CATEGORIES OF PERSONALITY DISORDERS
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR; American Psychiat-ric Association [APA], 2000) lists personality disorders as a separate and distinct category from other major mental illnesses. They are on axis II of the multiaxial classification system . The DSM-IV-TR classifies person-ality disorders into “clusters,” or categories, based on the predominant or identifying features:
· Cluster A includes people whose behavior appears odd or eccentric and includes paranoid, schizoid, and schizotypal personality disorders.
· Cluster B includes people who appear dramatic, emo-tional, or erratic and includes antisocial, borderline, histrionic, and narcissistic personality disorders.
· Cluster C includes people who appear anxious or fear-ful and includes avoidant, dependent, and obsessive– compulsive personality disorders.
In psychiatric settings, nurses most often encounter clients with antisocial and borderline personality disorders. Clients with antisocial personality disorder may enter a psychiatric setting as part of a court-ordered evaluation or as an alternative to jail. Clients with borderline personality disorder often are hospitalized because their emotional instability may lead to self-inflicted injuries.
Most clients with these disorders are not treated in acute care settings for these personality disorders. Nurses may encounter these clients in any health-care setting or in the psychiatric setting when a client is already hospitalized for another major mental illness.
Two disorders currently being studied for inclusion as personality disorders are depressive and passive-aggressive personality disorders, both of which are included in the DSM-IV-TR.