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PubMed2005

The relationship between attachment styles and Cluster B personality disorders in prisoners and forensic inpatients.

The relationship between attachment styles and Cluster B personality disorders were examined among prisoners, forensic inpatients and controls from the general population. Forensic inpatients and prisoners reported significantly less frequently the secure attachment style (Relationship Questionnaire) and significantly more the fearful attachment style compared to the normal controls. Both forensic groups could not be distinguished from each other. Further, prisoners, forensic inpatients and controls could not be differentiated on the basis of the dismissing nor the preoccupied attachment style. With respect to personality pathology, almost all relationships between Cluster C pathology, on the one hand, and attachment styles, on the other, were significant. Cluster A pathology was clearly related to the secure and fearful attachment style. With respect to cluster B pathology, the results were more specific but also less clear. The results were strongly dependent on the way the personality pathology variables were treated, as either categorical or dimensional. None of the cluster B personality pathology variables were associated with the fearful attachment style and histrionic personality pathology was negatively associated with the dismissing attachment style. Antisocial personality features were associated with a dismissing attachment style. Borderline personality pathology, when treated as a categorical variable, was significantly related to the preoccupied attachment style. These results show that (1) cluster A and cluster C pathology are more strongly associated with attachment than cluster B, (2) treating personality data as either dimensional or categorical is of major importance to the conclusions that can be drawn, (3) it is important to control for the influence of co-morbid personality pathology when examining the relationship between (Cluster B) personality pathology and attachment.

Adult↗
PubMedDate not supplied

Changes in spine loading patterns throughout the workday as a function of experience, lift frequency, and personality.

BACKGROUND CONTEXT: Psychosocial stressors have been associated with low back pain reporting. However, response to psychosocial risk factors may be dependent on the individual's personality type that, in turn, can affect muscle recruitment and spine loading. This study explores how personality might be associated with spine loading during repetitive lifting performed throughout an entire work shift. PURPOSE: Assess spine loading as a function of an individual's personality type during repetitive, long-term exposure to a materials handling tasks. STUDY DESIGN: Laboratory experiment where experienced and inexperienced participants performed repetitive, asymmetric lifts at various load and lift frequency levels throughout a series of 8-hour exposure periods. Spine loads were monitored throughout the work period. PATIENT SAMPLE: Twelve novice and 12 experienced materials handlers who were asymptomatic for back pain. OUTCOME MEASURES: Spine compression, anterior-posterior (A/P) shear, and lateral shear at the L5-S1 level. METHODS: Participants were categorized into personality types based upon the Myers-Briggs personality type indicator. An electromyography-assisted biomechanical model was used to assess spine compression, A/P shear, and lateral shear throughout the exposure period. RESULTS: The results indicate that intuitors had higher shear spinal loading regardless of moment exposure, lift frequency, and time through the work period, compared with the sensor personality type. In addition, higher spine compressive and shear forces occurred in the perceiver personality compared with the judgers' personality trait, regardless of moment and, often, lift frequency. Novice lifters typically experienced greater spine loading. CONCLUSIONS: The results suggest that when there exists a personality-job environment mismatch, spinal loading increases via an increase in antagonistic co-contraction. The trends suggest that inherent personality characteristics may play a role in one's motor control strategies when performing a repetitive lifting task.

Adult↗
PubMed1996

Personality and stress: an exploratory comparison of rheumatoid arthritis and osteoarthritis.

OBJECTIVE: To characterize and investigate the relationship between stress and personality in people with rheumatoid arthritis (RA) compared to those with osteoarthritis (OA). DESIGN: Survey of personality characteristics determined by using Cattell's 16 Personality Factor (16PF) questionnaire and stressful life events at disease onset determined by using the Social Readjustment Rating Scale of Holmes and Rahe. SETTING: Inpatients of an arthritis hospital and outpatients of a clinic, both of which specialize in rheumatic diseases and musculoskeletal problems. PARTICIPANTS: Diagnosed as "definite" or "classical" RA (N = 128) according to the ARA Diagnostic Criteria for Rheumatoid Arthritis (1958 Revision) or as OA (N = 79) according to radiological and clinical evidence; randomly selected, resulting in a close match for gender, age at disease onset, duration of disease, functional classification, and pattern of disease progress. All individuals approached participated. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Twenty personality characteristics, as well as amount of stressful life events at disease onset (Life Change Units). RESULTS: The RA subjects had significantly (p < .001) more stress at disease onset compared to the OA subjects. A subgroup of high-stress-at-onset RA subjects experienced a higher degree of disease severity (p < .01) than did the RA subjects with no stress at onset. Although the mean personality scores for those with RA were not significantly different from those with OA, the RA personality frequency distributions were different. Some of these differences could be explained by the stress-at-onset subgroup personality characteristics. CONCLUSIONS: As a group, subjects with RA exhibited more stress at disease onset than those with OA. Although mean personality scores were not different between RA and OA subjects, they did exhibit different frequency distributions. There appeared to be a high-stress-at-onset subgroup of RA patients who had a worse disease prognosis and who corresponded to a personality frequency subgroup. The interaction between these variables is more complex than implied by the "RA personality" concept.

Arthritis, Rheumatoid↗
PubMed2001

Personality disorders.

Some general recommendations can be made, collected from these subjective descriptions of personality types. Because determining an accurate psychiatric diagnosis is not the internist's aim, it is better for him or her to have a stance that generalizes to all patients, which can be refined as personality characteristics emerge. Tolerate the patient's affect (such as anger or anxiety), being firm and kind, rather than punitive or overinvested. Accept dependency and vulnerability. Accept and respect the underlying coping style. Understand that the patient's personality style is the best (and usually only) way he or she knows to have a relationship, including a relationship with the physician. Understand that personality traits additionally may have a function (e.g., to guard against anxiety or depression). Recognize that personality traits do not come in pure form. One personality trait is likely to blend into or overlap with other traits. Identify and treat any underlying symptom disorder, such as anxiety, depression, irritability, or thought disorder. Educate the patient clearly (and without patronizing) about medical illness. Document what was explained to the patient and how the patient responded, including dispassionate observations about behavior and emotional expression. Appreciate the patient's possible attachment to medical symptoms. Avoid arguments with patients who make unreasonable demands. Make timely judgments about whether or not to accede to a demand. When in doubt about a patient's honesty, give the patient the benefit of the doubt. Do not worry about being used because all patients use their physicians to some extent. Go to the limits of your tolerance for a patient's personality, but know your limits and refer to a colleague when you cannot work with the patient. Terminate an interaction and get help if there is a risk (or fear) of violence. Given the time it takes to manage the relationship and the psychiatric elements of treatment, a referral to a psychiatrist or other mental health professional often is wise if the patient will accept it. Include the mental health professional as part of the medical team. Although these various recommendations have been emphasized in connection with certain personality types, one can be flexible about their application in a variety of patients. It is important also to reiterate the limits of subjective descriptions. It is rare to find any of the aforementioned subjective descriptions in unmodified form; characteristics of more than one personality type usually appear in the same person. The descriptions are composites that provide a starting point for the physician. The physician should edit the composites based on experience with real patients. This article has described human characteristics and rough guidelines for helpful human responses and possible pharmacologic interventions. So equipped, the primary care physician may find it less troubling and more interesting to face the wide variation in human character.

Adaptation, Psychological↗
PubMed2004

Borderline personality disorder in patients with bipolar disorder and response to lamotrigine.

BACKGROUND: Recent reports suggesting lamotrigine as an effective treatment in bipolar disorder, and perhaps borderline personality disorder, a common comorbid personality disorder in bipolar patients, led us to retrospectively examine patients from two bipolar studies to investigate this pattern of comorbidity, and to determine whether lamotrigine effected the dimensions of borderline personality. METHODS: Fifteen months following entry into either study, we retrospectively assessed DSM-IV dimensions of borderline personality disorder pre- and post-treatment with lamotrigine in 35 bipolar patients. RESULTS: Forty percent met criteria for borderline personality disorder; this subgroup had a more frequent history of substance abuse and childhood symptoms of attention deficit hyperactivity disorder (ADHD). Dimensions of borderline personality improved significantly with treatment in both patient groups, and corresponded with response of bipolar symptoms. Six (43%) comorbid bipolar patients endorsed three or fewer criteria of borderline personality during treatment with lamotrigine. There was a trend for comorbid bipolar patients to require a second psychoactive medication in addition to lamotrigine during extended treatment. LIMITATIONS: Criteria for borderline personality and improvement were assessed retrospectively in an open manner. CONCLUSIONS: Dimensions of borderline personality disorder may respond to lamotrigine in comorbid bipolar patients; controlled studies appear warranted. Bipolar studies should assess and specify the number of patients with personality disorders in the trial.

Adult↗
PubMed2000

Social skills deficits in schizotypal personality disorder.

Evidence of long-standing social difficulties has been well documented in persons with schizophrenia. These deficits are often so rudimentary that a person with schizophrenia may never have developed the skills necessary to present as socially competent. Given the cognitive, biological, and neuroanatomical links between schizophrenia and schizotypal personality disorder (SPD), a study of social skills in persons with SPD may reveal a behavioral link. This study examined persons with SPD and their ability to label emotions in a recognition task, to display socially competent behaviors in a social role-play task, and to select appropriate behaviors from a multiple choice measure of social behavior. Results indicated that the performance of persons with SPD was similar to previously published findings in persons with schizophrenia. In terms of emotion recognition, the SPD group's ability to label positive emotions was significantly worse than their ability to label other emotions. Persons with SPD performed significantly worse than matched control participants on a social role-play task. However, the groups were equivalent in their ability to select socially appropriate behavior from a multiple choice measure. These results suggest that persons with SPD display social skills which mirror those previously reported in persons with schizophrenia.

Adolescent↗
PubMed2004

Personality pathology and outcome in recurrently depressed women over 2 years of maintenance interpersonal psychotherapy.

BACKGROUND: Empirical data on the impact of personality pathology on acute treatment outcome for depression are mixed, in part because of challenges posed by assessing trait-like personality patterns while patients are in an active mood episode. To our knowledge, no previous study has examined the effect of personality pathology on maintenance treatment outcome. By maintenance treatment we refer to long-term treatment provided to prevent depression recurrence among remitted patients. METHOD: Structured Clinical Interviews for the DSM-III-R Personality Disorders (SCID-II) were obtained on a sample of 125 recurrently depressed women following sustained remission of the acute mood episode and prior to entering maintenance treatment. SCID-II interviews were then repeated following 1 and 2 years of maintenance interpersonal psychotherapy. RESULTS: At the pre-maintenance assessment, 21.6% of the sample met SCID-II personality disorder criteria. Co-morbid personality pathology was related to an earlier age of onset, more previous depressive episodes, and a greater need for adjunctive pharmacotherapy to achieve remission of the acute mood episode. Co-morbid personality pathology predicted both higher rates of depression recurrence and a shorter time to recurrence over the 2-year course of maintenance treatment. Notably, among those patients who remained depression-free, continuous levels of personality pathology steadily declined over the 2-year course of maintenance therapy. CONCLUSIONS: Results highlight the need for early and effective intervention of both episodic mood disorder and inter-episode interpersonal dysfunction inherent to the personality disorders. Future maintenance treatment trials are needed to clarify the relationship between episodic mood disorder and personality function over time.

Adult↗
PubMed2005

The longitudinal relationship between personality disorder dimensions and global functioning in a community-residing population.

BACKGROUND: Little is known about the long-term outcome of personality disorder traits. The purpose of this study was to investigate, in a community-residing population, the longitudinal relationship between psychiatrist-assessed personality disorder scores and global functioning 13-18 years later. METHOD: A stratified random sample of residents of east Baltimore were examined by psychiatrists in 1981 and asssessed for DSM-III personality disorders using a semi-structured instrument, the Standardized Psychiatric Examination. A total of 292 persons were re-examined by different psychiatrists during 1994-1999 using the Schedules for the Assessment of Neuropsychiatry (SCAN). After completion of the SCAN, the subjects' functional status was evaluated using the Global Assessment of Functioning (GAF). The relationships between personality dimensions and follow-up GAF scores were evaluated using linear regression models. RESULTS: All of the personality disorder scales measured in 1981 were inversely related to functioning 13-18 years later, with the exception of narcissistic and compulsive scales. After controlling for Axis I disorders diagnosed contemporaneously with GAF assessment, schizoid, antisocial, borderline, histrionic, and avoidant personality disorder scores significantly predicted GAF scores. CONCLUSIONS: Most dimensions of DSM-III personality disorder traits were significantly associated with global functioning after an interval of 15 years. However, only schizoid, antisocial, borderline, histrionic, and avoidant personality disorder traits had long-term effects on functioning when Axis I disorders at follow-up were controlled. This suggests that the functional effect of the other personality disorder traits may be mediated through their relationship with Axis I disorders. Future research is needed using more specific and sensitive outcome measures.

Adolescent↗
PubMedDate not supplied

Stability and change of DSM-III-R personality disorder dimensions in adolescents followed up 2 years after psychiatric hospitalization.

We examined the stability of DSM-III-R personality disorder dimensions in a clinical sample of adolescents. Sixty adolescent inpatients were reliably assessed with the Personality Disorder Examination (PDE) soon after admission to the Yale Psychiatric Institute, and were independently reassessed with the same instrument 2 years following discharge. PDE symptom ratings were summed to create dimensional scores for each personality disorder. To assess the dimensional stability of personality disorders, intraclass correlation coefficients (ICCs) were computed. To assess the magnitude of the difference between baseline and follow-up scores, paired t tests were used. Significant ICCs were observed for histrionic, narcissistic, dependent, obsessive-compulsive, and passive-aggressive personality disorders. Compared to baseline, dimensional scores for most personality disorders were significantly lower at follow-up-and none was significantly higher. Diagnostic stability is a key defining feature of personality disorders. We observed low-to-moderate stability for dimensional measures of personality dysfunction in adolescents-suggesting that previous reports of modest personality disorder stability in this age group cannot be attributed solely to limitations of the categorical approach to such pathology. Alternatively, our findings may be viewed as consistent with reports in the adult literature that personality disorders may improve over time, and can potentially benefit from treatment.

Adolescent↗
PubMedDate not supplied

Western personality models applied in Eastern Europe: Yugoslav data.

In this study, two leading "Western" models of personality developed in the United States are tested in Eastern Europe, specifically in Yugoslavia. First, the models were tested psychometrically, for their construct validity and cross-cultural applicability. Next, these Western personality models were used to explore the underlying structure of axis II syndromes of personality disorder as observed in Yugoslav patients. Finally, the models were tested regarding their ability to diagnose and discriminate categorical diagnoses of axis I mental disorders (e.g., depression, anxiety, and psychoses). The Five Factor Model of personality and the Seven Factor Model of temperament and character were applied to normal subjects and clinical patients with categorical axis I and axis II diagnoses (depression, anxiety, psychosis, and personality disorder), at the Institute for Psychiatry, University of Belgrade, Yugoslavia. The sample included 120 subjects: 90 hospitalized psychiatric patients and 30 normal subjects. The patients were females, from 20 to 45 years of age, classified into three groups: 30 with depression, 30 with various anxiety syndromes, and 30 with psychosis (primarily patients with schizophrenia, paranoid type in remission). The results indicated solid psychometric validity of the two Western personality models in the ethnically and culturally different setting of Yugoslavia. Important diagnostic and structural relationships between dimensions of personality and axis I and II categorical diagnoses were observed. As expected, certain combinations of personality traits allowed for diagnosis, description, and discrimination of personality disorder subtypes. As a novel finding, personality traits discriminated anxious, depressive and psychotic axis I disorders.

Adult↗
PubMedDate not supplied

State personality disorder in social phobia.

To examine the effects of state on personality disorder characteristics, we compared individuals with social phobia before and after psychological intervention. Administration of the Personality Disorder Questionnaire (PDQ-4) before and after treatment allowed for the identification of three groups of patients: (1) individuals who showed elevated PDQ-4 scores but little changes from intake to post treatment (Trait PD group; n = 28); (2) individuals who showed a decrease in PDQ-4 scores from intake to post treatment (State group; n = 33); and (3) a group with no significant personality disorder characteristics at pre or post-treatment (No PD group; n = 32). There were trend differences between the Trait, State and No PD groups for being single, never married (81.5%, 44.4%, and 56.3%, p < .05) and a significant difference for having the generalized form of Social Phobia (96.4%, 88.9%, and 59.4%, p < .0001). The groups also differed in their level of trait anxiety (61.6, 51.2, 44.5, p < .001). Groups also differed in level of the personality measure Harm Avoidance (26.3, 23.3, 19.8, p < .0002). The reduction of personality disorder traits in the State PD groups from intake to post-treatment was not specific to any particular personality disorder or personality disorder cluster. Trait personality appeared to have a higher risk for suicide compared to the other two groups. A State Personality group was identified in individuals with social phobia by following changes in personality pathology from before and after a psychological intervention.

Adult↗
PubMed2002

The effect of anticholinesterases on personality changes in Alzheimer's disease.

Anticholinesterases are known to be effective against cognitive and non-cognitive symptoms of Alzheimer's disease (AD) but their effect on the personality changes in the disease is not known. This study examines the effect of anticholinesterase treatment on personality changes in AD. It involved the carers of patients with mild to moderate AD who were currently receiving anticholinesterases in south Manchester. The personality change was measured using the Brooks and McKinlay Personality Inventory. The carers were asked to complete the inventory for each of three periods in the patients' lives: before the onset of AD, after the diagnosis of AD but before starting anticholinesterases, and currently on anticholinesterases. Fifty-eight carers participated in the study. Personality became more negative (total score on the personality inventory became less) following the onset of AD (p < 0.001). Following anticholinesterase treatment, the total score on the personality inventory remained the same or increased in 23 (39%) patients. Scores on individual personality traits remained the same or increased in the majority of patients. In approximately one fifth of the patients, the traits 'does things himself', 'happy', 'calm' and 'cautious' showed improvement on anticholinesterases. The study confirms that personality changes are almost universal and negative in AD and suggests that anticholinesterases may have a positive effect. Further double blind prospective studies are needed to understand natural progression of personality changes in AD and to validate the findings of this study.

Aged↗
PubMed2002

The significance of personality factors for various dimensions of life quality among older people.

Quality of life has various dimensions with multiple meanings for people. One vital issue is whether a person's subjective experienced quality of life correlates with his or her personality. Several studies show a correlation between personality and quality of life, life satisfaction or well-being. The aim of this study was to examine the relationship between personality and life quality, in particular the way in which multi-dimensional conceptualization of personality relates to a multi-dimensional definition of life quality. Seventy-eight elderly individuals completed a quality of life questionnaire, the Lund Gerontology Centre's Life Quality Questionnaire (LGC), and a personality questionnaire, the Gordon Personal Profile Inventory (GP:A). Discriminant analysis showed that various personality characteristics relate to different aspects of life quality. Vigour alone predicted current quality of life, while emotional stability was related to psychological well-being and satisfaction with significant relationships. Ascendancy and ability to maintain personal relations were related to an optimistic outlook on life and absence of psychosomatic symptoms. Original thinking and sociability related to increased psychosomatic symptoms and sociability also correlated negatively with satisfaction with significant relationships. The results support the idea that various personality characteristics are related to various life quality dimensions in the investigated group, increasing the understanding of unique experience of life quality for each individual.

Aged↗
PubMed2002

Challenging two mental illness stigmas: personal responsibility and dangerousness.

Two stigmatizing attitudes related to dangerousness and personal responsibility may undermine the opportunities of persons with serious mental illness. This study set out to examine path models that explain how these attitudes lead to discriminatory behavior and to assess the impact of antistigma programs on components of personal responsibility and dangerousness models. Two hundred thirteen persons were randomly assigned to one of five antistigma conditions: education on personal responsibility, education on dangerousness, contact with a person with serious mental illness where personal responsibility is discussed, contact where dangerousness is discussed, or no change. Persons completed an attribution questionnaire (AQ) representing personal responsibility and dangerousness path models at pretest, posttest, and 1-week followup. They also completed tasks that represented helping behavior. Goodness of fit indexes from linear structural modeling were mixed for both models but suggested that fear of dangerousness was a key attitude leading to discriminatory behavior. Results also showed that subjects who had contact with persons with serious mental illness experienced greater changes than subjects in the education or control groups did on measures of attribution and helping behavior.

Adolescent↗
PubMed2005

Dangerous and severe personality disorder: an ethical concept?

Most clinicians and mental health practitioners are reluctant to work with people with dangerous and severe personality disorders because they believe there is nothing that mental health services can offer. Dangerous and severe personality disorder also signals a diagnosis which is problematic morally. Moral philosophy has not found an adequate way of dealing with personality disorders. This paper explores the question: What makes a person morally responsible for his actions and what is a legitimate mitigating factor? How do psychiatric nurses working with this client group understand the awful things some clients do? What concepts do they need, if they are to know how to explain and how to react? It is suggested that dangerous and severe personality disorder is best regarded as a moral category, framed in terms of goodness, badness, obligation and other ethical concepts. It seems plausible that in important ways the dangerous and severe personality disordered client does not understand morality or understands it differently. The peculiar position of the dangerous and severe personality disordered individual in our system of moral responsibility stems from his apparent inability to see the importance of the interests of others. It might be more helpful to regard personality disordered clients as we do children: partially but not fully reasonable for their actions. We might regard the dangerous and severe personality disordered client responsible for those actions which he most clearly understands, such as causing others physical pain, but not for those with which he is only superficially engaged, such as causing emotional pain. The paper concludes by suggesting that the dangerous and severe personality disordered individual does not fit easily into any conventional moral category, be it criminal, patient, animal or child, and thus an assessment of his moral accountability must take into consideration his special circumstances.

Attitude of Health Personnel↗
PubMed2004

Personality change after stroke: some preliminary observations.

OBJECTIVES: To describe changes in personality after stroke and effects on carers. METHODS: A consecutive series of patients was recruited from hospital admissions with stroke. A novel questionnaire was administered to the patients' main carer at nine months after the stroke to determine their perception of the patients' pre-stroke and post-stroke personality. Personality change was identified by changes in these ratings, and associations between personality change and the following variables explored: emotional disorder in patients and carers (measured using the hospital anxiety and depression scale and a structured psychiatric interview), stroke classification (Oxford community stroke classification), residual disability (Barthel index and Nottingham extended activities of daily living scale), and lesion characteristics on computed tomography (CT). RESULTS: Carers of 35 patients with stroke took part. Reported changes in personality after stroke included: reduced patience and increased frustration (both p<0.0001, t test of difference), reduced confidence, more dissatisfaction, and a less easy going nature (all p<0.005). Occasionally, aspects of personality change were seen as positive by carers. There were relations between greater personality change and interviewer rated patient depression or anxiety (p<0.001) but not when this was self rated; and between personality change and both emotional disorder in carers (p<0.005) and greater disability (p<0.01) but not CT lesion characteristics. CONCLUSIONS: Carers commonly perceive personality change in stroke patients. This is associated with self rated emotional distress in the carer. More research is needed to understand what carers mean by "personality change" and what factors contribute to the perceived change.

Activities of Daily Living↗
PubMed2005

Self awareness and personality change in dementia.

BACKGROUND: Loss of insight is a core diagnostic criterion for frontotemporal dementia (FTD), whereas failure to recognise cognitive deficits and unawareness of disease (anosognosia) are well established findings in Alzheimer's disease (AD). However, self awareness of personality has not been quantified in these patient groups. METHODS: Twenty two patients (12 with frontal variant FTD; 10 with early AD) and 11 older adult normal controls completed self report questionnaires (the Interpersonal Adjectives Scales) describing their current personality. First degree relative informants completed two questionnaires, one describing the subject's current personality, the other retrospectively describing the subject's personality before disease onset. Differences between subject and informant reports of current personality were used to measure the accuracy of self awareness. RESULTS: Discriminant function analysis showed significant differences in self awareness among the three groups, with those in the FTD group showing the greatest magnitude of error in the largest number of personality dimensions (dominance, submissiveness, cold heartedness, introversion, and ingenuousness). Despite personality changes over time, patients with AD showed accurate self awareness in all personality dimensions except submissiveness and extraversion. Normal controls showed a pattern of underestimating positive qualities, whereas patients with FTD exaggerated positive qualities and minimised negative qualities. For the personality facets showing impaired insight, the self reports of patients with FTD and AD most closely matched their premorbid personalities, suggesting a failure to update their self image after disease onset. CONCLUSIONS: This study operationalises research criteria for loss of insight in FTD.

Aged↗
PubMed2002

Study of psychopathology in patients with chronic non-lesional epilepsy: a Minnesota multiphasic personality inventory profile controlled study.

OBJECTIVE: Psychiatric morbidity and psychopathology have been widely assessed in patients with epilepsy. However, the issue of whether people with epilepsy are at increased risk for psychopathology remains highly controversial. These disorders are not evaluated in a systematic manner in patients with non-lesional epilepsy, so they could be underestimated. The objective is to evaluate personality disorders in patients with non-lesional epilepsy. METHODS: In this study, we investigated the presence of personality disorders in 63 patients with chronic non-lesional (idiopathic and cryptogenic) epilepsy and in 40 unrelated and randomly selected controls by means of Minnesota Multiphasic Personality Inventory (MMPI) and DSM-IV criteria for the different personality disorders. RESULTS: The overall scores were significantly higher in the patients in the subscales of schizophrenia, depression, hysteria, mania, paranoia, psychasthenia and psychopathic deviate. However, the differences in the proportion of patients with clinically significant scores occurred only for schizophrenia (57 vs. 20%), depression (55 vs. 15%), psychasthenia (28 vs. 10%) and paranoia (14 vs. 0%). According to DSM-IV criteria, only 11 patients met the criteria of schizotypal personality. We found excellent concordance for paranoid personality and depression between the two instruments of diagnosis. However, we did not find cases with either antisocial or avoidant personality. We also found a significant link between poor control of epilepsy and high scores in both paranoia and psychopathic deviate. CONCLUSIONS: In comparison with the DSM-IV criteria for such personality disorders, the MMPI was oversensitive in detecting schizotypal features. However, the MMPI correctly classified the remaining personality disorders, especially depression and paranoid personality. On the basis of these results, we conclude that psychopathology is overrepresented in patients with chronic non-lesional epilepsy and that, in determined variables, this is due to the severity of the condition rather than to the type and duration of epilepsy. The approach to patients with chronic epilepsy should include neurobehavioural scales.

Adolescent↗