A 38-year-old male lawyer consistently exploits colleagues, shows no remorse for harm caused, lies to clients, and has had two previous convictions for fraud. These traits have been stable since early adulthood. His presentation is most consistent with which DSM-5 personality disorder, and what is a key ICD-11 difference in its classification?

• A Narcissistic PD (DSM-5); ICD-11 does not include narcissistic PD as a specific type
• B Antisocial PD (DSM-5); ICD-11 replaces specific PD types with severity rating plus optional trait specifiers, subsuming antisocial traits under 'dissocial trait domain' ✓
• C Antisocial PD (DSM-5); ICD-11 classifies this as 'Dissocial Personality Disorder' requiring evidence of failure to conform to social norms only
• D Psychopathic PD (DSM-5); ICD-11 recognises psychopathy as a distinct category

Explanation

DSM-5 maintains categorical personality disorder types (including Antisocial PD), while ICD-11 adopts a dimensional-severity model: PDs are classified by severity (mild, moderate, severe) and optional trait specifiers (negative affectivity, detachment, dissociality, disinhibition, anankastia). Dissociality (callousness, manipulativeness, deceitfulness, remorselessness) is the trait domain corresponding to antisocial/psychopathic features, but ICD-11 no longer names it 'dissocial personality disorder' as a separate category. Psychopathy is also not a DSM-5 category (it is in the alternative model in Section III).

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.