Abdul Shakoor.
Co-morbidity of personality disorders and other psychiatric disorders.
Proceeding Shaikh Zayed Postgrad Med Inst Jan ;19(1):37-45.

Objective: To estimate the frequency of co-morbid personality disorders in psychiatric patients. Design: An institution based observational study. Place and duration: This study was conducted at the Academic Department of Psychiatry and Behavioural Sciences, Mayo Hospital, Lahore during September, 1997 and March, 1998. Patients and methods: A total sample of 231 psychiatric patients comprised of 106 outpatients, 105 inpatients and 20 patients with mental and behavioural disorders due to psychoactive substance use admitted for detoxification and rehabilitation. Clinical diagnoses of psychiatric disorders and personality disorders were made according to the ICD-10 diagnostic criteria after evaluating symptoms from history, mental state examination and The Present State Examination. The Personality Assessment Schedule was administered to all the patients and their informants for the diagnosis of personality disorders. Results: Out of 231 patients, 40 (17.3%) were diagnosed as suffering from ICD-10 personality d isorder and 76 (32.9%) had personality disorder according to The Personality Assessment Schedule. Inpatients had slightly higher rate of personality disorders, 36 (34.3%) vs. 30 (28.3%) of outpatients. Out of 20 inpatients with substance use disorders, 5 (25%) had ICD-10 and 10 (50%) PAS personality disorder. The most common personality disorder diagnosis was passive-dependent in 11 (5%) cases closely followed by sociopathic and paranoid in 10 (4.5%) cases each and anankastic in 8 (3.6%) of patients. The dysthymic personality disorder was diagnosed in 6 (2.7%) cases whereas explosive, histrionic and avoidant in 5 (2.3%) cases each, followed by anxious and schizoid in 4 (1.8%) cases each and sensitive-aggressive in 3 (1.3%) of the patients. Conclusion: Co-morbid personality disorders are quite common in psychiatric patients as 1 out of every 3 patients is estimated to have a personality disorder. Assessment of pre-morbid personality is expected to promote an individualized approach to the management.

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