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Multiple Axis-II Diagnoses of Personality Disorder

Published online by Cambridge University Press:  02 January 2018

Bridget Dolan ,
Chris Evans  and
Kingsley Norton
Bridget Dolan*
Affiliation:
Henderson Hospital, Sutton and St George's Hospital Medical School, London
Chris Evans
Affiliation:
St George's Hospital Medical School
Kingsley Norton
Affiliation:
Henderson Hospital and St George's Hospital Medical School
*
Dr Bridget Dolan, Section of Forensic Psychiatry, St George's Hospital Medical School, Tooting, London SW17 ORE
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Abstract

Background

Simultaneous diagnosis of more than one personality disorder (PD) has been termed ‘comorbidity’ or ‘co-occurrence’ implying that single diagnoses are the norm and multiple diagnoses interesting exceptions. Surveys of PD subjects in fact show 1.5–5.6 diagnoses per subject. Our study explores the hypothesis that multiple PD diagnosis is common and increases with increasingly personality disordered populations.

Method

The PDQ–R questionnaire was administered to three UK samples: referrals for specialist PD in-patient treatment (n = 275); high tariff offenders attending a probation centre (n = 57); and undergraduate students (n = 274).

Results

Means of 6.0 (95% CI 5.7–6.3), 4.0 (3. 1–5.0) and 3.4 (3.0–3.8) PDQ–R diagnoses per subject were found respectively. High rates of PD diagnosis in individual subjects suggest that multiple diagnosis is the norm rather than the exception.

Conclusions

Multiple diagnosis of PD is better construed as ‘breadth’ of psychopathology rather than comorbidity and is a function of sampling frame. High rates of multiple diagnoses question the interpretation of studies of any single PD. The graded construct of ‘breadth’ of axis–II pathology may further our understanding of PD.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 1 , January 1995 , pp. 107 - 112
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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