The relationship between symptom disorder and personality disorder according to DSM-III was studied in 289 consecutive outpatients. It was observed that personality disorders occurred frequently among the chronic affective and anxiety disorders. The "dramatic" personality disorders were observed especially frequently among patients with cyclothymic disorder, and the "eccentric" personality disorders among patients with a diagnosis of dysthymic disorder, social phobia and agoraphobia. Dramatic personality disorder was also common among patients with simple phobia. As expected, a close correspondence was observed between social phobia, agoraphobia and avoidant personality disorder, between substance use disorder and borderline personality disorder, and between obsessive-compulsive disorder and compulsive personality disorder. Even if a relationship was observed, it was not strong enough to warrant a combination of chronic symptom disorder diagnoses and personality disorder diagnoses.

Type and prevalence of Axis I and Axis II disorders (DSM-III) were assessed in a sample of 298 consecutive psychiatric outpatients. The instruments used were SCID and SIDP. About half of the Axis I diagnoses consisted of different subgroups of depression. Most patients had more than one diagnosis, anxiety being the second most common disorder. Eighty one percent of the subjects met the criteria for a personality disorder diagnosis; half of them obtained more than one Axis II diagnosis. Personality disorder was more common among men than among women. Avoidant and dependent personality disorders constituted the most frequent diagnoses.

The aim of this study was to investigate the role of personality deviations in the development and relapses of major depression. The study is based on an investigation of an initial sample of 298 psychiatric out-patients, who were re-evaluated after 6 years when the sample included 253 patients. SCID-R was used for assessment of possible relapses and new cases, and a logistic regression analysis was used to determine the best prediction of the recurrence of depression. Borderline personality disorders and dependency predicted relapses. In addition, borderline personality disorders, together with avoidant personality disorders, predicted the development of new cases. Comorbid clinical syndromes appear to be of no importance. These findings suggest that the comorbidity with personality deviations accounts for the chronicity and poor prognosis in major depression.

Reasons for overlap between the various DSM-III personality disorders are discussed. It is concluded that overlap may always take place when no hierarchical rules are applied, because of the orthogonal dimensional nature of the personality structure. Data are presented showing the localization of the various personality disorders in an orthogonal three-dimensional space, established by means of a questionnaire that measures oral, obsessive, and hysterical personality traits. It is observed that the dependent, avoidant and the passiveaggressive personality disorders are located close to one another, as are the obsessive and the paranoid; the histrionic, narcissistic, and the borderline; and finally the schizoid and the schizotypal personality disorder in a fourth cluster. A fourth dimension is proposed measuring reality weakness and a decision tree is presented, which will make it possible to proceed to the DSM-III-R personality disorder diagnoses without overlap. Finally a new system of personality disorders is derived from dichotomizing the four dimensions, resulting in 16 disorders; these include the current DSM-III-R diagnoses but also some new ones that are combinations of the already existing personality disorders.A major endeavor of the new American classification system for psychiatric disorders, DSM-III, has been the development of criteria for the diagnosis of personality disorders. This change in the classification system from DSM-II has placed the emphasis on personality in the field of psychiatry and re sulted in a number of papers about personality disorders in American psychiatric journals in the 1980s.Even though the reception of the personality disorder Axis II of DSM-III has been fairly positive, some problems have become obvious (see Frances

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