Diagnosis of personality disorders in learning disability

Abstract

Background: Though contentious, the diagnosis of personality disorders in persons with learning disability is clinically relevant because it affects many aspects of management.

Aims: To examine published literature on the diagnosis of personality disorders in learning disability.

Method: Selective review with computerised (Medline, Embase and PsychInfo) and manual literature searches.

Results: The variation in the co-occurrence of personality disorder in learning disability, with prevalence ranging from less than 1% to 91% in a community setting and 22% to 92% in hospital settings, is very great and too large to be explained by real differences.

Conclusions: The diagnosis of personality disorders in learning disability is complex and difficult, particularly in those with severe disability. Developing consensus diagnostic criteria, specific for various developmental levels, is one way forward. Such criteria may need to include objective proxy measures such as behavioural observations and informant accounts.