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The British Journal of Psychiatry (2002) 180: 543-546
© 2002 The Royal College of Psychiatrists

PRELIMINARY REPORT

Validity of the diagnosis of personality disorder in adults with learning disability and severe behavioural problems

Preliminary study

ANDREW FLYNN, MRCPsych, HELEN MATTHEWS, MRCPsych and SHEILA HOLLINS, FRCPsych

Department of Psychiatry of Disability, St George's Hospital Medical School, London

Correspondence: Andrew Flynn, Mental Health of Learning Disabilities, Oxleas NHS Trust, c/o 183 Lodge Hill, Goldie Leigh, Abbey Wood, London SE2 0AY, UK

Declaration of interest Support from Partnerships in Care.

Background Personality disorder in people with learning disability has received little research attention, with only a handful of cross-sectional surveys of prevalence available. As yet, there have been no studies to include an examination of validity.

Aims To investigate the prevalence of personality disorder in adults with learning disability who are in specialist challenging behaviour in-patient services and to examine the validity of the diagnosis of personality disorder in this group in terms of its association with abusive experience in early life.

Method The Standardised Assessment of Personality (SAP) was used to diagnose personality disorder in 36 individuals with mild/moderate learning disability. Case notes were reviewed for details of clinical diagnosis and early psychosocial history.

Results Thirty-nine per cent of the sample met the criteria for severe personality disorder. This diagnosis showed a significant association with early traumatic experience.

Conclusions Severe personality disorder is a common diagnosis in this group. There is preliminary evidence that the diagnosis is associated with abuse in childhood.




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