Patterns of Comorbidity among DSM-III-R Personality DisordersMarinangeli M.G. · Butti G. · Scinto A. · Di Cicco L. · Petruzzi C. · Daneluzzo E. · Rossi A.
aDepartment of Experimental Medicine, University of L’Aquila, bMedical Center ‘Villa Serena’, Città S. Angelo, Italy
The aim of this study was to examine patterns of comorbidity among personality disorders (PDs) in a sample of 156 psychiatric inpatients. PDs were assessed with Semistructured Clinical Interview for DSM-III-R Personality Disorders. To determine significant co-occurrence among axis II diagnoses, odds ratio and the percent of co-occurrence of pairs of disorders were calculated. Both statistical methods revealed high rates of comorbidity: significance association was found for 36 pairs of disorders using the percent of co-occurrence, and for 22 pairs of disorders using the odds ratio. These results support the concept of ‘apparent comorbidity’ for most PDs, deriving from conceptual and definitional artifacts or from a ‘state-biasing effect’. In light of these observations, a categorical approach to PDs, resulting in a list of diagnoses, appears useless in psychiatric practice. A dimensional classification is probably better suited for PDs, improving the understanding of personality psychopathology and its clinical implications.
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