The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams.
BACKGROUND
Personality status is seldom assessed in community mental health teams except at a rudimentary level. This study challenges the assumption that this policy is either prudent or wise.


OBJECTIVE
To measure the prevalence of personality disorder within community mental health teams and to investigate its relationship to mental state disorders and overall pathology.


METHODS
A cross-sectional survey of 2,528 of 2,567 psychiatric patients (98.5%) managed by community mental health teams in four urban settings in the UK in which diagnoses of personality and mental state pathology were assessed separately. Of these, a sample of 400 was interviewed, with a 70.5% completion rate for more in depth information.


RESULTS
In total, 40% of all patients in secondary care suffered from at least one personality disorder. Regression modelling showed personality pathology accounted for a greater degree of global psychopathology than psychosis, alcohol or drug dependence, but was associated with anxiety disorders.


CONCLUSIONS
Comorbid personality pathology contributes greatly to overall psychopathology in secondary psychiatric care. It should be both recognised and managed.
Newton-Howes
Giles
G
Department of Psychological Medicine, Faculty of Medicine, Imperial College, London, UK. giles.newton-howes@imperial.ac.uk
Tyrer
Peter
P
Anagnostakis
Katina
K
Cooper
Sylvia
S
Bowden-Jones
Owen
O
Weaver
Tim
T
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D010348:Patient Care Team; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology; D012044:Regression Analysis; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data