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crease

gram

of clients
who were
drop
in total
BPRS
limited
but

mission.

in BPRS total scores


froni prointake
to discharge
for a subset

to a specific

was

crease
We

was

retested.
This
scores
was not

consistent

symptom
with

in reported

de-

symptoms.

acknowledge
not a controlled

that because
this
study, the results

are not sufficient


evidence
ment
success.
Pmedischarge
was limited
to clients
who

conic

will also be needed.

The

authors

Tom

Wishart

1.

treattesting
remained

10:799-812,

2.

HedlundjL,
atric

such as potential
clients
to enter
the program
and

clients

drop

out within

days

other

out-

#{149}5.

Jim

Cheesman

in

6.

11:48-65.

3.

DR: The Brief PsvchiPsychological


Reports

D, Libernian
Symptom
nonitoring
of schizophrenic
Bulletin
12:578-602,
Ventura
al: Brief
expanded

of ad-

points,

Lukoff
D, Nuechterlein
Psychiatric
Rating
Scale
version
(4.0):
scales,
administration

manual.

Research

M,

1993

Suhotnik

in press

KL, Nuechterlein
KH: Prodromal
and symptoms
of schizophrenic
reJournal
of Abnornial
Psychology

97:405-412,

8.

Inch

Health,

sigus
lapse.

KH, et
(BPRS)
anchor

3:221-244,

B, Thorarinson
D, et al:
The challenges
of conducting
program
evaluation
in a psychiatric
day treatment
program:
the rewards
are worth
the sweat
and tears. Canadian
Journal
of Conimunitv

7.

HP Nuechterlein
KH:
in the rehabilitation
patients.
Schizophrenia
1986

J,

and

Psychiatric

Mental

Lukoff

4.

quality

Crossley

1962

Vieweg
NIS: The Brief PsychiScale (BPRS):
a comprehensive
Journal
of Operational
Psychiatry
1980

Re-

ME Shaner
A, et al: Trainassurance
with
the Brief
Rating
Scale:
the
drift
International
Journal
of Methods

ing and
Psychiatric
busters.

and

comments.

in Psychiatric

Ventura J, Green

Rating

review.

compami-

son groups,
who refuse
who

thank
for helpful

Overall
JE, Gorham
atric
Rating
Scale.

for

appropriate

with

References

planned
with program
staff.
Future
investigations
using
the
BPRS as a program
outcome
measure
include

variables

tionaljournal
ofMethods
search 3:227-244,
1993

reliability

validity

in the pmogramii a significant


period of
time
and
whose
discharge
was

should

on interrater

Acknowkdgments

cluster

a general

Data

and concurrent

1988

Overall
JE,
psychiatric

model.

LE,

Hollister
disorders:

Archives

16:146-151,

of

Pichot
P: Major
a four-dimensional
General
Psychiatry

1967

Guy w ECDEU
Assessment
Manual
for
Psychopharmacology
Pub DHE\V
(ADM)
76-338.
Rockville,
Md, National
Institute
of
Mental
Health,
1976

9.

Interns-

Mnemonics for DSM-1V


Personality Disorders
Harold

B. Plnkofsky,

The

paper

presents

M.D.,

several

Ph.D.

mne-

monics

he criteria-based

to assist clinicians
in recalling
DSM-IY
diagnostic
criteria
for per-

lined

sonality
disorders.
The mnemonics
are
acronyms,
and each letter is associated
with
a specific
criterion.
Each
ac-

difficulties.
memorize
ic mental

ronym

lection

reflects

a facet

of the

agnosis

related

in DSM-JV

of the

misdiagnosis.
Mnemonics
various
segments

for histrionic
personality
disorder
PRAISE
ME. The mnemonics

fession

have

ed

been

resi-

dens

dents

Iv

used

the conceptual
disorders
and

member
vices

to teach

the criteria.

48:1197-1198,

students
nature

to

help

and

developed

Di: Pinkofsky
is assistant
professor
in the
department
of psychiatry
at Louisiana
State University
Medical
Center,
P0. Box
33932,
Shreveport,
Louisiana
71130.
1997

Vol.

may

Mnemonics
and

result

paper

been
presents

help

tended

in

conjunction

number

number

in brackets

of the

DSM-IV

criterion
for the disorder.
The numben ofcritemia
needed
to make the diagnosis

acronym.

is

in

parentheses

after

the

#{149}

acronyms

1.

EA, Morse JH, et al:


Mnemonics
for eight
DSM-IlI-R
disorders. Hospital
and Community
Psychiatry
43:642-644,
1992

2.

Reeves

learn

in our

No.

1 the

to the

in

not as a substitute

References

for DSM-IV
The acronyms
respective
dis-

program

of DSM-IV

refers

used
and

dison-

idents

nature

be

for it.
In Table

These
mnemonics
have been
in teaching
students
and nesteaching

to
DSM-IV

them
remember
mnemonics
are in-

described

clinicians

dens
and
helping
the criteria.
The
with

for select-

DSM-IV

previously
to

certain

orders.
helpful
conceptual
48

present

have
been
used
by
of the medical
pro-

and
recollect
criteria
personality
disorders
reflect
a facet ofthein

Ser-

1997)

PSYCHIATRIC SERVICES . September

have

out-

practitioner
must
criteria
for specifImproper
recol-

criteria

DSM-IlI-R

( 1,2). This

of DSMthem
re-

(Psychiatric

(1-3).

to di-

disorders

can

The
specific
disorders.

disorder;
for example,
the acronym
for
the diagnostic
criteria
for paranoid
personality
disorder
is SUSPECI
and
it is

approach

of mental

the
disor-

Short DD, Workman

Mental

RB, Bullen
JA: Mnemonics
disorders.
Journal
ofNervous
Disease 138:556-551,
1995

Wynne
clinical
26:23-29,

AG, Fitzpatrick
endocrinology.
1991

DSM-IV

3.

for ten
and

LA: Mnemonics
in
Hospital
Practice

1197

Table

Mnemonics

for recalling

the

diagnostic

ofDSM-IV

criteria

personality

Cluster A personality
disorders
Paranoid personality
disorder: SUSPECT
(four criteria)
S [7]Spouse
fidelity suspected
U [5]Unforgiving
(bears grudges)
S [1]Suspicious
of others
P [6]Perceives
attacks (and reacts quickly)
E [2] Enemy
or friend (suspects associates
and friends)
C [3]Confiding
in others feared
T [4]Threats
perceived
in benign events
Schizoid

D
I
S
T
A

personality

[7]Detached

disorder:

DISTANT

(or flattened)

affect

(four

Narcissistic

nor enjoys close


in few activities

(odd) thinking

E [8] Envious

mental

(five criteria)

[1]

[6]Interpersonal

[9]Arrogant

[7]Lacks

[5]Reckless
disregard
for safety of self or others
[7]Remorse
hacking
[2lUnderhanded
(deceitful,
lies, cons others)
{3}Planning
insufficient
(impulsive)
[4}Temper
(irritable
and aggressive)
AM.

SUICIDE

(fIve

reactivity

I
C [8]Control
of anger
I [3]Identity
disturbance
D [9}Dissociative
(or paranoid)

(four

(restraint

criteria)

before

willing

taking
[6]Selfviewed

personal
(as

ones thoughts
in intimate

[1]

[3]Expressing

in

relation-

in)
signifi-

contact)

prevents

risks
unappealing,

new activity

inept,

or

disagreement

difficult

or

inferior)

personality
disorder:
RELIANCE
Reassurance
(required
for decisions)

to

shamed)

(potential)

criteria)

(five
(due

to fear

of loss

of support or approval)
[2}Life responsibilities
(needs to have these assumed
others)
[4ilnitiating
projects difficult (due to lack of self-confi-

[6]Alone

[5] Nurturance

(feels helpless
(goes

by

{7]Companionship
ly when
close

[8]Exaggerated

(four

disorder:

[2] Provocative
(or sexually
[8}Relationships
(considered
[1}Attention
(uncomfortable

nur-

(another
relationship
fears

relationship)
ends

ofbeing

left

sought

to care

for

urgent-

self

personality

disorder:

LA\V

F! RMS

point

ofactivity

(due

to preoccupation

with

de-

tail)
areas)

[2]Abihity to complete
tasks (compromised
b perfecionism)
[5}Worthless
objects (unable to discard)
[3]Fniendships
(and leisure activities)
excluded
(due to a

[4]

that are transient

of)

PRAISE

alone)

to ol)tain

criteria)
[1}Loses

feelings

when

lengths

criteria)2

of mood)

symptoms

and discomfort

to excessive

and support)

preoccupation

(chronic

[7}Lnfluenced

CRINGES

ofbeing

interpersonal

ME (five criteria)

work)

scrupulous,

or morality,

overconscientious

not accounted

(on ethics,

for by religion

or

culture)

seductive)
behavior
more intimate
than they are)
when not the center of attention)

[6]

Reluctant

to delegate

(unless

others

submit

to exact

guidelines)

easily

[5}Style
of speech
(impressionistic,
lacks detail)
[3]Emotions
(rapidly
shifting
and shallow)
[4]Made
up (physical
appearance
used to draw attention

with

Inflexible,

values,
P
R
A
I
S
E
M

to fear

Embarrassment

[7]

and stress related

personality

disorder:

Obsessive-compulsive
(marked

(or self-mutilating)
behavior
and intense relationships
[4}Impulsivity
(in two potentially
self-damaging

Histrionic

of self importance)

disorders

relationships

turance

S [5}Suicidal
U [2}Unstable

E [7]Emptiness

sense

dence)

disorder:

A {1]Abandonment
M [6] Mood instability

of

exploitation

due

R
R
U
P
T

are envious

[51 New interpersonal


relationships
(is inhibited
around occupational
activity (involving

criteria)

ignored

pov-

required

(grandiose

Intimate

[3]

Dependent
develop-

to law lacking

others

[2]Certainty
(ofbeing
liked required
get involved with others)
[4] Rejection
(or criticism)
preoccupies
social
situations

[6]Obhigations

success,

(haughty)
empathy

G [1]Gets
cant

(three

criteria)

(of unlimited

or believes

admiration

Conceited

ships

personality

[4] Excess

C [1}Conformity

Borderline

relations

CORRUPT

(five

and unique)

ideal love)

or

(of others,

disorder

Cluster B personality
disorders
Antisocial
personality
disorder:

fantasies

beauty

Cluster
C personality
Avoidant
personality

and pervasive

SPE1CIAL

he or she is special

him or her)
E [5]Entitlement

and speech

L [8]Lacks
close friends
I [1]Ideas
of reference
A [9]Anxiety
in social
situations
R
Rule
out psychotic
disorders

disorder:

er, brilliance,

criteria)

Schizotypal
personality
disorder:
ME PECULIAR
M [2]Magical
thinking
or odd beliefs
E [3] Experiences
unusual
perceptions
P [5]Paranoid
ideation
E [7] Eccentric
behavior or appearance
C [6]Constricted
(or inappropriate)
affect

U [4]Unusual

personality

S [3]Special
(believes
P [2] Preoccupied
with

[6}Indifferent
to criticism
and praise
[3]Sexual
experiences
ofhittle
interest
[2}Tasks (activities)
done solitarily
[5]Absence
ofclose
friends

N [1}Neither
desires
T [4lTakes pleasure

disorders

[7]Miserly

[8}Stubbornness

(toward

selfand
(and

others)

rigidity)

to

self)

E [6}Emotions
I

The number

exaggerated

in brackets

refers

(theatrical)
to the number

ofthe

DSM-IV

criterion.

The nuniber

ofcriteria

needed

to make

the diagnosis

is in parentheses

after

the

acronym.
2

This mnemonic

was

the State University

1198

adapted

from one developed

of New

York

by Lily Awad,

M.D.,

ofSt.

Elizabeths

Hospital

in Boston

and

provided

by Prakash

Masand,

M.D.,

of

No.

at Syracuse.

PSYCHIATRIC SERVIQIS . September

1997

Vol.

48