Dependent personality disorder

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Background

  • A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation

Clinical Features

  • Five (or more) of the following criteria, beginning by early adulthood and present in a variety of contexts:[1]
    • Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
    • Needs others to assume responsibility for most major areas of his or her life.
    • Has difficulty expressing disagreement with others because of fear of loss of support or approval.
    • Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
    • Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
    • Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.
    • Urgently seeks another relationship as a source of care and support when a close re­lationship ends.
    • Is unrealistically preoccupied with fears of being left to take care of himself or herself.

Differential Diagnosis

  • 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

Management

  • Referral for outpatient psychiatric treatment, as psychotherapy is the primary treatment.

Disposition

  • Discharge

See Also

External Links

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.