Avoidant personality disorder: Difference between revisions
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==Background== | ==Background== | ||
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation | *A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation | ||
==Clinical Features== | ==Clinical Features== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Anxiety disorders | *Anxiety disorders | ||
*Other personality disorders | *Other personality disorders | ||
*Personality change due to another medical condition | *Personality change due to another medical condition | ||
*Substance use disorders | *Substance use disorders | ||
==Evaluation== | ==Evaluation== | ||
A clinical diagnosis; however if entertaining other organic causes may initiate workup below | *A clinical diagnosis; however if entertaining other organic causes may initiate workup below | ||
{{General ED Psychiatric Workup}} | {{General ED Psychiatric Workup}} | ||
==Management== | ==Management== | ||
Referral for outpatient psychiatric treatment. Various techniques can be employed such as psychotherapy, social skills training, group therapy and exposure therapy to increase social contacts. | *Referral for outpatient psychiatric treatment. Various techniques can be employed such as psychotherapy, social skills training, group therapy and exposure therapy to increase social contacts. | ||
==Disposition== | ==Disposition== | ||
*Discharge | |||
==See Also== | ==See Also== | ||
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==External Links== | ==External Links== | ||
==References== | ==References== | ||
Revision as of 22:33, 21 October 2017
Background
- A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation
Clinical Features
- Four (or more) of the following criteria, beginning by early adulthood and present in a variety of contexts:[1]
- Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
- Is unwilling to get involved with people unless certain of being liked.
- Shows restraint within intimate relationships because of the fear of being shamed or ridiculed. **Is preoccupied with being criticized or rejected in social situations.
- Is inhibited in new interpersonal situations because of feelings of inadequacy.
- Views self as socially inept, personally unappealing, or inferior to others.
- Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
Differential Diagnosis
- Anxiety disorders
- Other personality disorders
- Personality change due to another medical condition
- Substance use disorders
Evaluation
- A clinical diagnosis; however if entertaining other organic causes may initiate workup below
General ED Psychiatric Workup
- Point-of-care glucose
- CBC
- Chem 7
- LFTs
- ECG (for toxicology evaluation)
- ASA level
- Tylenol level
- Urine toxicology screen/Blood toxicology screen
- EtOH
- Urine pregnancy/beta-hCG (if female of childbearing age)
- Consider:
- Ammonia (see Hepatic encephalopathy)
- TSH (hypo or hyperthyroidism may mimic mental illness)
- CXR (for Tb screen or rule-out delirium in older patient)
- UA (for rule-out delirium in older patients)
- Head CT (to rule-out ICH in patients with AMS)
- Lumbar puncture (to rule-out meningitis or encephalitis)
Management
- Referral for outpatient psychiatric treatment. Various techniques can be employed such as psychotherapy, social skills training, group therapy and exposure therapy to increase social contacts.
Disposition
- Discharge
See Also
External Links
References
- ↑ American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.