Skip to main content Accessibility help
×
Home

The Nottingham Study of Neurotic Disorder: relationship between personality status and symptoms

  • P. Tyrer (a1), N. Seivewright (a1), B. Ferguson (a1), S. Murphy (a1), C. Darling (a1), J. Brothwell (a1), D. Kingdon (a1) and A. L. Johnson (a1)...

Synopsis

Two hundred and ten psychiatric patients with one of three DSM-III diagnoses, generalized anxiety disorder (N = 71), panic disorder (N = 74) or dysthymic disorder (N = 65), were included in a clinical trial in which diazepam, dothiepin or placebo tablets, cognitive and behaviour therapy, or a self-help package were given over ten weeks. Personality status was assessed independently using a structured interview, the Personality Assessment Schedule. One hundred and ninety-eight patients had personality assessments, 89% with a close informant. Thirty-six per cent had a personality disorder and these patients had more severe psychopathology than those with no personality disorder. Personality disorder was more common in patients with dysthymic disorder and this group responded less well to treatment. The category of personality disorder had no apparent influence on symptoms.

Copyright

Corresponding author

1Address for correspondence: Dr P. Tyrer, St. Charles Hospital, London, W10 6DZ.

References

Hide All
Adler, G. (1979). The myth of the alliance with borderline patients. American Journal of Psychiatry 136, 642645.
Akiskal, H. S. (1983). Dysthymic disorder: psychopathology of proposed chronic depressive subtypes. American Journal of Psychiatry 140, 1120.
Akiskal, H. S., Rosenthal, T. L., Haykal, R. F., Lemmi, H., Rosenthal, R. H. & Scott-Strauss, A. (1980). Characterological depressions: clinical and sleep EEG findings separating ‘subaffective dysthymias’ from‘ character spectrum disorders’. Archives of General Psychiatry 37, 777783.
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn.American Psychiatric Association: Washington, DC.
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edition revised. American Psychiatric Association: Washington, DC.
Asberg, M., Montgomery, S. A., Perns, C., Schalling, D. & Sedvall, G. (1978). A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica Supplementum 271, 529.
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. International Universities Press: New York.
Beck, A. T., Emery, G. & Greenberg, R. L. (1985). Anxiety Disorders and Phobias; A Cognitive Perspective. Basic Books: New York.
Casey, P. & Tyrer, P. (1989). Personality disorder and psychiatric illness in general practice. British Journal of Psychiatry, (in the press).
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement 20, 3746.
Cutting, J., Cowen, P. J., Mann, A. H. & Jenkins, R. (1986). Personality and psychosis: use of the Standardized Assessment of Personality. Acta Psychiatrica Scandinavica 73, 8792.
Eysenck, H. J. (1987). The definition of personality disorders and the criteria appropriate for their description. Journal of Personality Disorders 1, 211219.
Goldberg, S. C., Shulz, S. C., Shulz, P. M., Resnick, R. J., Haymer, R. M. & Friedel, R. O. (1986). Borderline and schizotypal personality disorders treated with low dose thiothixene versus placebo. Archives of General Psychiatry 43, 680686.
Greer, H. S. & Cawley, R. H. (1966). Some Observations on the Natural History of Neurotic Illness. Australian Medical Association, Mervyn Archdall Medical Monograph no. 3. Australasian Medical Publishing Company: Glebe, Australia.
Kingdon, D., Farr, P., Murphy, S. & Tyrer, P. (1986). Hypomania following cognitive therapy. British Journal of Psychiatry 148, 103104.
Leonhard, K. (1968). Akzentuierte Personlichkeiten. Verlag Volk und Gesundheit: Berlin.
Mann, A. H., Jenkins, R.Cutting, J. C. & Cowen, P. J. (1981). The development and use of a standardized assessment of abnormal personality. Psychological Medicine 11, 839847.
Montgomery, S. A. & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382389.
Perry, J. C. & Flannery, R. B. Jr. (1982). Passive-aggressive personality disorder: treatment implications of a clinical typology. Journal of Nervous and Mental Disease 170, 164173.
Perry, J. C., Lavori, P. W. & Hoke, L. (1987). A Markov model for predicting levels of psychiatric service use in borderline and antisocial personality disorders and bipolar type II affective disorder. Journal of Psychiatric Research 21, 215232.
Rutter, M. (1987). Temperament, personality and personality disorder. British Journal of Psychiatry 150, 443458.
Shawcross, C. R. & Tyrer, P. (1985). Influence of personality on response to monoamine oxidase inhibitors and tricyclic antidepressants. Journal of Psychiatric Research 19, 3136.
Sheard, M. H., Marini, J. L., Bridges, C. I. & Wagner, E. (1976). The effect of lithium on impulsive aggressive behaviour in man. American Journal of Psychiatry 133, 14091413.
Soloff, P. H., George, A., Nathan, R. S., Shulz, P. M., Ulrich, R. F. & Perel, J. M. (1986). Progress in pharmacotherapy of borderline disorders: a double blind study of amitriptyline, haloperidol and placebo. Archives of General Psychiatry 43, 691697.
Spitzer, R. L. & Williams, J. B. W. (1983). Structured Clinical Interview for DSM-III (SCID). Biometrics Research Department, New York State Psychiatric Institute: New York.
Tyrer, P. & Alexander, J. (1979). Classification of personality disorder. British Journal of Psychiatry 135, 163167.
Tyrer, P. & Seivewright, H. (1988). Studies of outcome. In Personality Disorder: Diagnosis, Management and Course (ed. Tyrer, P.), pp. 119136. Wright: London.
Tyrer, P., Casey, P. & Gall, J. (1983). The relationship between neurosis and personality disorder. British Journal of Psychiatry 142, 404408.
Tyrer, P., Owen, R. T. & Cicchetti, D. (1984). The Brief Scale for Anxiety: a subdivision of the Comprehensive Psychopathological Rating Scale. Journal of Neurology, Neurosurgery and Psychiatry 47, 970975.
Tyrer, P., Casey, P. R. & Seivewright, N. (1986). Common personality features in neurotic disorder. British Journal of Medical Psychology 59, 289294.
Tyrer, P., Casey, P. & Ferguson, B. (1988 a). Personality disorder and mental illness. In Personality Disorder: Diagnosis, Management and Course (ed. Tyrer, P.), pp. 93104. Wright: London.
Tyrer, P., Seivewright, N., Murphy, S., Ferguson, B., Kingdon, D., Barczak, P., Brothwell, J., Darling, C., Gregory, S. & Johnson, A. L. (1988 b). The Nottingham study of neurotic disorder: comparison of drug and psychological treatments. Lancet ii, 235240.
Tyrer, P., Alexander, J. & Ferguson, B. (1988 c). Personality Assessment Schedule. In Personality Disorder: Diagnosis, Management and Course (ed. Tyrer, P.), pp. 140167. Wright: London.
Waldinger, R. O. (1987). Intensive psychodynamic therapy with borderline patients: an overview. American Journal of Psychiatry 144, 267274.
World Health Organization (1988). International Classification of Diseases, Draft for 10th Revision. World Health Organization: Geneva.
Zigmond, A. S. & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 57, 361370.
Zimmerman, M., Coryell, W., Pfohl, B., Corenthal, C. & Stangl, D. (1986). ECT response in depressed patients with and without a DSM-III personality disorder. American Journal of Psychiatry 143, 10301032.
Zimmerman, M., Pfohl, B., Coryell, W., Stangl, D. & Corenthal, C. (1988). Diagnosing personality disorder in depressed patients: a comparison of patient and informant interviews. Archives of General Psychiatry 45, 733737.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed