Personality disorders in late life

Abstract

Personality is dynamic and continues to evolve throughout the lifespan. Various methods have been developed to approach this complex entity, yet none is able to perfectly capture the phenomenon. Adding to this classification challenge is the fact that personality disorders have not been studied extensively among older populations, yet they can be associated with significant impairment in physical, emotional, and social functioning in later life. There is also a correlation with higher risk of depressive disorders, suicide, major neurocognitive disorder, and social isolation among older patients with personality disorders. Besides sometimes choosing a model that is a combination of various classifications, the most crucial elements in the diagnostic process of personality disorders are psychiatric history and biographical items; therefore, as people get older, more time should be allocated to those sections during the clinical interview. Treatment approaches (including psychotherapy and pharmacotherapy) are similar to evidence-based interventions for younger populations, but should take into account functional limitations and systemic medical conditions.