If someone has the majority of symptoms from not just one personality disorder but 4, (Antisocial, Borderline, Histrionic, and Narcissistic), what would the diagnosis be? Also, how do you deal with such a person without loosing your mind yourself?
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To answer your first question, it is appropriate to diagnose each personality disorder type separately if sufficient criteria are met for each of them to support the diagnosis. For instance, if full criteria were met for each personality disorder you’ve listed, you would just diagnose the personality disorders you’ve listed. I’ve also seen some clinicians make a diagnosis of Mixed Personality Disorder with X, Y and Z traits although this is not strictly by the (DSM-IV) book. If some criteria are met in each area, but not enough in any one of them to make a formal and supportable diagnosis in that area, the appropriate diagnosis is Personality Disorder NOS (not otherwise specified) with X, Y, and Z (or whatever) traits).
The answer to your second question is “with great care “. (grin!)
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