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The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Personality status is seldom assessed in community mental health teams except at a rudimentary level. This study challenges the assumption that this policy is either prudent or wise.

Aims

To measure the prevalence of personality disorder within community mental health teams and to investigate its relationship to mental state disorders and overall pathology.

Method

A cross-sectional survey of 2,528 of 2,567 psychiatric patients (98.5%) managed by community mental health teams in four urban settings in the UK in which diagnoses of personality and mental state pathology were assessed separately. Of these, a sample of 400 was interviewed, with a 70.5% completion rate for more in depth information.

Results

In total, 40% of all patients in secondary care suffered from at least one personality disorder. Regression modelling showed personality pathology accounted for a greater degree of global psychopathology than psychosis, alcohol or drug dependence, but was associated with anxiety disorders.

Conclusion

Comorbid personality pathology contributes greatly to overall psychopathology in secondary psychiatric care. It should be both recognised and managed.

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Acknowledgments

This work was undertaken by the authors who received funding under the Department of Health’s Drug Misuse Research Initiative (Grant No: 1217194). The views expressed in this publication are those of the authors and not necessarily those of the sponsors. The authors would like to express their gratitude to the funders for supporting this work.

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Department of Psychological Medicine, Faculty of Medicine, Imperial College, London, UK

    Giles Newton-Howes, Peter Tyrer & Tim Weaver

  2. Nottinghamshire Healthcare NHS Trust, Nottingham, UK

    Katina Anagnostakis & Sylvia Cooper

  3. Central and North West London Mental Health NHS Trust, London, UK

    Owen Bowden-Jones

Authors
  1. Giles Newton-Howes
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  2. Peter Tyrer
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  3. Katina Anagnostakis
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  4. Sylvia Cooper
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  5. Owen Bowden-Jones
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  6. Tim Weaver
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Corresponding author

Correspondence to Giles Newton-Howes.

Additional information

On behalf of the COSMIC study team.

Appendix: The COSMIC Study Group

Appendix: The COSMIC Study Group

  • Imperial College, London: Tim Weaver, Vikki Charles, Sylvia Cooper, Zenobia Carnwath, Peter Madden, Adrian Renton, Gerry Stimson, Peter Tyrer, Thomas Barnes, Chris Bench and Susan Paterson.

  • Turning Point, Brent: Chris Ford.

  • Central and North West London Mental Health NHS Trust: Jonathon Greenside, Owen Bowden Jones and William Shanahan.

  • Community Health Sheffield NHS Trust: Helen Bourne, Muhammad Z. Iqbal and Nicholas Seivewright.

  • Nottinghamshire Healthcare NHS Trust: Sylvia Cooper, Katina Anagnostakis, Hugh Middleton and Neil Wright.

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Newton-Howes, G., Tyrer, P., Anagnostakis, K. et al. The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams. Soc Psychiat Epidemiol 45, 453–460 (2010). https://doi.org/10.1007/s00127-009-0084-7

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  • DOI: https://doi.org/10.1007/s00127-009-0084-7

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