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Dragan M. Svrakic ; Medicinski fakultet Sveučilišta u Washingtonu, odjel psihijatrije, St Louis, MO, USA
Robert C. Cloninger ; Medicinski centar, St Louis, MO, USA

Puni tekst: engleski pdf 260 Kb

str. 153-166

preuzimanja: 3.052



After 30 years of clinicxal work and research based on categorical criteria for personality disorders (Diagnostic and Statistical manual of Mental Disorders - DSM IV TR) and (International Classification of Diseases - ICD 10th revision), a solid conceptual understanding and tratment of these disorders have not been established. For the field of move forward, it is imperative that future classification introduce major revisions of the concept, diagnostic, and classification of personality disorders. This paper proposes one such revision.
Based on recent advances in molecular biology and epigenetics, we define personality disorders and maladaptice syndromes developed through person-environment interaction. We conceptualitze maladaptationas a faliure of integrative functions of personality (i.e., those that carry out adaptive processes) caudes by strong biogenetic dispositions r by pathological environmentaleffects, or both. Hence, accurate diagnostic of personality depends upon neurobiological (innate) and adaptive (interactive)etiological factors. We propose a 2-step diagnostic algorithm for personality disorders: adaptive processes (i.e., character) are used to diagnose maladaptation, whereas biological aspects (i.e., temperament are used to specify dominant clinical presentation and for differential diagnostics. We suggest that the term "Personality Disorder" be replaced by a more appropriate term "Adaptation Disorder" as the letter reflects mor accurately the real nature of the disorder and distributes the causality of maladaptive syndromes more evenly, between the peron and the environment.
Diagnostic, research, and treatment advantages of the proposed solution are discussed in some detail.

Ključne riječi

epigenetics; psychiatric classification; diagnostis; personality disorders; adaptation

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