Personality Disorders and Schizophrenia Spectrum and Other Psychotic Disorders

Personality Disorders and Schizophrenia Spectrum and Other Psychotic Disorders

Research into personality disorders and psychotic disorders has found links between the two and substance use. This is in addition to substance use disorders, with a particular association with the onset of psychotic disorders such as schizophrenia with increased use of substances such as cannabis (Khan & Akella, 2009).Other forms of research have also found a link between personality disorders and substance use disorders, indicating that 50.7 percent of individuals with personality disorders as having substance use disorder (Substance Abuse and Mental Health Services Administration, 2014). The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides criteria for their identification. Important, however, is the fact that there are treatment interventions for these disorders. This paper will look at some of the disorders, their relationship with one another, and the DSM diagnosis as well as treatment interventions for individuals with personality and substance use disorders.

In their description, personality disorders are a cluster of mental illnesses whose characterization involves inflexible and unhealthy thought processes and behavior (Substance Abuse and Mental Health Services Administration, 2014). These mental illnesses are usually complex and serious, with thepossibility of misunderstanding and misdiagnosis of the individuals with the personality disorders. Among the most common personality disorders include borderline personality disorder, paranoid personality disorder and schizoid personality disorder among others.

The DSM provides the criteria for the description of both personality and psychotic disorders. The characterization of the disorders includes ingrained behavioral patterns, which do not concur with the expected behavior within the individual’s culture (Substance Abuse and Mental Health Services Administration, 2014). DSM additionally characterizes personality disorders as behavioral patterns that are inflexible, pervasive and incapable of changing. Further, the individuals have no sense of awareness of their behaviors’ as problematic or deviant from societal expectations.

From this characterization by the DSM, it is easy to see why mood swings, psychotic episodes impulsive action and tendency to harm oneself that describe borderline personality disorder fall within DSM diagnosis of personality and psychotic disorders. Paranoid personality disorder, on the other hand,is characterized by alack of trust in other people, constant suspicion and reading of threats and danger in normal routine (Kienast & Forester, 2008). Individuals with schizoid personality disorder, on the other hand, prefer to stay alone, getlittle pleasure in life and are not interested in establishing close relationships with other people.

For psychotic disorders, particularly schizophrenia spectrum, DSM describe it as a combination of signs and symptoms present within an individual for more than a month and largely associated with significant social/occupational dysfunction (Short et al., 2012). Delusional disorder is yet another type of psychotic disorder. This is characterized by false beliefs that involve real-life situations such as someone following the patient or people conspiring against the patient. Other forms of delusion are substance-induced and are as a result of use or withdrawal from use of substances such as cocaine or heroin.

Most personality disorders manifest in adolescent or early adulthood. In their manifestation, however, they present a problem especially in the use of drugs and other substances. According to Substance Abuse and Mental Health Services Administration (2014), most individuals with personality disorders have a higher risk of developing substance use disorders. From the research, 50.7 percent of individuals with personality disorders, particularly borderline personality disorder, had higher chances of getting a substance use disorder diagnosis (Substance Abuse and Mental Health Services Administration, 2014). A close link is however also present between schizophrenia and personality disorders, especially paranoid in that both patients usually experience voices in their heads. Often, the development of the two is because of childhood trauma: specifically emotional abuse from friends, parents, teachers or guardians.

The treatment of clients with substance use issue usually involves the enlistment of a counselor or therapist. It is also possible to enlist the services of an outpatient treatment program for such clients (Substance Abuse and Mental Health Services Administration, 2014). The presence of a personality disorder, however, complicates such treatment intervention. For clients with a combination of substance issue and personality disorder, a team approach may be necessary. This team may include an individual therapist, substance abuse counselor, a psychiatrist and a primary healthcare provider (Substance Abuse and Mental Health Services Administration, 2014). Important is the fact that the intervention should involve a planned and coordinated management of all the providers for success. Important is regular coordination and consultation among all the providers as a way of ensuring that all involved work towards the achievement of the same goals from each of the team member’s professional perspective. The intervention would, therefore, involve not only counseling and therapy sessions, but also an assessment of the progress of the client in relation to medication and where necessary, changing the medication.

There is a strong link between psychotic disorders and substance use disorders. This link extends to personality disorders. There are a number of personality disorders, which include borderline, paranoid, and schizoid. Each of these disorders has distinguishing characteristics.Although the treatment intervention for substance use disorders may only involve a substance counselor, a combination of substance use and personality disorder requires an interdisciplinary team effort for success. Such a team effort guarantees the success of the intervention with higher chances of quick recovery of the patients.



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Kienast, T., & Forester, J. (2008). Psychotherapy of personality disorders and concomitant substance dependence. Current
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SAMHSA. (2014). An introduction to co-occurring borderline personality disorder and substance use disorders. In Brief, 8(3), 1-9

Short, V. et al. (2012). Mental Illness, Personality Disorder, and Violence: A Scoping Review. Manchester: Offender health Research Network