Personality disorder misdiagnosed

The assessment of personality disorder is inaccurate, largely unreliable and frequently wrong, experts have claimed.Professor Peter Tyrer, a psychiatrist at Imperial College London, and his colleagues have challenged a key assumption that personality is 'pervasive' and 'ingrained' - that is, you're stuck with it. Instead, there is growing evidence that personality is unstable, providing more hope for therapists as well as challenges for diagnosticians.'Personality disorder' itself is an unhelpful term, Professor Tyrer says. "What can be assessed at a point in time is personality function, not disorder," he says. "Just as mental state can be dependent on environmental influences, so can personality status." Personality factors are very often ignored in clinical assessments and forgotten in research studies of mental illness. When personality is investigated, the process is usually cursory and brief. In 152 original papers in the British Journal of Psychiatry in 2005, only 13 included personality assessment as at least part of the focus.Existing classification and rating systems need urgent review, Professor Tyrer says. Clinicians are generally best at agreeing on who has so-called cluster B (flamboyant) traits and not too bad at defining cluster C (anxious/dependent) and cluster D (inhibited/obsessional) individuals, but they are poor at recognising cluster A (withdrawn) personalities.Amidst the debate, society continues to expect the medical profession to make perfect diagnoses. In the UK, for example, the Dangerous and Severe Personality Disorder Program is aiming to protect society from people deemed to pose a threat because of their 'personality' - or should that be 'disorder', 'disease' or 'function'?British Journal of Psychiatry 2007; 190(Suppl 49): s51-s59.Reproduced with permission from 6 Minutes.com.au, 2nd May 2007...