Modern concept and diagnostics of personality disorders

Contrary to expectations, the DSM (Diagnostic and Statistical Manual of Mental Disorder) categorical approach missed to increase diagnosis reliability in personality disorder, and that affected research quality in this field, especially the etiopathogenesis study and treatment. Future classifications imply introduction of huge reviews of concepts, diagnosis and personal disorder classification as utmost importance, in order to make progress in this area. This paper is suggestion of a review of a kind. Starting from the recent progress in molecular biology of epigenetic behavior modulations, the personality disorder is defined as maladaptive syndrome developed through interaction between a person and environment. Maladaptation is conceptualized as non-function of personal interactive functions, for example those in charge of adaptive processes such as conceptual learning, secondary emotions, moral reasoning, sociability, and so on. This adaptation incapability can be caused either by intense biogenetic dispositions or by pathologic environment impacts, or by both. Therefore, a precise diagnosis of personality disorder depends on neurobiological and adaptive pathogenic factors. We suggest the two steps personal disorder diagnostic algorithm: adaptive processes (for example: character) used for maladaptation diagnose, and neurobiological aspects (for example: temperament) used for clinical presentation classification and for differential diagnosis. We suggest the term 'personality disorder' to be replaced by more adequate term 'adaptation disorder' because this is the concept which with more precision points out to causality of maladaptive syndromes between personality and environment and diminishes the stigma related to this diagnosis. Advantages in diagnostic, researches and treatment offered in the suggested solution have been discussed in details.