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Personality Disorder: the Patients Psychiatrists Dislike

Published online by Cambridge University Press:  02 January 2018

Glyn Lewis*
General Practice Research Unit
Louis Appleby
Department of Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF


A sample of psychiatrists was asked to read a case vignette and indicate likely management and attitudes to the patient on a number of semantic-differential scales. Patients given a previous diagnosis of personality disorder (PD) were seen as more difficult and less deserving of care compared with control subjects who were not. The PD cases were regarded as manipulative, attention-seeking, annoying, and in control of their suicidal urges and debts. PD therefore appears to be an enduring pejorative judgement rather than a clinical diagnosis. It is proposed that the concept be abandoned.

Research Article
Copyright © Royal College of Psychiatrists, 1988 

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American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington DC: APA.Google ScholarPubMed
Chodoff, P. & Lyons, H. (1958) Hysteria, the hysterical personality and hysterical conversion. American Journal of Psychiatry, 114, 734740.CrossRefGoogle ScholarPubMed
Cleckley, H. (1976) The Mask of Sanity (5th edn). St Louis: C. V. Mosby.Google ScholarPubMed
Department of Health and Social Security (1987) Medical and dental staffing prospects in the NHS in England and Wales in 1986. Health Trends, 19, 17.Google ScholarPubMed
Farrell, B. A. (1979) Mental illness: a conceptual analysis. Psychological Medicine, 9, 2135.CrossRefGoogle ScholarPubMed
Gunn, J. & Robertson, G. (1976) Psychopathic personality: a conceptual problem. Psychological Medicine, 6, 631634.CrossRefGoogle ScholarPubMed
Henderson, D. K. (1939) Psychopathic States. New York: W. W. Norton.Google Scholar
Howard, C. (1985) The ‘inadequate personality’. In Handbook of Psychiatry, vol. 4. The Neuroses and Personality Disorders (eds Russell, G. F. M. & Hersov, L. A.). Cambridge: Cambridge University Press.Google Scholar
Kendell, R. E. (1975a) The Role of Diagnosis in Psychiatry. Oxford: Black well Scientific Publications.Google Scholar
Kendell, R. E. (1975b) The concept of disease and its implications for psychiatry. British Journal of Psychiatry, 127, 305315.CrossRefGoogle ScholarPubMed
Kreitman, N., Sainsbury, P., Morrissey, J., Towers, J. & Scrivener, J. (1961) The reliability of psychiatric diagnosis. Journal of Mental Science, 107, 887908.Google ScholarPubMed
Lewis, A. (1953) Health as a social concept. British Journal of Sociology, 4, 109124.CrossRefGoogle Scholar
Lewis, A. (1974) Psychopathic personality: a most elusive category. Psychological Medicine, 4, 133140.CrossRefGoogle ScholarPubMed
Mayou, R. (1977) Psychiatric decision making. British Journal of Psychiatry, 130, 374376.CrossRefGoogle ScholarPubMed
Mellsop, G., Varghese, F., Joshua, S. & Hicks, A. (1982) The reliability of axis II of DSM-III. American Journal of Psychiatry, 139, 13601361.Google ScholarPubMed
Mischel, W. (1968) Personality and Assessment. New York: Wiley.Google ScholarPubMed
Nisbett, R. & Ross, L. (1980) Human Inference: Strategies and Shortcomings of Social Judgement. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
O'Toole, R., Turbett, P. & Nalepka, C. (1983) Theories, professional knowledge and diagnosis of child abuse. In The Dark Side of Families: Current Family Violence Research (eds Finkelhor, D., Gellis, R. J., Hottaling, G. T. & Straus, M. A.). Beverly Hills: Sage.Google Scholar
Parry, R. A. (1978) Alcoholism. In Companion to Psychiatric Studies (2nd edn) (eds Forrest, A., Afleck, J. & Zealley, A.). Edinburgh: Churchill Livingstone.Google Scholar
Scheff, T. J. (1963) The role of the mentally ill and the dynamics of mental disorder. Sociometry, 26, 436453.CrossRefGoogle Scholar
Shepherd, M. & Sartorius, N. (1974) Personality disorder and the ‘International Classification of Diseases’. Psychological Medicine, 4, 141146.CrossRefGoogle Scholar
Slavney, P. R. & McHugh, P. R. (1974) The hysterical personality: a controlled study. Archives of General Psychiatry, 30, 325329.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, 241245.CrossRefGoogle ScholarPubMed
Walton, H. J. (1978) The psychoneuroses. In Companion to Psychiatric Studies (2nd edn) (eds Forrest, A., Affleck, J. & Zealley, A.). Edinburgh: Churchill Livingstone.Google Scholar
Walton, H. J. & Presly, A. S. (1973) Use of a category system in the diagnosis of abnormal personality. British Journal of Psychiatry, 122, 259268.CrossRefGoogle Scholar
Weiner, B. (1980) A cognitive (attribution)-emotion-action model of motivated behaviour: an analysis of judgements of help giving. Journal of Personality and Social Psychology, 39, 186200.CrossRefGoogle Scholar
Wootton, B. (1959) Social Science and Social Pathology. London: George Allen.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary & Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: World Health Organization.Google Scholar
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