Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-22T16:30:22.686Z Has data issue: false hasContentIssue false

A 15–20 Year Follow-Up of Adult Psychiatric Patients

Psychiatric Disorder and Social Functioning

Published online by Cambridge University Press:  02 January 2018

David Quinton*
Affiliation:
Department of Social Work, School for Policy Studies, University of Bristol
Lesley Gulliver
Affiliation:
MRC Child Psychiatry Unit, Institute of Psychiatry, London
Michael Rutter
Affiliation:
MRC Child Psychiatry Unit, Institute of Psychiatry, London
*
Dr David Quinton, Department of Social Work, School for Policy Studies, University of Bristol, 8 Woodland Rd, Bristol BS8 1TN. Fax: 0171 708 5800

Abstract

Background

An exploratory study was undertaken of the importance of personality disorder in predicting the long-term outcome for both episodic disorders and social functioning.

Method

In 1966–67, a representative series of patients with children, free of episodic illness for at least one year, was sampled from the Camberwell Psychiatric Register and systematically assessed over a four-year period, using measures of known reliability and validity. Psychiatric disorder was measured using a PSE-compatible instrument. The follow-up after 15–20 years used the PSE and a systematic assessment of social functioning.

Results

Overall outcomes were similar across diagnoses, but an initial categorical diagnosis of personality disorder predicted much poorer outcomes on psychiatric and social measures for patients with unipolar depressive disorders than for those with other diagnoses.

Conclusions

The findings indicate the importance for prognosis of including a systematic assessment of personality disorder in the clinical assessment of patients with depressive disorder.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, H. S., Hirschfeld, R. M. A. & Yervanian, B. I. (1983) The relationship of personality to affective disorders. Archives of General Psychiatry, 40, 801810.10.1001/archpsyc.1983.01790060099013Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III-R). Washington, DC: APA.Google Scholar
Andrews, G., Neilson, M., Hunt, C., et al (1990) Diagnosis, personality and the long-term outcome of depressives. British Journal of Psychiatry, 157, 1318.10.1192/bjp.157.1.13Google Scholar
Biehl, H., Maurer, K., Schubart, C., et al (1986) Prediction of outcome and utilization of medical services in a prospective study of first onset schizophrenias: results of a five year follow up study. European Archives of Psychiatry and Neurological Sciences, 236, 139147.10.1007/BF00380941Google Scholar
Charney, D. S., Nelson, C. J. & Quinlan, D. M. (1981) Personality tests and disorder in depression. American Journal of Psychiatry, 138, 16011604.Google Scholar
Costa, P. T. & McRae, R. R. (1986) Personality stability and its implications for clinical psychology. Psychology Review, 6, 407423.Google Scholar
Docherty, J. P., Fiester, S. J. & Shea, T. (1986) Syndrome diagnosis and personality disorder. In American Psychiatric Association Annual Review, Vol. 5 (eds A. J. Frances & R. E. Hales), pp. 315355. Washington, DC: American Psychiatric Press.Google Scholar
Drake, R. E. & Vaillant, G. E. (1988) Longitudinal view of personality disorder. Journal of Personality Disorders, 2, 4448.10.1521/pedi.1988.2.1.44Google Scholar
Duggan, C. F., Lee, A. S. & Murray, R. M. (1990) Does personality predict long-term outcome in depression? British Journal of Psychiatry, 157, 1924.10.1192/bjp.157.1.19Google Scholar
Duggan, C. F., Lee, A. S. & Murray, R. M. (1991) Do different subtypes of hospitalised depressives have different long-term outcomes? Archives of General Psychiatry, 48, 308312.10.1001/archpsyc.1991.01810280024003Google Scholar
Friedman, C. J., Shear, M. K. & Frances, A. (1987) DSM–III personality disorders in panic patients. Journal of Personality Disorders, 1, 132135.10.1521/pedi.1987.1.2.132Google Scholar
Greer, H. J. & Cawley, R. H. (1966) Natural History of Neurotic Illness. Mervyn Archdall Medical Monograph 3. Sydney: Australian Medical Association.Google Scholar
Huber, G., Gross, G., Schuttler, R., et al (1980) Longitudinal studies of schizophrenic patients. Schizophrenia Bulletin, 6, 593605.10.1093/schbul/6.4.592Google Scholar
Kendell, R. E. (1989) Clinical validity. Psychological Medicine, 19, 4555.10.1017/S0033291700011016Google Scholar
Kiloh, L. G., Andrews, G. & Neilson, M. (1988) The long-term outcome of depressive illness. British Journal of Psychiatry, 153, 752757.10.1192/bjp.153.6.752Google Scholar
Klein, M. H., Kupfer, D. J. & Shea, M. Y. (eds) (1993) Personality and Depression: A Current View. New York: Guilford Press.Google Scholar
Krieg, J-C., Wittchen, H-U. & Von Zerssen, D. (1987) Anxiety disorders: a long-term prospective and retrospective follow-up of former patients suffering from an anxiety neurosis or phobia. Acta Psychiatrica Scandinavica, 76, 3647.10.1111/j.1600-0447.1987.tb02860.xGoogle Scholar
Lee, A. S. & Murray, R. M. (1988) The long-term outcome of Maudsley depressives. British Journal of Psychiatry, 153, 741751.10.1192/bjp.153.6.741Google Scholar
McGlashan, T. H. (1986) The Chestnut Lodge follow-up study III: longterm outcome of borderline personalities. Archives of General Psychiatry, 43, 2030.10.1001/archpsyc.1986.01800010022003Google Scholar
Nystrom, S. (1979) Depressions: factors related to 10 year prognosis. Acta Psychiatrica Scandinavica, 60, 225238.10.1111/j.1600-0447.1979.tb03591.xGoogle Scholar
Rutter, M. (1987) Temperament, personality and personality disorder. British Journal of Psychiatry, 150, 443458.10.1192/bjp.150.4.443Google Scholar
Rutter, M. & Quinton, D. (1984) Parental psychiatric disorder: effects on children. Psychological Medicine, 14, 853880.10.1017/S0033291700019838Google Scholar
Shepherd, M., Watt, D., Falloon, I., et al (1989) The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics. Psychological Medicine (monograph suppl. 15).10.1017/S026418010000059XGoogle Scholar
Stone, M. H. (1993) Long-term outcome of personality disorders. British Journal of Psychiatry, 162, 299313.10.1192/bjp.162.3.299Google Scholar
Tyrer, P. (1988) What's wrong with DSM–III personality disorders? Journal of Personality Disorders, 2, 281291.10.1521/pedi.1988.2.4.281Google Scholar
Tyrer, P., Sievewright, N., Ferguson, B., et al (1992) The general neurotic syndrome: a coaxial diagnosis of anxiety, depression and personality disorder. Acta Psychiatrica Scandinavica, 85, 201206.10.1111/j.1600-0447.1992.tb08595.xGoogle Scholar
Vize, C. & Tyrer, P. (1994) The relationship between personality and other psychiatric disorders. Current Opinion in Psychiatry, 7, 123128.10.1097/00001504-199403000-00003Google Scholar
Weissman, M. M., Prusoff, B. A. & Klerman, G. L. (1978) Personality and the prediction of long-term outcome in depression. American Journal of Psychiatry, 135, 797800.Google Scholar
Wing, J. K. & Hailey, A. (1972) Evaluating a Community Psychiatric Service: The Camberwell Psychiatric Register 1964–1971. London: Oxford University Press.Google Scholar
Wing, J. K.Cooper, J. E. & Sartorius, N. (1974) The Description and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego System. London: Cambridge University Press.Google Scholar
World Health Organization (1978) The Ninth Revision of the International Classification of Diseases and Related Health Problems (ICD–9). Geneva: WHO.Google Scholar
Zimmerman, M. & Coryell, W. (1989) DSM–III personality disorder diagnoses in a nonpatient sample. Archives of General Psychiatry, 46, 682689.10.1001/archpsyc.1989.01810080012002Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.