Anankastic personality disorder
The content of the article:
- Causes and risk factors
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
Anankastic personality disorder is a mental disorder characterized by hypertrophied insecurity in one's actions and their consequences, pathological scrupulousness, excessive concentration on details, intransigence, pathological perfectionism, recurrent obsessive thoughts, ideas, actions, or a combination thereof.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), anankastic disorder refers to anxiety and panic disorders, sometimes referred to as psychosthenic psychopathy.
Synonym: obsessive-compulsive personality disorder, anankastic personality disorder (obsolete).
Anankastic personality disorder - a disorder characterized by an excessive tendency to doubt
Causes and risk factors
In some patients with personality disorder, changes in the electrical activity of the brain are recorded, which in some cases suggests the presence of pathological foci of arousal as the cause of the development of the disease.
A number of researchers indicate a history of neurological disorders that developed during childbirth or in the prenatal period in patients with personality disorders.
Personality disorder is a condition that is on the border of the definition of "accentuation". If, during accentuation, certain character traits are unnecessarily exacerbated, then with personality disorders they acquire a pathological character.
Under the influence of internal and external maladaptive influences (risk factors) in persons with a predisposition, the hypertrophy of such character traits as anxiety and suspiciousness is transformed into a painful state.
The main risk factors for the development of anankastic personality disorder are:
- hereditary predisposition (about 7%);
- age crisis;
- traumatic situation (including facts of physical or mental violence);
- massive hormonal changes;
- excessive psycho-emotional stress;
- persistent stress; etc.
Anankastic disorder usually debuts at school age with excessive shyness, constant fear of doing something wrong, and is aggravated when the patient begins to live independently, is forced to take responsibility for himself and his family.
Often, anankastic personality disorder accompanies mental illnesses such as autism, manic-depressive psychosis, and schizophrenia.
Symptoms
The spectrum of manifestations of anankastic personality disorder is very significant:
- constant painful doubts about the correctness of the decision made, the actions committed, in their possible unpleasant or wrong outcome;
- pathological perfectionism, manifested by the belief that the result obtained is not good enough or unacceptable due to imperfection. The patient is extremely careful to carry out any business, even an unimportant one, trying to bring everything to an impeccable, from his point of view, result;
- the need to constantly check what has been done;
- preoccupation with minor details when the global perspective is lost, which usually prevents the achievement of the goal of the work being performed;
- extreme conscientiousness, scrupulousness, concern for the correctness of performance, not allowing to feel satisfaction from the work performed;
- inability to fully express feelings of sympathy;
- rigidity, fixation on the need of others to obey the order established by the patient;
- the appearance of obsessions of thoughts, actions, invented signs and rituals, which, however, do not reach a pronounced degree (certain clothes for important occasions, a special route on the day when important events are coming, the need to touch objects in the right sequence "for good luck", etc.); P.);
- the need for planning in the smallest detail;
- lack of spontaneity, inability to emotional outbursts;
- obsessive anxiety about the future of loved ones and their own in the event that it is not possible to foresee a possible danger;
- refusal to share the work performed with anyone due to fears of unfair performance.
Excessive pedantry and a tendency to order is one of the symptoms of anankastic personality disorder
Diagnostics
Diagnostics is based on observation of behavioral features and cannot be correctly carried out until the patient reaches 16-17 years of age due to the age-related accentuation of character traits inherent in adolescence.
The diagnosis is inappropriate if there are separate characterological deviations, compensated and leading to pathological disturbances of behavior in short periods against the background of provoking factors.
Signs of a personality disorder are required for a diagnosis, such as:
- the totality of manifestations under any circumstances;
- the stability of manifestations identified in childhood and persisting throughout life;
- social maladjustment as a result of pathological character traits, regardless of the living environment.
In addition to the symptoms described, the patient must meet at least three of the following diagnostic criteria:
- excessive tendency to doubt and caution;
- concern with details, rules, order;
- perfectionism that prevents the completion of tasks;
- excessive scrupulousness and inadequate concern for productivity at the expense of interpersonal connections;
- increased pedantry and adherence to social conventions;
- stubbornness and unwillingness to change the program of action;
- unreasonable insistence on the exact repetition of the patient's actions in the work or unreasonable unwillingness to allow other people to do something;
- the appearance of persistent thoughts and drives.
Treatment
In the treatment of anankastic disorder, an integrated approach is required (pharmacotherapy, supplemented by psychotherapeutic influence):
- antipsychotic drugs;
- anxiolytics;
- antidepressants;
- group and individual psychotherapy;
- treatment of concomitant vegetative manifestations (sweating, palpitations, headaches, changes in blood pressure, etc.), if necessary;
- art therapy, color therapy and other techniques based on creative activity.
Patients with ananctastic personality disorder need qualified psychiatric help and drug therapy
Possible complications and consequences
The main consequence of anankastic personality disorder is a significant change and / or deviation from generally accepted behavioral norms and trends adopted in a particular social environment, accompanied by personal and social disintegration.
In this case, the formation of certain disorders in actions, thinking and perception of others is noted, which leads to a deterioration in the quality of life of the patient and his immediate environment.
Forecast
As mentioned, anankastic personality disorder usually begins in childhood or adolescence and continues throughout the patient's life. The possibility of social and labor adaptation in this case is individual and depends on the severity of the behavior disorder and external factors.
In most cases, the prognosis is favorable; signs of anankastic personality disorder lend themselves well to correction with an integrated approach. In the presence of residual manifestations, the disease becomes wavy in nature (with periods of remission and destabilization).
Patients can be adapted in favorable conditions for them (compensation) and maladapted in case of unfavorable influences (decompensation). The dynamics of the disease is closely related to age: the periods of puberty and involution are the most dangerous in terms of decompensation.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
