Personality Disorders Common in Outpatients

Article excerpt

NEW YORK -- Personality disorders are frequent in psychiatric outpatients and can be more readily diagnosed using semistructured interviews than other methods, Dr. Mark Zimmerman said at the annual meeting of the American Psychiatric Association.

Personality disorders were diagnosed in 31.4% of 859 psychiatric outpatients participating in the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project. Of those diagnosed, 12.4% had one personality disorder, 11.1% had two, and 7.9% had three or more disorders, he reported.

The most common diagnosis was avoidant personality disorder (14.7%), followed by personality disorder not otherwise specified (14.1%). When the "personality disorder not otherwise specified" category is included, 45.5% of patients had a personality disorder.

"A review of the clinical epidemiological literature suggests that at least half of psychiatric patients have a personality disorder, and this makes this group of disorders ... amongst the most frequently treated and seen by psychiatrists," Dr. Zimmerman said.

"It is our belief that personality disorders should be evaluated in every patient, because their presence can influence the course of treatment of the symptoms of Axis disorders, which are the symptoms that patients typically identify as their chief complaint," he said.

Dr. Zimmerman and his colleagues assessed 859 psychiatric outpatients using the Psychiatric Diagnostic Screening Questionnaire, the Structured Interview for DSM-IV Personality (SIDP-IV), and a clinical evaluation. The mean patient age was 37.8 years, 89% of patients were white, and 63.2% were women.

Patients were screened for 13 Axis I personality disorders. Data were not included for the two DSM-IV appendix diagnoses of passive-aggressive disorder and depressive disorder nor for the DSM-III-R diagnosis of self-defeating personality disorder.

The most common current Axis I disorders were major depressive disorder (47. …