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We examined the stability of DSM-III-R personality disorder dimensions in a clinical sample of adolescents. Sixty adolescent inpatients were reliably assessed with the Personality Disorder Examination (PDE) soon after admission to the Yale Psychiatric Institute, and were independently reassessed with the same instrument 2 years following discharge. PDE symptom ratings were summed to create dimensional scores for each personality disorder. To assess the dimensional stability of personality disorders, intraclass correlation coefficients (ICCs) were computed. To assess the magnitude of the difference between baseline and follow-up scores, paired t tests were used. Significant ICCs were observed for histrionic, narcissistic, dependent, obsessive-compulsive, and passive-aggressive personality disorders. Compared to baseline, dimensional scores for most personality disorders were significantly lower at follow-up-and none was significantly higher. Diagnostic stability is a key defining feature of personality disorders. We observed low-to-moderate stability for dimensional measures of personality dysfunction in adolescents-suggesting that previous reports of modest personality disorder stability in this age group cannot be attributed solely to limitations of the categorical approach to such pathology. Alternatively, our findings may be viewed as consistent with reports in the adult literature that personality disorders may improve over time, and can potentially benefit from treatment., (Copyright 2001 by W.B. Saunders Company)

Objective: The authors examined the comorbidity of borderline personality disorder with other personality disorders in a series of consecutively admitted adolescents. For comparison, the comorbidity of borderline personality disorder with other personality disorders was also examined in a series of adults consecutively admitted to the same hospital during the same period., Method: A total of 138 adolescents and 117 adults were reliably assessed with the Personality Disorder Examination, a semistructured diagnostic interview for DSM-III-R personality disorders. Sixty-eight adolescents and 50 adults met the diagnostic criteria for borderline personality disorder. The co-occurrence of other personality disorders in the group of subjects with borderline personality disorder was statistically compared to that in the group without borderline personality disorder, for adolescents and adults separately., Results: For the adults, Bonferroni-corrected chi-square analysis revealed significant diagnostic co-occurrence with borderline personality disorder for antisocial personality disorder only. For the adolescents, borderline personality disorder showed significant co-occurrence with schizotypal and passive-aggressive personality disorders., Conclusions: In the adults, borderline personality disorder was significantly comorbid only with another cluster B disorder. The adolescents, by comparison, displayed a broader pattern of comorbidity of borderline personality disorder, encompassing aspects of clusters A and C. These results suggest that the borderline personality disorder diagnosis may represent a more diffuse range of psychopathology in adolescents than in adults.

Structured diagnostic interviews were used to determine DSM-III-R axis I and II diagnoses among 136 female psychiatric inpatients. To distinguish comorbidity of eating disorders with axis I and II disorders from simple diagnostic overlap, the frequency and distribution of diagnoses among the 31 patients with an eating disorder and the 105 without an eating disorder were compared. Social phobia, substance use disorders, borderline personality disorder, and avoidant personality disorder were diagnosed in a significantly larger proportion of the group with eating disorders. Future studies should focus on interpreting the meaning of the co-occurrence of these disorders in patients with eating disorders.

This study assessed the relationship between substance use disorders and eating disorders in female psychiatric inpatients. Structured diagnostic interviews were reliably administered to a series of inpatients with substance use disorders (n = 67) and a comparison sample without substance use disorders (n = 69). Eating disorder diagnoses as a whole, including eating disorder not otherwise specified, were distributed significantly more frequently among subjects with substance use disorders than among psychiatric controls. Frequencies of the specific diagnoses of bulimia nervosa and anorexia nervosa, however, did not differ significantly between groups. The results suggest that eating disorder features may be overrepresented among female inpatients with substance use disorders.