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Long-Term Outcome in Personality Disorders

Published online by Cambridge University Press:  02 January 2018

Michael H. Stone
Michael H. Stone*
Affiliation:
Columbia College of Physicians and Surgeons
*
Suite 114, 225 Central Park West, New York City, NY10024, USA
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Abstract

Personality disorders meeting DSM or ICD criteria represent the severe end of the broad spectrum of personality configurations involving maladaptive traits. The literature regarding long-term outcome of personality disorders is sparse. Most attention is devoted to formerly institutionalised patients with borderline, antisocial, or schizotypal disorders. Borderline patients at 10–25-year follow-up have a wide range of outcomes, from clinical recovery (50–60%) to suicide (3–9%). Certain factors (e.g. artistic talent) conduce to higher recovery rates, others (e.g. parental cruelty) to lower rates. Schizoid and schizotypal patients tend to remain isolated, and to lead marginal lives. The long-term outcome in antisocial persons is bleak if psychopathic traits are prominent. Personality traits and their corresponding disorders are egosyntonic, harden into habit, and are both slow to change and hard to modify. There is no one treatment of choice. Psychoanalysis and related methods work best within the anxious/inhibited group; cognitive/behavioural techniques are well suited to the disorders requiring limit setting and the amelioration of maladaptive habits.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 3 , March 1993 , pp. 299 - 313
Copyright
Copyright © The Royal College of Psychiatrists 

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