DDx: Harry Potter

In the midst of preparations for the USMLE Step 1, we (medical students) sometimes resort to mnemonic devices and memory tricks to help us remember details on subjects with which we feel less comfortable. Some of these devices involve acronyms that stand for items in a series (e.g. microorganisms susceptible to a particular antibiotic); others might be pictures or stories. During our Human Behavior (Psychiatry) block, one of our professors had the excellent idea of illustrating personality disorders with movie characters; unfortunately, many people were not that familiar with the references to older films and plays (e.g. Vivien Leigh as the histrionic Blanche DuBois in A Streetcar Named Desire).

Here is my more contemporary comparison of fictional characters to personality disorders: the colorful inhabitants of the world of J. K. Rowling’s Harry Potter. 

**Warning: Minor spoilers below! (for those who have not read the Harry Potter series or seen the movies, however few of you there are out there)**

Cluster A Personality Disorders
• Paranoid [distrustful, skeptical, expecting betrayal] = Cornelius Fudge – irrationally fears that Albus Dumbledore is trying to overthrow him as the Minister of Magic
• Schizoid [voluntarily withdrawn, seeks isolation, reserved in expressing emotion] = Severus Snape – rarely expresses emotions and usually stays in his office or in the Potions chamber, away from the company of others
• Schizotypal [odd appearance, magical thinking, awkward in social settings] = Sybill Trelawney – a very eccentric Divination instructor

Cluster B Personality Disorders
• Antisocial [criminal behavior, disregards well-being of others, believes rules don’t apply to him/her] = Voldemort aka Tom Riddle – the classic model of a conduct disorder case growing into a full-fledged antisocial
• Borderline [dramatic mood swings, impulsive, unstable, feels empty] = Moaning Myrtle – technically she is too young to have a Personality Disorder diagnosis (these are not applied until behaviors stabilize in adulthood), but her expressed feelings of loneliness and abandonment mixed with the occasionally warm approach to frequent visitors is strongly reminiscent of this disorder
• Histrionic [dramatic expressions of emotion, seeks attention] = Bellatrix Lestrange – the theatrical right-hand woman of the Death Eaters craves the approval and appreciation of her master
• Narcissistic [feels entitled, grandiose self-perception] = Gilderoy Lockhart – self-indulgent and always expecting admiration and adoration, even where lacking

Cluster C Personality Disorders
• Avoidant [socially awkward but desires company, fearful of rejection] = Rubeus Hagrid – although he develops strong relationships with several characters in the series, Hagrid’s half-giant background and shameful exits from Hogwarts make him very sensitive to the opinions of others
• Obsessive-compulsive [overly concerned with perfection and control] = Dolores Umbridge – the temporary Headmistress and Inquisitor of Hogwarts upon Dumbledore’s disappearance is the perfect picture of obsessiveness and rigidity
• Dependent [lacks self-confidence or assertiveness, passive, needs to be cared for] = Peter Pettigrew – the once friend of James Potter, Harry’s father, shifts the target of his submissive behavior from James and his friends to Voldemort and the Death Eaters

Impressively, J. K. Rowling has done a wonderful job of creating characters with many different personality profiles, including debilitating and self-compromising flaws.