Personality Disorders and Older Adults

As an academic geriatric psychiatrist and a former training director of a geriatric psychiatry fellowship program, I am always on the lookout for books that can give a comprehensive review of topics in geriatric psychiatry for trainees to read. Over the years, I have reviewed multiple books and articles on personality disorders in the elderly, but was never impressed by what I saw or read. It was fortunate that I got a chance to review this wonderful book by Drs. Segal, Coolidge, and Rosowsky. In my opinion, Personality Disorders and Older Adults: Diagnosis, Assessment, and Treatment is a must-read for anyone who is caring for elderly patients. It is also a must-have for any medical library, as the contents of this book will be useful to any clinician interested in dealing with difficult elderly patients. The charm of the book lies in the fact that it is beautifully written in a simple style that catches one's attention immediately. It has enough material to not only provide basic information to satisfy the curiosity of a lay person but to also cater to the needs of a senior professional dealing with the care of the elderly. This book is very easy to read because it is well organized into different chapters starting with an introduction to personality disorder and aging (chapter 1) and ending with the chapter on the “Goodness of Fit” model and its implication for treatment (chapter 11). The book provides a comprehensive review of each cluster of personality disorders and addresses the issues of comorbidity, epidemiology, diagnosis, and treatment of the elderly with personality disorder. Case vignettes highlighting each of the clusters of personality disorders make the narrative more interesting. The authors have also done an excellent job of providing a comprehensive framework for conceptualizing personality disorders combining the psychodynamic, cognitive, and biological realms. It is a tribute to the authority of Drs. Segal, Coolidge, and Rosowsky on the concept of personality disorders in older adults that they have been able to provide such a comprehensive narrative on this difficult to understand and treat condition. Elegantly designed in hardcover and priced appropriately at $60.00, Personality Disorders and Older Adults: Diagnosis, Assessment, and Treatment is a wonderful addition to the growing world of literature on psychiatric issues in the elderly. Rajesh R. Tampi, M.D., M.S. Yale University School of Medicine, New Haven, Connecticut