The influence of personality disorder on the future mental health and social adjustment of young adults: a population-based cohort study

Paul A Moran, Helena Romaniuk, Carolyn Coffey, Andrew Chanen, Louisa Degenhardt, Rohan Borschmann, George Patton

Research output: Contribution to journalArticle (Academic Journal)

36 Citations (Scopus)
302 Downloads (Pure)

Abstract

Background
Existing knowledge about the consequences of personality disorders (PD) is substantially derived from the study of clinical populations. This paper reports findings from a large, population-based, longitudinal study of the long-term mental health and social consequences of PD.

Methods
Community-based, longitudinal study of a stratified random sample of 1635 non-treatment seeking young adults recruited from Victoria, Australia. Presence and severity of PD was assessed at age 24 years, using a semi-structured, informant-based interview (the Standardised Assessment of Personality). Psychosocial outcomes were assessed at age 35 years.

Outcomes
At age 24 years, 28% (n=458) of the sample had either personality difficulties or PD. The severity of PD was associated with absence of a degree or vocational qualification, the presence of common mental disorders and cigarette smoking. At age 35 years, PD severity was independently associated with not being in a relationship (adjusted odds ratio (aOR) for the effect of complex and severe PD vs. no PD or personality difficulty: 2.05, 95% CI: 1·21-3·45), increased odds of an anxiety disorder (aOR: 2·27, 95% CI: 1·20-4·28) and major depression (aOR: 2·23, 95% CI: 1·24-4·01).

Interpretation
The presence of PD predicts the occurrence of later anxiety and depression, as well as the absence of long-term relationships, effects that are not attributable to pre-existing common mental disorder. The study provides strong support for including PD in global studies of the burden of mental disorders.

Funding
The research was supported by grants from Australia’s National Health and Medical Research Council (NH&MRC) and Victoria’s Operational Infrastructure Support Program.
Original languageEnglish
Pages (from-to)636-645
Number of pages10
JournalLancet Psychiatry
Volume3
Issue number7
Early online date21 Jun 2016
DOIs
Publication statusPublished - Jul 2016

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