title: Personality disorder: still the patients psychiatrists dislike?
abstract: Aims and methodIn 1988, Lewis and Appleby demonstrated that psychiatrists hold negative attitudes towards patients with personality disorder. We assessed the attitudes of psychiatry trainees towards patients with borderline personality disorder and depression, expecting an improvement. 166 trainees were block randomised to receive one of four case vignettes that varied by diagnosis and ethnic group. We used Lewis and Appleby's original questionnaire and the Attitudes to Personality Disorder Questionnaire (APDQ).ResultsWe received 76 responses. Lewis and Appleby's questionnaire showed more negative attitudes towards personality disorder than depression, with no significant patient ethnic group effects, and the APDQ also showed a (weak) trend towards more negative attitudes to personality disorder. In subgroup analysis, only in the White British patient group were there significantly more negative attitudes to personality disorder. Factor analysis showed significantly less sense of purpose when working with personality disorder.Clinical implicationsThe perceived greater lack of purpose in working with personality disorder should be the target of clinical training and intervention. Targeted interventions that include training in managing personality disorder, supervision and practice in non-specialist, general psychiatry settings are important.
authors.affiliation: Camden and Islington NHS Foundation Trust, London.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Chartonas
authors.affiliation: South London and Maudsley NHS Foundation Trust.
authors.forename: Michalis
authors.initials: M
authors.lastname: Kyratsous
authors.affiliation: East London NHS Foundation Trust.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dracass
authors.affiliation: East London NHS Foundation Trust.
authors.forename: Tennyson
authors.initials: T
authors.lastname: Lee
authors.affiliation: Queen Mary University of London.
authors.forename: Kamaldeep
authors.initials: K
authors.lastname: Bhui