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Personality Disorder in Perspective

Published online by Cambridge University Press:  02 January 2018

Peter Tyrer ,
Patricia Casey  and
Brian Ferguson
Peter Tyrer*
Affiliation:
St Charles Hospital, London WW 6DZ
Patricia Casey
Affiliation:
Mater Misericordiae Hospital, Dublin, Republic of Ireland
Brian Ferguson
Affiliation:
Mapperley Hospital, Nottingham
*
∗Correspondence
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Abstract

Personality disorders have for many years been on the fringe of psychiatry, with considerable doubts expressed about the usefulness, implications and validity of the concept. It is argued here that developments in the past few years have brought personality disorders into the mainstream of psychiatric practice. In particular, the recognition that personality function can be separated usefully from clinical symptoms, and that both mental state and personality can be disordered simultaneously, has led to better assessment and understanding. Advances in the classification, epidemiology, treatment and prognosis of personality disorders show that these conditions are common, extensive in their pathology, and cause much suffering. They cannot be ignored or dismissed as peripheral to psychiatry for they are an essential part of good psychiatric practice.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 159 , Issue 4 , October 1991 , pp. 463 - 471
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

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References

Adlington, R. (ed. & trans.) (1925) A Book of Characters (by Theophrastus). London: George Routledge.Google Scholar
Akiskal, H. S., Chen, S. E., Davis, G. C., et al (1986) Borderline: an adjective in search of a noun. In Essential Papers on Borderline Disorders: One Hundred Years at the Border (ed. Stone, M. S.), pp. 549–568. New York: New York University Press.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM—III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1989) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM—III—R). Washington, DC: APA.Google Scholar
Bayer, R. & Spitzer, R. L. (1985) Neurosis, psychodynamics and DSM—III: a history of the controversy. Archives of General Psychiatry, 42, 187–196.CrossRefGoogle ScholarPubMed
Blackburn, R. (1988) On moral judgements and personality disorders. The myth of psychopathic personality revisited. British Journal of Psychiatry, 153, 505–512.Google Scholar
Bluglass, R. S. (1977) A psychiatric study of Scottish prisoners. MD thesis, St Andrew's University.Google Scholar
Bowman, M. J. & Sturgeon, D. A. (1977) A clinic within a general hospital for the assessment of urgent psychiatric problems. Lancet, ii, 1067–1068.Google Scholar
Casey, P. R. (1985) Psychiatric morbidity in general practice: a diagnostic approach. MD thesis, National University of Ireland.Google Scholar
Casey, P. R. (1989) Suicide intent and personality disorder. Acta Psychiatrica Scandinavica, 79, 290–295.Google Scholar
Casey, P. R., Tyrer, P. J. & Dillon, S. (1984) The diagnostic status of patients with conspicuous psychiatric morbidity in primary care. Psychological Medicine, 14, 673–681.Google Scholar
Casey, P. R. & Tyrer, P. J. (1986) Personality, functioning and symptomatology. Journal of Psychiatric Research, 20, 363–374.Google Scholar
Cleckley, H. (1941) The Mask of Sanity. London: Henry Kimpton.Google Scholar
Coid, J. W. (1989) Psychopathic disorders. Current Opinion in Psychiatry, 2, 750–756.CrossRefGoogle Scholar
Cooper, B. (1965) A study of one hundred chronic psychiatric patients identified in general practice. British Journal of Psychiatry, 111, 595–605.Google Scholar
Cutting, J., Cowen, P. J., Mann, A. H., et al (1986) Personality and psychosis: use of the Standardized Assessment of Personality. Acta Psychiatrica Scandinavica, 73, 87–92.Google Scholar
Dahl, A. (1986) Some aspects of the DSM—III personality disorders illustrated by a consecutive series of hospitalized patients. Acta Psychiatrica Scandinavica, 73, 61–66.Google Scholar
Dahl, G. & Merskey, D. M. (1981) Clinical patterns in a behavior modification unit. Canadian Journal of Psychiatry, 26, 460–463.CrossRefGoogle Scholar
Davis, D. R. (1967) How useful a diagnosis is borderline personality? British Medical Journal, 294, 265–266.CrossRefGoogle Scholar
Department of Health and Social Security (1985) Mental Illness in Hospitals and Units in England. Results from the Mental Health Inquiry Statistical Bulletin, Government Statistical Services. London: HMSO.Google Scholar
Dohrenwend, B. P. & Dohrenwend, B. S. (1969) Social Status and Psychological Disorder. A Causal Inquiry. New York: Wiley Interscience.Google Scholar
Ferguson, B. & Tyrer, P. (1989) Personality disorders. In The Instruments of Psychiatric Research (ed. Thompson, C.), pp. 239–251. Chichester: Wiley.Google Scholar
Frances, A. (1980) The DSM—III personality disorders section: a commentary. American Journal of Psychiatry, 137, 1050–1054.Google Scholar
Fyer, M. R., Frances, A. J., Sullivan, T., et al (1988) Comorbidity of borderline personality disorder. Archives of General Psychiatry, 45, 348–352.Google Scholar
Greer, H. S. & Cawley, R. H. (1966) Some Observations on the Natural History of Neurotic Illness. Australian Medical Association, Mervyn Archdall Medical Monograph No. 3. Glebe, Australia: Australasian Medical Publishing Company.Google Scholar
Gunderson, J. G. & Singer, M. T. (1975) Defining borderline patients: an overview. American Journal of Psychiatry, 132, 1–10.Google Scholar
Gunn, J. (1988) Personality disorder: a clinical suggestion. In Personality Disorders: Diagnosis Management and Course (ed. Tyrer, P.), pp. 33–42. London: Wright.Google Scholar
Gunn, J., Robertson, G., Dell, S., et al (1978) Psychiatric Aspects of Imprisonment. London: Academic Press.Google Scholar
Henderson, D. K. (1939) Psychopathic States. New York: Norson.Google Scholar
Hoch, P. & Polatin, P. (1949) Pseudo-neurotic forms of schizophrenia. Psychiatric Quarterly, 23, 248–276.Google Scholar
Hoeper, E. W., Nyez, G. R., Cleary, P. D., et al (1979) Estimated prevalence of RDC mental disorder in primary medical care. International Journal of Mental Health, 8, 6–15.CrossRefGoogle Scholar
Horowitz, M. J. (1977) Hysterical Personality. New York: Jason Aronson.Google Scholar
Kass, F., Skodol, A., Charles, E., et al (1985) Scaled ratings of DSM—III personality disorders. American Journal of Psychiatry, 142, 627–630.Google Scholar
Kernberg, O. F. (1975) Borderline Conditions and Pathological Narcissism. New York: Jason Aronson.Google Scholar
Kessel, N. (1960) Psychiatric morbidity in a London general practice. British Journal of Preventive and Social Medicine, 14, 16–22.Google Scholar
Koch, J. L. A. (1891) Die psychopathischen Minderwertigkeiten. Dora: Ravensburg.Google Scholar
Kohut, H. (1971) The Analysis of the Self. New York: International Universities Press.Google Scholar
Leighton, D. C., Harding, J. S., Macklin, D. B., et al (1963) Psychiatric findings of the Stirling County study. American Journal of Psychiatry, 119, 1021–1026.Google Scholar
Lewis, G. & Appleby, L. (1988) Personality disorder: the patients psychiatrists dislike. British Journal of Psychiatry, 153, 44–49.Google Scholar
Livesley, W. J. (1987) A systematic approach to the delineation of personality disorders. American Journal of Psychiatry, 144, 772–777.Google Scholar
Livesley, W. J. & Jackson, D. (1988) The internal consistency and factorial structures of behaviors judged to be associated with DSM—III personality disorders. American Journal of Psychiatry, 139, 1360–1361.Google Scholar
Loranger, A. W., Susman, V. L., Oldham, M. M., et al (1987) The Personality Disorder Examination: a preliminary report. Journal of Personality Disorders, 1, 1–13.Google Scholar
Maudsley, H. (1868) A Physiology and Pathology of Mind (2nd edn), p. 516. London: Macmillan.Google Scholar
McGlashan, T. H. (1984) The Chestnut Lodge follow-up study. i. Follow-up methodology and study sample. Archives of General Psychiatry, 40, 573–585.CrossRefGoogle Scholar
Millon, T. (1969) Modern Psychopathology: A Biosocial Approach to Maladaptive Learning and Functioning. Philadelphia: Saunders.Google Scholar
Millon, T. (1981) Disorders of Personality, DSM—III: Axis II. New York: Wiley.Google Scholar
Morey, L. (1988) Personality disorders in DSM—III and DSM—III—R: convergence, coverage, and internal consistency. American Journal of Psychiatry, 145, 573–577.Google Scholar
Muller, J. J., Chafetz, M. E. & Blare, H. T. (1967) Acute psychiatric services in the general hospital: III, statistical survey. American Journal of Psychiatry, 124, 56.Google Scholar
Murthy, V. N. (1969) Personality and the nature of suicide attempts. British Journal of Psychiatry, 115, 791–795.Google Scholar
Myers, J. K., Weissman, M. M., Tischler, G. L., et al (1984) Six month prevalence of psychiatric disorders in three communities, 1980—1982. Archives of General Psychiatry, 41, 959–967.Google Scholar
O'Hare, A. & Walsh, D. (1986) Activities of Psychiatric Hospitals and Units 1983. Dublin: The Medico-Social Research Board.Google Scholar
OVENSTONE, I. K. (1973) Spectrum of suicidal behaviours in Edinburgh. British Journal of Preventive and Social Medicine, 27, 27–35.Google Scholar
Pallis, D. J. & Birtchnell, J. (1977) Seriousness of suicide attempts in relation to personality. British Journal of Psychiatry, 130, 253–259.Google Scholar
Parloff, M. B. & Dies, R. R. (1977) Group psychotherapy outcome research, 1966—1975. International Journal of Group Psychotherapy, 27, 281–319.Google Scholar
Pfohl, B., Coryell, W., Zimmerman, M., et al (1986) DSM—III personality disorders: diagnostic overlap and internal consistency of individual DSM—III criteria. Comprehensive Psychiatry, 27, 21–34.Google Scholar
Philips, A. E. (1970) Traits, attitudes and symptoms in a group of attempted suicides. British Journal of Psychiatry, 116, 475–482.Google Scholar
Pierce, D. W. (1977) Suicide intent and self-injury. British Journal of Psychiatry, 130, 377–385.CrossRefGoogle ScholarPubMed
Pinel, P. (1801) A Treatise on Insanity (trans. Davis, D. D., 1962). New York: Hafner.Google Scholar
Pope, H. G., Jonas, J. M., Hudson, J. I., et al (1983) The validity of DSM—III borderline personality disorder: a phenomenologic, family history, treatment response and long-term follow-up study. Archives of General Psychiatry, 40, 23–30.CrossRefGoogle ScholarPubMed
Prichard, J. C. (1837) A Treatise on Insanity and Other Diseases Affecting the Mind. Philadelphia: Harwell, Barrington & Harwell.Google Scholar
Rado, S. (1953) Dynamics and classification of disordered behaviour. American Journal of Psychiatry, 110, 406–416.Google Scholar
Reich, J. & Thompson, W. D. (1987) DSM—III personality disorder clusters in three generations. British Journal of Psychiatry, 150, 471–475.CrossRefGoogle Scholar
Robins, L. N. (1966) Deviant Children Grown Up. Baltimore: Williams & Wilkins.Google Scholar
Rosenthal, D., Wender, P. H., Kety, S. S., et al (1971) The adopted-away offspring of schizophrenics. American Journal of Psychiatry, 128, 307–311.CrossRefGoogle ScholarPubMed
Rutter, M. L. (1987) Temperament, personality and personality disorder. British Journal of Psychiatry, 150, 443–458.CrossRefGoogle ScholarPubMed
Schneider, K. (1923) Die Psychopathischen Personlichkeiten. Berlin: Springer.Google Scholar
Seivewright, N. (1987) Relationship between life events and personality in psychiatric disorder. Stress Medicine, 3, 163–168.CrossRefGoogle Scholar
Shepherd, M., Cooper, B., Brown, A. C., et al (1966) Psychiatric Illness in General Practice. Oxford: Oxford University Press.Google Scholar
Soloff, P. H., George, A., Nathan, R. S., et al (1986) Progress in pharmacotherapy of borderline disorders: a double blind study of amitriptyline, haloperidol and placebo. Archives of General Psychiatry, 43, 691–697.CrossRefGoogle ScholarPubMed
Srole, L., Langer, T., Michael, S., et al (1962) Mental Health in the Metropolis. New York: McGraw Hill.Google Scholar
Stone, M., Hurt, S. & Stone, D. (1987) The PI 500: long-term follow-up of borderline inpatients meeting DSM III criteria. Journal of Personality Disorders, 1, 291–298.CrossRefGoogle Scholar
Thompson, D. J. & Goldberg, D. (1987) Hysterical personality disorder: the process of diagnosis in clinical and experimental settings. British Journal of Psychiatry, 150, 241–245.CrossRefGoogle ScholarPubMed
Tyrer, P. (1988) What's wrong with DSM—III personality disorders? Journal of Personality Disorders, 2, 281–291.Google Scholar
Tyrer, P. & Alexander, J. (1979) Classification of personality disorder. British Journal of Psychiatry, 135, 163–167.Google Scholar
Tyrer, P., Casey, P. & Gall, J. (1983a) The relationship between neurosis and personality disorder. British Journal of Psychiatry, 142, 404–408.Google Scholar
Tyrer, P., Owen, R. & Dawling, S. (1983b) Gradual withdrawal of diazepam after long-term therapy. Lancet, i, 1402–1406.Google Scholar
Tyrer, P. & Ferguson, B. (1988) Development of the concept of abnormal personality. In Personality Disorders: Diagnosis, Management and Course (ed. Tyrer, P.), pp. 1–11. London: Wright.Google Scholar
Tyrer, P. & Seivewright, H. (1988) Studies of outcome. In Personality Disorders: Diagnosis, Treatment and Course (ed. Tyrer, P.), pp. 119–136. London, Wright.Google Scholar
Tyrer, P., Alexander, J. & Ferguson, B. (1988) Personality assessment schedule. In Personality Disorders: Diagnosis, Management and Course (ed. Tyrer, P.), pp. 140–167. London: Wright.Google Scholar
Tyrer, P., Seivewright, N., Ferguson, B., et al (1990) The Nottingham study of neurotic disorder: relationship between personality status and symptoms. Psychological Medicine, 20, 423–431.Google Scholar
Vernon, P. E. (1964) Personality Assessment: A Critical Survey, pp. 240–241. London: Methuen.Google Scholar
Waldinger, R. O. (1987) Intensive psychodynamic therapy with borderline patients: an overview. American Journal of Psychiatry, 144, 267–274.Google Scholar
Waldinger, R. O. & Gunderson, J. (1987) Effective Psychotherapy with Borderline Patients. New York: Macmillan.Google Scholar
Weissman, M. M., Myers, J. K. & Harding, P. S. (1978) Psychiatric disorder in a US urban community. American Journal of Psychiatry, 135, 459–462.Google Scholar
Widiger, T., Trull, T., Hurt, S., et al (1987) A multidimensional scaling of the DSM—III personality disorders. Archives of General Psychiatry, 44, 557–563.CrossRefGoogle ScholarPubMed
Widiger, T. & Rogers, J. H. (1989) Prevalence and comorbidity of personality disorders. Psychiatric Annals, 19, 132–136.Google Scholar
Wolff, S. & Chick, J. (1980) Schizoid personality in childhood: a controlled follow-up study. Psychological Medicine, 9, 85–100.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD—9). Geneva: WHO.Google Scholar
World Health Organization (1989) International Classification of Diseases, draft of 10th revision (ICD—10). Geneva: WHO.Google Scholar
Zanarini, M., Frankenburg, F., Chauncey, D., et al (1987) The Diagnostic Interview for Personality Disorders: interrater and test—retest reliability. Comprehensive Psychiatry, 28, 467–480.Google Scholar
Zimmerman, M., Coryell, W., Pfohl, B., et al (1988) ECT response in depressed patients with and without a DSM—III personality disorder. American Journal of Psychiatry, 143, 1030–1032.Google Scholar
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