9 ran, raK, yria, =i"ya, 4u"a, 7orthEorea, and udan# n the year 2:::, it named ran as the most acti!e
supporter of terrorism for aid to groups such as %e
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REPERTORIAL APPROACH
87/%. 0.+.0/O08
M7$ .4/O7
Anarchist
Antisocial
3rutality
4orrupt
Mania, homicial
+assionate
+rogramming e!erything
6nsympathetic
ecreti!e
E.7/F 0.+.0/O08
M7$ .4/O7
Audacity (+age no#-*)
4ruelty (+age no#-1B)
.stranged from family , society (+age no#-*G)
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%ard hearted (+age no#-51)
nsanity, "eha!e lie cra
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/hreatening (+age no#-DD)
6nfilling (+age no#-G1)
iolent (+age no#-G1)
3O0$.0=7. +.0O7A=/8 $O0$.0
/he central feature of "orderline personality disorder is a per!asi!e
pattern of unsta"le and intense interpersonal relationships, self-perception, and moods# mpulse control is maredly impaired#
/ransiently, such patients may appear psychotic "ecause of the
intensity of their distortions# 3orderline personality disorder is one of
the most commonly o!erused diagnoses in $M--/0# $iagnosticcriteria reKuire at least 5 of the following features9
rantic efforts to a!oid epected a"andonment
6nsta"le and intense interpersonal relationships
Maredly and persistently unsta"le self-image
mpulsi!ity in at least 2 areas that are potentially self-damaging(e#g#, se, su"stance a"use, recless dri!ing)
0ecurrent suicidal "eha!iors or threats or self-mutilation
Affecti!e insta"ility
4hronic feelings of emptiness
nappropriate and intense anger
/ransient paranoia or dissociation
REPERTORIAL APPROACH
87/%. 0.+.0/O08
M7$ .4/O7
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Anger (+age no#-G1)
$eath, desire (+age no#-G1)
Moping (+age no#-G1)
E.7/F 0.+.0/O08
M7$ .4/O7 (+age no#-G1)
Anger (+age no#-G1)
.motional (+age no#-G1)
n?ure, fears to "e alone, lest he should himself (+age no#-G1)
Mutilating (+age no#-G1)
uicidal disposition (+age no#-G1)
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3340
M7$ .4/O7
rrita"le (+age no#-2:G)
3eside, oneself frantic, madness (+age no#-1G')
.cstasy (+age no#-1GG)
uicidal (+age no#-21D)
%/0O74 +.0O7A=/8 $O0$.0
+atients with histrionic personality disorder display ecessi!e
emotionality and attention-seeing "eha!ior# /hey are Kuite dramatic
and often seually pro!ocati!e or seducti!e# /heir emotions arela"ile# n clinical settings, their tendency to !ague and
impressionistic speech is often highlighted
REPERTORIAL APPROACH
87/%. 0.+.0/O08
M7$ .4/O7
4oKuettish
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ri!olous
E.7/F 0.+.0/O08
M7$ .4/O7
Amorous (+age no#-2)
7A04/4 +.0O7A=/8 $O0$.0
7arcissistic patients are grandiose and reKuire admiration from
others# +articular features of the disorder include the following9
.aggeration of their own talents or accomplishments
ense of entitlement
.ploitation of others
=ac of empathy
.n!y of others
An arrogant, haughty attitude
REPERTORIAL APPROACH
87/%. 0.+.0/O08
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M7$ .4/O7
Arrogant
Admiration
%aughty
+ompous
anity
E.7/F 0.+.0/O08
M7$ .4/O7
Arrogance (+age no#-G)
.n!y (+age no#-*G)
Jealousy (+age no#-:)
%aughty (+age no#-51)
+ride (+age no#-G)
3340
M7$ .4/O7
4ontemptuous, mocing (+age no#-1G)
$ogmatic (+age no#-1GG)
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$omineering (+age no#-1GG)
mportance feels his (+age no#-2:B)
+roud, arrogant, self esteem, haughty (+age no#-21')
AO$A7/ +.0O7A=/8 $O0$.0
A!oidant patients are generally !ery shy# /hey display a pattern ofsocial inhi"ition, feelings of inadeKuacy, and hypersensiti!ity to
re?ection# 6nlie patients with schi
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E.7/F 0.+.0/O08
M7$ .4/O7
A"andoned (+age no#-1)
Aniety (+age no#-')
$e?ection (+age no#-1D)
ear, people, of (+age no#-')
orsaen (+age no#-'G)
rightened easily (+age no#-'G)
ensiti!e (+age no#-BG)
hy (+age no#-D:)
olitude (+age no#-G)
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3340
M7$ .4/O7
6nsocia"le, shy, a!erse to society (+age no#-22:)
$.+.7$.7/ +.0O7A=/8 $O0$.0
Lhile many people ehi"it dependent "eha!iors and traits, peoplewith dependent personality disorder ha!e an ecessi!e need to "e
taen care of that result in su"missi!e and clinging "eha!ior,
regardless of conseKuences# $iagnosis reKuires at least 5 of the
following features9
$ifficulty maing decisions without guidance and reassurance
7eed for others to assume responsi"ility for most ma?or areas of the
persons life
$ifficulty epressing disagreement with others
$ifficulty initiating acti!ities "ecause of lac of confidence
.cessi!e measures to o"tain nurturance and support
$iscomfort or helplessness when alone
6rgent seeing for another relationship when one has ended
6nrealistic preoccupation with fears of "eing left to fend for
themsel!es
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REPERTORIAL APPROACH
87/%. 0.+.0/O08
M7$ .4/O7
taciturn
E.7/F 0.+.0/O08
M7$ .4/O7
4linging (+age no#-
12)
4ompany, desire for (+age no#-12)
ear, alone, of "eing (+age no#-'*)
rresolution (+age no#-5B)
Magneti
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3340
M7$ .4/O7
$e?ection (+age no#-1GB)
$epression (+age no#-1GD)
$espair (+age no#-1GD)
=ow pirited (+age no#-21:)
Melancholy (+age no#-215)
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O3..-4OM+6=. +.0O7A=/8 $O0$.0
+eople with o"sessi!e-compulsi!e personality disorder are maredlypreoccupied with orderliness, perfectionism, and control# /hey lac
flei"ility or openness# /heir preoccupations interfere with their
efficiency despite their focus on tass# /hey are often scrupulous and
inflei"le a"out matters of morality, ethics, and !alues to a point"eyond cultural norms# /hey are often stingy as well as stu""orn#
REPERTORIAL APPROACH
87/%. 0.+.0/O08
M7$ .4/O7
Acti!ity, desires
4hecing
4ompulsions
$ogmatic
oppish
7eurosis
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2#3oger 3oenninghausen 4haracteristic 0epertory
*# 3orderline +ersonality $isorder $M-
'# %offman 3, inside terrorism 4olum"ia 6ni!ersity
5# EentFs repertory
# EnerrFs repertory
B# =eft wing etremist data & satp(2:1:)
D# Organon of Medicine #ynthesis repertory
G# ynthesis 0epertory
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