Karolinska Scales of Personality (KSP) and descriptions of high scores for each scale

personality

drug re- lated

KSP scales

Description of high scores

Risk behaviors should include the following:

• Self-harm.

• Violence to others.

• Arson.

• Sexual assault/ inappropriate behavior.

• Verbal abuse.

• Absconding from hospital.

• Non-compliance with medication.

• Substance abuse.

• Self-neglect.

• Vulnerability.

• Risk to child.

• Disengagement from mental health after-care.

• Lack of insight.

Anxiety

Somatic anxiety

Psychic anxiety

Muscular tension

Psychastenia

Inhibition of aggression

Autonomic disturbances, restless, panicky

Worrying, anticipating, lacking self-confidence

Tense and stiff, not relaxed

Easily fatigued, feeling uneasy when urged to speed up

Lacks ability to speak up and be self-assertive in social situations

Extra-intro versions

Impulsiveness

Monotony avoidance Detachment

Acting on the spur of the moment, non-planning, impulsive

Avoiding routine, need for change and action

Avoiding involvement with others, being withdrawn

Confor

mity Incon-

form.

Socialization

Social desirability

Positive childhood experiences, satisfied with present life situation

Socially conforming, friendly, helpful

Risk assessment should be performed at the following times:

• At screening assessment.

• At triage assessment.

• At full needs assessment.

• At review.

• At any other time that the worker feels that the degree of risk has changed.

Aggres

sion

Verbal aggression

Indirect aggression Irritability

Guilt

Suspicion

Getting into arguments, berating people when annoyed

Sulking, slamming doors when angry

Irritable, lacking patience

Remorseful, ashamed of bad thoughts

Suspicious, distrusting people's motives

Petter Gustavsson

DSM-IV MOOD DISORDER CATEGORIZATION

DISORDER CATEGORY

DISORDER TYPE

KEY FEATURES

Depressive Disorders (no history of manic,* mixed manic,** or hypomanic*** episodes)

Major depressive disorder

2-week duration, with depressed mood/loss of interest

Dysthymic disorder

Chronic, less severe than MDD; 2-year duration

Bipolar Disorders

(manic,* mixed,** or

hypomanic***

episodes plus major

depressive episodes)

Bipolar I

One or more manic/ mixed and depressive episode

Bipolar II

One or more depressive and at least one hypomanic episode

Cyclothymia

Chronic/less severe form of bipolar disorder; 2-year duration,

with multiple periods of hypomania/depression

Substance-Induced Mood Disorder

Prominent and persistent mood disturbance, direct physiologic consequence of substance use

*Manic episode: abnormally elevated/expansive/irritable mood for at least 1 week.

** Mixed episode: meets criteria for manic and depressed episode daily for 1 week.

***Hypomanic episode: elevated/expansive/irritable mood for at least 4 days—little functional impairment.

Medications used for the treatment of mood disorders

in substance abusers

MOOD DISORDER

AGENTS USED

AGENTS TO AVOID

Depression

Serotonin Reuptake Inhibitors: Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Citalopram (Celexa), Escitalopram (Lexapro)

Tricyclic Antidepressants: Imipramine (Tofranil), Nortriptyline (Pamelor),

Other: Venlafaxine (Effexor), Bupropion (Wellbutrin)

Monoamine Oxidase Inhibitors

Tranylcypromine

(Parnate)

Phenelzine (Nardil)

Bipolar Disorder

Mood Stabilizers: Lithium (Eskalith), Valproate (Depakote), Lamotrigine (Lamictal)

Atypical Antipsychotics:Olanzapine (Zyprexa), Risperidone (Risperdal)

Typical Antipsychotics: Haloperidol (Haldol), Benzodiazepines* Clonazepam (Klonopin)

Benzodiazepines: Diazepam (Valium), Alprazolam, (Xanax)

Stimulants: Methylphenidate (Ritalin)

source: nfm

Personality disorder and Violence

Personality Disorder

Relative risk

Personality Disorder

Relative risk

Alcohol dependence

1.2

Borderline PD

1.4

Anxiety Disorder

0.6

Narcissistic

2

Mood disorder

1.6

Paranoid

1.15

2 or more PD

4.6