A SCL-90-R DERIVED INDEX OF THE SEVERITY OF PERSONALITY-DISORDERS

Aim: To find a useful measure of the severity of subjective distress f or patients with personality disorders. The measure should be minimall y confounded by coexisting anxiety and mood disorders. Material: Forty -seven patients with schizotypal and/or borderline personality disorde rs were compared to 41 patients with Cluster C personality disorders a nd Axis I disorders only. Methods: Diagnoses were reliably assessed ac cording to Diagnostic and Statistical Manual of Mental Disorders (DSM- III-R) criteria. The self-report inventory SCL-90-R was administered i n a state of decompensation, after day hospital treatment and at 3 yea r follow-up. Results: Borderline and schizotypal patients perceived th emselves as more interpersonally vulnerable and more aggressive, and p erceived others as more hostile at all three points in time. We sugges t personality severity index (PSI) as a label for the mean score of th e SCL-90-R subscales interpersonal sensitivity, hostility, and paranoi d ideation. This index differentiated between schizotypal/borderline a nd Cluster C/Axis I disorders even when statistically corrected for th e influence of anxiety and mood disorders. The PSI was more stable ove r time than the other SCL-90-R symptom subscales, in particular compar ed with anxiety and depression subscales. Conclusion: The PSI might be a useful measure of the severity of subjective distress for patients with Cluster A and B personality disorders.