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Psychiatric Bulletin (2007) 31: 194. doi: 10.1192/pb.31.5.194
© 2007 The Royal College of Psychiatrists
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Correspondence

Personality disorder - a stigmatising diagnosis?

Kate Robertson, Senior House Officer

Bushey Fields Hospital, Dudley DY2 1LZ, email: Kate.robertson{at}dudley.nhs.uk

Floriana Coccia, Senior House Officer

Bushey Fields Hospital, Dudley

We were interested in John Gunn’s anecdote (Psychiatric Bulletin, January 2007, 31, 25-28) regarding a patient who had apparently been informed that he ‘was a personality disorder’ by the registrar. Professor Gunn’s reply is worth quoting in full: ‘I never use that term, I don’t use that term in my clinic, it’s not something I ever say to any patient.’ This raises the questions: does Professor Gunn not believe in the diagnostic category, as seems to be implied (rather than not believing that this diagnostic category fits this person), or does he acknowledge the category but perceives the label as stigmatising? Either is interesting, given that the category itself is well recognised in both ICD-10 and DSM-IV, and is therefore likely to be used by at least some practising psychiatrists. If Professor Gunn perceives the term ‘personality disorder’ as stigmatising and/or unhelpful, would it not be better to discuss the possibility of this label being applied, and the grounds for its application, with the individual concerned, rather than distancing himself from the concept? Presumably the person to whom the label was applied remained the same person before and after the diagnosis. If psychiatrists genuinely believe in reducing the stigma still attached to mental illness in general and personality disorder in particular (Lewis & Appleby, 1988), is avoidance a rational way to deal with diagnostic labels perceived to be stigmatising? It seems that even among the most justly esteemed psychiatrists, the label personality disorder still elicits aversive responses. Perhaps psychiatric fear of personality disorder still needs exploring.

References

LEWIS, G. & APPLEBY, L. (1988) Personality disorder: the patients psychiatrists dislike. British Journal of Psychiatry, 153, 44 -49.[Abstract/Free Full Text]





This Article
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Right arrow Articles by Robertson, K.
Right arrow Articles by Coccia, F.

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