Histrionic personality disorder

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Background

  • A pervasive pattern of excessive emotionality and attention seeking

Clinical Features

  • Five (or more) of the following criteria, beginning by early adulthood and present in a variety of contexts:[1]
    • Is uncomfortable in situations in which he or she is not the center of attention.
    • Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
    • Displays rapidly shifting and shallow expression of emotions.
    • Consistently uses physical appearance to draw attention to self.
    • Has a style of speech that is excessively impressionistic and lacking in detail.
    • Shows self-dramatization, theatricality, and exaggerated expression of emotion.
    • Is suggestible (i.e., easily influenced by others or circumstances).
    • Considers relationships to be more intimate than they actually are.

Differential Diagnosis

Evaluation

  • A clinical diagnosis; however if entertaining other organic causes may initiate workup below

General ED Psychiatric Workup

Management

  • Set clear boundaries
  • Expect interruptions
  • Tolerate emotions but not outbursts
  • Be empathetic but avoid overt emotionality
  • Referral for outpatient psychiatric treatment, as psychotherapy is the primary treatment. Medication does little to affect the personality disorder but can be helpful with symptoms such as depression.

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.