Assessment of personality disorder

Banerjee, Penny; Gibbon, Simon; Huband, Nick

doi:10.1192/apt.bp.107.005389

Cited by 13 publications

(6 citation statements)

References 33 publications

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“…We selected study factors a priori based on previous reviews of mental health prevalence 14,36 and the assessment of personality disorder prevalence specifically. [37][38][39] We conducted univariate metaregressions for each factor. Covariates associated with heterogeneity at the P < 0.05 level were included in the multivariate analysis.…”

Section: Subgroup Analysis and Meta-regression Analysismentioning

confidence: 99%

The prevalence of personality disorders in the community: a global systematic review and meta-analysis

et al. 2019

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BackgroundPersonality disorders are now internationally recognised as a mental health priority. Nevertheless, there are no systematic reviews examining the global prevalence of personality disorders.AimsTo calculate the worldwide prevalence of personality disorders and examine whether rates vary between high-income countries and low- and middle-income countries (LMICs).MethodWe systematically searched PsycINFO, MEDLINE, EMBASE and PubMed from January 1980 to May 2018 to identify articles reporting personality disorder prevalence rates in community populations (PROSPERO registration number: CRD42017065094).ResultsA total of 46 studies (from 21 different countries spanning 6 continents) satisfied inclusion criteria. The worldwide pooled prevalence of any personality disorder was 7.8% (95% CI 6.1–9.5). Rates were greater in high-income countries (9.6%, 95% CI 7.9–11.3%) compared with LMICs (4.3%, 95% CI 2.6–6.1%). In univariate meta-regressions, significant heterogeneity was partly attributable to study design (two-stage v. one-stage assessment), county income (high-income countries v. LMICs) and interview administration (clinician v. trained graduate). In multiple meta-regression analysis, study design remained a significant predictor of heterogeneity. Global rates of cluster A, B and C personality disorders were 3.8% (95% CI 3.2, 4.4%), 2.8% (1.6, 3.7%) and 5.0% (4.2, 5.9%).ConclusionsPersonality disorders are prevalent globally. Nevertheless, pooled prevalence rates should be interpreted with caution due to high levels of heterogeneity. More large-scale studies with standardised methodologies are now needed to increase our understanding of population needs and regional variations.

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Section: Subgroup Analysis and Meta-regression Analysismentioning

confidence: 99%

The prevalence of personality disorders in the community: a global systematic review and meta-analysis

et al. 2019

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“…Unrecognized and unformulated state-shifting accounts for much of the everyday felt confusion of patients with identity disturbance issues and also much of the diagnostic uncertainty in the professionals attempting to treat them (Ryle & Kerr, 2002). It has commonly emphasized that clinicians need to have access to appropriate tools for use in routine practice to assess personality disordered patients, due to the significant impact on functioning across all aspects of life (Banerjee, Gibbon, & Hubbard, 2009). The brevity of the PSQ (eight items) demonstrates that assessment of identity disturbance can be relatively rapidly achieved, with brief measures having strong clinical appeal.…”

Section: Discussionmentioning

confidence: 99%

Assessment of identity disturbance: Factor structure and validation of the Personality Structure Questionnaire in an Italian sample.

Berrios

Kellett

Fiorani

et al. 2016

Psychological Assessment

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There are few brief measures of identity disturbance for use in clinical practice that have been subject to any cross-cultural validation. This study investigated the construct validity of the Personality Structure Questionnaire (PSQ) in Italian clinical (N = 237) and community (N = 296) samples. Confirmatory factor analysis was conducted to investigate the internal structure of the PSQ. A 3-factor structure (i.e., differing self-states, mood variability, and behavioral loss of control) including a second-order factor provided the best fit to the data. This structure was demonstrated to be invariant across sex and clinical diagnosis, with clinical diagnosis significantly predicting increased PSQ scores. A global PSQ score of between 26 and 28 was found to be an appropriate cutoff for assisting in diagnostic processes. The clinical implication of the study is that quantitative assessment of identity disturbance can be rapidly achieved via the PSQ, usefully supplementing necessary diagnostic and formulation work.

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“…In response to a consensus statement on PD that described the neglect and exclusion of those given the diagnosis (Lamb et al, 2018), the Royal College of Psychiatrists' position statement on PD stressed the need for staff training, supervision and reflective practice (RCPsych, 2020). A diagnosis of a PD is a serious mental health condition affecting up to 52% of psychiatric outpatients and 70% of inpatients and forensic patients (Banerjee et al, 2009; Bowden‐Jones et al, 2004; Keown et al, 2002; Singleton et al, 1998). Given the significant public health implications associated with the disorder—including extensive use of healthcare resources, high rates of suicide and reduced life expectancy—effective treatment is a priority (Chiesa et al, 2002; Fok et al, 2012; Lamb et al, 2018; Moran et al, 2016; Stone, 1993).…”

Section: Introductionmentioning

confidence: 99%

Perspectives of service users and carers with lived experience of a diagnosis of personality disorder: A qualitative study

Balmer

Sambrook

Roks

et al. 2023

Psychiatric Ment Health Nurs

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Accessible SummaryWhat the paper adds to existing knowledge? Personality disorder is a serious mental health condition affecting up to 52% of psychiatric outpatients and 70% of inpatients and forensic patients. People with a diagnosis of personality disorder have higher morbidity and mortality than those without. Service users and carers reported a lack of training for staff in the management of individuals with a diagnosis of personality disorder, particularly with regard to self‐harm and suicidal behaviours. Staff burnout creates barriers to compassionate person‐centred care for individuals with a diagnosis of personality disorder as staff struggled to accommodate the nature of the presentation when under significant emotional, psychological and professional strain caused by understaffing and lack of support. What are the implications for practice? This paper adds new knowledge by informing services of ways to improve care provision from the perspectives of both carers and service users. A more holistic and less medicalised approach to the treatment of problems associated with a diagnosis of a personality disorder should be adopted, and personality disorder training introduced for all healthcare practitioners, to improve patient outcomes. AbstractIntroductionThere is limited understanding of the experience of people with complex mental health (CMH) needs, including those with a diagnosis of personality disorder (PD) and carers of those individuals. Little is known about carers of those in inpatient forensic settings, yet it has been identified that they may have additional needs when compared to general carers. Research highlights that community carer support services were perceived as inadequate and out‐of‐area placements were described as putting an added strain on ability to support loved ones. Understanding PD within a population of people with CMH needs and how a diagnosis described as PD impacts on care and treatment experience is vital to providing high‐quality care.AimTo evaluate the care experience of service users and carers with lived experience of a diagnosis of PD and out‐of‐area placements.MethodSemi‐structured interviews were conducted with six service users and four carers to explore the experiences and perspectives of people with a diagnosis of PD. Interviews were audio recorded and thematically analysed.ResultsFour interrelated themes were developed; Influence of a diagnosis of PD on Staff, Early and Appropriate Intervention, Recognition of the Individual and Training and Knowledge of people with a diagnosis of PD.DiscussionAnti‐stigma interventions for staff, research on care provision and structural changes to services including more evidence‐based therapy for individuals with a diagnosis of PD may help reduce disparate treatment and improve prognosis for recovery.Implications for PracticeThis paper informs services of ways to improve care provision from the perspective of carers and service users. A more holistic and less medicalised approach to the treatment of problems associated with diagnoses of PD should be adopted, and PD training for all healthcare practitioners to improve patient outcomes.

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Assessment of personality disorder

Cited by 13 publications

References 33 publications

The prevalence of personality disorders in the community: a global systematic review and meta-analysis

The prevalence of personality disorders in the community: a global systematic review and meta-analysis

Assessment of identity disturbance: Factor structure and validation of the Personality Structure Questionnaire in an Italian sample.

Perspectives of service users and carers with lived experience of a diagnosis of personality disorder: A qualitative study

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