Relationship between Neurosis and Personality Disorder

Abstract

316 psychiatric patients--predominantly out-patients--with a clinical diagnosis of neurosis (International Classification of Disease), were given an interview schedule for assessing personality disorders. Nearly two fifths were rated as having personality disorder, the anankastic type being the most common and sociopathic personality disorder the least. Patients with anxiety, phobic and obsessional neurosis were all significantly more likely to show personality disorder than those with depressive neurosis. Broadly, passive-dependent personalities were linked to anxiety neurosis, anankastic personality disorder to obsessional neurosis, and both anankastic and passive-dependent personalities to phobic neurosis. In a clinical trial of the efficacy of two dosage regimes of phenelzine in 60 patients the presence of personality disorder significantly impaired clinical outcome. The results suggest strongly that the assessment of personality in neurotic disorders is necessary to make an adequate diagnosis and predict the outcome of treatment.

Personality traits and treatment outcome in obsessive-compulsive disorder

“…22 Nevertheless, the first published trial testing this hypothesis is relatively recent, dating from 1983 23 and no previous study had investigated the impact of personality traits using a dimensional approach in clearly distinct subgroups as defined in this study. Our findings support the notion that there are distinct patterns of temperament and character in OCD patients who respond and do not respond to current treatments.…”

Psychiatric Comorbidity in Greek Patients with Generalized Anxiety Disorder

“…It is not clear whether a personality disorder that leads to an earlier onset and to severer psychopathology of the clinical syndrome preexists, or whether a syndrome with a severer clinical picture, which is manifested early in life, influences the patient's personality and 'creates' personality disorders. Tyrer et al [64] found that 40% of neurotics had premorbid personality diagnoses. On the other hand, there are reports that personality diagnoses assigned to some anxiety or depressive patients were not found in posttreatment evaluation [65][66][67], and also that an improvement in the clinical syndrome was accompanied by an improvement in personality functioning [65,68], a finding leading to the suggestion that symptom severity may be a confounding factor in personality assessment, the so-called trait-state artifact [67][68][69].…”

Personality diatheses: a superior explanation than disorder

“…Empirical studies have shown this is not the case. Thus, epidemiological studies have shown repeatedly that whilst the prevalence of personality disorder is only 4-5 % in the community (Coid et al 2006), this increases to 25-30 % in primary care (Casey & Tyrer, 1990 ;Moran et al 2000) whereas high percentages are found in outpatients (Tyrer et al 1983), with even higher proportions in community and specialist teams with more severe illness (Keown et al 2002 ;Ranger et al 2004). In general there is also greater intensity of symptoms in those who have co-occurrent personality disorders ) and this also is difficult to explain with the spectrum concept but predicted readily by the diathesis one, which postulates greater tendency to recurrence as well as higher intensity of symptom expression.…”