Comparison between Personality Disorder Diagnoses in DSM-III and DSM-III-R: Reliability, Diagnostic Overlap, Predictive Validity

Vaglum, Per; Friis, Svein; Vaglum, Sonja; Larsen, Frode

doi:10.1159/000284612

Cited by 20 publications

(8 citation statements)

References 4 publications

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“…This study employs the index hospitalization diagnoses. The interrater reliability of this set of diagnoses was found to be satisfactory and is reported separately (19). The distribution of Axis I disorders is displayed in Table 1.…”

Section: Methodsmentioning

confidence: 84%

Personality disorders 2–5 years after treatment: a prospective follow‐up study

Mehlum

Friis

Irion

et al. 1991

Acta Psychiatr Scand

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Ninety-seven patients consecutively admitted to a day unit specializing in the treatment of personality disorders were included in a prospective follow-up study. At follow-up an average of 3 years after index admission, patients with borderline personality disorder (BPD) displayed a moderate symptom reduction and a fair global outcome. Patients with schizotypal personality disorder (STP) showed a similar reduction in symptoms but retained relatively poor global functioning. Individuals with cluster C personality disorders, in contrast, showed both a good global outcome and a marked symptom reduction. STP individuals were the least socially adjusted, employed and self-supporting of all diagnostic subgroups. STP and BPD individuals had far more inpatient treatment in the follow-up period than other groups. The overall suicide rate was low compared with most similar studies.

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Section: Methodsmentioning

confidence: 84%

Personality disorders 2–5 years after treatment: a prospective follow‐up study

Mehlum

Friis

Irion

et al. 1991

Acta Psychiatr Scand

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“…The least discriminating symptoms are illusions/depersonalisation/derealisation. Whereas depression as a symptom does not discriminate between SPD and BPD, transient psychoses and brief paranoid experiences fit better as SPD criteria Vaglum et al 30 n total = 97 psychiatric patients, n SPD = 21 (by DSM-III rating), n SPD = 13 (by DSM-III-R rating) DSM-III and DSM-III-R criteria The inter-rater reliability is for DSM-III and DSM-III-R equally good (kappa value for DSM-III diagnosis is 0.64 and for DSM-III-R of 0.67). When diagnosed by DSM-III-R criteria, the number of SPD diagnosed was reduced by 40% compared to DSM-III criteria.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies aimed at evaluating the variables of the diagnostic criteria, the shifts in diagnosis from DSM-III to -5 or ICD-8 to -10 and their effect on diagnostic sensitivity, specificity, and diagnostic overlap, 27 , 28 , 30 , 31 , 41 as indicated in Table 1 . The reliability of the DSM-III criteria had an adequate mean kappa of 0.71.…”

Section: Resultsmentioning

confidence: 99%

“…This offered a sharper discrimination between STPD and related PDs, such as BPD and schizoid PD. 30 In the evolution of the ICD system, the threshold for meeting symptom criteria was also crucial for differential diagnosis: Whereas in ICD-8/-9 less patients would have been diagnosed with STPD, in ICD-10 the threshold was lowered and more patients were diagnosed with STPD. In the ICD system, the severity of the disease may mark the discrimination between STPD and schizophrenia, which would favor a dimensional diagnosis concept.…”

Section: Resultsmentioning

confidence: 99%

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Diagnosis and treatment of schizotypal personality disorder: evidence from a systematic review

et al. 2018

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The main objective of this review was to evaluate studies on the diagnosis, treatment, and course of schizotypal personality disorder and to provide a clinical guidance on the basis of that evaluation. A systematic search in the PubMed/MEDLINE databases was conducted. Two independent reviewers extracted and assessed the quality of the data. A total of 54 studies were eligible for inclusion: 18 were on diagnostic instruments; 22, on pharmacological treatment; 3, on psychotherapy; and 13, on the longitudinal course of the disease. We identified several suitable and reliable questionnaires for screening (PDQ-4+ and SPQ) and diagnosing (SIDP, SIDP-R, and SCID-II) schizotypal personality disorder. Second-generation antipsychotics (mainly risperidone) were the most often studied drug class and were described as beneficial. Studies on the longitudinal course described a moderate remission rate and possible conversion rates to other schizophrenia spectrum disorders. Because of the heterogeneity of the studies and the small sample sizes, it is not yet possible to make evidence-based recommendations for treatment. This is a systematic evaluation of diagnostic instruments and treatment studies in schizotypal personality disorder. We conclude that there is currently only limited evidence on which to base treatment decisions in this disorder. Larger interventional trials are needed to provide the data for evidence-based recommendations.

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“…Patients were also excluded on the basis of age: patients younger than 18 years were excluded from the study, according to DSM-III-R criteria not to diagnose PD before that age. An upper age limit was set at 65 to avoid unreliable anamnestic data secondary to memory affects [10,11].…”

Section: Patientsmentioning

confidence: 99%

Patterns of Comorbidity among DSM-III-R Personality Disorders

Marinangeli

Butti²,

Scinto

et al. 2000

Psychopathology

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The aim of this study was to examine patterns of comorbidity among personality disorders (PDs) in a sample of 156 psychiatric inpatients. PDs were assessed with Semistructured Clinical Interview for DSM-III-R Personality Disorders. To determine significant co-occurrence among axis II diagnoses, odds ratio and the percent of co-occurrence of pairs of disorders were calculated. Both statistical methods revealed high rates of comorbidity: significance association was found for 36 pairs of disorders using the percent of co-occurrence, and for 22 pairs of disorders using the odds ratio. These results support the concept of ‘apparent comorbidity’ for most PDs, deriving from conceptual and definitional artifacts or from a ‘state-biasing effect’. In light of these observations, a categorical approach to PDs, resulting in a list of diagnoses, appears useless in psychiatric practice. A dimensional classification is probably better suited for PDs, improving the understanding of personality psychopathology and its clinical implications.

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Comparison between Personality Disorder Diagnoses in DSM-III and DSM-III-R: Reliability, Diagnostic Overlap, Predictive Validity

Cited by 20 publications

References 4 publications

Personality disorders 2–5 years after treatment: a prospective follow‐up study

Personality disorders 2–5 years after treatment: a prospective follow‐up study

Diagnosis and treatment of schizotypal personality disorder: evidence from a systematic review

Patterns of Comorbidity among DSM-III-R Personality Disorders

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