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37 Epidemiology of DSM-Ill PDs might be used to establish conshuct validity. Biological markers will also be important in future research as another source of external validation. Another method of validation is to determine whether the course or natural history of PDs justifies their differentiation. Few such studies have been done, because of the time and wst of prospective designs. hut longitudinal studies can pmvide information not available from crosssectional ones. They could identify predictors of future PDs, modifying variables, and medical and social service needs. They also offer an opportunity to examine the effect of temperament as an important predisposing variable. Another issue that wuld be explored in this way is the temporal stability of PDs. Although as defined in the ICD-l0 and DSM-111, PDs are long-lasting disorders, very limited data are available regarding this. For this reason it would be worth investigating the epidemiology of PDs in different age groups, as an indication of the course of PDs. Longitudinal studies will also provide evidence for the validity of the concept of PD as constant maladaptive behaviour across time and environmental circumstances." Finally, treatment response is also a validator. Although PDs are considered stable and long lasting, it is possible that effective treatments will ultimately be developed, as with other psychiatric disorders, and treatment response could also be used to validate the different types of PD. There has been a remarkable advance in our understanding of the epidemiology of PDs in the last few years. As this continues, we should better understand not only the PDs, but also other mental disorders. References l Casey, P.R Epidemiology of personality disorders. In Tyrer, P. (ed.) Personalily Disorders: Diagnosis. Management andcourse. London: Wrighf 1988. 2 Metikangas, K.R. & Weissman, M.M. Epidemiology of DSM-111 Axis 11 personality disorders. In: Frances, A.J. & Hales, R.E. (eds), APA Annual Review, vol. 5. Psychiarry Update, pp. 258-78. Washington, DC: American Psychiauic Press. 1986. 3 Merikangas. K.R. Epidemiology of DSM-111 personality disorders. In Michels, R. er al., (eds.). Psychiatry, v01 3, pp 1-16. Philadelphia: Lippincott, 1989. 4 Weissman, M.M. The epidemiology of personality disorders: A 1990 update. Journal ofPersonalily Disorders. 1993; 7.4462. 5 Andrwli, A., Glessot, G., Aapro. N., Tricot, L. & Gognalons, M.Y. Personality disorders as a predictor of outcome. Joumal of Personality Disorders, 1989; 3: 307-20. 6 Reich. J.H. & Green, A.I. Effect of personality disorders on outcome of treatment. Joumal ofNewousandMenralDisease. 1991; 179: 74-82.
38 J. H. Reich and G. de Girolamo 7 Neugebauer, R.. Dohrenwend, B.P. & Dohrenwend, B.S. Formulation of hypotheses about the true prevalence of functional psychiatric disorders among adults in the US. In Dohrenwend, B.P., Dohrenwend, B.S., Gould, M.S., Link. B., Neugebauer, R. & Wunsch-Hilzir, R. (eds.). Mental Illness in rhe United States: Epidemiological Esrimares. pp. 5692. New York: Praeger, 1980. 8 Perry, C. & Vaillant, G.E. personality Disorders. In Kaghan, H.I., Sadock, B.J. (eds.). Comprehensive Texrbook of Psychiarry, pp. 1352-86. Baltimore: William & Wirekins, 1989. 9 Casey, P.R. & Tyrer, P.J. Personality, functioning and symptomatology. Journal ofPsychiatricResearch. 1986; 20: 363-74. 10 Maier, W., Lichtermann. D., Klingler. T. & Heun, R. Prevalences of personality disorders (DSM-III-R) in the community. Journal of Personality Disorders, 1992; 6: 187-96. l1 Reich, J., Boerstler, H., Yates, W. & Nduaguba, M. Utilization of medical resources in persons with DSM-I11 personality disorders in a community sample. International Journal of Psychiatry in Medicine, 1989a; 19: 1-9. 12 Zimmennan, M. & Coryell, W.H. Diagnosing personality disorders in the community. Archives of General Psychiarry, 1990; 47: 527-31. 13 Reich, 1. & Troughton, E. Frequency of DSM-Ill personality disorders in patients with panic disorder: comparison with psychiatric and normal control subjects. Psychiarry Research, 1988; 26: 89-100. 14 Baron. M., Gruen, R., Rainer, J.D., Kane, I., Asnis, L. & Lord, S. A family study of schizophrenic and normal control probands: Implications for the spectrum concept of schizophrenia. American Journal of Psychiarry, 1985; 142: 447-55. 15 Reich, J.H., Yates, W. & Nduaguba, M. Prevalence of DSM-I11 personality disorders in thecommunity. SocialPsychiarry, 1989b: 24: 12-16. 16 Nestadt. G., Romanoski, AI., Chahal. R., Merchant, A., Folstein, M.F., Gruenberg, E.M., & McHugb, P.R. An epidemiological study of histrionic personality disorder. Psychological Medcine, 1990; 20: 413-22. 17 Weissman. M.M. & Myers. J.K. Psychiatric disorders in a US community. Acta Psychiarrica Scandinavica, 1980: 62: 99-1 l l. l8 Swartz, M,, Blazer. D.. George. L. & Winfield, I. Estimating the prevalence of borderline personality disorder in the community. Journal of Personality Disorders, 1990,4: 257-72. 19 Akhtar. S., Byme, J.P. & Doghramji, K. The demographic profile of borderline personality disorder. Journalof Clinical Psychiarry, 1986: 47:196-198. 20 Widiger, T.A. & Weissman. M.M. Epidemiology of borderline personality disorder. Hospital and Community Psychiatry, 1991; 42: 1015-21. 21 Reich, J. Sex distribution of DSM-I11 personality disorders in psychiatric outpatients. American JournalofPsychiarry, 1987; 144: 4854. 22 Kass, F., Skodol, A.E., Charles, E., Spitzer, R.L. & Williams. J.B.W. Scaled ratings of DSM-I11 personality disorders. American Journal of Psychiarry, 1985: 142: 627-30.
Page 2 and 3: Until recently, the standardization
Page 4 and 5: Assessment and diagnosis of persona
Page 6 and 7: Contents Contributors Preface Annan
Page 8 and 9: Contributors Dr Antonio Andreoli Ho
Page 10 and 11: Preface One of the major goals of t
Page 12 and 13: ... Xlll Acknowledgements The IPDE
Page 14 and 15: Problems in the field of personalit
Page 16 and 17: 5 Problems in the field of PD perso
Page 18 and 19: 7 Problems in the field of PD In DS
Page 20 and 21: 9 Problems in the field of PD cultu
Page 22 and 23: 11 Review of diagnostic instruments
Page 30 and 31: 19 Epidemiology of DSM-Ill PDs in c
Page 32 and 33: Table l. Prevalence rates of specif
Page 35 and 36: 24 1. H. Reich and G. de Girolamo (
Page 37 and 38: 26 .- 5 2 0 W C .- 0 P g F ? g e Q
Page 39 and 40: 28 J. H. Reich and G. de Girolarno
Page 41 and 42: Table 3. Prevalence rates ofpersona
Page 44 and 45: Pfohl etal.. l986 (67) Pilgrim & Ma
Page 46 and 47: 35 Epidemiology of DSM-Ill PDs were
Page 50 and 51: 39 Epidemiology of DSM-Ill PDs 23 R
Page 52 and 53: 4 1 Epidemiology of DSM-Ill PDs 55
Page 54 and 55: 43 International personality disord
Page 56 and 57: I 45 IPDE iner what he is actually
Page 58 and 59: 47 IPDE Sample of IPDE item The que
Page 60 and 61: 49 IPDE dimensional scores are not
Page 62 and 63: 1 9 IPDE considerable training and
Page 64 and 65: 53 Experiences with IPDE The invest
Page 66 and 67: 55 Experiences with IPDE passive ag
Page 68 and 69: 57 Field Trial
Page 70 and 71: 59 Sampling, inte~iewers, interview
Page 72 and 73: Description of centres participatin
Page 74 and 75: 63 Centres participating in IPDE fi
Page 82 and 83: P- P Table 1. Sample sizes and IPDE
Page 84 and 85: 73 Results Table 3. ICD-I0 Disorder
Page 86 and 87: 75 Results Table 5. Frequency of CO
Page 88 and 89: 77 Results Table 8. Interrater reli
Page 90 and 91: Discussion and conclusions Armand W
Page 92 and 93: 8 1 Discussion and Conclusions stab
Page 94 and 95: 83 Discussion and Conclusions Repet
Page 96 and 97: Discussion and Conclusions of princ
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87 Discussion and Conclusions Frequ
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89 Discussion and Conclusions emoti
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9 1 Discussion and Conclusions inte
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93 Appendix Table A2 Persomlity dis
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95 Appendix Table A4 Personality di
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97 Appendix Table A6 Personaliry di
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99 Appendix Table SA Personaliry di
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Table A10 Personality disorder diag
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103 Appendix Table A12 Personality
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Table A13 (con?) Criterion B7 B8 1
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107 Appendix Table A13 (cont) Frequ
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109 Appendix Table A14 (cont.) Freq
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Acknowledgements 113 Manual History
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Manual History of the IPDE One of t
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116 Manual Struchlre of the IPDE Th
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118 Manual that is likely to enhanc
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120 Manual data. If examiners have
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122 Manual Scoring conventions Much
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124 Manual Recording the scores Req
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126 Manual Q. What do you do when s
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128 Manual section, if there are qu
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ICD-10 criteria and corresponding I
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132 ICD-10 criteria and correspondi
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134 IPDE ICD-10 module screening qu
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136 Screening questionnaire 47 1 lo
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I 138 IPDE ICD-10 module* interview
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140 Interview schedule 2. 0 1 2 7 0
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142 Inte~iew schedule 4. O 1 2 I N
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144 Interview schedule 6. O l Z ? 0
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146 Interview schedule 8. 0 1 2 1 0
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148 Interview schedule .10. 0 1 2 ?
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150 Interview schedule 12. 0 1 2 7
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152 lnte~iew schedule 14. 0 1 2 ? 0
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154 Interview schedule 16. 0 1 2 ?
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156 interview schedule 18. 0 1 2 ?
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158 Interview schedule 20. O 1 2 N
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164 Interview schedule *26. 0 1 2 ?
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166 lntewiew schedule 28. 0 1 2 ? 0
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170 lnte~iew schedule 32. O 1 2 7 N
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174 lntewiew schedule 36. 0 1 2 ? 0
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176 lnterv~ew schedule 38. 0 1 2 ?
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184 lnte~iew schedule 46. 0 1 2 7 0
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~ 186 Interview schedule 48. 0 1 2
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194 Interview schedule 56. 0 1 2 1
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196 Interview schedule VI. IMPULSE
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Page 210 and 211:
200 Interview schedule Have you eve
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202 Interview schedule 1 63. 0 1 2
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204 Intewiew schedule Rate the foll
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206 IPDE ICD-10 module handscoring
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+ 39+44=4, 208 Handscoring algorith
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210 Handscoring algorithms and summ
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IPDE ICD-10 module summary scoreshe
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224 Index paranoid 108 schizoid 108
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226 Index Personalily Assessment Sc
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