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Personality Disorder and Psychiatric Illness in General Practice

Published online by Cambridge University Press:  02 January 2018

Patricia R. Casey*
Affiliation:
Department of Psychiatry, University College, Cork, Ireland
Peter Tyrer
Affiliation:
Senior Lecturer (Early Intervention Service), St Charles' Hospital, Exmoor Street, London W10
*
Correspondence

Abstract

In a one-year prevalence study of conspicuous psychiatric morbidity in two group general practices, one urban and the other rural, personality disorder was diagnosed in 5.3% by the GP and in 5.6% by the psychiatrist, but this increased to 28% when personality disorder was assessed using a structured interview. The prevalence of personality disorder was higher in the urban practice than in the rural one but there was no consistent association between personality disorder and mental state disorder, with the exception of alcohol abuse and dependence. The high rate of personality disorder found using the interview schedule is likely to be a true finding, and failure to recognise this hidden morbidity is important in both general and psychiatric practice.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1990

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Casey, P. R., Dillon, S. & Tyrer, P. J. (1984) The diagnostic status of patients with conspicuous psychiatric morbidity in primary care. Psychological Medicine, 14, 673681.CrossRefGoogle ScholarPubMed
Casey, P. R., & Tyrer, P. J. (1986) Personality, functioning and symptoms. Journal of Psychiatric Research, 20, 363374.CrossRefGoogle Scholar
Cooper, B. (1965) A study of one hundred chronic psychiatric patients identified in general practice. British Journal of Psychiatry, 111, 595605.10.1192/bjp.111.476.595CrossRefGoogle ScholarPubMed
Cutting, J. (1985) The Psychology of Schizophrenia. Edinburgh: Churchill Livingstone.Google Scholar
Goldstein, S. G. & Linden, J. D. (1969) Multivariate classification of alcoholics by means of the MMPI. Journal of Abnormal Psychology, 74, 661669.CrossRefGoogle ScholarPubMed
Hobson, R. F. (1953) Prognostic factors in electro-convulsive therapy. Journal of Neurology, Neurosurgery and Psychiatry, 16, 275281.CrossRefGoogle Scholar
Hoeper, E. W., Nycz, G. R., Cleary, P. D., et al (1979) Estimated prevalence of RDC mental disorder in primary medical care. International Journal of Mental Health, 8, 615.CrossRefGoogle Scholar
Kelleher, M. J. (1972) Cross-national (Anglo-Irish) differences in obsessional symptoms and traits of personality. Psychological Medicine, 2, 3341.CrossRefGoogle ScholarPubMed
Kendell, R. E. (1973) Psychiatric diagnoses: a study of how they are made. British Journal of Psychiatry, 122, 437445.10.1192/bjp.122.4.437CrossRefGoogle Scholar
Kessel, N. (1960) Psychiatric morbidity in a London general practice. British Journal of Preventive and Social Medicine, 14, 1622.Google Scholar
Kessel, N. & Walton, H. (1969) Alcoholism. London: Penguin Books.Google Scholar
Leighton, D. C., Harding, J. S., Macklin, D. B., et al (1963) Psychiatric findings of the Stirling County study. American Journal of Psychiatry, 119, 10211026.10.1176/ajp.119.11.1021CrossRefGoogle Scholar
McCord, W. & McCord, J. (1960) The Origins of Alcoholism. London: Tavistock Publications.Google Scholar
Paykel, E. S., Klerman, G. L. & Prusoff, B. A. (1976) Personality and symptom pattern in depression. British Journal of Psychiatry, 129, 327334.10.1192/bjp.129.4.327CrossRefGoogle ScholarPubMed
Presly, A. S. & Walton, H. J. (1973) Dimensions of abnormal personality. British Journal of Psychiatry, 122, 269276.CrossRefGoogle Scholar
Remington, M. & Tyrer, P. J. (1979) The Social Functioning Schedule – a brief semi-structured interview. Social Psychiatry, 40, 151157.10.1007/BF00582182CrossRefGoogle Scholar
Robins, L. N., Helzer, J. E., Weissman, M. M., et al (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry, 41, 949958.CrossRefGoogle ScholarPubMed
Selzer, M. L. (1971) The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. American Journal of Psychiatry, 127: 8994.CrossRefGoogle ScholarPubMed
Shepherd, M., Cooper, B., Brown, A. C., et al (1966) Psychiatric Illness in General Practice. Oxford: Oxford University Press.Google Scholar
Sims, A. (1975) Factors predictive of outcome in neurosis. British Journal of Psychiatry, 129, 5462.CrossRefGoogle Scholar
Snaith, R. P., McGuire, R. J. & Fox, K. (1971) Aspects of personality and depression. Psychological Medicine, 1, 239246.10.1017/S0033291700041866CrossRefGoogle ScholarPubMed
Srole, L., Langer, T., Michael, S., et al (1962) Mental Health in the Metropolis. New York: McGraw-Hill.Google Scholar
Syme, L. (1957) Personality characteristics and the alcoholic: a critique of current studies. Quarterly Journal of Studies on Alcohol, 18, 288302.CrossRefGoogle ScholarPubMed
Tyrer, P. J. & Alexander, J. (1979) Classification of personality disorder. British Journal of Psychiatry, 135, 163167.CrossRefGoogle ScholarPubMed
Tyrer, P. J., Alexander, M. S., Cicchetti, D., et al (1979) Reliability of a schedule for rating personality disorder. British Journal of Psychiatry, 135, 168174.CrossRefGoogle Scholar
Tyrer, P. J., Casey, P. R. & Gall, J. (1983) The relationship between neurosis and personality disorder. British Journal of Psychiatry, 142, 404408.10.1192/bjp.142.4.404CrossRefGoogle ScholarPubMed
Tyrer, P. J., Cicchetti, D. V., Casey, P. R., et al (1984) Cross-national reliability of a schedule for assessing personality disorders. Journal of Nervous and Mental Disease, 172, 718721.10.1097/00005053-198412000-00004CrossRefGoogle ScholarPubMed
Tyrer, P. J., Alexander, J. & Ferguson, B. (1988) Personality Assessment Schedule. In Personality Disorders: Diagnosis, Management and Course (ed. Tyrer, P.). London: Wright.Google Scholar
Tyrer, P. J. & Sievewright, H. (1988) Studies of outcome. In Personality Disorder: Diagnosis, Management and Course (ed. Tyrer, P.). London: Wright.Google Scholar
Vaillant, G. E. (1964) Prospective predictors of schizophrenic remission. Archives of General Psychiatry, 11, 509518.10.1001/archpsyc.1964.01720290051007CrossRefGoogle Scholar
Weissman, M. M., Myers, J. K. & Harding, P. S. (1978) Psychiatric disorders in a U.S. urban community. 1975–1976. American Journal of Psychiatry, 134, 459462.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
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