isiksusehäire

Isiksusehäire, commonly translated as personality disorder, refers to a group of mental health conditions characterized by enduring, inflexible patterns of thinking, feeling, and behaving that deviate significantly from cultural expectations and cause distress or impairment. These patterns emerge early, are stable over time, and are pervasive across settings, such as work, family, and social relationships.

Diagnostic guidelines, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM‑5) and the International Classification of Diseases (ICD‑11), require persistent maladaptive traits that are self‑detached, socially significant, and associated with significant distress or disability. Clinicians assess for core features such as cognitive, affective, interpersonal, and impulse-control domains, using structured interviews and collateral information.

Within the DSM‑5 classification, eleven distinct personality disorders are recognized, grouped into three clusters. Cluster A includes paranoid, schizoid, and schizotypal disorders; Cluster B encompasses antisocial, borderline, histrionic, and narcissistic disorders; and Cluster C comprises avoidant, dependent, and obsessive‑compulsive types. Each disorder has specific criteria, but many symptoms overlap, reflecting shared underlying trait dimensions such as neuroticism and antagonism.

Research points to a multifactorial etiology involving genetic predisposition, neurobiological abnormalities, early attachment disruptions, and ongoing psychosocial stressors. Twin studies indicate moderate heritability, while neuroimaging reveals structural and functional variations in limbic and prefrontal regions that may underlie emotion regulation deficits.

Effective treatment combines psychotherapy and, when appropriate, pharmacotherapy. Psychodynamic therapy, dialectical behavior therapy, schema therapy, and cognitive behavioral approaches are evidence‑based methods for modifying maladaptive patterns. Medications target secondary symptoms such as anxiety, mood instability, or psychosis but are not disorder‑specific. Early intervention, consistent therapeutic relationships, and integration of family or community support enhance outcomes and reduce long‑term impairment.