Personality disorders in consultation-liaison psychiatry

Abstract

Purpose of review: Liaison psychiatrists treat patients who present with self-harm, with medically unexplained symptoms (MUSs) and physical illnesses with psychological comorbidity. We sought to explore recent studies into the impact of personality disorder in liaison psychiatry.

Recent findings: One in five patients presenting to most liaison psychiatry services suffers from a personality disorder. Patients who have self-harmed have a high rate of personality disorder, but there is little research on how liaison psychiatrists can engage these patients in appropriate treatments. Most patients with MUSs or a functional somatic syndrome do not have a personality disorder, but the prevalence is probably higher than in the general population. Little is known about how a personality disorder might affect the efficacy of treatment in these conditions. Patients with personality disorders have higher rates of physical illness. Personality disorders may complicate the treatment of patients with long-term physical conditions, and talking therapies have recently been described in primary and secondary care.

Summary: Liaison psychiatrists have an ideal therapeutic opportunity to engage patients with a personality disorder in treatment when these patients present with self-harm. There is a need to understand and research how personality disorders might affect the prognosis and treatment of patients with MUSs or a functional somatic syndrome. Personality disorders may complicate the treatment of patients with long-term physical conditions, and talking therapies recently described in primary and secondary care may help their physical and psychological health.