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O mundo relacional na perturbação de personalidade narcísica : um caso clínico
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A Perturbação de Personalidade Narcísica (PPN) é caracterizada por um padrão difuso de grandiosidade, necessidade de admiração e falta de empatia para com o outro. Apesar dos dados acerca da sua prevalência serem variáveis, é indiscutível que esta tem vindo a aumentar ao longo dos anos e que tem um grande impacto na vida destes indivíduos. Um dos mais preponderantes é a dificuldade em estabelecer e manter relações afetivas estáveis. Muitos destes doentes apresentam também outras comorbilidades psiquiátricas que, além de dificultarem o diagnóstico desta perturbação, acabam por comprometer a sua qualidade de vida.
Este trabalho tem como principal objetivo uma melhor compreensão do funcionamento do mundo relacional de um doente com PPN. Procura-se perceber se existe uma tendência para o isolamento social, mas também que tipo de relações afetivas estabelecem e a duração das mesmas. Secundariamente, procura-se perceber quais são as características da PPN que mais influenciam o curso destas relações, tanto no início, como na manutenção e no término das mesmas.
A metodologia adotada é o estudo de caso clínico. A doente é seguida há 4 anos na consulta de Psiquiatria do Centro Hospitalar Lisboa Norte, por psiquiatras e um psicólogo. O seguimento iniciou-se por sintomas depressivos, mas ao longo do tempo foram sendo percetíveis subtis traços de personalidade narcísica, bem como uma vida relacional claramente atribulada e instável. O estudo foi baseado numa entrevista com a doente e nos seus registos clínicos. Como meios bibliográficos foram utilizados o estudo de diversos autores relevantes na área e a revisão de artigos relacionados com a PPN.
Apesar do diagnóstico desta perturbação poder ser desafiante, o reconhecimento do narcisismo patológico é fundamental para que os clínicos possam ajudar estes doentes a prevenir relações disfuncionais e a melhorar as suas competências interpessoais, embora estes indivíduos possam apresentar alguma resistência ao diagnóstico e à terapia.
ABSTRACT: Narcissistic Personality Disorder (NPD) is characterised by a diffuse pattern of grandiosity, need for admiration and lack of empathy for others. Although existing data on its prevalence is quite variable, it is unquestionable that it has been increasing over the years and that it has a profound impact on the lives of these individuals. One of the most preponderant is the difficulty in establishing and maintaining stable affective relationships. Many of these patients also have other psychiatric comorbidities which, in addition to adding difficulty to the diagnosis of this disorder, also end up compromising their quality of life. The main objective of this study is a better understanding of the functioning of the relational world of a patient with NPD. The aim is to understand whether there is a tendency towards social isolation, but also what type of affective relationships are established and how long do they last. Secondarily, we aimed to understand which are the characteristics of NPD that influence the most the course of these relationships, both at the beginning, maintenance, and end of them. The adopted methodology is a clinical case study. The patient has been followed by psychiatrists and a psychologist for the past 4 years in the Psychiatry consultation at the Centro Hospitalar Lisboa Norte. The follow-up started due to depressive symptoms, but over time subtle traces of narcissistic personality were perceptible, as well as a clearly troubled and unstable relational life. based on an interview with the patient in question and on her clinical records. The study was based on an interview with the patient and on her clinical records. The study of several relevant authors in the area and the review of articles related to PPN were used as bibliographic resources. Although the diagnosis of this disorder can be challenging, the recognition of pathological narcissism is essential for clinicians to help these patients prevent dysfunctional relationships and improve their interpersonal skills, although these individuals may present some resistance to diagnosis and therapy.
ABSTRACT: Narcissistic Personality Disorder (NPD) is characterised by a diffuse pattern of grandiosity, need for admiration and lack of empathy for others. Although existing data on its prevalence is quite variable, it is unquestionable that it has been increasing over the years and that it has a profound impact on the lives of these individuals. One of the most preponderant is the difficulty in establishing and maintaining stable affective relationships. Many of these patients also have other psychiatric comorbidities which, in addition to adding difficulty to the diagnosis of this disorder, also end up compromising their quality of life. The main objective of this study is a better understanding of the functioning of the relational world of a patient with NPD. The aim is to understand whether there is a tendency towards social isolation, but also what type of affective relationships are established and how long do they last. Secondarily, we aimed to understand which are the characteristics of NPD that influence the most the course of these relationships, both at the beginning, maintenance, and end of them. The adopted methodology is a clinical case study. The patient has been followed by psychiatrists and a psychologist for the past 4 years in the Psychiatry consultation at the Centro Hospitalar Lisboa Norte. The follow-up started due to depressive symptoms, but over time subtle traces of narcissistic personality were perceptible, as well as a clearly troubled and unstable relational life. based on an interview with the patient in question and on her clinical records. The study was based on an interview with the patient and on her clinical records. The study of several relevant authors in the area and the review of articles related to PPN were used as bibliographic resources. Although the diagnosis of this disorder can be challenging, the recognition of pathological narcissism is essential for clinicians to help these patients prevent dysfunctional relationships and improve their interpersonal skills, although these individuals may present some resistance to diagnosis and therapy.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Perturbação de personalidade narcísica Narcisismo patológico Relações afetivas Dificuldades interpessoais Psiquiatria