Nowadays, it is apparent that personality disorder is a common condition. Some of the concepts of personality disorder that are currently in use are flawed and need to be revised. The aim of this article is to discuss the controversy created by the uncertainties in the current classification system and to suggest ways forward. In particular, the clinician needs to be aware of the importance of assessing personality abnormality in terms of a severity dimension, and of the ways in which such an abnormality can impact on treatments for other conditions. These changes in the notion of personality disorder are needed as, for the first time, a good evidence base is being established for potential treatments and these will be maximized if we have a classification fit for therapeutic purpose.
Personality Disorders

No abstract available.
Personality Disorders*

Objective: This study examines the current prevalence of mood, anxiety and personality disorders in patients with multiple sclerosis (MS), the impact of personality disorders on clinical features of MS and the existence of depressive and anxiety disorders. Methods: The study sample comprised of 55 patients with relapsing-remitting MS and 56 control subjects. Axis I diagnoses including mood and anxiety disorders and personality disorders were ascertained by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition / Clinical Version and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders, respectively. The Expanded Disability Status Scale (EDSS) was used to determine degree of disability due to MS. Results: The prevalence of any mood, any anxiety and any personality disorders in patients with MS were 40.0%, 38.2% and 45.5%, respectively, which are significantly higher than the control subjects. Major depression, generalized anxiety disorder, avoidant personality disorder and obsessivecompulsive personality disorder were more frequent in patients with MS compared to the controls. In comparison to MS patients without personality disorders, MS patients with personality disorders had a more frequent occurence of any mood disorder, any anxiety disorder, major depression, posttraumatic stress disorders and MS attacks, and higher scoresof EDSS. Conclusions: Mood, anxiety and personality disorders are frequently seen in patients with MS. The results also suggest that personality disorders may negatively affect the existence of mood and anxiety disorders as well as the clinical course of MS in the patients.
Multiple Sclerosis ; Personality Disorders ; Anxiety Disorders

OBJECTIVES: To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma. METHODS: According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI）. RESULTS: The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients （18.7%） of mild craniocerebral trauma （P<0.05）. Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences （P<0.05） in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences （ P>0.05） in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma. CONCLUSIONS The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.
Craniocerebral Trauma/pathology* ; Humans ; Personality ; Personality Disorders/psychology* ; Personality Inventory ; Psychotic Disorders/psychology*

OBJECTIVES: The purpose of the study was to examine the relationships between temperament and character dimensions and family environments, and to investigate the influences of those factors on the antisocial personality traits in delinquent adolescents. METHODS: The subjects consisted of 160 male adolescents detained at the public prosecutor's office on the suspicion of crimes. To assess personality dimensions and family environmental factors, the Temperament and Character Inventory(TCI) and the Family Environment Scale(FES) were completed. Antisocial personality traits were assessed by the number of antisocial personality disorder symptoms of the Personality Disorder Questionnaire-Revised. RESULTS: Most of the TCI dimensions except Reward Dependence(RD) were highly correlated with the subscales of FES. Among temperament dimensions, Novelty Seeking(NS) and Persistence(P) were significantly affected by Organization, and Harm Avoidance(HA) was influenced by Expressiveness of FES. Self-Directednss(SD) was best predicted by Organization and Achievement-Orientation. While the Independence had significant effect on Cooperativeness, Expressiveness and Achievement-Orientation best predicted the level of Self-Transcendence(ST). On factor analysis, NS, HA, SD and ST were allocated to the same factors with subscales of FES. The level of antisocial personality trait was best predicted by NS, P and SD scores of TCI, and conflict subscale scores of FES. CONCLUSION: The findings of this study suggest that not only the character dimensions but also the temperament dimensions have close relationships with family environmental factors, and that the antisocial personality traits of delinquent adolescents may developed by the interaction between temperament/character dimensions and family environments.
Adolescent* ; Antisocial Personality Disorder* ; Crime ; Humans ; Personality Disorders ; Reward ; Temperament*

It is known that the personality is the crucial factor in the treatment outcome of depression. The authors tried to identify the results of such studies and various components which determine the treatment outcome of depression. Nearly 60 papers published between the year 1990 and 2000 about the treatment of depression and personality were reviewed. Among them about 30 papers were selected to compere the research methods, results and discussions. The arguments and critics of the papers were discussed. In the many debates, the authors admitted the fact that premorbid personality trait influences the treatment outcome of depression negatively regardless of treatment method. Subtyping of depression is feasible along the presence of good or bad predictors of treatment outcome for depression. Differentiation of depression and personality seems to have no problem, however test of personality state before the development of psychiatric disorder such as depression is not amenable. For example, cluster A personality trait is often misunderstood as depression in clinical setting. In some cases cognitive behavioral therapy is effective in the treatment of depression accompanying personality disorder. The authors insist that the analysis of personality in the dimensional aspect rather than in the categorical aspect gives more information in the research of personality influencing the treatment outcome of depression. In addition, the reason why we understand the relationship between depression and personality were discussed.
Cognitive Therapy ; Depression* ; Personality Disorders ; Treatment Outcome

OBJECTIVES: The diagnosis and assessment of personality disorders are crucial for research, as well as for clinical practice. The Structured Interview for the DSM-IV Personality (SIDP-IV) is a structured diagnostic interview for DSM-IV personality disorders (PD). This study aimed to develop the Korean version of the SIDP-IV and to test its inter-rater reliability. METHODS: A panel consisting of 7 psychiatrists translated the SIDP-IV into Korean. Six psychiatrists and 1 psychiatric nurse, all trained to apply the SIPD-IV, interviewed 70 inpatients (male, 30;female, 40) using this translation, two joint-examiners per patient interview. We used kappa coefficients to test diagnosis agreement, the Pearson correlation coefficient to test K-SIDP-IV total score agreement, and percent agreement to test the agreement on the number of DSM-IV criteria met. RESULTS: The kappa coefficients for most of the PDs, such as paranoid, borderline, histrionic, narcissistic, avoidant, dependent, and obsessive-compulsive, were excellent (> or =0.80). Moreover, the kappa coefficients for schizoid and antisocial PD were acceptable (k=0.66). The Pearson correlation coefficient for the K-SIDP-IV total scores were high for all personality disorders (r=0.91-0.97). Percent agreement regarding the number of DSM-IV criteria met varied from 92.9% to 100%. CONCLUSION: The Korean version of the SIDP-IV is a reliable instrument for the assessment and diagnosis of personality disorders.
Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Inpatients ; Personality Disorders ; Psychiatry

OBJECTIVES: The purpose of this study is to investigate the differences of personality trait between two social phobic subgroups. METHODS: MMPI (Minnesota Multiphasic Personality Inventory) data were selected from 81 patients diagnosed as social phobia, and 13 MMPI basic scales and 11 personality disorder sub-scales between the two subgroups were compared. RESULTS: Generalized group showed significantly higher scores in D (Depression), Pt (Psychasthenia) and Si (Social introversion) basic scales, and DEP (Dependant), AVD (Avoidant), and SZD (Schizoid) personality disorder sub-scales than non-generalized group. Non-generalized group showed significantly higher scores in Ma (hypomanic) basic scale, and HST (Histrionic), NAR (Narcissistic), BDL (Borderline), ANT (Antisocial) personality disorder sub-scales than generalized group in MMPI. CONCLUSION: Although there were few differences in the basic MMPI profile patterns between the two social phobic subgroups, there were differences in the personality traits.
Ants ; Humans ; MMPI ; Personality Disorders ; Phobic Disorders ; Weights and Measures

OBJECTIVES: The aims of this study were to evaluate acceptability and usefulness of the Korean version of Self-report Standardized Assessment of Personality-Abbreviated Scale (SAPAS-SR) as an instrument for screening patients with a personality disorder. METHODS: The Korean version of the SAPAS-SR was administered to a non-random sample of 186 psychiatric patients (155 patients with a personality disorder and 31 patients with no personality disorder). The International Classification of Diseases 10th version Personality Assessment Schedule was used as a gold standard in diagnosis of personality disorder. Receiver-operant-characteristics and validity indicators were determined. In addition, the SAPAS-SR was administered to 22 healthy men to examine the test-retest reliability. RESULTS: The area under the curve for the SAPAS-SR was 0.69 (95% confidence interval 0.59-0.79). The SAPAS-SR score of 4 or more correctly classified 67.2% of patients with a personality disorder. Sensitivity (0.67) and specificity (0.68) were slightly lower compared with the original English version. CONCLUSION: This study provides preliminary evidence of the usefulness of the Korean version of the SAPAS-SR as a self-administered instrument for screening personality disorders in the clinical population.
Appointments and Schedules ; Diagnosis ; Humans ; International Classification of Diseases ; Male ; Mass Screening* ; Personality Assessment ; Personality Disorders* ; Sensitivity and Specificity

OBJECTIVES: The purpose of this study was to examine the reliability and the validity of the Korean version of Personality Disorder Questionnaire-4+ (PDQ-4+). METHODS: PDQ-4+ was administered to 540 subjects of general population group and 37 subjects of personality disorder group. For measuring concurrent reliability, we tested internal consistency, split-half reliability, test-retest reliability and correlation of item score of subscale and mean of subscale. And also, we performed factor analysis for the evaluation of validity, and t-test to group difference of the total scores between general population group and personality disorder group. RESULTS: In general population group and personality disorder group, internal consistency was above .500 (range of Cronbach alpha: .4007 to .6693) in most of the Personality disorder categories. Split-half reliability was .839 between even and odd items. Test-retest reliability done 2 weeks interval was .868. Item scores of subscales and mean of subscales showed high correlation coefficient. Group difference of the total scores between general population and personality disorder group showed very significant difference (t=9.146, df=76, p=.000). CONCLUSION: The PDQ-4+ shows a reasonable degree of reliability and validity and could be a valuable tool in screening for overall personality disturbances.
Humans ; Mass Screening ; Personality Disorders* ; Population Groups ; Reproducibility of Results*