Hi doctor, I got married before 1-1/2 years. By seeing the aggressive behaviour of my wife, I took her to a hospital in my town and she was diagnosed with OCPD, EUPD and anger discontrol from childhood. She refused to accept the disease and apprehended to take the medicine. We have been attending the marital counselling session too but without any improve in her condition. I would like to mention few of her behaviour conditions to make you realise the importance of my query. She is finding very difficult to trust people. Extreme suspicious behaviour towards all including me and easily lies on anything and make the conversation complicated. She is emotionally cold towards others and no sense of guilt even if she gets angry on small issues or when committed any mistake. She suffers from mood swing with anger outburst. She slaps herself and bang her head against wall. She believe that she has a sixth sense and prejudge the people by telling something bad is going to happen. She behaves overemotional, dramatic, irrational reasoning and weeping without tears. She has fear of locking herself in toilet or room. So, she will keep the door open at home or outside. She suffers with forgetfulness and unable to concentrate on anything. She used to keep re-checking the things in kitchen. She used to keep things in order and gets very disturbed and upset if things are not in the place. Feel dirt everywhere and keep on cleaning.  She is reluctant on spending money. Despite having hand dermatitis she carries a wet cloth whole day and clean and urge to wash hand repetitively. From 8 AM to 4 PM she will be engaged in household job, But, she do not feel to take rest or sleepy in noon or at night. Once she is exhausted physically and mentally then only she feels sleepy. Her sleep problem urge her watching horror or investigative movies late night. She often gets sad and scary dreams and murmurs at night to herself. She visualises images whenever she is alone and trying to hold the imaginary figure in air and talk to them. She gets negative depressive thoughts often and suicidal threat whenever in anger. I request you to evaluate her condition based on the above and provide further line of treatment accordingly. My further request is to perform personality test if required to confirm her actual personality disorder or any other available tool for her assessment and plan the treatment accordingly.My doubts are, is this ailment hereditary and spread to my kids too? Is this a completely curable one? In her current state of mind when she is not accepting her ailment and occasional anger outburst and suicidal threat, what could be the severity of her disease in future? What should be the future course of management for her? I would appreciate your insight and further assessment. Thanks.
Hi. I have read the detailed history that you have mentioned in your query and I can understand your concern. The symptoms does not fit in a particular personality type and this is the reason why she has been diagnosed with different personalities. As you have mentioned that her symptoms are present since childhood so apart from personality disorders other conditions should also be ruled out like bipolar disorder or some psychotic episode. Fear of locking in toilet, mistrust, etc., suggest anxiety. Visualising images, repetitive work pattern, keeping things in order, jealousy, obsessive ideas of cleanliness, feeling dirt everywhere, etc., are pointing towards OCD. She is not accepting her illness and this means she has lost insight related to her illness. For further infomration consult a psychiatrist online -->