This page has moved. Click here to view.
Histrionic Personality Disorder
DSM-IV Diagnostic Criteria
A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood, as indicated by five or more of the following:
- The patient is not comfortable unless he is the center of attention.
- The patient is often inappropriately sexually seductive or provocative with others.
- The patient displays rapidly shifting and shallow expression of emotions.
- The patient consistently uses physical appearance to attract attention.
- Speech is excessively impressionistic and lacking in detail.
- Dramatic, theatrical and exaggerated expression of emotion is used.
- The patient is easily influenced by others or by circumstances.
- Relationships are considered to be more intimate than they are in reality.
Clinical Features of Histrionic Personality Disorder
- The patient is bored with routine, and dislikes delays in gratification.
- The patient begins projects, but does not finish them (including relationships).
- Dramatic emotional "performances" appear to lack sincerity
- The patient attempts to control relationships with seduction, manipulation, or dependency.
- The patient may resort to suicidal gestures and threats to get attention.
Epidemiology of Histrionic Personality Disorder
- Histrionic Personality Disorder is much more common in women than men.
- These patients have higher rates of depression, somatization and conversion.
Differential Diagnosis
Borderline Personality Disorder
- Patients with Borderline Personality can also be sensation-seeking, impulsive, superficially charming and manipulative.
- Histrionic patients lack identity disturbance, transient psychosis and dissociation seen in Borderline patients.
- Some patients meet criteria for both diagnoses.
Histronic Personality Disorder
- Antisocial patients are also sensation-seeking, impulsive, superficially charming and manipulative.
- Histrionic patients are dramatic and theatrical but typically lack histories of antisocial behavior.
Narcissistic Personality Disorder
- Narcissists also seek constant attention, but it must be positive in order to confirm grandiosity and superiority.
- Histrionics are less selective and will appear weak and dependent to get attention.
Personality Change Due to a General Medical Condition and Substance-Related Disorder: Acute symptoms are temporally related to medication, drugs or a medical condition.
Treatment
- Insight-oriented psychotherapy is the treatment of choice.
- Keeping them in therapy can be challenging since these patients dislike routine.
- Use antidepressants if criteria for Major Depres