Personality problems and disorders

This chapter deals with the controversial issue of personality disorder, whether these are meaningful diagnoses and, if so, how they affect management. The classification is entirely pragmatic: the definitions and classification in both ICD-10 and DSM-V are outlined along with proposals to abandon categories in favour of a dimensional approach. The issue of treatability is explored, but we conclude that ignoring personality and personality disorders is not a viable alternative for outreach workers. Most of the chapter deals with the management of dissocial personality disorder (usually in men) and borderline personality disorder (usually in women). Specific psychotherapies are not dealt with here; the focus is on how to use team work to manage individuals with severe mental illness and disorders of personality.