The effect of age on prevalence, type and diagnosis of personality disorder in psychiatric inpatients

Abstract

OBJECTIVE: To examine age-related differences in personality disorder (PD) comorbidity and in their diagnosis in psychiatric inpatients. METHODS: Two hundred thirty-one consenting adults consecutively admitted to inpatient psychiatry units and aged between the age of 18 and 100 were assessed using the Structured Clinical Interview for DSM IV Axis I and II (SCID-I and -II), after excluding cognitively impaired, non-English speaking, short stay and respite patients. Hospital files were audited for clinical diagnoses, in particular for recorded PDs. Rates of PD prevalence and clinician diagnosis were compared for young (n = 76), middle-age (n = 57) and older (n = 98) patients. RESULTS: Significant personality comorbidity was evident at all ages, but rates were lowest in the older group. PD was present in 73.7% of young, 71.9% of middle-age and 58.8% of older patients. Complex PD was more common in young patients. Only 19.8% of PDs were noted by their clinicians to have PD. CONCLUSION: Comorbid PD is common in psychiatric inpatient groups regardless of age but seldom diagnosed clinically.