Personality Disorders- Differential Diagnosis

(1) Cluster A Personality Disorders- Differential Diagnosis

1. Paranoid Personality Disorder

Paranoid Personality Disorder Delusional disorder and Schizophrenia
Reality testing intact Reality testing lost

 

Paranoid Personality Disorder Schizoid and Avoidant personality disorder
  Amount and Degree of paranoia is significantly less

2. Schizoid Personality Disorder

Schizoid Personality Disorder Schizophrenia
1. Reality testing intact Reality testing not intact
Abstracting ability normal Abstracting ability impaired
Presence of formal thought process formal thought process impaired

 

Schizoid Personality Disorder Paranoid Personality Disorder
Less socially oriented ideations More socially oriented ideations
Amount and Degree of paranoia is significantly less  

 

Schizoid Personality Disorder Obsessive Compulsive & Avoidant Personality Disorder
  often socially isolated, but view loneliness as ego-dystonic or ego-alien and they enjoy a richer interpersonal history

3. Schizotypal Personality Disorder

Schizotypal Personality Disorder Paranoid & Schizoid Personality Disorder
Share many core features; but differs by degree or absence of eccentricity

 

Schizotypal Personality Disorder Borderline Personality Disorder
Share unusual speech & perceptual style; but demonstrates stronger affect & connection to others

 

Schizotypal Personality Disorder Avoidant Personality Disorder
Also uncomfortable & inept in social situations; but are not eccentric & crave for contact with others.

 

Schizotypal Personality Disorder Schizophrenia
  1) Reality testing lost. 2) Psychosis present
 

(2) Cluster B Personality Disorders- Differential Diagnosis

1. Antisocial Personality Disorder

Antisocial Personality Disorder Borderline Personality Disorder
demonstrate more repetitive suicidal and parasuicidal behaviors, as well as intense affect and self-loathing

 

Antisocial Personality Disorder Narcissistic Personality Disorder
Blue collar crime (primary motivation is short-term material gain) White collar crime (primary motivation is to maintain their grandiose self-image- power and money)

 

Antisocial Personality Disorder Bipolar Mania
often lack a significant degree of childhood conduct problems, & antisocial behavior is usually limited to manic episodes

 

Antisocial Personality Disorder Substance abuse disorder
criminal behaviors associated with substance abuse disorders generally center around using and obtaining the drugs

2. Borderline Personality Disorder

Histrionic, Narcissistic, & Dependent Personality Disorder Borderline Personality Disorder
more stable identities & rarely engage in self-mutilation or chronic suicidal behaviors

 

Borderline Personality Disorder Bipolar Spectrum Disorder
mood swings does not meet criteria for manic or hypomanic episodes mood swings meet criteria for manic or hypomanic episodes

3. Histrionic Personality Disorder

Histrionic Personality Disorder Narcissistic Personality Disorder
is more outwardly emotional and deeply involved with others lack empathy for others ; and more preoccupied with grandiosity and envy

 

Histrionic Personality Disorder Dependent Personality Disorder
Both shares the need for acceptance and reassurance; DPD lacks the degree of emotionality seen in histrionic individuals

 

Histrionic Personality Disorder Dependent Personality Disorder
Both shares the need for acceptance and reassurance; DPD lacks the degree of emotionality seen in histrionic individuals

 

Histrionic Personality Disorder Somatization disorder
greater emphasis on physical complaints

4. Narcissistic Personality Disorder

Histrionic Personality Disorder Narcissistic Personality Disorder
is more outwardly emotional and deeply involved with others lack empathy for others ; and more preoccupied with grandiosity and envy

 

Antisocial Personality Disorder Narcissistic Personality Disorder
Blue collar crime (primary motivation is short-term material gain) White collar crime (primary motivation is to maintain their grandiose self-image- power and money)

 

(3) Cluster C Personality Disorders- Differential Diagnosis

 

1. Avoidant Personality Disorder

Avoidant Personality Disorder Schizoid Personality Disorder
Desire relationships with others Do not desire relationships with others

 

Avoidant Personality Disorder Dependent Personality Disorder
  greater fear of abandonment, and embraces, rather than avoids, relationships

 

Avoidant Personality Disorder Social phobia
  more specific fears around social performances

2. Dependent Personality Disorder

Dependent Personality Disorder Histrionic Personality Disorder
Both shares the need for acceptance and reassurance; DPD lacks the degree of emotionality seen in histrionic individuals have issues of dependency, but shorter and more numerous relationships

 

Dependent Personality Disorder Borderline Personality Disorder
become more placating around real or perceived abandonment express more affect and anger around real or perceived abandonment

 

Dependent Personality Disorder Avoidant Personality Disorder
When faced with rejection or termination of a relationship, they quickly seek out a new relationship to fill the void When faced with rejection or termination of a relationship, they withdraw from further contact

 

Dependent Personality Disorder Agorophobia
  higher level of fear around leaving specific safe environments, especially home

3. Obsessive-Compulsive Personality Disorder

Obsessive-Compulsive Personality Disorder (OCPD) obsessive-compulsive disorder (OCD)
have true obsessions and compulsions that they find ego-dystonic find that their behaviors are ego-syntonic and rewarded by others

Please do post your questions or comments below. 


Dr. Harvinder Singh, M.D. (Admin)


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