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Personality disorders by Mircea Revenco.

Mircea Revenco, Professor, Doctor in Medical Sciences, Head of the Department of Psychiatry and Narcology of "Nicolae Testemitanu" Medical University Chicinau, author of over 240 scientific papers in the field of psychiatry and forensic psychiatry, catches again the attention of readers with a monograph on the basic features of personality disorders (viewed from a multidisciplinary perspective), with a focus on the field of forensic psychiatry, in the context of offences committed by people diagnosed with personality disorders. The work entitled Personality Disorders (with a subtitle reading Clinic and forensic psychiatry aspects) was published in Chicinau, in 2015, and it aimed to update written information related to this category of psychiatric disorders and to adapt it to the new diagnostic and clinical approach guidelines developed at international level. Instead of a preface, the author presents an argument for the book, which advocates the need for deeper and more systematic insight into the specificities and multidimensional implications of personality disorders, especially in matters of forensic expertise. The argument also anticipates the presentation of illustrative case studies for each personality disorder individually.

The monograph is divided into eight chapters that refer to the following: history of personality disorders; their causal hypotheses; their classification differentiated by each acknowledged diagnostic guideline and by the diagnostic criteria used in current practice; and the general and particularized clinical features of psychopathies. Furthermore, the author outlines the thematic evolution of these psychiatric disorders in terms of their structure, of evolution patterns decompensations. In addition, the author refers to the influence of negative prognostic factors such as addictions, cranio-cerebral trauma, or other organic conditions aggravating the evolution and prognosis of psychopathies. The author also structures a chapter on the most severe forms of personality disorders, and finally he addresses the specificities of forensic psychiatric evaluation in the context of potential criminal acts committed by people with personality disorders.

Whereas the classification of personality disorders begins with historical elements (of Russian influence, rather outdated), the author continues by listing the classification and diagnostic criteria imposed by guidelines in effect today, used in current clinical practice: ICD-10 and DSM-5. Classifications are made in didactic and comparative terms, useful for a better understanding of clinical approach differences from the perspective of the American and European guidelines used worldwide.

The description of each personality disorder (mainly following the structure of ICD10, not including the personality disorders detailed exclusively in DSM-5) is illustrated by originally penned case studies, intriguing through the narrative style with belletristic touches, which emphasizes on the socio-familial component and the emotional potential of each individual studied.

Subsequently, the author resumes the discussion on the so-called psychopathic reactions using older bibliographical references (that have not lost their clinical value, thus representing a new element and providing originality to a contemporary book). Hence, Prof. Mircea Revenco wrote a book adjusted to the current Western tendencies in psychiatry and mostly to the direction concerning psychopathies. At the same time however, he does not lose contact with notions and theories with significant historical value, which is actually a rara avis in contemporary scientific works. The book comprises several slightly romanticized images concerning personality disorders that readers find attractive.

This monograph also posits the notion of personality disorder with severe structure, describing it as a psychiatric entity with rare occurrence in clinical practice, but frequent in the field of forensic psychiatry, because social dysfunction level degenerates into criminality.

The book ends with a brief summary of the main ideas approached throughout the eight chapters. Bibliographical references enhance the contrasting style of the book, split between old and new, between actuality and tradition, including very recent and highly relevant items for clinical practice and items with historical value (both Western European and Russian language literature).

This combination of the newest diagnostic criteria supported by DSM-5 and ICD-10 and the old classifications (presented comparatively), as well as the concomitant use of current trends regarding personality disorders and of a narrative style with belletristic nuances for case studies provide an original perspective, an overview of the evolution of personality disorders as a concept (including details on its main forms). The book goes beyond strict clinical utility and sometimes too standardized and rigorous style of contemporary scientific literature (observing to the letter the drafting rules of written scientific products) by providing a humanistic view of the bio-psycho-social and forensic impact of personality disorders, especially of those with increased criminal potential.

Mircea Revenco's Personality Disorders is a new book, which observes the current scientific information and uses it as an essential pillar, but which also preserves the mark of the historical evolution of psychiatric concepts regarding personality disorders. It provides a multidimensional and unique synthesis on their causality, evolution dynamics, and complex social, familial, and forensic implications. At the same time, it takes into account the main potential comorbidities (of a natural, traumatic, or addictive nature).

Vasile CHIRITA--Professor, M. D., Ph. D., "Socola" Institute of Psychiatry, Iasi, Romania; Honorary Member of the Academy of Medical Sciences

Ilinca UNTU--M. D., Ph. D. Student, "Socola" Institute of Psychiatry, Iasi, Romania
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Author:Chirita, Vasile; Untu, Ilinca
Publication:Bulletin of Integrative Psychiatry
Article Type:Book review
Date:Dec 1, 2015
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