The relevance of a geriatric sub‐classification of personality disorders in the DSM‐V

Abstract

Little is known about the course of personality disorders across the life span. A major problem is that the current DSM nosology for personality disorders does not account for age-associated changes in behaviour and interpersonal functioning. This editorial will discuss the main diagnostic bottlenecks when applying the current DSM-IV-TR Axis II criteria to older adults. Subsequently, suggestions will be given for future research and the development of a geriatric sub-classification.

Personality Traits and Personality Disorders in Late Middle and Old Age: Do They Remain Stable? A Literature Review

“…To improve the construct and criterion validity of (maladaptive) personality traits in old age, age-neutral criteria, defining a geriatric subclassification or the designation of gero-cut-off points in a dimensional approach, could be very useful (Agronin & Maletta, 2000;Van Alphen, Engelen, Kuin, & Derksen, 2006). Identifying personality disorders in old age is of relevance, because the prognosis of a psychiatric disorder is generally worse when comorbid personality pathology is present and there is a greater likelihood of recidivism and noncompliance with treatment (Segal, Coolidge, & Rosowsky, 2006).…”

Personality disorders in older adults: diagnosis and management

“…25 It is thought that the development of future editions of diagnostic criteria, which give adequate consideration to the evolution of personality disorders with age, and take into account the changes in behaviour and interpersonal functioning, would aid with these diagnostic difficulties. 23,26,27 The diagnostic criteria may actually contain this bias to such an extent as to make them wholly inadequate for the older adult cohort. 28 Furthermore, a shift away from categorical classifications and towards more dimensional measures may help, especially when the context of later life is specifically considered.…”

De psychometrische eigenschappen van de Hetero-Anamnestische Persoonlijkheidsvragenlijst (HAP) bij ouderen in de ggz en het verpleeghuis

“…Dat hangt samen met de erkenning van het belang van persoonlijkheidsonderzoek in de geestelijke gezondheidszorg. De uitkomsten van persoonlijkheidsdiagnostiek dragen bij aan de keuze van de behandeling en aan de bepaling van de strategie van interventies bij de oudere patiënt, diens familie en zorgverleners (Segal, Coolidge, & Rosowsky, 2006;Van Alphen, Engelen, Kuin, & Derksen, 2006). Het aantal instrumenten voor persoonlijkheidsonderzoek bij ouderen is echter nog beperkt (Oltmanns & Balsis, 2011).…”