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Psychiatr Clin North Am. 2008 Sep;31(3):495-503, viii. doi: 10.1016/j.psc.2008.03.010.

Longitudinal course and outcome of personality disorders.

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  • Institute for Mental Health Research, 3300 N. Central Avenue, Suite 2380, Phoenix, AZ 85012, USA. askodol@imhr.org


The notion of personality disorders (PDs) as stable disorders has persisted despite traditional follow-up studies showing that fewer than 50% of patients diagnosed with PDs retained these diagnoses over time. Because these studies had methodological limitations, four more rigorous large-scale studies of the naturalistic course of PDs have been conducted. The results indicate (1) personality psychopathology improves over time at unexpectedly significant rates; (2) maladaptive personality traits are more stable than PD diagnoses; (3) although personality psychopathology improves, residual effects can be seen in the form of persistent functional impairment, continuing behavioral problems, reduced future quality of life, and ongoing Axis I psychopathology; (4) improvement in personality psychopathology may eventually be associated with reduction in ongoing personal and social burden.

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