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Diagnosis of personality disorders in learning disability^*

Leicester Frith Hospital, Leicester LE3 9QF, UK

SHERVA COORAY, FRCPsych

Parkside NHS Trust, Kingsbury, UK

Correspondence: Dr Regi Alexander, Leicester Frith Hospital, Mansion House, Groby Road, Leicester LE3 9QF, UK

Declaration of interest None.

^* Paper presented at the second conference of the British and Irish Group for the Study of Personality Disorders (BIGSPD), University of Leicester, UK, 31 January to 3 February 2001.

Background Though contentious, the diagnosis of personality disorders in persons with learning disability is clinically relevant because it affects many aspects of management.

Aims To examine published literature on the diagnosis of personality disorders in learning disability.

Method Selective review with computerised (Medline, Embase and PsychInfo) and manual literature searches.

Results The variation in the co-occurrence of personality disorder in learning disability, with prevalence ranging from less than 1% to 91% in a community setting and 22% to 92% in hospital settings, is very great and too large to be explained by real differences.

Conclusions The diagnosis of personality disorders in learning disability is complex and difficult, particularly in those with severe disability. Developing consensus diagnostic criteria, specific for various developmental levels, is one way forward. Such criteria may need to include objective proxy measures such as behavioural observations and informant accounts.

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