Histrionic personality disorder

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.

Clinical Features:

ICD-10 diagnostic criteria(F60.4)

  1. Self dramatization, theatricality, exaggerated expressions of emotions.
  2. Suggestible, easily influenced by others.
  3. Shallow & labile affect.
  4. Seek for excitement & appreciation by others, & activities in which the patient is center of attention.
  5. Inappropriate seductiveness in appearance or behaviour.
  6. Over concern with physical attractiveness.


(a) Somatization disorder.
(b) Conversion disorder
(c) Dissociative disorder
(d) Brief reactive psychosis.

Differential Diagnosis:

(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.

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