Personality Disorders as a Psychiatric Emergency

Abstract

A personality disorder is defined in psychiatric terms as a long-term pervasive pattern of maladaptive behaviors that have reached a degree of severity that they interfere with normal functioning. In contrast to, for example, an acute depressive episode where a patient has a discrete period of mood symptoms, patients with either a full-blown personality disorder or maladaptive personality traits have sometimes life-long patterns of thought and behavior that interfere with their ability to work and form relationships. While patients with paranoid, schizotypal, avoidant, obsessional, or schizoid traits may present to the ED for various reasons, borderline, narcissistic, and antisocial patients are by far the most frequent source of ED presentations and also cause the most distress for providers and families. It is usually not possible to diagnose someone with a personality disorder based on one brief encounter in the ED, but recognizing patterns of behavior and gathering longitudinal history can be helpful in informing disposition and treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved)