Dependent Personality Disorder

People with Dependent Personality Disorder have difficulty in making decisions & need others to take responsibility for more areas of their lives.

Aetiology:

Classical hypothesis indicate that the cause is deprivation (not overgratification) in oral phase of psychosexual development.

Epidemiology:

👉0.7% in general population.
👉Male~Female

Clinical Features:

ICD-10 criteria:F60.7

1. Encourage or allowing others to make most of one’s important life decisions.

2. Subordination of one’s own needs to those of others on whom one is dependent, & undue compliance with their wishes.

3. Unwillingness to make even reasonable demands on the people one depends on.

4. Feeling uncomfortable or helpless when alone, because of exaggerated fear of inability to care for oneself.

5. Preoccupation with fears of being abandoned by a person with whom one has a close relationship & of being left to care for oneself.

6. Limited capacity to make everyday decision without an excessive amount of advice & reassurance from others.

⭐They accept unpleasant tasks, are self-sacrificing & tolerate verbal, physical or sexual abuse.

⭐⭐When an intimate relationship is terminated by separation or death, they urgently seek another person who will provide the care & support they seek.

Course:

Childhood:

👉Separation anxiety
👉Chronic physical illness in childhood requiring long periods of care & attention.

Adulthood:

Dependent personality features present in adolescence may evolve positively in adulthood or lead to a personality disorder.

⭐Dependent individuals are at Increased risk of depression, anxiety & Adjustment disorders.

Differential Diagnosis:

👉Histrionic personality disorder:

Obtain attention & care by seductive or manipulative behaviours where as, dependent personality disorder patients wait passively for others to care for them.

👉Avoidant personality disorder:

Dependents lack sense of embarrassment & social shyness & fear loneliness or abandonment.

👉Borderline personality disorder:

Both (Borderline & Dependent) share an excessive fear of abandonment.
But borderline personality disorder patients react to separation with feelings of emptiness & rage & are demanding.

👉Dependent behaviours in specific life situations:

Elderly people with chronic or debilitating disorder.

Treatment:

Pharmacotherapy:

For Depression & anxiety symptoms.
👉SSRIS
👉Benzodiazepines

Psychotherapy:

👉Self-confidence & self-esteem should be enhanced
👉Help patient in enjoying the feeling of “personal autonomy” & independence.
👉Cognitive restructuring & social skills training are often useful.

⭐Therapist must avoid the development of excessively dependent attachment.

Reference:

  • New Oxford Textbook of Psychiatry(2nd edition).
  • ICD-10 Classification of Mental and Behavioural Disorders.

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