Histrionic personality disorder is characterized by colorful, dramatic, extroverted behavior in exit able, emotional persons. Accompanying their flamboyant presentation, however, is often an inability to maintain deep, long lasting attachments. This is also known as hysterical personality.
Epidemiolgy :
    The exact prevalence of histrionic personality disorder is unknown. It is diagnosed more frequently in women than in men. Some studies have found an association with somatization disorder and alcoholism.
Clinical Features :
    Patients with histrionic personality disorder show a high degree of attention seeking behavior. They tend to exaggerate their thoughts and feelings, making everything sound more important than it really is. They will display temper tantrums, tears and accusations if they are not the centre of attention or are not receiving praise or approval. Seductive behavior is common in both sexes. Sexual fantasies about persons with whom they are involved are common, but they are inconsistent about verbalizing these fantasies and may be coy or flirtatious rather than sexually aggressive. In fact, histrionic patients may have psychosexual dysfunction the women may be anorgasmic, and the men may impotent. They may act on their sexual impulses to reassure them selves that they are attractive to the sex. Their need for reassurance is sendless. Their relationships tend to be superficial , however, and these persons can be vain, self absorbed, and fickle. Their strong dependency needs makes them overly trusting and gullible.
Course And Prognosis :
    With age, patients with histrionic personalities tend to show fewer symptoms but because they lack the same energy they had when younger, that difference may be more apparent than real. These patients are cessation seekers and may get into trouble with the law, abuse drugs, and act promiscuously. Treatment : Patients with histrionic personality disorder are often unaware of their own real feelings, there fore, clarification of their inner feelings is an important therapeutic process. Psychoanalytically oriented psychotherapy, whether group or individual, is probably the treatment for choice for this personality disorder. Pharmacotherapy can be adjunctive when symptoms are targeted ( e.g., antidepressants for depression and somatic complaints, antianxiety agents for anxiety, and antipsychotic for derealizaiton or illusions).
(Author is Consultant Psychiatrist at Raahat Hospital, Aurangabad.)