A. Okasha et al., COMORBIDITY OF AXIS-I AND AXIS-II DIAGNOSES IN A SAMPLE OF EGYPTIAN PATIENTS WITH NEUROTIC DISORDERS, Comprehensive psychiatry, 37(2), 1996, pp. 95-101
Neurosis and personality disorder (PD) are two of the most used but le
ast clarified and understood terms in psychiatry. The separation of PD
by the American Psychiatric Association in DSM-III and -IV as a discr
ete axis of classification has been a major advance in psychiatric nos
ology. Also with the advent of DSM-III and its multiaxial system, it w
as recognized that both PD and clinical syndromes can coexist, and in
some cases this coexistence may have implications on treatment respons
e and prognosis. This study was performed on 200 neurotic patients in
an attempt to investigate possible correlations between various neurot
ic subcategories and personality types. Our results confirm that PD an
d personality abnormality are significantly higher in neurotic patient
s than in controls and need to be considered in diagnostic assessment.
Some comorbidity was shown between borderline PD and somatoform disor
der: compulsive PD and obsessive-compulsive disorder (OCD), and genera
lized anxiety disorder (GAD); and avoidant PD and phobia. However, our
data failed to show a correlation between the presence of an addition
al PD and particular neurotic symptomatology. It seems that the associ
ation between neurotic disorders and PD should not be taken to indicat
e a direct causative relationship. It is likely that personality is ju
st one of the predisposing factors that influence the individual respo
nse to psychological trauma and determine the form of neurosis. The mo
st prevalent PD was found to be PD NOS, followed by borderline, compul
sive, avoidant, and finally histrionic PDs. The term, multiple PD, sho
uld be given substance to characterize the diagnosis as a disorder, ra
ther than leaving it at its current status of what seems to be a nondi
stinct clinical picture. Extensive research has to be undertaken in an
attempt to decide which specific PDs most deserve to be included in t
he official nomenclature. Copyright (C) 1996 by W.B. Saunders Company