Personality Disorder

Established: April 2005

Convenor (Chair): Professor Peter Tyrer, Imperial College London

Members: seven psychiatrists: Antony Bateman, Mike Crawford, Jeremy Coid, Conor Duggan, Anthony Maden, Paul Moran, and Peter Tyrer; four psychologists: Kate Davidson, Peter Fonagy, Sheilagh Hodgins, Glenys Parry; a health economist: Sarah Byford

Remit and Aims:
Personality disorder has recently been recognised to be an under-researched and under-treated group of conditions and attempts are being made to correct this (NIMHE, 2003). New services for personality disorder have now been established across the country and there is currently a great deal of interest in new forms of treatment for personality disorders and this is likely to be a major part of MHRN portfolio of research.

Current Status & Future Plans:
Potential research ideas:
1. Cognitive-behavioural interventions for antisocial personality disorder
This is currently the subject of an MRC pathfinder grant (PI Kate Davidson, with Mike Crawford and Peter Tyrer as co-applicants) involving a two-year randomized controlled trial. This will finish in the autumn of 2007 and, depending on the results, may be expanded.

2. Assessment of personality status of patients with early psychosis (PsyGrid)   
A new method of recording personality status from documented information only (PAS-DOC) has been developed (PI: Tyrer) and is being incorporated into the baseline assessments in the PsyGrid study. This should yield important information about the links between personality and psychosis and its influence on outcome.
 
3. Efficacy of therapeutic community treatment
There is still no adequate evaluation of the benefits of therapeutic community treatment for severe personality disorder and a possible randomized evaluation of the day hospital form of the treatment is being discussed (PI: Crawford)

4. Impact of comorbid personality disorder on outcome of severe mental illness
This is an emerging subject in the literature and currently application for national funding is being made to study it in more depth (PI: Crawford).

5. Systematic review of treatments for personality disorder
A systematic review of all treatments for personality disorder is being expanded to incorporate both new and existing data and will also be complemented by an examination of preferred outcomes and a meta-analysis (PI: Duggan).

6. Efficacy of nidotherapy in personality disorder
A recent pilot randomized controlled trial has shown evidence that nidotherapy (the systematic manipulation of the environment to minimise handicap in chronic mental illness) is cost-effective (PI: Tyrer). This may now be compared with other therapies.     

User involvement
A special user group has been set up within the North London Hub to advise on studies planned or taking place with people with personality disorders.