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The effect of personality disorder on clinical outcome, social networks and adjustment: a controlled clinical trial of psychiatric emergencies

Published online by Cambridge University Press:  09 July 2009

P. Tyrer ,
S. Merson ,
S. Onyett  and
T. Johnson
P. Tyrer*
Affiliation:
Academic Unit of Psychiatry, St Charles Hospital, (St Mary's Hospital Medical School), London; Sainsbury Mental Health Centre, London; MRC Biostatistics Unit, Cambridge
S. Merson
Affiliation:
Academic Unit of Psychiatry, St Charles Hospital, (St Mary's Hospital Medical School), London; Sainsbury Mental Health Centre, London; MRC Biostatistics Unit, Cambridge
S. Onyett
Affiliation:
Academic Unit of Psychiatry, St Charles Hospital, (St Mary's Hospital Medical School), London; Sainsbury Mental Health Centre, London; MRC Biostatistics Unit, Cambridge
T. Johnson
Affiliation:
Academic Unit of Psychiatry, St Charles Hospital, (St Mary's Hospital Medical School), London; Sainsbury Mental Health Centre, London; MRC Biostatistics Unit, Cambridge
*
1Address for correspondence: Professor Peter Tyrer, Academic Unit of Psychiatry, St Charles Hospital, London W10 6DZ
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Synopsis

One hundred psychiatric emergencies presenting to an inner London teaching hospital had formal assessments of psychopathology, personality disorder (using both ICD-10 and the Personality Assessment Schedule), social networks and social functioning before being randomly assigned to a multidisciplinary community-based team (Early Intervention Service (N = 48) or conventional hospital-based psychiatric services (N = 52) and treated for a period of 12 weeks. The ICD-10 classification yielded a higher proportion (50%) of personality disordered patients than the Personality Assessment Schedule (34%) and those from ethnic minorities (mainly Afro-Caribbean) and upper social classes had a lower incidence of personality disorder. Social networks were smaller in personality disordered patients and there were fewer attachment figures. Improvement in social function, and to a lesser extent with depressive symptomatology, was better in patients with no personality disorder referred to the community service compared with the hospital service. No differences were found between the numbers and duration of social contacts in the two services and it is concluded that the better outcome in the community-treated patients was independent of changes in social networks.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 3 , August 1994 , pp. 731 - 740
Copyright
Copyright © Cambridge University Press 1994

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