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

Published online by Cambridge University Press:  09 July 2009

P. Tyrer ,
N. Seivewright ,
B. Ferguson ,
S. Murphy ,
C. Darling ,
J. Brothwell ,
D. Kingdon  and
A. L. Johnson
P. Tyrer*
Affiliation:
Mapperley Hospital, Nottingham and MRC Biostatistics Unit, Cambridge
N. Seivewright
Affiliation:
Mapperley Hospital, Nottingham and MRC Biostatistics Unit, Cambridge
B. Ferguson
Affiliation:
Mapperley Hospital, Nottingham and MRC Biostatistics Unit, Cambridge
S. Murphy
Affiliation:
Mapperley Hospital, Nottingham and MRC Biostatistics Unit, Cambridge
C. Darling
Affiliation:
Mapperley Hospital, Nottingham and MRC Biostatistics Unit, Cambridge
J. Brothwell
Affiliation:
Mapperley Hospital, Nottingham and MRC Biostatistics Unit, Cambridge
D. Kingdon
Affiliation:
Mapperley Hospital, Nottingham and MRC Biostatistics Unit, Cambridge
A. L. Johnson
Affiliation:
Mapperley Hospital, Nottingham and MRC Biostatistics Unit, Cambridge
*
1Address for correspondence: Dr P. Tyrer, St. Charles Hospital, London, W10 6DZ.
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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.

Type
Original Articles
Information
Psychological Medicine , Volume 20 , Issue 2 , May 1990 , pp. 423 - 431
Copyright
Copyright © Cambridge University Press 1990

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References

Adler, G. (1979). The myth of the alliance with borderline patients. American Journal of Psychiatry 136, 642–645.Google Scholar
Akiskal, H. S. (1983). Dysthymic disorder: psychopathology of proposed chronic depressive subtypes. American Journal of Psychiatry 140, 11–20.Google ScholarPubMed
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, 777–783.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn.American Psychiatric Association: Washington, DC.Google Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edition revised. American Psychiatric Association: Washington, DC.Google Scholar
Asberg, M., Montgomery, S. A., Perns, C., Schalling, D. & Sedvall, G. (1978). A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica Supplementum 271, 5–29.CrossRefGoogle ScholarPubMed
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. International Universities Press: New York.Google Scholar
Beck, A. T., Emery, G. & Greenberg, R. L. (1985). Anxiety Disorders and Phobias; A Cognitive Perspective. Basic Books: New York.Google Scholar
Casey, P. & Tyrer, P. (1989). Personality disorder and psychiatric illness in general practice. British Journal of Psychiatry, (in the press).Google Scholar
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement 20, 37–46.CrossRefGoogle Scholar
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, 87–92.CrossRefGoogle ScholarPubMed
Eysenck, H. J. (1987). The definition of personality disorders and the criteria appropriate for their description. Journal of Personality Disorders 1, 211–219.CrossRefGoogle Scholar
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, 680–686.CrossRefGoogle Scholar
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.Google Scholar
Kingdon, D., Farr, P., Murphy, S. & Tyrer, P. (1986). Hypomania following cognitive therapy. British Journal of Psychiatry 148, 103–104.CrossRefGoogle ScholarPubMed
Leonhard, K. (1968). Akzentuierte Personlichkeiten. Verlag Volk und Gesundheit: Berlin.Google Scholar
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, 839–847.CrossRefGoogle ScholarPubMed
Montgomery, S. A. & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382–389.CrossRefGoogle ScholarPubMed
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, 164–173.CrossRefGoogle ScholarPubMed
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, 215–232.CrossRefGoogle ScholarPubMed
Rutter, M. (1987). Temperament, personality and personality disorder. British Journal of Psychiatry 150, 443–458.CrossRefGoogle ScholarPubMed
Shawcross, C. R. & Tyrer, P. (1985). Influence of personality on response to monoamine oxidase inhibitors and tricyclic antidepressants. Journal of Psychiatric Research 19, 31–36.CrossRefGoogle ScholarPubMed
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, 1409–1413.Google ScholarPubMed
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, 691–697.CrossRefGoogle ScholarPubMed
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.Google Scholar
Tyrer, P. & Alexander, J. (1979). Classification of personality disorder. British Journal of Psychiatry 135, 163–167.CrossRefGoogle ScholarPubMed
Tyrer, P. & Seivewright, H. (1988). Studies of outcome. In Personality Disorder: Diagnosis, Management and Course (ed. Tyrer, P.), pp. 119–136. Wright: London.Google Scholar
Tyrer, P., Casey, P. & Gall, J. (1983). The relationship between neurosis and personality disorder. British Journal of Psychiatry 142, 404–408.CrossRefGoogle ScholarPubMed
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, 970–975.CrossRefGoogle ScholarPubMed
Tyrer, P., Casey, P. R. & Seivewright, N. (1986). Common personality features in neurotic disorder. British Journal of Medical Psychology 59, 289–294.CrossRefGoogle ScholarPubMed
Tyrer, P., Casey, P. & Ferguson, B. (1988 a). Personality disorder and mental illness. In Personality Disorder: Diagnosis, Management and Course (ed. Tyrer, P.), pp. 93–104. Wright: London.Google Scholar
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, 235–240.CrossRefGoogle Scholar
Tyrer, P., Alexander, J. & Ferguson, B. (1988 c). Personality Assessment Schedule. In Personality Disorder: Diagnosis, Management and Course (ed. Tyrer, P.), pp. 140–167. Wright: London.Google Scholar
Waldinger, R. O. (1987). Intensive psychodynamic therapy with borderline patients: an overview. American Journal of Psychiatry 144, 267–274.Google ScholarPubMed
World Health Organization (1988). International Classification of Diseases, Draft for 10th Revision. World Health Organization: Geneva.Google Scholar
Zigmond, A. S. & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 57, 361–370.CrossRefGoogle Scholar
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, 1030–1032.Google ScholarPubMed
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, 733–737.CrossRefGoogle ScholarPubMed