Personality disorders and therapeutic approaches

Detalhes bibliográficos
Autor(a) principal: Figueiredo, Inês
Data de Publicação: 2022
Tipo de documento: Artigo
Idioma: por
Título da fonte: Debates em Psiquiatria (Online)
Texto Completo: https://revistardp.org.br/revista/article/view/392
Resumo: Introduction: the diagnosis and classification of Personality Disorders are a controverse and complex area of debate because it is often questioned the advantage of separating them in different clusters or using a dimensional classification and also because some wonder if a Personality Disorder is itself a disease and if so how prejudicial can the diagnosis be. Functional impact is a crucial aspect of these diagnosis and it should be a major component of evaluation and therapeutical approach. Objective: review the characteristics of the different Personality Disorders, identify the maladaptive traits in order to better adapt its therapeutical approach and analyze which one of the latter is more efficient. Methods: a systematic review was made using PubMed. The MeSH term used was “Personality Disorder”. Results: The borderline Personality Disorder is the one with more evidence in the literature, being antipsychotics the major pharmacological approach used with efficacy found for olanzapine, risperidone, haloperidol, thiothixene and also the antidepressant fluoxetine. In Personality Disorders of Cluster C and Narcissistic Personality Disorder, it was seen that a cognitive and psychodynamic approach lead to medium or high positive results, although it is clear that these subtype of Personality Disorders benefits more with this approach. Conclusion: the evidence suggests that comorbid or latent with Personality Disorders are associated with worse treatment adhesion when consider Axis 1 disorders. It was found that, generally, there is not enough information to make viable and strong conclusions in terms of pharmacological approaches and that the majority of the studies are related to the borderline Personality Disorder.
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spelling Personality disorders and therapeutic approachesTrastornos de la personalidad y enfoques terapéuticosOs transtornos de personalidade e abordagens terapêuticasTranstornos da PersonalidadeConduta do Tratamento MedicamentosoPsicoterapiaPersonality DisordersMedication Therapy ManagementPsychotherapyTrastornos de la PersonalidadAdministración del Tratamiento FarmacológicoPsicoterapiaIntroduction: the diagnosis and classification of Personality Disorders are a controverse and complex area of debate because it is often questioned the advantage of separating them in different clusters or using a dimensional classification and also because some wonder if a Personality Disorder is itself a disease and if so how prejudicial can the diagnosis be. Functional impact is a crucial aspect of these diagnosis and it should be a major component of evaluation and therapeutical approach. Objective: review the characteristics of the different Personality Disorders, identify the maladaptive traits in order to better adapt its therapeutical approach and analyze which one of the latter is more efficient. Methods: a systematic review was made using PubMed. The MeSH term used was “Personality Disorder”. Results: The borderline Personality Disorder is the one with more evidence in the literature, being antipsychotics the major pharmacological approach used with efficacy found for olanzapine, risperidone, haloperidol, thiothixene and also the antidepressant fluoxetine. In Personality Disorders of Cluster C and Narcissistic Personality Disorder, it was seen that a cognitive and psychodynamic approach lead to medium or high positive results, although it is clear that these subtype of Personality Disorders benefits more with this approach. Conclusion: the evidence suggests that comorbid or latent with Personality Disorders are associated with worse treatment adhesion when consider Axis 1 disorders. It was found that, generally, there is not enough information to make viable and strong conclusions in terms of pharmacological approaches and that the majority of the studies are related to the borderline Personality Disorder.Introducción: El diagnóstico y clasificación de los Trastornos de la Personalidad es un área de debate con controversia y complejidad, ya sea en cuanto a su distribución en categorías o enfoque dimensional, si se considera o no una verdadera enfermedad y cuanto daño puede traer este diagnóstico. El impacto funcional es central en la mayoría de estas patologías, por lo que debe ser un componente central en la evaluación y abordaje terapéutico. Objetivo: Revisar las características de los Trastornos de la Personalidad, identificar los trazos desadaptativos para adecuar mejor la respectiva terapia y analizar qué tratamientos son más efectivos. Método: se realizó una revisión sistemática basada en PubMed, donde se utilizó el término MeSH “Personality Disorder”. Resultados: El Trastorno Límite de la Personalidad es el que más evidencia tiene, y los fármacos más utilizados son los antipsicóticos, con efectividad evidenciada para la olanzapina, risperidona, haloperidol, tiotixeno y también en el antidepresivo fluoxetina. En los Trastornos de la personalidad del Grupo C y el Trastorno narcisista, se ha descubierto que un enfoque cognitivo y psicodinámico produce efectos positivos de medianos a altos, aunque está claro que este subtipo de personalidad se beneficia más de él.  Conclusión: La evidencia sugiere que los Trastornos de la Personalidad comórbidos o latentes se asocian con una menor adherencia al tratamiento y mejores resultados cuando se trata del Eje 1. Concluyo que, en general, no hay suficiente información para sacar conclusiones sobre la eficacia de las intervenciones farmacológicas, y la mayoría de las pruebas están relacionadas con el trastorno límite de la personalidad.Introdução: O diagnóstico e a classificação de Transtorno de Personalidade são uma área de debate com alguma controvérsia e complexidade, seja quer no benefício da sua distribuição em categorias ou numa abordagem dimensional, seja no facto de se considerar uma verdadeira doença ou não e no quão prejudicial isso possa ser. O impacto funcional é nuclear da maioria destas patologias pelo que deve ser um componente central na avaliação e abordagem terapêutica. Objectivo: Rever as características dos Transtornos de Personalidade, identificar os traços maladaptivos de forma a melhor adaptar a respetiva terapêutica e analisar quais os tratamentos mais eficazes. Método: foi feita uma revisão sistemática com base na PubMed onde foi usado o termo MeSH “Transtorno de Personalidade”. Resultados: O Transtorno de Personalidade borderline é a que detém de maior evidência, sendo que os fármacos mais usados são os antipsicóticos, com eficácia evidenciada para a olanzapina, risperidona, haloperidol, tiotixeno e ainda no antidepressivo fluoxetina. Nos Transtornos de Personalidade do Cluster C e Transtorno Narcísico, concluiu-se que uma abordagem cognitiva e psicodinâmica resulta em efeitos positivos médios a elevados, embora seja claro que este subtipo de personalidade beneficie mais com a  mesma. Conclusão: A evidência sugere que Transtornos de Personalidade comórbidos ou latentes estão associados a uma menor adesão ao tratamento e a piores outcomes quando se trata de doenças do Eixo 1. Conclui-se que, na generalidade, não há informação suficiente para ser possível tirar conclusões quanto à eficácia das intervenções farmacológicas, sendo a maioria da evidência relativa ao Transtorno de Personalidade Borderline.Associação Brasileira de Psiquiatria2022-12-14info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-ReviewedRevisado por ParesAvaliado Pelos Paresapplication/pdfhttps://revistardp.org.br/revista/article/view/39210.25118/2763-9037.2022.v12.392Debates in Psychiatry; Vol. 12 (2022); 1-17Debates em Psiquiatria; Vol. 12 (2022); 1-17Debates em Psiquiatria; v. 12 (2022); 1-172763-90372236-918Xreponame:Debates em Psiquiatria (Online)instname:Associação Brasileira de Psiquiatria (ABP)instacron:ABPporhttps://revistardp.org.br/revista/article/view/392/366Copyright (c) 2022 Inês Figueiredohttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessFigueiredo, Inês2024-01-04T23:42:10Zoai:ojs.emnuvens.com.br:article/392Revistahttps://revistardp.org.br/revista/oaiPUBhttps://revistardp.org.br/revista/oairdp@abp.org.br2763-90372236-918Xopendoar:2024-01-04T23:42:10Debates em Psiquiatria (Online) - Associação Brasileira de Psiquiatria (ABP)false
dc.title.none.fl_str_mv Personality disorders and therapeutic approaches
Trastornos de la personalidad y enfoques terapéuticos
Os transtornos de personalidade e abordagens terapêuticas
title Personality disorders and therapeutic approaches
spellingShingle Personality disorders and therapeutic approaches
Figueiredo, Inês
Transtornos da Personalidade
Conduta do Tratamento Medicamentoso
Psicoterapia
Personality Disorders
Medication Therapy Management
Psychotherapy
Trastornos de la Personalidad
Administración del Tratamiento Farmacológico
Psicoterapia
title_short Personality disorders and therapeutic approaches
title_full Personality disorders and therapeutic approaches
title_fullStr Personality disorders and therapeutic approaches
title_full_unstemmed Personality disorders and therapeutic approaches
title_sort Personality disorders and therapeutic approaches
author Figueiredo, Inês
author_facet Figueiredo, Inês
author_role author
dc.contributor.author.fl_str_mv Figueiredo, Inês
dc.subject.por.fl_str_mv Transtornos da Personalidade
Conduta do Tratamento Medicamentoso
Psicoterapia
Personality Disorders
Medication Therapy Management
Psychotherapy
Trastornos de la Personalidad
Administración del Tratamiento Farmacológico
Psicoterapia
topic Transtornos da Personalidade
Conduta do Tratamento Medicamentoso
Psicoterapia
Personality Disorders
Medication Therapy Management
Psychotherapy
Trastornos de la Personalidad
Administración del Tratamiento Farmacológico
Psicoterapia
description Introduction: the diagnosis and classification of Personality Disorders are a controverse and complex area of debate because it is often questioned the advantage of separating them in different clusters or using a dimensional classification and also because some wonder if a Personality Disorder is itself a disease and if so how prejudicial can the diagnosis be. Functional impact is a crucial aspect of these diagnosis and it should be a major component of evaluation and therapeutical approach. Objective: review the characteristics of the different Personality Disorders, identify the maladaptive traits in order to better adapt its therapeutical approach and analyze which one of the latter is more efficient. Methods: a systematic review was made using PubMed. The MeSH term used was “Personality Disorder”. Results: The borderline Personality Disorder is the one with more evidence in the literature, being antipsychotics the major pharmacological approach used with efficacy found for olanzapine, risperidone, haloperidol, thiothixene and also the antidepressant fluoxetine. In Personality Disorders of Cluster C and Narcissistic Personality Disorder, it was seen that a cognitive and psychodynamic approach lead to medium or high positive results, although it is clear that these subtype of Personality Disorders benefits more with this approach. Conclusion: the evidence suggests that comorbid or latent with Personality Disorders are associated with worse treatment adhesion when consider Axis 1 disorders. It was found that, generally, there is not enough information to make viable and strong conclusions in terms of pharmacological approaches and that the majority of the studies are related to the borderline Personality Disorder.
publishDate 2022
dc.date.none.fl_str_mv 2022-12-14
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-Reviewed
Revisado por Pares
Avaliado Pelos Pares
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://revistardp.org.br/revista/article/view/392
10.25118/2763-9037.2022.v12.392
url https://revistardp.org.br/revista/article/view/392
identifier_str_mv 10.25118/2763-9037.2022.v12.392
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://revistardp.org.br/revista/article/view/392/366
dc.rights.driver.fl_str_mv Copyright (c) 2022 Inês Figueiredo
https://creativecommons.org/licenses/by-nc/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2022 Inês Figueiredo
https://creativecommons.org/licenses/by-nc/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Associação Brasileira de Psiquiatria
publisher.none.fl_str_mv Associação Brasileira de Psiquiatria
dc.source.none.fl_str_mv Debates in Psychiatry; Vol. 12 (2022); 1-17
Debates em Psiquiatria; Vol. 12 (2022); 1-17
Debates em Psiquiatria; v. 12 (2022); 1-17
2763-9037
2236-918X
reponame:Debates em Psiquiatria (Online)
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reponame_str Debates em Psiquiatria (Online)
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