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Long-term outcome in personality disorders

M H Stone1

  • 1Columbia College of Physicians and Surgeons.

The British Journal of Psychiatry : the Journal of Mental Science
|March 1, 1993
PubMed
Summary

Long-term outcomes for personality disorders vary widely, with some patients recovering and others facing bleak prognoses. Treatment effectiveness depends on the specific disorder and individual factors.

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Area of Science:

  • Psychiatry
  • Clinical Psychology

Background:

  • Personality disorders represent severe maladaptive personality configurations.
  • Existing literature on the long-term prognosis of personality disorders is limited.
  • Research primarily focuses on borderline, antisocial, and schizotypal disorders.

Observation:

  • Borderline personality disorder outcomes range from recovery (50-60%) to suicide (3-9%) over 10-25 years.
  • Factors like artistic talent correlate with better outcomes, while parental cruelty is linked to worse prognoses.
  • Schizoid and schizotypal patients often experience social isolation and marginal life outcomes.

Findings:

  • Antisocial personality disorder prognosis is poor when psychopathic traits are prominent.
  • Personality disorders are ego-syntonic, habitual, and resistant to change.
  • No single treatment is universally effective for all personality disorders.

Implications:

  • Psychoanalytic therapies benefit anxious/inhibited individuals.
  • Cognitive-behavioral techniques are effective for disorders needing limit-setting and habit modification.
  • Understanding long-term trajectories is crucial for personalized treatment planning.

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