TY - JOUR PY - 2015// TI - The influence of personality disorder on outcome in adolescent self-harm JO - British journal of psychiatry A1 - Ayodeji, Eunice A1 - Green, Jonathan A1 - Roberts, Chris A1 - Trainor, Gemma A1 - Rothwell, Justine A1 - Woodham, Adrine A1 - Wood, Alison SP - 313 EP - 319 VL - 207 IS - 4 N2 - BackgroundLittle is currently known about the presence and impact of personality disorder in adolescents who self-harm.AimsTo evaluate personality disorder in repeated self-harm in adolescence and its impact on self-harm psychopathology and adaptation outcomes over 1 year.

METHODA clinical referral sample (n = 366) of adolescents presenting with repeated self-harm aged 12-17 years, as part of a randomised controlled trial (Assessment of Treatment in Suicidal Teenagers study, ASSIST). Personality disorder was assessed using the Structured Clinical Interview for DSM-IV Axis II (SCID-II). One-year outcomes included frequency and severity of repeat self-harm, self-reported suicidality, mood and functional impairment.

RESULTSAbout 60% of the referred adolescents showed one or more forms of personality disorder. Personality disorder was associated with significantly greater severity of self-harm, overall psychopathology and impairment. There was a complex association with treatment adherence. Personality disorder predicted worse 1-year outcomes in relation to self-harm frequency and severity, as well as impairment, suicidality and depressive symptoms.

CONCLUSIONSPersonality disorder can be reliably measured in adolescence and showed high prevalence in this clinical self-harm sample. Controlling for other variables, it showed a strong independent association with self-harm severity at referral and predicted adherence to treatment and clinical outcomes (independent of treatment) over 1 year. Consideration of personality disorder diagnosis is indicated in the assessment and management of adolescents who repeatedly self-harm.

Language: en

LA - en SN - 0007-1250 UR - http://dx.doi.org/10.1192/bjp.bp.113.138941 ID - ref1 ER -