When is a mental disorder considered rare?

Psychiatry, Psychosomatics & Psychotherapy

The personality disorders are divided into three main groups. The main group A includes the paranoid and schizoid personality disorders under the keywords “strange, eccentric”. The main group B summarizes the histrionic, narcissistic, antisocial and borderline personality disorder under the keywords “dramatic, emotional, moody”. In main group C there are personality disorders that have behavioral characteristics from the area of ​​anxiety disorders. Keywords are "insecure, dependent, and obsessive-compulsive" personality disorder.

Paranoid personality disorder

People with paranoid personality disorder are suspicious, wait-and-see, and always ready to be attacked or hurt by others. They are overly sensitive to criticism and show excessive and inappropriate reactions in conflicts or disputes. If they feel disadvantaged or attacked, paranoid personalities go over to counterattack. At the same time, these people are good at analyzing situations and have astute minds.

Paranoid personality disorder is rare (1% of the population). It must be distinguished from delusional disorders with paranoia.

Schizoid personality disorder

Schizoid personality disorder is rare - it affects 1% of the general population. Schizoid personalities appear distant, indifferent, lackluster, or disinterested in others. You live withdrawn and have few contacts with other people. They are typical loners who, however, do not suffer from their lack of contact. They have little emotional response to environmental stimuli. The schizoid personality disorder only becomes a burden for those affected when the relationship with a partner suffers from the detachment and low emotionality. Those affected only go into therapy if the disorder is relatively mild. In severe cases, there is no desire for a partnership relationship. Differential diagnosis from autism spectrum disorders is often difficult.

Histrionic Personality Disorder

Histrionic personality disorder occurs with a frequency of about 2% in the general population. Affected people are heavily dependent on external affection and attention and are constantly looking for recognition from others. They are often extroverted, have acting skills, are fun-loving and can inspire others. Although these people often have a large circle of friends and a lot happens in their lives, they know phases of loneliness, dissatisfaction and inner emptiness with gnawing self-doubt. Most of these people do not come to therapy because of their personality problems, but because they have a depressive mood after a separation or because of other difficulties.

Narcissistic Personality Disorder

Narcissistic personalities often come across as demanding, arrogant, or arrogant. Outwardly they appear to be very self-confident, but at the same time they are very sensitive, vulnerable and find it difficult to deal with criticism. It is based on a rather weak and, above all, fragile self-esteem that should be hidden by staging a great facade.

The first problems often arise in the work environment at a young age, as narcissistic people do not live up to their demands and are plagued by fear of failure, for example before exams. In later life, they often stand out due to work disruptions and fall short of their own standards and capabilities. People can get into existential crises with great inner despair, which can lead to suicide. The narcissistic personality has the highest suicide rate at 14%.

Emotionally unstable personality disorder (borderline type)

The "International Statistical Classification of Diseases and Related Health Problems" (ICD-10) differentiates between two manifestations of emotionally unstable personality disorder: an impulsive type, which is characterized by emotional instability and a lack of impulse control and a borderline type. The borderline type includes the criteria of the impulsive type and additional features. Therefore, only borderline disorder is discussed below because it includes all aspects of the emotionally unstable personality.

Borderline personality disorder is a serious psychiatric condition. Overall, around 3% of the general population suffer from the disease. Those affected experience themselves as victims of their violent moods and tend to self-damaging, sometimes aggressive behavior. They appear very moody and are sensitive to rejection. Those affected describe that they feel “strange” and that they cannot identify with themselves
For more detailed information, see the article on borderline disorder.

Dissocial Personality Disorder

Antisocial or antisocial personality disorder is characterized by a tendency towards aggressive behavior and violence. Affected people therefore often come into conflict with the law because they disregard social norms and act irresponsibly. Dissocial personalities are easily irritable, impulsive, have a low tolerance for frustration and a subgroup of those affected has no empathy. Long-term consequences of an action or possible alternatives are apparently not considered. Everyday routine at work or in a partnership quickly leads to boredom and a feeling of discomfort for those affected. Hence, they look for excitement, adventure and variety. In the interpersonal area, antisocial personalities are unreliable and in some cases they manipulate and abuse other people. Your own advantage is in the foreground of the action. In the general population, 3-7% of men and 1-2% of women have an antisocial personality.

Insecure Personality Disorder

Self-insecure or anxious-avoidant personality disorder is relatively common in the general population with a frequency of 3-5%. The people affected are shy, feel inhibited and insecure in many interpersonal situations and isolate themselves out of fear of negative evaluation, criticism or rejection. You don't like to be the center of attention and have difficulty speaking in front of people. They experience themselves as inferior and therefore avoid contact with other people. On the other hand, they are often valued by other people as friends and helpers because they are often sensitive, sensitive and considerate. This personality disorder can also be viewed as a particularly severe form of generalized social phobia that has existed since childhood or adolescence.

Anxious avoidant personalities are prone to developing other mental illnesses. Above all, anxiety disorders (social phobia), obsessive-compulsive disorders and depression should be mentioned here. Such an additional illness is often the reason why these people seek therapy.

Dependent personality disorder

People with dependent or dependent personality disorder feel that they cannot lead their own lives. You always need someone to support you and make important decisions for you. For fear of losing this caregiver, they submit to their partner and do not express their own feelings or needs. However, this “clingy behavior” is often the trigger for relationship problems. Because people with personality disorder are affectionate, reliable, helpful, and loyal, they are valued as good and reliable friends. Affected people can often cope for a long time without any problems in a stable environment; However, a change in the life situation, e.g. due to moving, separation, death of the partner or other circumstances can lead to a psychological crisis.

Anankastic (compulsive) personality disorder

Compulsive personalities often appear neat and correct on the outside. They try hard not to make mistakes. Their accuracy and reliability are highly valued (especially at work), but they also have high expectations of others. This leads to interpersonal conflicts because they lack ease and spontaneity. Due to their over-correctness and inability to divide up work, they can be prone to exhaustion, especially in the further course of life.