Histrionic personality disorder is characterized by excessive emotionality, attention seeking, dramatic, colourful and extroverted behaviour.
Egocentric, dependent & demanding interpersonal relationships are typical of this disorder.
2-3% of general population.
10-15% in clinical settings.
Traits such as extraversion, emotional expression & rewards dependence have a strong genetic origin.
Serotonin deficiency is found in histrionic patients with marked emotional instability & impulsive behaviours.
Abnormally intense attachment with parental figures is seen.
ICD-10 diagnostic criteria(F60.4)
- Self dramatization, theatricality, exaggerated expressions of emotions.
- Suggestible, easily influenced by others.
- Shallow & labile affect.
- Seek for excitement & appreciation by others, & activities in which the patient is center of attention.
- Inappropriate seductiveness in appearance or behaviour.
- Over concern with physical attractiveness.
(a) Somatization disorder.
(b) Conversion disorder
(c) Dissociative disorder
(d) Brief reactive psychosis.
(a) Hypomania/ Mania.
(b) Narcissistic personality disorder.
Course & Prognosis:
(a) Depressive symptoms & suicide attempts are frequent.
(b) Histrionic personality disorder may gradually improve with age, as if a maturation of histrionic infantilism occurs over the years.
For Depressive & Anxious symptoms:
(Vulnerable for medication abuse & non-compliance.)
Supportive therapy:For acutely distressed patient.
Psychoanalytic techniques:For clarification of patient’s covert inner feelings.
*Patient often want to take special place in therapist’s life & act out during sessions, threaten to abandon treatment or undertake dangerous actions.
So clear limits should be set & demanding behaviour should not be rewarded.
- New Oxford Textbook of Psychiatry(2nd edition).
- ICD-10 Classification of Mental and Behavioural Disorders.