What are the recommended first-line treatment options for patients diagnosed with avoidant personality disorder?

Recommended first-line treatment options for avoidant personality disorder (AvPD) primarily involve psychological interventions. Although the provided UK guidelines do not explicitly address avoidant personality disorder, they offer relevant guidance for related conditions such as social anxiety disorder, which shares clinical features with AvPD.

For adults diagnosed with social anxiety disorder, which is closely related to avoidant personality disorder, the first-line treatment is individual cognitive behavioural therapy (CBT) specifically developed for social anxiety disorder (based on the Clark and Wells or Heimberg models) ¹.

If the patient declines individual CBT, CBT-based supported self-help is recommended as an alternative psychological intervention ¹.

Pharmacological treatment with selective serotonin reuptake inhibitors (SSRIs), such as escitalopram or sertraline, is considered if psychological interventions are declined or ineffective ¹.

Given the overlap in symptoms and treatment approaches, these recommendations can be cautiously extrapolated to avoidant personality disorder, with psychological therapies as the mainstay and SSRIs as a pharmacological option when indicated.