Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-19T03:04:45.302Z Has data issue: false hasContentIssue false

Personality disorder among first ever admissions to an Irish public and private hospital

Published online by Cambridge University Press:  13 June 2014

John M Cooney
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital, West Smithfield, London EC 1A 7BE, England
Conor K Farren
Affiliation:
Yale University School of Medicine, 1 Long Wharf, New Haven, CT 06511, USA
Anthony W Clare
Affiliation:
St Patrick's Hospital, James's St, Dublin 8, Ireland

Abstract

Objective: The identification of personality disorder among psychiatric in-patients is important because of the effect on the course and outcome of illness. The introduction of a multiaxial approach to diagnosis, has resulted in a higher than previously reported rate of occurrence of personality disorder in a variety of psychiatric settings. A prevalence of personality disorder of 4.9% is reported in the official statistics for Irish psychiatric hospitals. The aim of this study is to determine the true prevalence of personality disorders in two Irish psychiatric hospitals, one public and one private, using a multiaxial approach to diagnosis.

Methods: The Standardised Assessment of Personality (SAP) is a validated, semistructured, informant based instrument that reliably generates diagnoses of personality disorder irrespective of current mental state. Over a four month period, 78 consecutive, first ever admissions to two hospitals were examined using the SAP.

Results: The prevalence of personality disorder in this population was 26%. There was no significant difference in the rate of personality disorder between the public and private institutions.

Conclusions: The prevalence of personality disorder amongst in-patients in both public and private psychiatric hospitals in Ireland is far higher than previously reported. This highlights the importance of a multiaxial approach to diagnosis in order to establish the true extent of psychiatric morbidity.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Tyrer, P. Personality disorders: Diagnosis, management and treatment. Wright: London, 1988.Google Scholar
2.Weissman, MM, Prusoff, BA, Klerman, GL. Personality and the prediction of long term outcome of depression. Am J Psychiatry 1978; 135: 797800.Google ScholarPubMed
3.Frank, E, Kupfer, DJ, Jacob, M. Personality features and response to acute treatment in recurrent depression. J Personality Disorders 1987; 175: 467–73.Google Scholar
4.McGlashan, TM. Borderline personality disorder and unipolar affective disorder: long term effects of comorbidity. J Nerv Ment Dis 1987; 175: 467–73.CrossRefGoogle ScholarPubMed
5.Norton, KRW. The Health of the Nation: the impact of personality disorder on key areas. Postgrad Med J 1992; 68: 350–4.CrossRefGoogle ScholarPubMed
6.Blackburn, R. On moral judgements and personality disorders. The myth of psychopathic personality revisited. Br J Psychiatry 1988; 153: 505–12.CrossRefGoogle ScholarPubMed
7.American Psychiatric Association: Diagnostic and statistical manual of mental dDisorders. Third edition. Washington DC: APA, 1980.Google Scholar
8.WHO: The ICD-10 Classification of Mental and Behavioural Disorders. Geneva.Google Scholar
9.Tyrer, P, Casey, P, Ferguson, B. Personality disorder in perspective. Br J Psychiatry 1991; 159: 463–71.CrossRefGoogle Scholar
10.Mann, A H, Jenkins, R, Cutting, JC, Cowen, PJ. The development and use of a standard assessment of abnormal personality. Psychol Med 1981; 11: 839847.CrossRefGoogle ScholarPubMed
11.Pilowski, I: Personality and depressive illness. Acta Psychiatr Scand 1979; 60: 170–6.CrossRefGoogle Scholar
12.Hirschfeld, RM, Klerman, GK, Clayton, PJ, Keller, MB, McDonald-Scott, P, Larkin, B. Assessing Personality: effects of the depressive state on trait measurement. Am J Psychiatry 1983; 140: 695–9.Google ScholarPubMed
13.Reich, J. Sex distribution of DSM-III personality disorders in psychiatric outpatients. Am J Psychiatry 1987; 144: 485–8.Google ScholarPubMed
14.Moran, R, Walsh, D. Activities of Irish psychiatric hospitals and units. Health Research Board. 1989.Google Scholar
15.Pilgrim, JA, Mellers, JD, Boothby, HA, Mann, AH. Inter-rater and temporal reliability of the standard assessment of personality and the influence of informant characteristics. Psychol Med 1993; 23: 779–86.CrossRefGoogle ScholarPubMed
16.Farren, C, Mcloughlin, D, Clare, A. Procedures for involuntary admission to public and private psychiatric facilities. Ir J Psychol Med, 1992, 9, 96100.CrossRefGoogle Scholar
17.Pilgrim, J, Mann, A. Use of the ICD-10 version of the standard assessment of personality to determine the prevalence of personality disorder in psychiatric inpatients. Psychol Med 1990; 20: 985–92.CrossRefGoogle Scholar
18.Tyrer, P, Casey, P, Gall, J. Relationship between neurosis and personality disorder. Br J Psychiatry 1983; 142: 404–8.CrossRefGoogle ScholarPubMed
19.Casey, P, Tyrer, P. Personality disorder and psychiatric illness in general practice. Br J Psychiatry 1990; 156: 261–5.CrossRefGoogle ScholarPubMed
20.Cutting, J, Cowen, PJ, Mann, AH, Jenkins, R. Personality and psychosis: use of the standard assessment of personality. Acta Psychiatr Scand 1986; 73: 8792.CrossRefGoogle ScholarPubMed
21.Tyrer, P, Alexander, J, Ferguson, B. Personality Assessment Schedule. In: Personality disorders: diagnosis, management and course. Wright: London, 1988; 140–7.Google Scholar
22.Chodoff, P. The depressive personality: a critical review. Int J Psych 1973; 11: 196217.Google ScholarPubMed
23.Casey, P, Dillon, S, Tyrer, P. The diagnostic status of patients with conspicuous psychiatric morbidity in primary care. Psychol Med 1984; 673–81.CrossRefGoogle ScholarPubMed
24.Irwin, M, Schuckitt, M, Smith, T L. Clinical importance of age of onset in type 1 and type 2 primary alcoholics. Arch Gen Psychiatry 1990; 47: 320–4.CrossRefGoogle ScholarPubMed
25.Dahl, A. Some aspects of the DSM-III personality disorders illustrated by a consecutive series of hospitalized patients. Acta Psychiatr Scand 1986; 73: 8792.CrossRefGoogle Scholar
26.Loranger, AW, Susman, VL, Oldham, MM, et al.The personality disorder examination: a preliminary report. J Pers Disorders 1987; 1: 113.CrossRefGoogle Scholar
27.Widiger, T, Trull, T, Hurt, S, et al.A multidimensional scaling of the DSM-III personality disorders. Arch Gen Psychiatry 1987; 44: 557–63.CrossRefGoogle ScholarPubMed
28.Williams, R, Walsh, D, Dalby, JT. Services to schizophrenic patients: epidemiological and cost-effectiveness issues. Irish J Psychol Medicine 1992; 9: 8389.CrossRefGoogle Scholar