Psychiatr. pro Praxi, 2004; 2: 55-59

Závislá porucha osobnosti - diagnostika a léčb

Mgr. Petra Houbová1, doc. MUDr. Ján Praško CSc1,3,2,4, PhDr. Marek Preiss1
1 Psychiatrické centrum Praha, 3. LF UK, Praha
2 Centrum neuropsychiatrických studií, Praha
3 Psychiatrická klinika FN a LF UP, Olomouc
4 3. LF UK, Praha

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Keywords: dependent personality disorder, etiology, symptomatology, epidemiology, pharmacotherapy, psychotherapy, group psychotherapy, cognitive-behavioral therapy.

Published: December 31, 2004  Show citation

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Houbová P, Praško J, Preiss M. Závislá porucha osobnosti - diagnostika a léčb. Psychiatr. praxi. 2004;9(2):55-59.

Mezi typické rysy závislé poruchy osobnosti patří nadměrná potřeba péče druhých. To vede k submisivitě, přilnavosti a strachu z opuštění. Tato porucha pravděpodobně vzniká interakcí mezi vrozeným úzkostně-inhibovaným temperamentem a nestálou nebo hyperprotektivní výchovou. Nejisté připoutání a bezmoc se dají vytvářet ve vztahu rodič-dítě, nadměrnou připoutaností rodiče nebo průběžnou infantilizací během období, kdy se běžně objevuje individuace a separace. Závislá porucha osobnosti se objevuje u 5-30% pacientů a mezi 2-4 % osob v celé populaci. Je diagnostikována častěji u žen než u mužů. Tito lidé častěji vyhledávají léčbu pro depresi, dystymii nebo některou z úzkostných poruch. Řada z nich hledá terapeutický vztah k uspokojení svojí potřeby podpory, uznání a přijetí. Zjišťování vzniku a zdrojů potřeby péče a podpory jsou důležité součásti léčby. Kognitivně-behaviorální techniky mohou pomoci při zacílení na pocity nedostatečnosti, nekompetence a bezmoci. Nácvik sociálních dovedností, řešení problémů a nácvik asertivity může mít rovněž důležitou roli. Depresivní a úzkostné příznaky mohou dobře reagovat na podání antidepresiv.

Dependent personality disorder - diagnostics and treatment

Dependent personality disorder involves a extensive need to be taken care of. That leads to submissiveness, clinging and fear of separation. This disorder represents an interaction of an anxious-inhibited temperament with inconsistent or overprotective parenting. Insecure attachment and helplessness were generated through a parent-child relationship, perhaps by a clinging parent or a continued infantilization during a time in which individuation and separation normally occurs. Dependent personality disorders occur in 5 to 30% of patients and 2-4% of the general community. It is diagnosed more frequently in females. These persons are often in treatment for depressive episode, dysthymia or an anxiety disorder. Many of them find the therapeutic relationship to satisfy their need for support, concern, and involvement. Exploration of the breadth and source of the need for care and support is often an important component of treatment. Cognitive-behavioral techniques are useful in addressing the feelings of inadequacy, incompetence, and helplessness. Social skills, problem solving, and assertiveness training also makes important contribution. Many depressive or anxiety symptoms of persons with dependent personality disorder will respond to antidepressants.

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