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NICE PD Guideline Coverage — MRCPsych Paper B MCQ

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ModeratePersonality DisordersNICE PD Guideline CoverageMRCPsych Paper B

A 45-year-old man has an established diagnosis of paranoid personality disorder and persistent suspiciousness about colleagues. Assessment finds no delusions, hallucinations or formal thought disorder, and he has no coexisting depressive disorder. Which statement best describes current NICE guideline coverage relevant to his diagnosis?

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Correct answer: C — CG78 covers borderline and CG77 covers antisocial personality disorder; neither is a guideline for paranoid personality disorder

NICE has disorder-specific clinical guidelines for borderline personality disorder (CG78) and antisocial personality disorder (CG77), but no standalone guideline specifically for paranoid personality disorder. Therefore, C is correct. CG78 does not cover every personality disorder subtype. CG178 concerns psychosis and schizophrenia; suspiciousness associated with a personality disorder, without delusions, hallucinations or thought disorder, does not bring the case within that guideline. NG222 addresses depression, including depression coexisting with a personality disorder, but is not a general personality disorder guideline. Obsessive-compulsive disorder guidance does not provide disorder-specific management for paranoid personality disorder. Management should instead be individualised, with relevant NICE guidance followed for any coexisting mental disorder.

Reference: National Institute for Health and Care Excellence. 2018 surveillance of personality disorders (NICE guidelines CG77 and CG78), 2018. https://www.nice.org.uk/guidance/cg78/resources/2018-surveillance-of-personality-disorders-nice-guidelines-cg77-and-cg78-pdf-6358811143669