[Personality disorders in adolescence. A pilot study on classification and early course]

72 case histories of former adolescent psychiatric inpatients diagnosed on discharge as suffering from a personality disorder were evaluated. It was possible to re-examine 33 (46%) of them. The discharge diagnosis was made according to ICD 9, the follow-up diagnosis according to ICD 10 and DSM-III-R. Depending on the instrument and criterion, 40% to 87.9% of the discharge diagnoses made could be confirmed after an average follow-up period of 3.4 years. Only in 12.1% of the cases there was no personality disorder established. There was no indication of any change of diagnosis to other psychiatric disorders. The re-diagnosis rates obtained are thus similar to those for adults. The classifications of ICD 10 and DSM-III-R corresponded much better than those of ICD 9 to clinical reality. The classification systems and assessment instruments that have normally been verified only for adults thus also seem suitable for use among adolescents. In both adolescents and adults the avoidant personality disorder is a particularly frequent subtype. However, the current study was unable to resolve the question of what the decisive criteria should be in the case of competing definitions such as puberty crisis, personality development disorder, personality disorder and emotional or affective disorder. This issue requires further investigation.