Frequently it is relatively easy to establish prevalent clinical syndrome in treated patients, yet influence of personality is frequently neglected. Professional approach towards personality pathology might help to avoid misunderstandings and achieve better treatment results. This case presents 35-year-old woman, treated in different psychiatric hospitals 9 times in 5 years. She was diagnosed with several disorders (moderate or severe depressive episode with or without psychotic symptoms; anxious or mixed personality disorder; schizotypal disorder; schizoaffective disorder; harmful use of alcohol etc) and treated by many psychiatrists, psychotherapists using both medication (typical and atypical antipsychotics, tryciclic and other antidepressant drugs, including SSRI, SNRI, NDRI,NARI, SARI, NaSSA, anxiolytics, antimanic drugs) and psychotherapy. Treatment was unsuccessful and provoked helplessness, frustration, rage, hopelessness for the staff. Patient's behavior was demonstrative, manipulative, focused on communication with young male inpatients. She exhibited dramatization, exaggerated expression, continuous seeking for attention (often by inappropriate sexually provocative behavior), overwhelming separation anxiety when abandoned by love objects.

Description of treatment peculiarities of histrionic personality

Case analysis

During last hospitalization, the patient received a diagnosis of histrionic personality disorder at borderline personality organization level (identity diffusion, sufficient reality testing, primitive defenses). Treatment results were better after discontinuing medication.

This case description:

1. 1. Illustrates the powerful feelings of the staff during treatment of histrionic disorders.

2. 2. Reveals the amount of health care resources demanded for treatment of this type of patients (both material and immaterial) because of frequent hospitalizations, frequent shifting of diagnoses and treatment.