The effect of personality disorder on clinical outcome, social networks and adjustment: a controlled clinical trial of psychiatric emergencies

1994 ◽  
Vol 24 (3) ◽  
pp. 731-740 ◽  
Author(s):  
P. Tyrer ◽  
S. Merson ◽  
S. Onyett ◽  
T. Johnson
Keyword(s):  
Social Networks ◽  
Personality Disorder ◽  
Personality Assessment ◽  
Depressive Symptomatology ◽  
Controlled Clinical Trial ◽  
Community Based ◽  
Psychiatric Emergencies ◽  
Intervention Service ◽  
Icd 10 ◽  
Personality Disordered

SynopsisOne hundred psychiatric emergencies presenting to an inner London teaching hospital had formal assessments of psychopathology, personality disorder (using both ICD-10 and the Personality Assessment Schedule), social networks and social functioning before being randomly assigned to a multidisciplinary community-based team (Early Intervention Service (N = 48) or conventional hospital-based psychiatric services (N = 52) and treated for a period of 12 weeks. The ICD-10 classification yielded a higher proportion (50%) of personality disordered patients than the Personality Assessment Schedule (34%) and those from ethnic minorities (mainly Afro-Caribbean) and upper social classes had a lower incidence of personality disorder. Social networks were smaller in personality disordered patients and there were fewer attachment figures. Improvement in social function, and to a lesser extent with depressive symptomatology, was better in patients with no personality disorder referred to the community service compared with the hospital service. No differences were found between the numbers and duration of social contacts in the two services and it is concluded that the better outcome in the community-treated patients was independent of changes in social networks.

Adolf Hitler: a re-assessment of his personality status

1993 ◽  
Vol 10 (3) ◽  
pp. 148-151
Author(s):  
Desmond Henry ◽  
Dick Geary ◽  
Peter Tyrer
Keyword(s):  
Personality Disorder ◽  
Personality Assessment ◽  
Third Reich ◽  
Structured Interview ◽  
Adolf Hitler ◽  
Historical Figures ◽  
Icd 10 ◽  
Special Knowledge ◽  
The Third Reich ◽  
Personality Disturbance

AbstractObjective: The assessment of the personality status of Adolf Hitler using a structured interview schedule, the Personality Assessment Schedule, with two informants, one a psychiatrist with an interest in psychohistory and the other a historian with special knowledge of the Third Reich and Weimar Republic. Method: The Personality Assessment Schedule was given in two forms to the two informants at different times; on each occasion Hitler was assessed as he was in 1937. Results: There was considerable discrepancy between the ratings of the two informants, the historian recording less-personality disturbance in all areas of function, although correlations between the two sets of ratings were relatively high (R1 0.5-0.6), with rater bias accounting for the differences in severity. Both informants regarded Hitler as having a dissocial personality disorder (using the new ICD-10 criteria), but the psychiatrist's rating also scored the diagnosis of paranoid and histrionic personality disorders. Conclusions: Interview schedules which use informants to assess personality disorder can be of value in examining the personality status of historical figures.

scholarly journals Prevalence of personality disorder in the case-load of an inner-city assertive outreach team

2004 ◽  
Vol 28 (12) ◽  
pp. 441-443 ◽  
Author(s):  
Maja Ranger ◽  
Caroline Methuen ◽  
Deborah Rutter ◽  
Bharti Rao ◽  
Peter Tyrer
Keyword(s):  
Personality Disorder ◽  
Inner City ◽  
Personality Assessment ◽  
Clinical Implications ◽  
National Service ◽  
Assertive Outreach ◽  
Outreach Team ◽  
National Service Framework ◽  
Icd 10 ◽  
Service Framework

Aims and MethodThe aim was to record the prevalence, type and severity of personality disorder dealt with by an inner-city outreach team. Patients on the register of an assertive outreach team were approached and asked to give informed consent for an informant interview with their principal worker to determine their personality status, using the informant-based ICD–10 version of the Personality Assessment Schedule.ResultsOf the 73 patients, 62 (85%) of whom had a psychotic diagnosis, 67 (92%) had at least one personality disorder, with 37 (51%) having complex or severe personality disorders.Clinical ImplicationsThe findings suggest that the National Service Framework requirements for assertive outreach teams tend to select many patients with comorbid personality disorder in addition to other severe psychiatric disorders.

scholarly journals Establishing prevalence of diagnosis of personality disorder across high secure forensic services using the ICD 10 and ICD 11 classification

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S291-S291
Author(s):  
Anju Soni ◽  
Samrat Sengupta ◽  
Ian Treasaden
Keyword(s):  
Personality Disorder ◽  
Personality Assessment ◽  
Negative Affectivity ◽  
Secondary Diagnosis ◽  
Clinical Validity ◽  
Paranoid Personality Disorder ◽  
Different Types ◽  
Icd 10 ◽  
Emotionally Unstable Personality Disorder

AimsThere has been an increasing recognition of the lack of clinical validity of different types of ICD10 personality disorder.The prevalence was established among patients in a high secure hospital in England of those with either a primary or secondary diagnosis of personality disorder and its recorded type according to ICD10 and then ICD11.The new ICD11 classification increased the validity of diagnosis of personality disorder as well as its severity.BackgroundICD 11 has proposed the dropping of the classification of personality disorder based on particular types of personality disorder and instead adopting a diathesis model based on 2 dimensions: presence of personality disorder and three levels of severity (Mild, Moderate and Severe) and the option of specifying one or more prominent trait domain qualifiers (Negative Affectivity, Detachment, Disinhibition, Dissociality, and Anankastia) and also specify a Borderline Pattern qualifier.MethodThe electronic medical records were used to establish the presence and type of personality disorder using the criteria of ICD10 and ICD11.The researchers assured reliability by rating some vignettes using the Schedule for Personality Assessment from Notes and Documents (SPAN-DOC) before rating actual cases.ResultFrom a total population of 208 patients, 64(30.8%) were classified as having either a primary or secondary diagnosis of personality disorder according to the ICD 10.30 (47%) had dissocial personality disorder (DSPD), 19(30%) emotionally unstable personality disorder (EUPD) and 8(13%) paranoid personality disorder. 20 (31%) had a comorbid diagnosis of mental illness and about a tenth had diagnoses of multiple personality disorders. These types of personality disorder diagnosed by the researchers using ICD 10 did not always match the types of personality disorder diagnosed by clinicians at the hospital.All patients met the criteria of personality disorder under ICD 11 but the number with a borderline specifier was greater than those with an ICD10 diagnosis of EUPD. Using the trait domain qualifiers in ICD 11, patients with ICD 10 diagnoses of EUPD or DSPD showed dissociation and disinhibition, with those with a DSPD showing low and those with EUPD high negative affectivity.ConclusionThe results confirm that while psychiatrists in a high secure hospital reliably diagnose the presence of a personality disorder, they are much less able to make an accurate diagnosis as to the actual type of personality disorder. The new ICD 11 classification will increase the clinical validity of the diagnosis of personality disorder and its severity.

An assessment of the Standardized Assessment of Personality as a screening instrument for the International Personality Disorder Examination: a comparison of informant and patient assessment for personality disorder

1999 ◽  
Vol 29 (4) ◽  
pp. 985-989 ◽  
Author(s):  
A. H. MANN ◽  
P. RAVEN ◽  
J. PILGRIM ◽  
S. KHANNA ◽  
A. VELAYUDHAM ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Random Order ◽  
Epidemiological Studies ◽  
Random Allocation ◽  
Standard Assessment ◽  
Standardized Interview ◽  
High Negative Predictive Value ◽  
Icd 10 ◽  
Personality Disordered ◽  
Level Of Agreement

Background. The International Personality Disorder Examination (IPDE) has been developed as a standardized interview for personality disorders. While it has good psychometric properties, its length makes it difficult to use in the community in population research, particularly outside psychiatric settings. The informant-based Standard Assessment of Personality (SAP), which has been in use since 1981, could serve as a valid screen to detect likely personality disordered individuals who would then receive a definitive diagnosis by IPDE. This study aimed to compare the two instruments in their capacity to detect personality disorder according to ICD-10 taxonomy and to estimate the efficiency of the use of the two together in a case-finding exercise.Method. Ninety psychiatric out-patients in Bangalore, India, were assessed for personality disorder using the two methods. Assessment was conducted by a pair of trained interviewers in random order and by random allocation to interviewer.Results. Overall agreement between the two instruments in the detection of ICD-10 personality disorder was modest (kappa = 0·4). The level of agreement varied according to personality category, ranging from kappa 07·66 (dependent) to kappa 0·09 (dyssocial). The SAP proved to have a high negative predictive value (97%) for IPDE as the gold standard, suggesting its potential as a screen in samples where the expected prevalence of personality disorder is low.Conclusion. A two-stage approach to epidemiological studies of personality disorder may be practicable.

Diagnostic Concordance Between Categorical and Dimensional Instruments to Assess Personality Disorder in Chronic Fatigue Syndrome

2017 ◽  
Vol 33 (3) ◽  
pp. 158-165
Author(s):  
Natalia Calvo ◽  
Naia Sáez-Francàs ◽  
Sergi Valero ◽  
Jesús Castro-Marrero ◽  
José Alegre Martín ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Chronic Fatigue Syndrome ◽  
Personality Assessment ◽  
Chronic Fatigue ◽  
Specific Pattern ◽  
Harm Avoidance ◽  
Assessment Instrument ◽  
Compulsive Disorder ◽  
Fatigue Syndrome ◽  
Self Transcendence

Abstract. The study examines the relationship between a categorical and a dimensional personality assessment instrument in patients with Chronic Fatigue Syndrome (CFS). A total of 162 CFS patients were included in the study (91.4% women; mean age 47.5 years). All subjects completed the Spanish versions of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Temperament and Character Inventory-Revised (TCI-R). Results: 78 (48.1%) of the patients presented a Personality Disorder (PD), the most frequent being Cluster C, specifically Obsessive-compulsive disorder, followed by Avoidant disorder. PDs showed a specific pattern of correlation with temperament scales. All PD clusters correlated positively with Harm Avoidance and Self-Transcendence, and negatively with Reward Dependence, Self-Directedness, and Cooperativeness. In a logistic regression analysis, Self-Directedness and Cooperativeness predicted PD presence. The findings are consistent with previous studies in non-CFS samples and suggest that the combination of the Temperament and Character dimensions (low Self-Directedness and Cooperativeness and high Harm Avoidance and Self-Transcendence) correlates with PD severity, and that Self-Directedness and Cooperativeness are associated with PD presence in CFS patients. The integration of these two perspectives expands the current comprehension of personality pathology in CFS patients.

Acetaminophen Reduces Distrust in Individuals With Borderline Personality Disorder Features

2017 ◽  
Vol 6 (1) ◽  
pp. 145-154 ◽  
Author(s):  
Ian D. Roberts ◽  
Ian Krajbich ◽  
Jennifer S. Cheavens ◽  
John V. Campo ◽  
Baldwin M. Way
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Assessment ◽  
Personality Assessment Inventory ◽  
Borderline Personality ◽  
Trust Game ◽  
Placebo Condition ◽  
Double Blind ◽  
Adult Participants ◽  
Interpersonal Difficulties

People with borderline personality disorder (BPD) tend to distrust others. We hypothesized that acetaminophen might reduce distrust in people with high BPD features because disordered affective responses are partially responsible for the interpersonal difficulties of people with BPD features, and acetaminophen has been shown in multiple studies to reduce negative affect. Using a double-blind, parallel-arm design, 284 young adult participants were administered either acetaminophen (1,000 mg; acute) or placebo and subsequently completed an economic trust game. BPD features were assessed with the Personality Assessment Inventory–Borderline Features scale. Participants with elevated BPD features showed less trust in their partners in the placebo condition but increased trust in the acetaminophen condition. Acetaminophen did not change expectations of trustee’s trustworthiness and did not impact trusting behavior in participants low in BPD features. Our results indicate that acetaminophen may reduce the behavioral distrust exhibited at high levels of BPD features.

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