Tvp22 01 omslag kijk verder

Tijdschrift voor Psychiatrie 56 (2014) 12, 816 - 820

Short report

DSM-5 classification of personality disorders in older persons

S.P.J. van Alphen, G. Rossi, E. Dierckx, R.C. Oude Voshaar

background Although it is generally agreed that personality disorders are an important topic in old-age psychiatry, dsm-5 has paid relatively little attention to older persons affected with this severe mental disorder.
aim To look closely and carefully at several aspects of the way in which dsm-5 defines personality disorders relating to older persons.
method We make a critical evaluation of the description of personality disorders given in dsm-5.
results First of all, we question whether the phrase ‘personality change due to another medical condition’ should really be included in the dsm-5 chapter of personality disorders because a personality change actually has the features of a persistent conduct disorder. Secondly, we argue that in a future revised version of dsm-5 personality disorders affecting older persons should be referred to specifically as ‘late-onset’ personality disorders. Thirdly, we stress that the research programme relating to the dimensional dsm-5 model of personality disorders should involve a larger number of older persons. In addition, more research is needed with regard to the use, wording and validity of the phrase ‘personality change due to a medical condition’. Those responsible for the revision of the Dsm-5 should ensure that the concept ‘late-onset personality disorders’ is incorporated in the text.
conclusion The description of personality disorders in dsm-5 is confusing. This is probably due to the transitional period between the old categorical (dsm-iv) system and the newly proposed dimensional approach to personality disorders in dsm-5, an approach that needs further investigation. However, this intervening period could be a good opportunity for doing further research into personality disorders in older adults.

keywords DSM-5, late-onset personality disorder, older persons, personality disorders