Personality Disorders And Sexual Disorders: Psychiatric Relevance, Clinical Manifestations, Treatment And Management

These are known by several terms such as abnormal personality, psychopathic personality, etc. This is a situation arising out of one or more abnormal character traits. Due to this abnormal trait, these individuals become maladaptive in society. So the individual as well as the society suffer. Some common types of personality disorders are described below.

Cyclothymic personality: These subjects show recurring and alternating periods of happiness and sadness. The mood changes are not attributable to external environment.

Schizoid personality: These individuals are shy, oversensitive and seclusive, often with autistic thinking and poor emotional relationship with others.

Obsessive compulsive personality (Anantastic personality): These subjects show excessive concern with conformity and adherence to standards of behaviour. They are rigid, overinhibited, overcutious and overdutyful.

Antisocial personality: They are unsocial individuals creating repeated conflicts with society and showing low frustration tolerance. These individuals are selfish, callous, irresponsible and impulsive and they show no sense of guilt or shame. They fail to learn from experience or punishment. They commonly commit antisocial activities.

Etiology: Genetic factors, constitutional factors, and disturbance in family environment during childhood have been implicated. Some criminal psychopaths show an extra “Y” chromosome (XYY syndrome- pp 10). Some criminal psychopaths may show abnormal EEG (electroencephalogram) pattern.

Treatment: Since these are life pattern disturbances, treatment modalities are less effective. Individual and group psychotherapy are the methods of choice. Psychotropic drugs help during periods of crisis.

The natural sexual activity in humans is the coital union of man and woman culminating in orgasm in both the partners. Seminal discharge occurs in the male during this state. Disorders in sexual relations are well recognized. It may be disorder in the heterosexual functioning such as impotence and frigidity, a disorder in the direction of the sexual drive and many more. These are commonly known as sexual perversions or deviations.

Disorder of heterosexual function:

Impotence: The psychic factors leading to impotence are venereophobia, lack of privacy, inertia in the opposite partner, fear of castration and incestuous feelings.

Psychiatric disorders: Depression, hysteria and anxiety neurosis are associated with impotence.

Frigidity: Frigidity denotes the orgasmic failure in women. It is not an uncommon disorder, but rarely reported. It is mostly psychogenic. Fear of pregnancy, wrongful ideas about sex, premature ejaculation in the husband, lack of affection in the husband, marital disharmony and lack of adequate foreplay are the common causes.

Psychiatric illnesses like hysteria, depressions and schizophrenia may account for a few cases.In the management of impotence and frigidity, several new techniques have been devised.