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The distinction between personality disorder and mental illness

  • R. E. Kendell (a1)

Abstract

Background

Proposals by the UK Government for preventive detention of people with ‘dangerous severe personality disorders' highlight the unresolved issue of whether personality disorders should be regarded as mental illnesses.

Aims

To clarify the issue by examining the concepts of psychopathy and personality disorder, the attitudes of contemporary British psychiatrists to personality disorders, and the meaning of the terms ‘mental illness'and ‘mental disorder’.

Method

The literature on personality disorder is assessed in the context of four contrasting concepts of illness or disease.

Results

Whichever of the four concepts or definitions is chosen, it is impossible to conclude with confidence that personality disorders are, or are not, mental illnesses; there are ambiguities in the definitions and basic information about personality disorders is lacking.

Conclusions

The historical reasons for regarding personality disorders as fundamentally different from mental illnesses are being undermined by both clinical and genetic evidence. Effective treatments for personality disorders would probably have a decisive influence on psychiatrists' attitudes.

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Copyright

COPYRIGHT: © Royal College of Psychiatrists, 2002 

References

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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV).Washington, DC: APA.
Baxter, J. (2000) Obesity surgery – another unmet need. British Medical Journal, 321, 523–524.
Bateman, A. & Fonagy, P. (1999) Effectiveness of partial hospitalisation in the treatment of borderline personality disorder: a randomised controlled trial. American Journal of Psychiatry, 156, 1563–1569.
Blackburn, R., Gunn, J., Hill, J., et al (1993) Personality disorders. In Forensic Psychiatry: Clinical, Legal and Ethical Issues (eds Gunn, J. & Taylor, P. J.), pp. 373–406. Oxford: Butterworth-Heinemann.
Bourse, C. (1975) On the distinction between disease and illness. Philosophy and Public Affairs, 5, 49–68.
Campbell, E. J. M., Scadding, J. G. & Roberts, R. S. (1979) The concept of disease. British Medical Journal, ii, 757–762.
Coccaro, E. F. & Kavoussi, R. J. (1997) Fluoxetine and impulsive aggressive behavior in personality-disordered subjects. Archives of General Psychiatry, 54, 1081–1088.
Department of Health & Home Office (2000) Reforming the Mental Health Act. Cm 5016. London: Stationery Office.
Drake, R. E. & Vaillant, G. E. (1985) A validity study of Axis II of DSM –III. American Journal of Psychiatry, 142, 553–558.
Harris, E. C. & Barraclough, B. (1998) Excess mortality of mental disorder. British Journal of Psychiatry, 173, 11–53.
Home Office & Department of Health (1999) Managing Dangerous People with Severe Personality Disorder: Proposals for Policy Development. London: Home Office/Department of Health.
Kendell, R. E. (1975) The concept of disease and its implications for psychiatry. British Journal of Psychiatry, 127, 305–315.
Kendell, R. E. (1986) What are mental disorders? In Issues in Psychiatric Classification (eds Freedman, A. M., Brotman, R., Silverman, I., et al), pp. 23–45. New York: Human Sciences Press.
Kendell, R. E. (1993) The nature of psychiatric disorders. In Companion to Psychiatric Disorders (5th edn) (eds Kendell, R. E. & Zealkey, A. K.), pp. 1–7. Edinburgh: Churchill Livingstone.
King, L. S. (1954) What is disease? Philosophy of Science, 21, 193–203.
Kräupl Taylor, F. (1971) A logical analysis of the medico-physiological concept of disease. Psychological Medicine, 1, 356–364.
Lewis, A. (1974) Psychopathic personality: a most elusive category. Psychological Medicine, 4, 133–140.
Lewis, G. & Appleby, L. (1988) Personality disorder: the patients psychiatrists dislike. British Journal of Psychiatry, 153, 44–49.
Lilienfeld, S. O. & Marino, L. (1995) Mental disorder as a Roschian concept: a critique of Wakefield's ‘harmful dysfunction’ analysis. Journal of Abnormal Psychology, 104, 411–420.
Linehan, M. M., Armstrong, H. E., Suarez, A., et al (1991) Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064.
Martin, R. L., Cloninger, R., Guze, S B., et al (1985) Mortality in a follow up of 500 psychiatric outpatients. Archives of General Psychiatry, 42, 47–54; 58–66.
Scadding, J. G. (1967) Diagnosis: the clinician and the computer. Lancet, ii, 877–882.
Schneider, K. (1950) Die psychopatischen Personlichkeiten (9th edn). Vienna: Deuticke.
Wakefield, J. C. (1992) The concept of mental disorder: on the boundary between biological facts and social values. American Psychologist, 47, 373–388.
Wakefield, J. C. (1999) Evolutionary versus prototype analyses of the concept of disorder. Journal of Abnormal Psychology, 108, 374–379.
World Health Organization (1980) International Classification of Impairments, Disabilities and Handicaps. Geneva: WHO.
World Health Organization (1992a) The ICD–10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO.
World Health Organization (1992b) International Classification of Diseases and Related Health Problems (10th revision) (ICD–10).Geneva: WHO.
  • Cited by 91

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The distinction between personality disorder and mental illness

  • R. E. Kendell (a1)

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  • Cited by 91

  • Access

The distinction between personality disorder and mental illness

  • R. E. Kendell (a1)
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