REFERENCES
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
2. Hahn SR, Thompson KS, Wills TA, et al. The difficult clinician-patient relationship: somatization, personality and psychopathology. J Clin Epidemiol. 1994:47:647-657.
3. Schafer S, Nowlis DP. Personality disorders among difficult patients. Arch Fam Med. 1998;7:126-129.
4. Paris J. Estimating the prevalence of personality disorders in the community. J Pers Disord. 2010;24:405-411.
5. Newton-Howes G, Tyrer P, Anagnostakis K, et al. The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams. Soc Psychiatry Psychiatr Epidemiol. 2010;45:453-460.
6. Zimmerman M, Rothschild L, Chelminski I. The prevalence of DSM-IV personality disorders in psychiatric outpatients. Am J Psychiatry. 2005;162:1911-1918.
7. Moran P, Jenkins R, Tylee A, et al. The prevalence of personality disorder among UK primary care attenders. Acta Psychiatr Scand. 2000;102:52-57.
8. Newton-Howes G, Tyrer P, Johnson T. Personality disorder and the outcome of depression: Meta-analysis of published studies. Br J Psychiatry. 2006;188:13-20.
9. Blasco-Fontecilla H, Baca-Garcia E, Dervic K, et al. Severity of personality disorders and suicide attempt. Acta Psychiatr Scand. 2009;119:149-155.
10. Colpaert K, Vanderplasschen W, De Maeyer J, et al. Prevalence and determinants of personality disorders in a clinical sample of alcohol-, drug-, and dual-dependent patients. Subst Use Misuse. 2012;47:649-661.
11. Yu R, Geddes JR, Fazel S. Personality disorders, violence, and antisocial behavior: A systematic review and meta-regression analysis. J Pers Disord. 2012;26:775-792.
12. Frankenburg FR, Zanarini MC. The association between borderline personality disorder and chronic medical illnesses, poor health-related lifestyle choices, and costly forms of health care utilization. J Clin Psychiatry. 2004;65:1660-1665.
13. Lee HB, Bienvenu OJ, Cho SJ, et al. Personality disorders and traits as predictors of incident cardiovascular disease: Findings from the 23-year follow-up of the Baltimore ECA Study. Psychosomatics. 2010;51:289-296.
14. Skodol AE, Gunderson JG, McGlashan TH, et al. Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder. Am J Psychiatry. 2002;159:276-283.
15. Bender DS, Dolan RT, Skodol AE, et al. Treatment utilization by patients with personality disorders. Am J Psychiatry. 2001;158:295-302.
16. Livesley WJ. An empirically-based classification of personality disorder.
J Pers Disord. 2011;25:397-420.
17. Bender DS, Morey LC, Skodol AE. Toward a model for assessing personality functioning in DSM-5, part I: a review of theory and methods. J Pers Assess. 2011;93:332-346.
18. Fonagy P, Gergely G, Jurist EL, et al. Affect Regulation, Mentalization, and the Development of the Self. New York, NY: Other Press; 2002.
19. Yen S, Shea MT, Battle CL, et al. Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: findings from the collaborative longitudinal personality disorders study. J Nerv Ment Dis. 2002;190:510-518.
20. Morey LC, Stagner BH. Narcissistic pathology as core personality dysfunction: comparing DSM-IV and the DSM-5 proposal for narcissistic personality disorder. J Clin Psychol. 2012;68:908-921.
21. Lynch TR, Chapman AL, Rosenthal MZ, et al. Mechanisms of change in dialectical behaviour therapy: theoretical and empirical observations.
J Clin Psychol. 2006;62:459-480.
22. Kliem S, Kröger C, Kosfelder J. Dialectical behavior therapy for borderline personality disorder: a meta-analysis using mixed-effects modeling.
J Consult Clin Psychol. 2010;78:936-951.
23. Clarkin JF, Levy KN, Lenzenweger MF, et al. Evaluating three treatments for borderline personality disorder: a multiwave study. Am J Psychiatry. 2007;164:922-928.
24. Gregory RJ, DeLucia-Deranja E, Mogle JA. Dynamic deconstructive psychotherapy versus optimized community care for borderline personality disorder co-occurring with alcohol use disorders: a 30-month follow-up. J Nerv Ment Dis. 2010;198:292-298.
25. Bateman A, Fonagy P. Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. Am J Psychiatry. 2009;166:1355-1364.
26. McMain SF, Links PS, Gnam WH, et al. A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. Am J Psychiatry. 2009;166:1365-1374.
27. Ogrodniczuk JS, Piper WE. Day treatment for personality disorders: a review of research findings. Harv Rev Psychiatry. 2001;9:105-117.
28. Paris J. Pharmacological treatments for personality disorders. Int Rev Psychiatry. 2011;23:303-309.
29. Ripoll LH, Triebwasser J, Siever LJ. Evidence-based pharmacotherapy for personality disorders. Int J Neuropsychopharmacol. 2011;14:1257-1288.
30. Steinberg PI. The use of low-dose neuroleptics in the treatment of patients with severe personality disorder: An adjunct to psychotherapy. BCMJ. 2007;49:306-310.
31. Zanarini MC, Frankenburg FR. Olanzapine treatment of female borderline personality disorder patients: a double-blind, placebo controlled pilot study. J Clin Psychiatry. 2001;62:849-854.
32. Nickel MK, Loew TH, Pedrosa Gil F. Aripiprazole in treatment of borderline patients, part II: an 18-month follow up. Psychopharmacology (Berl). 2007;191:1023-1026.
33. Silk KR. The process of managing medications in patients with borderline personality disorder. J Psychiatr Pract. 2011;17:311-319.
34. Linehan MM, Dimeff LA, Reynolds SK, et al. Dialectal behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug Alcohol Depend. 2002;67:13-26.
35. Rossberg JI, Karterud S, Pedersen G, et al. An empirical study of countertransference reactions toward patients with personality disorders. Compr Psychiatry. 2007;48:225-230.
Clinical Review
“Difficult” Patient? Or Is It a Personality Disorder?
Clinician Reviews. 2015 February;25(2):40-46
Author and Disclosure Information
David Kealy, MSW, Paul I. Steinberg, MD, FRCPC, John S. Ogrodniczuk, PhD
David Kealy, Paul I. Steinberg, and John S. Ogrodniczuk are in the Department of Psychiatry at the University of British Columbia, Vancouver. This article originally appeared in The Journal of Family Practice (2014;63[12]:697-703).
Recommended Reading
Related Articles
-
-
Clinical Review
Patient abusing alcohol or drugs? Help starts with a single question
- Author:
- Daniel C. Vinson, MD, MSPH
Although binge drinking and drug use are rarely discussed during office visits, they’re common, costly, and potentially fatal. Help patients stop...
-
Commentary
I Am Psyched; Are You?
- Author:
- O. T. Wendel, PhD