Personality change in the Nottingham Study of Neurotic Disorder: 30-Year cohort study
File(s)
Published version
Author(s)
Yang, Min
Tyrer, Helen
Johnson, Tony
Tyrer, Peter
Type
Journal Article
Abstract
Background:
Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and depressive disorders involved in a randomised controlled trial initiated in 1983 had full personality status assessed at baseline. We repeated assessment of personality status on three subsequent occasions over 30 years.
Methods:
Personality status was recorded using methods derived from the Personality Assessment Schedule, which has algorithms for allocating Diagnostic and Statistical Manual of Mental Disorders (DSM) and the 11th International Classification of Diseases (ICD-11) categories. The category and severity of personality diagnosis were recorded at baseline in the randomised patients with DSM-III anxiety and depressive diagnoses. The same methods of assessing personality status was repeated at 2, 12 and 30 years after baseline.
Results:
Using the ICD-11 system, 47% of patients, mainly those with no personality disturbance at baseline, retained their personality status; of the others 16.8% improved and 20.4% worsened to more severe disorder. In DSM-III diagnosed patients, those diagnosed as Cluster A and Cluster C increased in frequency (from 14% to 40%, p < 0.001, and 21.5% to 36%, p < 0.001, respectively) over follow-up, while those with Cluster B showed little change in frequency (22% to 18%, p = 0.197).
Conclusion:
In this population of patients with common mental disorders, personality status showed many changes over time, inconsistent with the view that personality disorder is a persistent or stable condition. The increase in diagnoses within the Cluster A and C groups suggests personality disorder generally increases in frequency as people age.
Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and depressive disorders involved in a randomised controlled trial initiated in 1983 had full personality status assessed at baseline. We repeated assessment of personality status on three subsequent occasions over 30 years.
Methods:
Personality status was recorded using methods derived from the Personality Assessment Schedule, which has algorithms for allocating Diagnostic and Statistical Manual of Mental Disorders (DSM) and the 11th International Classification of Diseases (ICD-11) categories. The category and severity of personality diagnosis were recorded at baseline in the randomised patients with DSM-III anxiety and depressive diagnoses. The same methods of assessing personality status was repeated at 2, 12 and 30 years after baseline.
Results:
Using the ICD-11 system, 47% of patients, mainly those with no personality disturbance at baseline, retained their personality status; of the others 16.8% improved and 20.4% worsened to more severe disorder. In DSM-III diagnosed patients, those diagnosed as Cluster A and Cluster C increased in frequency (from 14% to 40%, p < 0.001, and 21.5% to 36%, p < 0.001, respectively) over follow-up, while those with Cluster B showed little change in frequency (22% to 18%, p = 0.197).
Conclusion:
In this population of patients with common mental disorders, personality status showed many changes over time, inconsistent with the view that personality disorder is a persistent or stable condition. The increase in diagnoses within the Cluster A and C groups suggests personality disorder generally increases in frequency as people age.
Date Issued
2022-03-01
Date Acceptance
2021-07-01
Citation
Australian & New Zealand Journal of Psychiatry, 2022, 56 (3), pp.260-269
ISSN
0004-8674
Publisher
SAGE Publications
Start Page
260
End Page
269
Journal / Book Title
Australian & New Zealand Journal of Psychiatry
Volume
56
Issue
3
Copyright Statement
© The Author(s) 2021. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
License URL
Sponsor
Nicola Pigott Fund (Central & NW London Mental NHS Charity T
Greater Manchester West Mental Health NHS Foundation Trust
Identifier
https://journals.sagepub.com/doi/10.1177/00048674211025624
Grant Number
N/A
N/A
Subjects
Science & Technology
Life Sciences & Biomedicine
Psychiatry
Personality disorder
change
follow-up
stability
LONGITUDINAL COURSE
10-YEAR COURSE
FOLLOW-UP
BORDERLINE
STABILITY
PSYCHOPATHOLOGY
CLASSIFICATION
PHENOMENOLOGY
SCHIZOTYPAL
AVOIDANT
Personality disorder
change
follow-up
stability
Psychiatry
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
Publication Status
Published
Date Publish Online
2021-07-10