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Long-term impact of temporary and persistent personality disorder on anxiety and depressive disorders.

BACKGROUND
It is of interest to know if temporary and persistent personality disorders are associated with different outcomes.


METHOD
A cohort of 210 people with anxiety and depressive disorders was followed up on nine occasions over 12 years. During this study, personality status was assessed at baseline and after 2 years using two methods, one linked to the new International Classification of Diseases 11th Revision (ICD-11) severity codes. The impact on the symptomatic outcome and social function of temporary (i.e. personality disorder on one occasion only) and persistent personality disorder (personality disorder present on both occasions) was compared.


RESULTS
Of the 162 patients studied we identified four groups (no personality disorder at any time (n = 46), two with temporary personality disorder (baseline only (n = 33) and 2 years only (n = 28), and persistent personality disorder (n = 55). Those with persistent personality disorder had significantly worse outcomes than other groups for self-rated anxiety symptoms (p = 0.02) and overall social function (p < 0.001), 81% had a current DSM diagnosis at 12 years compared with 52-65% in the other groups (p < 0.03). Significantly, more patients with ICD-11 moderate or severe personality disorder at baseline had persistent personality disorder than had temporary disorders (p = 0.017).


CONCLUSION
Persistent personality disorder is associated with more severe personality dysfunction and has a negative impact on the outcome of common mental disorder and particularly on long-term social functioning. Copyright © 2016 John Wiley & Sons, Ltd.