Personality and comorbidity of common psychiatric disorders

Department of Psychiatry, Virginia Commonwealth University, Ричмонд, Virginia, United States
The British Journal of Psychiatry (Impact Factor: 7.34). 04/2005; 186:190-6. DOI: 10.1192/bjp.186.3.190
Source: PubMed

ABSTRACT We know little about the degree to which comorbidity, socommonly seen among psychiatric disorders, arises from variation in normal personality.
To study the degree to which variation in normal personality accounts for the comorbidity of eight common psychiatric and substance use disorders.
Internalising disorders (major depression, generalised anxiety and panic disorders, phobias), externalising disorders (alcohol and drug dependence, antisocial personality and conduct disorders) and personality dimensions of neuroticism, extraversion and novelty seeking were assessed in 7588 participants from a population-based twin registry. The proportion of comorbidity explained by each personality dimension was calculated using structural equation modelling.
Neuroticism accounted for the highest proportion of comorbidity within internalising disorders (20-45%) and between internalising and externalising disorders (19-88%). Variation in neuroticism and novelty seeking each accounted for a modest proportion (10-12% and 7-14%, respectively) of the comorbidity within externalising disorders. Extraversion contributed negligibly.
High neuroticism appears to be a broad vulnerability factor for comorbid psychiatric disorders. Novelty seeking is modestly important for comorbid externalising disorders.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Personality disorders are common and ubiquitous in all medical settings, so every medical practitioner will encounter them frequently. People with personality disorder have problems in interpersonal relationships but often attribute them wrongly to others. No clear threshold exists between types and degrees of personality dysfunction and its pathology is best classified by a single dimension, ranging from normal personality at one extreme through to severe personality disorder at the other. The description of personality disorders has been complicated over the years by undue adherence to overlapping and unvalidated categories that represent specific characteristics rather than the core components of personality disorder. Many people with personality disorder remain undetected in clinical practice and might be given treatments that are ineffective or harmful as a result. Comorbidity with other mental disorders is common, and the presence of personality disorder often has a negative effect on course and treatment outcome. Personality disorder is also associated with premature mortality and suicide, and needs to be identified more often in clinical practice than it is at present. Copyright © 2015 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd. All rights reserved.
    The Lancet 02/2015; 385(9969):717-26. DOI:10.1016/S0140-6736(14)61995-4 · 39.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Los rasgos de temperamento y carácter pueden determinar diferencias en las presentaciones clínicas y el desenlace del trastorno bipolar. Comparamos los rasgos de personalidad en pacientes bipolares e individuos sanos utilizando el cuestionario de temperamento y carácter (Temperament and Character Inventory [TCI]) y tratamos de verificar si la comorbilidad con el alcoholismo o los trastornos de ansiedad se asocia con rasgos específicos de la personalidad. Se comparó a 73 pacientes con trastorno bipolar, basado en los criterios del Diagnostic and Statistical Manual of Mental Disorders, 4.ª edición (DSM-IV), con 63 individuos sanos usando el TCI. En una segunda fase, la muestra de pacientes bipolares se dividió en subgrupos según la comorbilidad psiquiátrica que tuvieran (alcoholismo, n = 10; trastornos de ansiedad, n = 23; alcoholismo más trastornos de ansiedad, n = 21; ausencia de comorbilidad, n = 19). Los pacientes bipolares obtuvieron puntuaciones significativamente más altas que los individuos sanos en la búsqueda de novedades, evitación de riesgos y autotrascendencia y puntuaciones más bajas en autodirección y cooperación. Los pacientes bipolares con alcoholismo comórbido exclusivo obtuvieron puntuaciones significativamente más bajas que aquellos sin ninguna comorbilidad en la perseverancia. Los pacientes bipolares con trastornos de ansiedad comórbidos exclusivos obtuvieron puntuaciones significativamente más altas en evitación de riesgos y más bajas en autodirección que aquellos sin ninguna comorbilidad. Las limitaciones de este estudio son el diseño transversal y el reducido tamaño de la muestra, específicamente en el análisis de subgrupos. Sin embargo, los resultados indican que los pacientes bipolares manifiestan una estructura de la personalidad diferente que los individuos sanos y que la comorbilidad psiquiátrica en este trastorno se asocia con rasgos específicos de personalidad. Estos hallazgos indican que la personalidad, al menos hasta cierto punto, media el fenómeno de la comorbilidad en el trastorno bipolar.
    03/2009; 16(1):12-21. DOI:10.1016/S1134-5934(09)71886-X
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: High rates of obsessive-compulsive symptoms (OCS) in schizophrenia require pathogenic explanations. Personality traits may represent risk and resiliency factors for the development of mental disorders and their comorbidities. The aim of the present study was to explore the associations between Five-Factor Model (FFM) personality traits and the liability for OCS in patients with psychotic disorders and in their un-affected siblings. FFM traits, occurrence and severity of OCS and (subclinical) psychotic symptoms were assessed in 208 patients and in 281 siblings. Differences in FFM traits between participants with vs. without comorbid OCS were examined and the predictive value of FFM traits on group categorization was evaluated. Associations between FFM traits and OCS severity were investigated. Patients and siblings with OCS showed significantly higher Neuroticism compared to their counterparts without OCS. Neuroticism was positively associated with higher OCS severity and significantly predicted group assignment in both patients and in siblings. Patients with comorbid OCS presented with lower scores on Extraversion and Conscientiousness. Higher Neuroticism, and to a lesser degree lower Extraversion and Conscientiousness might add to the vulnerability of patients with a psychotic disorder to also develop OCS. Future prospective studies are needed to elucidate proposed personality-psychopathology interrelations and possible mediating factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 02/2015; 225(3):464-470. DOI:10.1016/j.psychres.2014.11.066 · 2.68 Impact Factor


Available from