Therapeutic community treatment for personality disordered adults: changes in neurotic symptomatology on follow-up

Personality disordered patients are important as they place high continuing demands on services and are often refractory to traditional treatments. Often personality disorders may co-exist with neurotic symptomatology, worsening prognosis of the latter. This paper reports change in neurotic symptomatology following intensive, long term, therapeutic community treatment for such patients. Sixty two subjects with personality disorder were followed up for eight months after discharge (response rate 65%). Results showed a highly significant reduction in symptomatic distress as measured by the SCL-90R questionnaire. Investigation of the reliability and clinical importance of the change in individual subjects demonstrated that 55% of subjects had improved reliably, and in 32% this change was also clinically significant, whilst only 6.5% of subjects had deteriorated reliably.