Issues regarding the proposed DSM-5 personality disorders in geriatric psychology and psychiatry

Abstract

The official introduction of the psychiatric diagnosis of personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) began in 1952 with the publication of the first edition (American Psychiatric Association, 1952). DSM-I contained 12 main types of PDs with a total description for all types in only two paragraphs. In the following DSM-II (American Psychiatric Association, 1968), just 10 specific types of PDs were described, including a very brief general definition of PDs. The DSM-III (American Psychiatric Association, 1980) included a significant paradigm shift from the medical model by incorporating the design of a multi-axial approach, in which the combinations of symptoms of more than five primary axes were used to describe the pathological state and formulate the diagnosis. Notably, the PDs were placed on a separate axis (Axis II) to distinguish their long-standing nature from the more episodic clinical disorders placed on Axis I. PDs were recognized as important formal diagnoses and included a more comprehensive listing of polythetic diagnostic criteria for each specific PD.

Screening, detection and management of delirium in the emergency department – a pilot study on the feasibility of a new algorithm for use in older emergency department patients: the modified Confusion Assessment Method for the Emergency Department (mCAM-ED)

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“…The most commonly identified consequences of multimorbidity include functional impairment and disability, poor quality of life, increased risk of early death (although findings are inconsistent), high health-care utilization, high out-of-pocket costs and the significant burden placed on patients and their families (France et al 2012; Marengoni et al 2011). In terms of risk factors, long-term care residents are at high risk for mental–physical multimorbidity (van den Brink et al 2012). Certain combinations of chronic conditions (e.g., chronic respiratory disease, congestive heart failure and diabetes) present a greater risk for physical decline than other combinations; however, there is inconsistent evidence of the impact of patients' income, sex, age and ethnicity on multimorbidity (France et al 2012).…”

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