An operationalized procedure for the recognition of premorbid personality types in biographical case notes on psychiatric patients

Abstract

A method for the assessment of six premorbid personality types from biographical data in psychiatric case histories is described. Trained raters have to fill in a list comprising 106 items as descriptors of a patient's premorbid behavioural development. The assignment to the types in question (the "manic type" and its rare variant, the "happy-go-lucky type", the "melancholic type", the "anxious insecure type" and its rare variant, the "unrealistic dreamy type", and finally, the "nervous tense type") is computed on the basis of the item scores by forming type scores and comparing their height intraindividually. The subject under study is assigned to the type reaching the comparatively highest value. Two raters independently analyzed 261 records from which all information on mental disorders in family members and the patient himself/herself as well as all biographical data from the first manifestation of a symptom disorder onwards had been erased by technical assistants. In 106 of the records, a global assignment to the types of premorbid personality had already been performed by one of the authors of the typology. The scores for the same type assessed by the two ratings correlated highly with each other (0.77 to 0.80), the concordance of types reached a kappa-value of 0.55 (P < 0.001), and the results of the operationalized typing agreed in the same order with the result of global typing in the subsample of n = 106.(ABSTRACT TRUNCATED AT 250 WORDS)