COMORBIDITY OF AXIS-I AND AXIS-II DIAGNOSES IN A SAMPLE OF EGYPTIAN PATIENTS WITH NEUROTIC DISORDERS

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