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The course of personality pathology

Gutiérrez, Fernando

Current Opinion in Psychiatry: January 2014 - Volume 27 - Issue 1 - p 78–83
doi: 10.1097/YCO.0000000000000027
PERSONALITY DISORDERS: Edited by Aleksandar Janca and Charles Pull

Purpose of review Durability has traditionally been considered to be a defining feature of personality disorders, but recent studies have challenged this notion. We review the most recent findings on the stability and course of personality pathology.

Recent findings Personality disorders seem to remit more often and faster than previously thought, and their relapse rate is low. However, the recent optimism regarding these disorders is mitigated by the existence of highly heterogeneous trajectories among patients and traits, the identification of certain methodological shortcomings, and the maintenance of psychosocial impairment long after symptomatic relief. The causes of personality improvement are largely unknown, but involve intermingled genetic and environmental effects.

Summary Recent follow-up studies of patients with personality pathology are changing orthodox conceptions of their inevitably negative prognosis. The current taxonomies must be reviewed and future research should be integrated with adjacent fields. Treatments need to target the enduring real-life hardships of these patients, apart from their acute symptoms.

Personality Disorder Unit, Institute of Neuroscience, Hospital Clínic de Barcelona, and IDIBAPS (Institut d’Investigacions Biomediques August Pi Sunyer), Barcelona, Spain

Correspondence to Fernando Gutiérrez, Personality Disorder Unit, Institute of Neuroscience, Hospital Clinic de Barcelona, Villarroel 170, 08036 Barcelona, Spain. Tel: +34 93 227 54 00x2407; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins