
Suffering From Systemic Lupus, Alcoholic. Unbelievable Lying, Attention Seeking, Violence, Suspicion. Cause?

Kirsty
Thanks for your query.
Important aspects of your query are:
• 32 year old male.
• Alcohol addiction.
• Worry related to manipulative and anti social behavior of partner.
From the information it is apparent that your partner is not suffering from major psychiatric illness. But he appear to addicted to alcohol.
His behavior more related to his personality, which appear to in cluster B group of personality. I want to give information related to personality disorders so that you can understand the complexity of its assessment and concurrent need of assessment of psychiatric disorder during examination.
Definition: Personality disorders as enduring subjective experiences and behavior that deviate from cultural standards, are rigidly pervasive, have an onset in adolescence or early adulthood, are stable through time, and lead to unhappiness and impairment. When personality traits are rigid and maladaptive and produce functional impairment or subjective distress, a personality disorder may be diagnosed.
Personality disorder subtypes classified in DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) are: schizotypal, schizoid, and paranoid (Cluster A); narcissistic, borderline, antisocial, and histrionic (Cluster B); and obsessive-compulsive, dependent, and avoidant (Cluster C).
Cluster A includes three disorders with odd, aloof features, such as paranoid, schizoid, and schizotypal.
Cluster B includes four disorders with dramatic, impulsive, and erratic features, such as borderline, antisocial, narcissistic, and histrionic.
Cluster C includes three disorders sharing anxious and fearful features, such as avoidant, dependent, and obsessive-compulsive.
Personality disorder is a common and chronic disorder. Its prevalence is estimated between 10 and 20 percent in the general population, and its duration is expressed in decades. Persons with personality disorder are frequently labeled as aggravating, demanding, or parasitic and are generally considered to have poor prognosis.
Personality disorder is also a predisposing factor for other psychiatric disorders (e.g., substance use, suicide, affective disorders, impulse-control disorders, eating disorders, depression and anxiety disorders) in which it interferes with treatment outcomes of other psychiatric disorder and increases personal incapacitation, morbidity, social complication and mortality of these patients.
Persons with personality disorders are far more likely to refuse psychiatric help and to deny their problems than persons with anxiety disorders, depressive disorders, or obsessive-compulsive disorder. Personality disorder symptoms are alloplastic (i.e., able to adapt to, and alter, the external environment) and ego-syntonic (i.e., acceptable to the ego). Persons with personality disorders do not feel anxiety about their maladaptive behavior. Because they do not routinely acknowledge pain from what others perceive as their symptoms, they often seem disinterested in treatment and impervious to recovery.
Following measures will help you:
• Personality assessment by clinical psychologist or trained psychiatrist. It may take several days to make final diagnosis. Following tests are used to assess personality which is administered by trained psychologist: Clinical interview, Sentence completion test, Rorschach Inkblot Test, Thematic Apperception Test (TAT), Minnesota-Multiphasic Personality Inventory (MMPI) and several other tests
• Psychotherapeutic treatment after assessment in form of counselling +/- drug therapy.
• Treatment of co morbid illness like: anxiety, depression or other problems.
• Improvement may take months or years depending on the case.
Hope this answers your query. I will be available for follow up queries if any.
Regards,

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