Personality disorders in an Irish mental health service: the Waterford Mental Health Survey

Abstract

The Waterford Mental Health Survey aimed to document the prevalence of personality disorders (PDs) in patients attending the public mental health service in Waterford, Ireland and outline the implications of this for service development. Between July 2011 and June 2014, 100 inpatients and 99 outpatients were evaluated with the Structured Clinical Interviews for (Diagnostic and Statistical Manual) DSM-IV axis I and II disorders, the Childhood Trauma Questionnaire, the Global Assessment of Functioning rating scale, the Systemic Clinical Outcome and Routine Evaluation family assessment instrument, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Ninety-eight per cent of cases had DSM-IV axis I psychiatric disorders and 39.3% of these had comorbid axis II PDs. Between approximately a half and three-quarters of cases with PDs had comorbid anxiety, depressive or alcohol and substance use disorders. Compared to those without PDs, cases with PDs had experienced more child maltreatment; had poorer personal and family functioning and more severe presenting problems; and reported greater unmet service needs and motivation for psychotherapy. Approximately two out of five patients attending the public mental health services in Waterford, and other similar services internationally, require specialist psychological therapy for PDs which addresses low levels of personal and family functioning and past history of child maltreatment.

Keywords:

• personality disorders
• child maltreatment
• CTQ

Disclosure statement

No potential conflict of interest was reported by the authors.

This research project was supported by HSE-South clinical psychology training sponsorships to KO'H, MDW, MF and EH.