Verlauf und Prognose der schweren Persönlichkeitsstörungen

Course and prognosis of severe personality disorders The stability of the diagnosis “personality disorder” (PD) is lower than expected. This applies more to its categorical and less to its dimensional stability, which is validated by studies on the natural course of PD and its course under treatment. Results of longitudinal studies show that in relation to the natural course of PD some half of disorders are already in remission in the first year. Remarkable, however, is a substantial shift to other diagnoses. Symptoms such as “self-injurious behaviour” undergo more marked changes, whereas personality traits such as “affective lability”, “impulsivity” or “ callous-unemotional behaviour” change less. Specialised psychotherapeutic techniques have proved effective (especially for the treatment of borderline PD). The worst course and prognosis and the least effective treatment approaches can be found in antisocial PD, where much more effort is needed to develop effective treatments.