Personality—Behavioral Disorder

A triad of major clinical finding characterizes disease abnonnal involuntai y movements, personality/behavioral disorders, and cognitive deteiioration. 

K. E. Appel and E. A. Strecker. Practical Examination of Personality and Behavior Disorders. New York Macmillan, 1936. 

Mood Stabilizers. Lithium (Eskalith, Lithobid), valproic acid (Depakene), sodium valproate (Depakote), and carbamazepine (Tegretol) are most often used by psychiatrists to treat the bipolar disorders. These so-called mood stabilizers are also used to treat impulsivity and agitation in a variety of psychiatric disorders including dementia, certain personality disorders, and the disruptive behavior disorders of childhood. 

Feelings of isolation were common among interviewees at both historically black colleges and universities and historically white colleges and universities. In instances where the chemists were the only persons of color in the department or perhaps the first ones ever appointed to a faculty position in chemistry, many became discouraged and sometimes very depressed. Benjamin (1991) posits that the social isolation faced by many upwardly mobile African Americans often leads to stress, which can manifest itself in physiological disorders, such as hypertension, behavioral disorders, and even suicide. One Cohort V interviewee offered the following comments ... 

Personality and behavioral disorders due to brain disease, damage, and dysfunction... 

Unless they come into contact with something or someone and are awakened, people with REM behavior disorder are unaware that they are acting out their dreams. For those who only act out part of their dream, there is no telling which part will just be kept inside the person s head and which will be acted out. Interestingly, most people who suffer from RED are generally calm and friendly during the day and do not appear to have violent tendencies. 

As mentioned in Chapter 2, another side effect of these newer types of antidepressants is that they can cause people to show signs of REM behavior disorder, which is characterized by periodic moments of acting out dreams. Rather than having the person stop taking the antidepressant altogether to avoid this, many times a doctor will prescribe a benzodiazepine such as clonazepam (Klonopin) that helps to suppress the REM behavior disorder symptoms. 

The most important problem encountered with amphetamines is abuse and the development of dependence. The most rapid amfetamine epidemic occurred in Japan after World War II, where there had been little or no previous abuse (83). Although a high proportion of amfetamine users probably already have emotional and social difficulties, sustained abuse can result in serious psychiatric complications, ranging from severe personality disorders to chronic psychoses (84,85). Whereas signs of intense physical dependence are not thought to occur (SED-9, 9), withdrawal may be associated with intense depression (SED-9, 9) (86), and relapses in psychiatric disorders have often been noted. Some countries in which the problem became widespread banned amphetamines, and Australia restricted their use to narcolepsy and behavioral disorders in children. Amfetamine dependence developed into a serious problem in the USA (and to a lesser extent in the UK), where it followed the typical pattern of drug dependence (SED-9, 7,10). 

Thomas S. Szasz, The Psychiatric Classification of Behavior A Strategy of Personal Constraint, in Leonard D. Eron (Ed.), The Classification of Behavior Disorders, pp. 123-170. 

Anxiety disorders and insomnia represent relatively common medical problems within the general population. These problems typically recur over a person s lifetime (3,4). Epidemiological studies in the United States indicate that the lifetime prevalence for significant anxiety disorders is about 15%. Anxiety disorders are serious medical problems affecting not only quaUty of life, but additionally may indirecdy result in considerable morbidity owing to association with depression, cardiovascular disease, suicidal behavior, and substance-related disorders. 

Interpersonal therapy and cognitive behavioral therapy are types of psychotherapy that have well-documented efficacy for the treatment of MDD. Psychotherapy alone is an initial treatment option for mild to moderate cases of depression, and it may be useful when combined with pharmacotherapy in the treatment of more severe cases of depression. In fact, the combination of psychotherapy and pharmacotherapy can be more effective than either treatment modality alone in cases of severe or recurrent MDD. Psychotherapy can be especially helpful for patients with significant psychosocial stressors, interpersonal difficulties, or comorbid personality disorders.16... 

Patients with bipolar disorder have a high risk of suicide. Factors that increase that risk are early age at disease onset, high number of depressive episodes, comorbid alcohol abuse, personal history of antidepressant-induced mania, and family history of suicidal behavior.15 In those with bipolar disorder, 1 of 5 suicide attempts are lethal, in contrast to 1 of 10 to 1 of 20 in the general population. 

Personality disorders are inflexible and maladaptive patterns of behavior that deviate markedly from expectations of society. These patterns are stable over time, pervasive and rigid, and lead to distress or impairment in the individual s life. Onset is in adolescence or early adulthood.1 Personality disorders and bipolar disorder may be comorbid, and patients with personality disorders may have mood symptoms. The two diagnoses are distinguished, however, by the predominance of mood symptoms and the episodic course of bipolar disorder, in contrast to the stability and persistence of the behavioral patterns of personality disorders. 

The term alcoholism as a disease entity was coined by the Swedish physician, Magnus Huss, in the mid-19th century to describe the harmful physical and mental effects of chronic excessive alcohol consumption. This strictly medical model held sway for almost a century before it became apparent that a variety of psychosocial factors also influence the onset and course of the disorder. Indeed, drinking behavior and the problems attributable to excessive drinking, including alcoholism, vary widely within and across different cultures and population groups, and even within the same person across the fife span. In the last 30 years, basic and... 

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