Former Clusters

Personality disorders

Personality disorders (PD) are a group of mental health conditions characterised by persistent patterns of thinking, feeling, and behaving that are significantly different from cultural expectations. These patterns can lead to distress or problems in personal, social, and occupational functioning. It is thought that around 1 in 20 people have a personality disorder.

For many years patients were diagnosed with a specific 'named' personality disorder, such as narcissistic or paranoid. This approach was changed significantly with the introduction of the ICD-11 classification which marked a shift towards a more dimensional model, such as severity and specific problems. This allows for a more flexible and comprehensive understanding of personality pathology.

The majority of patients you'll encounter with personality disorders will be 'labelled' using the previous classification system. We've therefore included details of this classification at the end of the notes.

ICD-11 classification of personality disorders

Key Features of Personality Disorder (ICD-11)

• Persistent Pattern: The individual's patterns of cognition, emotional experience, behaviour, and interpersonal functioning deviate from cultural expectations. These patterns are stable over time and span across various personal and social situations.
• Impairment: The deviation results in significant problems or dysfunctions in the person’s life, especially in relationships, work, or social functioning.
• Duration: These characteristics are stable over time, beginning in adolescence or early adulthood, and are not transient.
• Distress or Dysfunction: The impairment may result in distress to the individual or others. These patterns are not explained by another mental disorder, a medical condition, or substance misuse.

Severity Classification in ICD-11

In the ICD-11, personality disorders are classified based on the degree of severity. This provides a broader and more flexible approach:

Mild Personality Disorder:

• Some impairments in functioning, often limited to specific areas of life (e.g., intimate relationships or work).
• Symptoms may be noticeable to others but do not cause pervasive distress or dysfunction.
• The individual may still maintain relatively stable relationships and occupational roles.

Moderate Personality Disorder:

• More significant impairments in multiple areas of life (personal, social, and work).
• The individual may struggle with maintaining close relationships, and there may be greater interpersonal difficulties.