title: Personality disorder--not otherwise specified evidence of validity and consideration for DSM-5.
abstract: Personality disorder-not otherwise specified (PD-NOS) has received little study despite being a very prevalent diagnosis of personality disorder (PD). Although some studies suggest that PD-NOS is intermediate in severity between subjects with, and without, formal PD, studies examining a comprehensive set of measures and control subjects have not been reported. Nearly 800 subjects were studied with semi-structured diagnostic interviews and with a variety of measures of temperament, character, and specific dimensions of personality and behavior. The subjects were divided into healthy controls (n = 176), Axis I controls (n = 87), PD subjects (n = 344) and PD-NOS subjects (n = 177). Subjects who met General Diagnostic Criteria for Personality Disorder (GDCPD), but not criteria for any one, specific PD, were designated as PD-NOS. On nearly all measures, PD-NOS differed from Healthy and from Axis I Controls in the direction of more pathology. Although subjects meeting criteria for specific PDs appeared more pathological than PD-NOS, this was always due to severity of PD as reflected by the Structured Interview for the Diagnosis of DSM Personality 4 severity score. When compared with subjects with only one specific PD diagnosis, subjects with PD-NOS did not differ in any way. When diagnosed by GDCPD, subjects with PD-NOS are similar to subjects with specific personality disorders and differ, as expected, from Healthy and Axis I Controls on measures of psychosocial function and on various dimensions of personality and related behavior. Accordingly, PD-NOS by GDCPD is as valid a PD as any other specific PD by DSM criteria.
authors.affiliation: Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago, IL 60637, USA. ecoccaro@yoda.bsd.uchicago.edu
authors.forename: Emil F
authors.initials: EF
authors.lastname: Coccaro
authors.forename: Habiba
authors.initials: H
authors.lastname: Nayyer
authors.forename: Michael S
authors.initials: MS
authors.lastname: McCloskey
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010551:Personality; D010552:Personality Assessment; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology