Subtypes
Millon
Psychologist Theodore Millon notes that because most patients present a mixed picture of symptoms, their personality disorder tends to be a blend of a major personality disorder type with one or more secondary personality disorder types. He identified four adult subtypes of avoidant personality disorder. Others
In 1993, Lynn E. Alden and Martha J. Capreol proposed two other subtypes of avoidant personality disorder:

Diagnosis
ICD
The World Health Organizations ICD-10 lists avoidant personality disorder as anxious (avoidant) personality disorder (F60.6). It is characterized by the presence of at least four of the following:
persistent and pervasive feelings of tension and apprehension;
belief that one is socially inept, personally unappealing, or inferior to others;
excessive preoccupation with being criticized or rejected in social situations;
unwillingness to become involved with people unless certain of being liked;
restrictions in lifestyle because of need to have physical security;
avoidance of social or occupational activities that involve significant interpersonal contact because of fear of criticism, disapproval, or rejection.Associated features may include hypersensitivity to rejection and criticism. It is a requirement of ICD-10 that all personality disorder diagnoses also satisfy a set of general personality disorder criteria. DSM
The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association also has an avoidant personality disorder diagnosis (301.82). It refers to a widespread pattern of inhibition around people, feeling inadequate and being very sensitive to negative evaluation. Symptoms begin by early adulthood and occur in a range of situations.
An additional procedure involves a mesh that is placed over the diaphragm to block any holes that may have been missed in the first surgery. Hormonal therapies can also be used to suppress ovulation. Surgical removal of the endometrial tissue should be endeavored during menstruation for optimal visualization. Pleurodesis may also be effective in removing the space between the lung and the chest wall; preventing air build up between these layers. Non-surgical treatment includes pharmacological treatment via continuous oral contraceptive therapy to avoid cyclical bleeding with monthly menstruation. Oral contraceptives appear to be preferable for patients due to fewer negative side effects than treatment with GnRH agonist therapy, which can lead to hypoestrogenic effects including osteoporosis, resulting in discontinuation of therapy and thus a higher likelihood of recurrence of catamenial pneumothorax. Epidemiology
Some sources claim this entity represents 3 to 6% of pneumothorax in women. In regard of the low incidence of primary spontaneous pneumothorax (i.e. not due to surgical trauma etc.) in women (about 1/100000/year), this is a very rare condition. Hence, many basic textbooks do not mention it, and many doctors have never heard of it. Therefore, catamenial pneumothorax is probably under-recognized. See also
Catamenial epilepsy
Catamenial migraine

References


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