Psych · General adult psychiatry — personality disorders
Dependent personality disorder
Also known as DPD · Dependent PD · Cluster C dependent · Dependent personality · Asthenic personality (historical)
Exam-exhaustive fellowship reference on dependent personality disorder — DSM-5-TR ≥5 of 8 criteria, ICD-11 severity and trait mapping, Bornstein interactionist dependency model, differentials (AVPD, BPD, depression, culture), post-separation risk and IPV, CBT for autonomy and schema therapy, pharmacotherapy only for comorbidity. FRANZCP-primary, globally tagged.
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Red flags
- Suicidal ideation or self-harm after relationship breakdown, bereavement, or threatened abandonment — same-day risk review, means restriction, documented safety plan
- Intimate partner violence or exploitation of submissiveness (financial, sexual, coercive control) — dual safeguarding and clinical plan; do not collude with staying 'for support'
- Iatrogenic dependence: clinician or service becomes permanent decision-maker and substitute caretaker without graded autonomy goals
- Late-onset 'new dependence' with cognitive change, weight loss, or neurology — exclude organic disease and severe mood disorders before a lifelong PD label
- Missed major depression, separation anxiety, or borderline PD while attributing all morbidity to 'clinginess'
- Akathisia or marked activation after antidepressant start/titration — reassess risk and regimen immediately
Meet the patient
A 29-year-old woman arrives with her mother, three weeks after a breakup. She cannot tell you what she had for lunch without glancing at Mum first. She moved home within days of the split, matched with a new partner within a fortnight, and when he stopped replying she took twelve paracetamol. "I just can't do life on my own," she says — and she means it literally, not dramatically.[1][3][13]
The examiner's question hiding in this stem: is this borderline, avoidant, depressed — or dependent? Get that discriminator right and the rest of this topic writes itself.[1][2]
References16ShowHide
- [1]Disney KL Dependent personality disorder: a critical review Clin Psychol Rev, 2013.PMID 24185092
- [2]Bornstein RF From dysfunction to adaptation: an interactionist model of dependency J Pers, 2012.PMID 22458867
- [3]Bornstein RF The dependent personality: developmental, social, and clinical perspectives Psychol Bull, 1992.PMID 1529038
- [4]Gude T, Hoffart A, Hedley L, Rø Ø The dimensionality of dependent personality disorder J Pers Disord, 2004.PMID 15615670
- [5]Gjerde LC, Czajkowski N, Røysamb E, Orstavik RE, et al. The heritability of avoidant and dependent personality disorder assessed by personal interview and questionnaire Acta Psychiatr Scand, 2012.PMID 22486635
- [6]Grant BF, Hasin DS, Stinson FS, Dawson DA, et al. Prevalence, correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions J Clin Psychiatry, 2004.PMID 15291684
- [7]Lenzenweger MF, Lane MC, Loranger AW, Kessler RC DSM-IV personality disorders in the National Comorbidity Survey Replication Biol Psychiatry, 2007.PMID 17217923
- [8]Torgersen S, Kringlen E, Cramer V The prevalence of personality disorders in a community sample Arch Gen Psychiatry, 2001.PMID 11386989
- [9]Winsper C, Bilgin A, Thompson A, Marwaha S, et al. The prevalence of personality disorders in the community: a global systematic review and meta-analysis Br J Psychiatry, 2020.PMID 31298170
- [10]Bamelis LL, Evers SM, Spinhoven P, Arntz A Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders Am J Psychiatry, 2014.PMID 24322378
- [11]Bamelis LL, Arntz A, Wetzelaer P, Verdoorn R, et al. Economic evaluation of schema therapy and clarification-oriented psychotherapy for personality disorders: a multicenter, randomized controlled trial J Clin Psychiatry, 2015.PMID 26579561
- [12]Hopwood CJ, Thomas KM Schema therapy is an effective treatment for avoidant, dependent and obsessive-compulsive personality disorders Evid Based Ment Health, 2014.PMID 25009174
- [13]Loas G, Guilbaud O, Perez-Diaz F, Verrier A, et al. Dependency and suicidality in addictive disorders Psychiatry Res, 2005.PMID 16233920
- [14]Kane FA, Bornstein RF Beyond passivity: Dependency as a risk factor for intimate partner violence J Nerv Ment Dis, 2016.PMID 26542755
- [15]Cipriani A, Furukawa TA, Salanti G, Chaimani A, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis Lancet, 2018.PMID 29477251
- [16]Kim YR, Tyrer P, Mulder R, King JD, et al. ICD-11 classification of personality disorder: there is no other way forward Br J Psychiatry, 2026.PMID 41906979