Psychiatria pre prax 2/2004

Dependent personality disorder – diagnostics and treatment

Dependent personality disorder involves a extensive need to be taken care of. That leads to submissiveness, clinging and fear of separation. This disorder represents an interaction of an anxious-inhibited temperament with inconsistent or overprotective parenting. Insecure attachment and helplessness were generated through a parent-child relationship, perhaps by a clinging parent or a continued infantilization during a time in which individuation and separation normally occurs. Dependent personality disorders occur in 5 to 30% of patients and 2–4% of the general community. It is diagnosed more frequently in females. These persons are often in treatment for depressive episode, dysthymia or an anxiety disorder. Many of them find the therapeutic relationship to satisfy their need for support, concern, and involvement. Exploration of the breadth and source of the need for care and support is often an important component of treatment. Cognitive-behavioral techniques are useful in addressing the feelings of inadequacy, incompetence, and helplessness. Social skills, problem solving, and assertiveness training also makes important contribution. Many depressive or anxiety symptoms of persons with dependent personality disorder will respond to antidepressants.

Keywords: dependent personality disorder, etiology, symptomatology, epidemiology, pharmacotherapy, psychotherapy, group psychotherapy, cognitive-behavioral therapy.