Personality disorders 'change over time'

Anxiety disorders become worse over time

Personality disorders change over time - so patients should not be permanently labelled with the mental illness, researchers warn.

Their conclusions, published in the Lancet, come just days after the government announced people with the illness could be locked up even if they had not committed a crime.

But the researchers say that could be dangerous, as people's condition is likely to change over time.

Doctors from the department of psychological medicine at Imperial College School of Medicine, London, assessed 178 patients who had personality disorders in addition to other mental illnesses.

It shows that it's not hopeless for people with personality disorder and we can offer treatment

Professor Pamela Taylor, Institute of Psychiatry

They were divided into three groups according to their personality disorder traits; flamboyant - exhibiting histrionic or antisocial behaviour (the most likely group to be locked up), odd and eccentric and anxious or fearful.

They were reassessed 12 years later.

It was found the condition of those who displayed histrionic or antisocial behaviour became better over time.

But the behaviour of those in the other groups became more pronounced.

'No-one will have them'

Peter Tyrer, professor of community psychiatry at Imperial College School of Medicine, who led the research told BBC News Online that it meant labelling people as having personality disorders was dangerous.

"The danger is once it's stuck to you, you can't lose it.

"Although there have long been indications that antisocial and impulsive personalities mature and lessen with age this is the first time that we have clear evidence that anxious, obsessional, suspicious and withdrawn traits increase with older age.

"If the findings are replicated in other groups apart from those with common neurotic disorders, it has implications for health services, treatment interventions and quality of life."

He added that the government's proposal to detain people with personality disorders for treatment even if they had not committed a crime could be dangerous.

"Once people have been through this, even if they are found to be better - which could be as a consequence of both time and treatment.

"Because they have received that diagnosis, no-one will have them, so it's difficult to get them out of secure accommodation."

Optimism

Pamela Taylor, professor of special hospital psychiatry at the Institute of Psychiatry in London, said: "Intuitively, this is what I would have expected because we certainly see changes and improvements in people with personality disorders that we work with.

"There have been a number of trials that suggest people respond to therapy."

She said the paper offered a message of optimism.

"It shows that it's not hopeless for people with personality disorder and we can offer treatment."

Dr Michael Crowe, a consultant psychiatrist at the Institute said the trends the study detected were to be expected, but he said he had concerns about the patients it looked at.

"The weren't actually assessing people who had personality disorders.

"They had personality disorder traits in a group with neurotic and depressive disorders."

He added that if people with personality disorders were detained for treatment, their situation had to be reviewed regularly.