Clinical Guide to the Diagnosis and Treatment of Mental Disorders

Two key challenges face mental health practitioners: making the correct psychiatric diagnosis and choosing the most appropriate treatment option. This book aims to help with both. Clinical Guide to the Diagnosis and Treatment of Mental Disorders - Second Edition combines clinically-relevant information about each of theDSM-IV-TR diagnoses with clear, detailed information on treatment options, giving full clinical management advice. Once again, the editors, both leading psychiatrists, have condensed the chapters on Disorders from Tasman et al’s acclaimed two volume textbook of Psychiatry (now in its Third Edition), retaining only the content they deem particularly relevant to the clinician for ease of use. Each disorder is discussed under the headings of Diagnosis (including Assessment Issues, Comorbidity, Course, and Differential Diagnosis, giving diagnostic decision trees where relevant) and Treatment (listing all therapeutic options, giving practical advice for patient management, summarising treatment specifics with tables and treatment flowcharts). The original edition established itself as the first point of reference for any clinician or mental health practitioner needing expert advice on therapeutic options for any psychiatric disorder. This edition features an additional chapter on the psychiatric interview and assessment of mental status to increase its utility. It echoes the progress in psychiatry regarding the establishment of an evidenced-based model of taxonomy, diagnosis, etiology, and treatment. Indeed, from a psychologist's perspective, the equal consideration provided to empirically supported psychosocial treatments versus somatic treatment is a significant development in the field of psychiatry. (Jonathan Weinand in PsycCritiques, the American Psychological Association Review of Books) Michael B First,  Professor of Clinical Psychiatry at Columbia University and the Psychiatric Institute of New York. He is an expert on the DSM-IV-TR classification and is playing a key role in the development of DSM-V.      Allan Tasman,  Professor and Chairman of the Department of Psychiatry and Behavioral Sciences at the University of Louisville School of Medicine, Kentucky, USA. Professor Tasman is Past President of the American Psychiatric Association and President of the Pacific Rim College of Psychiatrists. He is a world-renowned psychiatric leader and educator and is Secretary for Education of the World Psychiatric Association, responsible for all of the association’s worldwide education programmes and initiatives.  CONTENTS Preface Chapter 1 The Psychiatric Interview Goals of the psychiatric interview The psychiatric database Database components Identifying data Chief complaint History of the present illness Past psychiatric history Past medical history Family history Personal history Mental status examination Conduct of the interview General features of psychiatric interviews Setting Verbal communication Nonverbal communication  Listening and observation Attitude and behavior of the interviewer Structure of the interview Chapter 2 Childhood Disorders: Intellectual Disability Concept of intellectual disability Prevalence of intellectual disability Comorbidity patterns Approaches to classification of the causation of intellectual disability  Elements of biomedical assessment First stage work-up History Physical examination Diagnostic studies Prenatal diagnosis Differential diagnosis of intellectual disability Course and natural history of intellectual disability Habilitation and treatment approaches to intellectual disability Overall goals of treatment of persons with intellectual disability Overall principles of treatment of persons with intellectual disability Normalization principle Right to community living  Employment of adults in the community according to their abilities Use of normal community services and facilities  Advocacy and appropriate protective measures  Prevention of intellectual disability  Primary prevention  Secondary prevention Tertiary prevention Prevention of psychosocial dysfunction Mental disorders in persons with intellectual disability Behavior disorders Special issues in the psychiatric assessment of persons with intellectual disability Forensic and legal issues in intellectual disability Noncriminal forensic issues Guardianship Parental competency in child protection cases Overall goals of psychiatric treatment of persons with intellectual disability Principles of pharmacological interventions in persons with intellectual disability  Psychosocial interventions  Programmatic and educational approaches Psychotherapies  Comparison of DSM-IV/ICD-10 diagnostic criteria Chapter 3 Childhood Disorders: Learning and Motor Skills Disorders Diagnosis DSM-IV-TR criteria Educational criteria The educational curriculum and diagnosis Differential diagnosis Evaluation of the child or adolescent Family evaluation Environmental and cultural assessment Epidemiology  Comorbidity patterns Social problems Treatment Educational interventions Educational interventions for developmental coordination disorders Psychotherapeutic interventions  Education of the individual and family Individual therapy Family therapy Social skills training Use of medications Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 4 Childhood Disorders: Communication Disorders Expressive and mixed expressive–receptive language disorders Diagnosis Treatment Phonological disorder Diagnosis Treatment Stuttering viii Contents Diagnosis Treatment Communication disorder not otherwise specified Comparison of DSM-IV/ICD-10 diagnostic criteria Chapter 5 Childhood Disorders: The Pervasive Developmental Disorders Autistic disorder Diagnosis Treatment Asperger’s disorder Diagnosis Treatment Childhood disintegrative disorder Diagnosis Treatment Rett’s Disorder Diagnosis Treatment Pervasive developmental disorder not otherwise specified Diagnosis Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 6 Childhood Disorders: Attention-Deficit and Disruptive Behavior Disorders Diagnosis Definition and diagnostic/clinical features Associated features and impairment Assessment Epidemiology Comorbidity patterns Course Differential diagnosis Treatment Treatment goals Somatic treatments Psychosocial treatments Comparing response to medication, psychosocial, and combination treatments Treatment algorithms and practice guidelines Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 7 Childhood Disorders: Feeding and Related Disorders of Infancy or Early Childhood Feeding disorder of infancy or early childhood Diagnosis Treatment Rumination Disorder Diagnosis Treatment Pica Diagnosis Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Contents ix Chapter 8 Childhood Disorders: Tic Disorders Diagnosis Diagnostic assessment  Course Comorbidity Differential diagnosis Treatment Psychoeducation Treatment of co-occurring disorders The suppression strategies Clinically complex patients Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 9 Childhood Disorders: Elimination Disorders and Childhood Anxiety Disorders Enuresis Definition Course and natural history Differential diagnosis Assessment Treatment Assessment and management of diurnal enuresis  Encopresis Definition Course and natural history Epidemiology Differential diagnosis Comorbidity Treatment Separation anxiety disorder Definition Natural history and course Diagnosis and differential diagnosis Treatment Selective mutism Definition Epidemiology Assessment  Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 10 Stereotypic Movement Disorder and Reactive Attachment Disorder 9 Stereotypic movement disorder Diagnosis  Treatment Reactive attachment disorder Diagnosis Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 11 Delirium, Dementia, and Other Cognitive Disorders Delirium Diagnosis x Contents Course Differential diagnosis Delirium due to a general medical condition Medication-induced delirium Substance intoxication delirium Substance withdrawal delirium  Delirium due to multiple etiologies Treatment Dementia Diagnosis Mental status examination Physical and neurological examinations in dementia Associated features Course Differential diagnosis Treatment Dementia of the Alzheimer’s Type (DAT) Diagnosis Laboratory and radiological findings Treatment Vascular Dementia Treatment Dementia due to other medical conditions Dementia due to HIV disease Dementia due to Pick’s disease Dementia due to Parkinson’s disease Dementia due to Huntington’s disease Subacute sclerosing panencephalitis Creutzfeldt–Jakob disease Neurosyphilis Dementia due to head trauma Normal-pressure hydrocephalus Wilson’s disease Other medical conditions Substance-induced persisting dementia  Diagnosis Treatment Dementia due to multiple etiologies Amnestic disorders Diagnosis Differential diagnosis Selected amnestic disorders  Treatment 1 Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 12 Mental Disorders Due to a General Medical Condition Psychotic disorder due to a general medical condition Diagnosis Treatment Mood disorder due to a general medical condition with depressive features Diagnosis Treatment Contents Mood disorder due to a general medical condition with manic features Diagnosis Treatment Anxiety disorder due to a general medical condition with panic attacks or with generalized anxiety Diagnosis Treatment Anxiety disorder due to a general medical condition with obsessive–compulsive symptoms Diagnosis Treatment Catatonic disorder due to a general medical condition Diagnosis Differential diagnosis Personality change due to a general medical condition Diagnosis Differential diagnosis Treatment Mental disorder not otherwise specified due to a general medical condition Comparison of DSM-IV-TR/ICD-10 diagnostic criteria  Chapter 13 General Approaches to Substance and Polydrug Use Disorders  Substance dependence and abuse Substance intoxication Substance withdrawal Diagnosis and assessment Phenomenology and variations in presentation Special issues in the psychiatric examination Physical examination and laboratory findings Differential diagnosis Comorbidity patterns Course and natural history Treatment Goals of treatment Pharmacotherapy Psychosocial treatments Treatment of psychiatric comorbidity Treatment-refractory patients Other substance use disorders: anabolic steroids and nitrites Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 14 Substance-Related Disorders: Alcohol Alcohol dependence and abuse Alcohol intoxication Alcohol withdrawal Alcohol-induced persisting amnestic disorder Alcohol-induced persisting dementia Alcohol-induced mood disorder Alcohol-induced anxiety disorder Alcohol-induced psychotic disorder Alcohol-induced sleep disorder Alcohol-induced sexual dysfunction xii Contents Assessment of alcohol use disorders Screening Psychiatric history and examination Relevant physical examination and laboratory findings Epidemiology Psychiatric comorbidity Course Treatment Treatment goals The management of alcohol withdrawal Therapeutic modalities: nonpharmacological Therapeutic modalities: pharmacological Alcoholics anonymous (AA) and mutual help organizations Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 15 Substance-Related Disorders: Amphetamine Diagnosis Amphetamine dependenc Amphetamine abuse Amphetamine intoxication Amphetamine withdrawal Epidemiology Patterns and routes of use Medical complications Treatment Treatment of ATS intoxication Treatment of ATS withdrawal Psychosocial treatments for ATS dependence Pharmacotherapy for ATS dependence Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 16 Substance-Related Disorders: Caffeine Caffeine intoxication Diagnosis Assessment Epidemiology Comorbidity patterns Course Differential diagnosis Treatment Caffeine withdrawal Diagnosis Assessment Comorbidity patterns Course Differential diagnosis Treatment Caffeine dependence Diagnosis Assessment Course Differential diagnosis Contents xiii Treatment Caffeine-induced anxiety disorder Diagnosis Treatment Caffeine-induced sleep disorder Diagnosis Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 17 Substance-Related Disorders: Cannabis Cannabis intoxication Cannabis abuse Cannabis dependence Cannabis Intoxication Delirium Cannabis-induced psychotic disorder Cannabis-Induced Anxiety Disorder Treatment Psychotherapy Pharmacotherapy Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 18 Substance-Related Disorders: Cocaine Epidemiology Natural history of use Diagnosis Cocaine abuse Cocaine dependence Cocaine intoxication Cocaine withdrawal Other cocaine-induced disorders Medical complications Course Treatment Psychosocial treatments Clinician–patient relationship considerations Pharmacotherapy Common problems in management Relapse to cocaine use Diagnosis of other mental disorders Comorbid substance use disorders Premature treatment termination Treatment refractoriness Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 19 Substance-Related Disorders: Hallucinogens and MDMA Hallucinogen intoxication Diagnosis Assessment Differential diagnosis Epidemiology Comorbidity patterns Course xiv Contents Psychosocial factors Treatment Hallucinogen abuse Diagnosis Assessment Epidemiology Comorbidity Course Differential diagnosis Treatment LSD-related psychotic disorders Diagnosis Assessment Epidemiology Comorbidity patterns Course Differential diagnosis Treatment Hallucinogen persisting perception disorder (HPPD) Diagnosis Epidemiology Comorbidity patterns Course Differential diagnosis Treatment MDMA (“Ecstasy”)-related disorders Diagnosis Comorbidity patterns Course Differential diagnosis Acute positive psychological effects Acute adverse psychological effects Physical consequences of MDMA use Social/environmental factors Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 20 Substance-Related Disorders: Inhalants Epidemiology Inhalant use disorders Inhalant abuse Inhalant dependence Inhalant-induced disorders  Psychiatric disturbances associated with abuse of organic solvents Presentations of Inhalant Abuse Clinical manifestations after chronic abuse of inhalants Neurological sequelae of chronic abuse of inhalants Non-nervous-system toxicity of abuse of inhalants Neonatal syndrome Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Contents xv Chapter 21 Substance-Related Disorders: Nicotine Diagnosis Assessment Epidemiology  Comorbidity patterns Course Differential diagnosis Treatment  Treatment goals Overall approach to treatment and phases of treatment Psychiatric medication management issues with abstinence Psychosocial treatments Combined psychosocial and psychopharmacological therapies Problems in management: repeated relapse Special considerations in treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 22 Substance-Related Disorders: Opioids Opioid-related disorders Epidemiology of opioid abuse and dependence Opioid intoxication Opioid Withdrawal Opioid Dependence Opioid Abuse Assessment and clinical picture Physical examination Laboratory findings Differential diagnosis Course Treatment Detoxification: long-term, short-term, rapid, and ultra-rapid  Opioid agonist pharmacotherapy Antagonist maintenance Psychosocial/behavioral treatments Addressing comorbidity Harm reduction Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 23 Substance-Related Disorders: Phencyclidine Epidemiology Tolerance and dependence Diagnosis Phenomenology and variations in presentation Psychiatric presentation Nonpsychiatric presentation Assessment Special issues in examination and history Relevant physical examination and laboratory findings Differential diagnosis Course Treatment Treatment goals xvi Contents Standard approaches to treatment Somatic treatments Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 24 Substance-Related Disorders: Sedatives, Hypnotics, and Anxiolytics Sedative-, hypnotic-, and anxiolytic-related disorders Sedative, hypnotics, anxiolytics and GABA receptors Abuse and abuse potential Barbiturates Methaqualone Benzodiazepines Nonbenzodiazepine hypnotics Polydrug use/abuse Acute intoxication with sedatives, hypnotics, or anxiolytics Dependence Withdrawal Iatrogenic dependence Diagnosis and differential diagnosis Psychiatric comorbidity Types of withdrawal syndrome High-dose withdrawal syndrome Low-dose withdrawal syndrome Protracted withdrawal syndrome Evaluation Drug use history Comorbidity Physical findings Laboratory tests Treatment High-dose withdrawal Psychosocial treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 25 Schizophrenia and Other Psychoses Schizophrenia Diagnosis  DSM-IV-TR subtypes of schizophrenia Mental status examination in schizophrenia Physical examination Additional testing Epidemiology Differential diagnosis Course First episode schizophrenia Treatment Clinician–patient relationship  Psychopharmacological treatment Acute treatment Maintenance treatment Depression and schizophrenia Risks and side effects of FGAs Side effects of SGAs Contents xvii Treatment resistance and negative symptoms Nonpharmacological treatment of schizophrenia Combining pharmacological and psychosocial treatments Self-directed treatment Schizoaffective disorder Diagnosis Course Differential diagnosis Treatment Brief psychotic disorder Diagnosis Course Differential diagnosis Treatment Schizophreniform disorder Diagnosis Specifiers for prognostic features Course Differential diagnosis Treatment Delusional disorder Subtypes Course Treatment Shared psychotic disorder Diagnosis Course Differential diagnosis Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 26 Mood Disorders: Depressive Disorders Diagnosis Comorbidity Course Subtypes and specifiers Severity specifiers Psychotic features Catatonic features Melancholic features Atypical features Seasonal pattern Differential diagnosis Gender-related differences Depression in children and adolescents Depression in the elderly Treatment Treatment goals: response, remission, recovery Acute treatment xviii Contents The role of therapeutic drug monitoring Continuation and maintenance treatment Continuation treatment Prophylaxis of new episodes Somatic treatments Management of medication side effects Treatment-emerging suicide and suicidality Treatment-refractory depression Psychopharmacological strategies in case of nonresponsiveness to antidepressant treatments Nonpharmacological somatic treatments Psychosocial treatments Treatment of depression during pregnancy, postpartum depression, and breast-feeding Treatment of depression in children and adolescents Treatment of depression in the elderly Dysthymic Disorder Diagnosis Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 27 Mood Disorders: Premenstrual Dysphoric Disorder Diagnostic features Course  Differential diagnosis Treatment Somatic treatments  Lifestyle modifications and psychosocial treatments Comparison of DSM-IV-TR/ICD-10 diagnostic criteria  Chapter 28 Mood Disorders: Bipolar Disorder Diagnosis Diagnosis of mood episodes Additional specifiers: psychosis and rapid cycling Assessment Comorbidity Course Differential diagnosis Treatment Somatic treatments Balancing risks and benefits of antidepressant treatment Guiding principles for managing side effects Psychosocial treatments Treatment of bipolar disorder in childhood and adolescence Treatment during pregnancy 3 Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 29 Anxiety Disorders: Panic Disorder With and Without Agoraphobia Diagnosis Assessment Comorbidity patterns Course Differential diagnosis  Contents xix Treatment Treatment goals Psychosocial treatments Somatic treatments Combined treatments Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 30 Anxiety Disorders: Social and Specific Phobias Diagnosis Specific phobia phenomenology and subtypes Social phobia phenomenology and subtypes Behavioral tests Comorbidity Specific phobia Social phobia Course Differential diagnosis  Treatment Somatic treatments Psychosocial treatments Psychosocial vs. somatic treatments Treatment-refractory patients Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 31 Anxiety Disorders: Obsessive–Compulsive Disorder Diagnosis Comorbidity Course Differential diagnosis Treatment Somatic treatments Assessing treatment resistance Augmentation strategies Psychosocial treatments Neurosurgery Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 32 Anxiety Disorders: Traumatic Stress Disorders Posttraumatic stress disorder Diagnosis Epidemiology Comorbidity patterns Course Differential diagnosis Treatment Acute stress disorder Diagnosis Epidemiology Course Differential diagnosis Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria xx Contents Chapter 33 Anxiety Disorders: Generalized Anxiety Disorder Diagnosis Comorbidity Course Differential diagnosis Treatment Somatic therapies Psychosocial treatments Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 34 Somatoform Disorders Differential diagnosis Differentiation among the various somatoform disorders Treatment Somatization disorder Definition and diagnostic features Course Differential diagnosis Treatment Undifferentiated somatoform disorder Definition and diagnostic features Course Differential diagnosis Treatment Conversion disorder Diagnosis Course Differential diagnosis Treatment Pain disorder Diagnosis Course Differential diagnosis Treatment Hypochondriasis Diagnosis Course Differential diagnosis Treatment Body dysmorphic disorder Diagnosis Course Differential diagnosis Treatment Somatoform disorder not otherwise specified Diagnosis Differential diagnosis Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 35 Factitious Disorders Factitious disorder Diagnosis Contents xxi Assessment Comorbidity patterns Course Differential diagnosis Treatment Factitious disorder by proxy Diagnosis Assessment Comorbidity patterns Course Differential diagnosis Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 36 Dissociative Disorders Dissociative amnesia Treatment Dissociative fugue Treatment Depersonalization disorder Treatment Dissociative identity disorder (multiple personality disorder) Course Comorbidity Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 37 Sexual Disorders The components of sexuality The sexual dysfunctions Sexual desire disorders Differential diagnosis Treatment Problems with sexual arousal Female sexual arousal disorder (FSAD) Male erectile disorder (ED) Treatment Problems with orgasm Female orgasmic disorder Male orgasmic disorder Premature ejaculation Sexual pain disorders Dyspareunia Vaginismus  Sexual dysfunction not otherwise specified Gender identity disorder Diagnosis Gender identity disorder not otherwise specified (GIDNOS) Treatment The Paraphilias Diagnosis Criminal sex offending behaviors xxii Contents Treatment Sexual dysfunction due to a general medical condition Substance-induced sexual dysfunction Sexual disorder not otherwise specified Comparison of DSM-IV-TR/ICD-10 diagnostic criteria  Chapter 38 Eating Disorders Anorexia nervosa Diagnosis Assessment Epidemiology  Comorbidity patterns Course Differential diagnosis Treatment  Bulimia nervosa Definition Assessment Comorbidity patterns  Course  Natural history Differential diagnosis Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 39 Sleep and Sleep–Wake Disorders General approach to the patient with a sleep disorder Role of the sleep laboratory in clinical sleep disorders Primary insomnia Diagnosis Assessment Treatment Primary hypersomnia Diagnosis Assessment Differential diagnosis Treatment  Narcolepsy Diagnosis  Course Differential diagnosis Treatment Breathing-related sleep disorder Diagnosis Comorbidity patterns Course Differential diagnosis Treatment Circadian rhythm sleep disorder (sleep–wake schedule disorders) Diagnosis Delayed sleep phase type Shift work type Contents xxiii Jet lag type  Parasomnias Nightmare disorder Sleep terror disorder  Sleepwalking disorder Sleep disorders related to another mental disorder Causality of sleep disturbances in mental disorders: “chicken or egg?” Treatment Sleep disorders due to a general medical condition Substance-induced sleep disorder Alcohol Nicotine Amphetamines and cocaine Caffeine Opiates Sedatives, hypnotics, and anxiolytics Other substances Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 40 Impulse Control Disorders Intermittent explosive disorder Diagnosis Assessment Epidemiology Differential diagnosis Treatment Kleptomania Diagnosis Assessment Course Treatment Pyromania and fire-setting behavior Diagnosis Assessment Epidemiology Comorbidity patterns Course Differential diagnosis Treatment Pathological gambling Assessment Epidemiology Comorbidity patterns Course Differential diagnosis Treatment Trichotillomania Diagnosis Assessment Epidemiology Course Differential diagnosis xxiv Contents Treatment Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 41 Adjustment Disorders Diagnosis Course Treatment Psychosocial treatments Pharmacological treatments Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Chapter 42 Personality Disorders Personality disorder Definition Cultural biases in diagnosis Comorbidity Course Treatment The DSM-IV-TR personality disorders Paranoid personality disorder (PPD) Definition Differential diagnosis Course Treatment Schizoid personality disorder (SZPD) Definition Differential diagnosis Course Treatment Schizotypal personality disorder (STPD) Definition Differential diagnosis Course Treatment Antisocial personality disorder (ASPD) Definition Differential diagnosis  Course Treatment Borderline personality disorder (BPD) Definition Differential diagnosis Course Treatment Histrionic personality disorder (HPD) Definition Differential diagnosis Course Treatment Narcissistic personality disorder (NPD)  Definition Differential diagnosis Contents xxv Course Treatment Avoidant personality disorder (AVPD) Definition Differential diagnosis Course Treatment Dependent personality disorder (DPD) Definition Differential diagnosis Course Treatment Obsessive–compulsive personality disorder (OCPD) Definition Differential diagnosis  Course Treatment Personality disorder not otherwise specified Comparison of DSM-IV-TR/ICD-10 diagnostic criteria Index