Skip to main content
×
×
Home

Accurate recording of personality disorder in clinical practice

  • Peter Tyrer (a1)
Summary

Disturbances of personality are recorded very poorly in official statistics, but there are signs that this is changing. For many years, personality disorder has been either regarded as a secondary diagnosis that can be forgotten in the presence of another mental disorder, or avoided as the diagnosis gives the impression of untreatability or stigma. What is now abundantly clear is that under-diagnosis of personality disorder represents a disservice to patients and practitioners. It prevents a proper understanding of the longitudinal course of psychiatric disorder and an appreciation of some of the positive aspects of abnormal personality that can be used in treatment. We must no longer bury personality disorder, ostrich-like, in the diagnostic sand. It is there for the asking and needs to be embraced honestly and without fear if we are to improve the management of psychiatric patients.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Accurate recording of personality disorder in clinical practice
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Accurate recording of personality disorder in clinical practice
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Accurate recording of personality disorder in clinical practice
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Peter Tyrer (p.tyrer@imperial.ac.uk)
References
Hide All
1Hossain, A, Malkov, M, Lee, T, Bhui, K. Ethnic variation of personality disorder of 6 years of hospital admissions in East London. BJPsych Bull 2018; this issue.
2Pilgrim, J, Mann, A. Use of the ICD-10 version of the Standardized Assessment of Personality to determine the prevalence of personality disorder in psychiatric in-patients. Psychol Med 1990; 20: 985–92.
3Tyrer, P, Crawford, M, Sanatinia, R, Tyrer, H, Cooper, S, Muller-Pollard, C, et al. Preliminary studies of the ICD 11 classification of personality disorder in practice. Pers Ment Health 2014; 8: 254–63.
4Ranger, M, Methuen, C, Rutter, D, Rao, B, Tyrer, P. Prevalence of personality disorder in the caseload of an inner city assertive outreach team. Psychiatr Bull 2004; 28: 441–3.
5Health and Social Care Information Centre. Hospital Episode Statistics. Department of Health, 2010.
6Newton-Howes, G, Mulder, R, Tyrer, P. Diagnostic neglect: the potential impact of losing a separate axis for personality disorder. Br J Psychiatry 2015; 206: 355–6.
7Bateman, AW, Gunderson, J, Mulder, R. Treatment of personality disorder. Lancet 2015; 385: 735–43.
8Tyrer, P. Nidotherapy: a new approach to the treatment of personality disorder. Acta Psychiatr Scand 2002; 105: 469–71.
9Sanatinia, R, Wang, D, Tyrer, P, Tyrer, H, Cooper, S, Crawford, M, et al. The impact of personality status on the cost and outcomes of cognitive behaviour therapy for health anxiety. Br J Psychiatry 2016; 209: 244–50.
10Tyrer, P, Wang, D, Tyrer, H, Crawford, M, Cooper, S. Dependent personality and its influence on the short and long-term outcomes of cognitive behaviour therapy for health anxiety: randomised controlled trial. Pers Ment Health 2016; 10: 96105.
11Tyrer, P, Reed, GM, Crawford, M. Classification, assessment, prevalence, and effect of personality disorder. Lancet 2015; 385: 717–26.
12Tyrer, P, Merson, S, Onyett, S, Johnson, T. The effect of personality disorder on clinical outcome, social networks and adjustment: a controlled clinical trial of psychiatric emergencies. Psychol Med 1994; 24: 731–40.
13Crawford, MJ, Rushwaya, T, Bajaj, P, Tyrer, P, Yang, M. The prevalence of personality disorder among ethnic minorities: findings from a national household survey. Pers Ment Health 2014; 6: 175–82.
14Olajide, K, Tyrer, P, Singh, SP, Burns, T, Rugkåsa, J, Thana, L, et al. Likelihood and predictors of detention in patients with personality disorder compared with other mental disorders: a retrospective, quantitative study of Mental Health Act assessments. Pers Ment Health 2016; 10: 191204.
15Alexander, RT, Green, FN, O'Mahony, B, Gunaratna, IJ, Gangadharan, SK, Hoare, S. Personality disorders in offenders with intellectual disability: a comparison of clinical, forensic and outcome variables and implications for service provision. J Intellect Disabil Res 2010; 54: 650–8.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 20
Total number of PDF views: 79 *
Loading metrics...

Abstract views

Total abstract views: 146 *
Loading metrics...

* Views captured on Cambridge Core between 20th July 2018 - 16th August 2018. This data will be updated every 24 hours.

Accurate recording of personality disorder in clinical practice

  • Peter Tyrer (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *