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Personality disorder

What is personality disorder?

Most people have personalities that enable them to adapt to their environments as needed. Those who have difficulty adapting, find problems are created for both themselves and others.

Deciding when these problems constitute a 'disorder' or remain within normal variation of personality is difficult. It is quite wrong to think that those with a personality disorder are fundamentally different from the rest of the population. There is considerable disagreement on what the definition of personality disorder should be. Two examples of definitions are below.

NICE personality disorder guidelines NICE have recently published guidelines for the care and treatment of individuals with a diagnosis of Borderline Personality Disorder and Anti-social Personality Disorder.

Definitions of personality disorder

1.The Diagnostic and Statistical Manual of Mental Disorders - Version 4 (DSM-IV; American Psychiatric Association, 1994) states that personality disorder is: "...an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual's culture, is pervasive inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment".

2. The World Health Organisation defines personality disorder in the International Classification of Mental and Behavioural Disorders (WHO, 1992) as:"...a severe disturbance in the characterlogical condition and behavioural tendancies of the individual, usually involving several areas of the personality, and nearly always associated with considerable and social disruption".

3. Another description: problematic ways of coping with everyday life and dealing with self and others.

Prevalence

Most studies suggest 25-30% of GP attendees have a personality disorder. This rises to 35-40% for those attending psychiatric outpatient facilities and community teams, to over 50% in psychiatric inpatients and up to 90% of those in prisons, special hospitals and specialist teams (Moran, 2000).

References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Moran, P., Jenkins, R., Tylee, A., Blizard, R. & Mann A. (2000). The prevalence of personality disorder among UK primary care attenders. Acta Psychiatrica Scandinavica, 102(1), 52-57. World Health Organization (1992). International Statistical Classification of Diseases and Related Health Problems, 10th revision. WHO, Geneva. 

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