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Symptoms and Signs
The DSM-IV states that the essential feature of this disorder is "pervasive and excessive emotionality and
Patients with histrionic personality disorder experience reactive dysphoria in the face of loss or rejection as well as difficulty with linear, analytic thought, although they are often creative and
Patients are impressionable, suggestible, and intuitive; ie, they "play hunches" instead of thinking decisions through
They draw attention to themselves by their dramatic, lively, and at times seductive social behavior. There is a tendency toward somatization, with dramatic and shifting presentations of histreonic, histronic
Differential Diagnosis
Histrionic personality disorder must be differentiated from somatization disorder, borderline personality disorder, and narcissistic personality disorder. These three disorders may coexist in some combination with histrionic personality disorder, in which case all relevant diagnoses may be assigned.
Epidemiology
The prevalence has been estimated to be 10% to 15% of psychiatric outpatient and inpatient populations.
Etiology & Pathogenesis
The causes of histrionic personality disorder are mainly psychological; in better-functioning patients, these are typically unresolved oedipal
The more immature, dependent (so-called oral) hysteric has a history of disturbance early in life in attachments and
Treatment
Long-term psychoanalytic psychotherapy is the treatment of choice and should focus on developing the patient's insight into the reasons for repetitive difficulties in sustaining love relationships and on
The therapist should also help the patient think more clearly and systematically, so that information processing and decision making are not distorted by vagueness or failure to attend to
For people with histrionic personalities, self-esteem is heavily centered in perception of their body image, with physical prowess and attractiveness being prized attributes. Men with histrionic personality disorder may, when physically ill, display
Such counterphobic behavior may worsen the course of illness. Such men may act in an overtly seductive fashion toward female physicians and other members of the