Abstract- Poster

Abstract

BACKGROUNDAn aggressive patient presenting at a Mental Health Care Facility may be diagnosed with a psychotic disorder and administration of psychotropics may obscure the existence of a long-standing Personality Disorder.AIMSTo highlight the challenges in diagnosis and management of a case of non-psychotic aggression in a 22-year-old male with history of aggressive outbursts since childhood.METHODSStandardised scales like Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D), and ICD 10 International Personality Disorder Examination (IPDE) were used to rule out any psychotic/mood disorders and to assess the personality of the patient, respectively.RESULTSTrial of psychotropics in the past and after in-patient treatment showed little response and the patient’s scores on IPDE suggested a mixed disorder comprising Dissocial Personality Disorder, Emotionally Unstable Personality Disorder: Impulsive Type and/or Borderline Type. The patient started showing improvement only with Dialectical Behaviour Therapy (DBT) and Family Therapy along with Sodium Valproate 500mg BD.CONCLUSIONPersonality Disorders may present with extreme aggression and poor response to psychotropics where we should consider entertaining a diagnosis of a Personality Disorder which carry poor prognosis and need Psychotherapeutic intervention more than Psychopharmacological intervention alone.