Assessment and diagnosis of personality disorders - World Health

237 Pages·2008·4.65 MB·English

Until recently, the standardization of diagnosis and assessment of per-
sonality disorders has lagged considerably behind that for most other
mental disorders. The IPDE is a new instrument which can produce
through its two modules diagnoses in accordance with both ICD-10 and
DSM-N criteria. The IPDE is a semistructured clinical interview that
provides a means of arriving at the diagnosis of major categories of per-
sonality disorders and of assessing personality traits in a standardized
and reliable way. It is unique in that it secures reliable information in dif-
ferent cultural settings. Written by leading international authorities, this
volume forms an invaluable reference manual to the IPDE instrument.
Its first section includes an overview of the results of the worldwide field
trials of the interview and discussion of the current status of diagnosis
and assessment research. The second section detailing the full interview
schedule and scoring system for the instrument will further facilitate its
use by both clinician and researcher.
Assessment and diagnosis of personality disorders
Assessment and diagnosis of
personality disorders
The ICD-l0 international personality
disorder examination (IPDE)
Armand W. Loranger, Cornell University Medical Col\ege.
Aleksandar Janca, World Health Organization,
Norman Sartorius, University of Geneva
CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, SHo Paulo
Cambridge University Press
The Edinburgh Building, Cambridge CB2 8RU. UK
Published in the United States ofAmerica by Cambridge UniversiIy Press, New York
www.cambridge.org
Information on this title: www.cambridge.arg/9780521580434
Q World Health Organization 1997
This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements;
no reproduction of any part may take place without the written
permission of Cambridge University Press.
First published 1997
This digitally printed version 2007
A catalogue recordfor this publication is available from the British Library
Library of Congress Cataloguing in Publication data
Assessment and diagnosis of personality disorders: the International Personality Disorder
Examination (1PDE)ledited by Armand W. Loranger, Aleksandar Janca, and Norman
Sartorius.
p. cm.
Includes index.
ISBN 0-521-58043-9 (hardback)
1. International Penonality Disorder Examination. 2. Personality disorders-Diagnosis.
I. Loranger, Armand W. (Armand Walter), 1930- . 11. Janca, A. 111. Sartorius, N.
[DNLM 1. Personality Disorders - diagnosis. 2. Psychiatric Status Rating Scales.
3. Personality Assessment. WM 190A846 19971
RC544.A87 1997
616.85'84~21 96.45992 CIP
DNLMiDLC
for Library of Congress
lSBN 978-0-521-58043-4 hardback
lSBN 978-0-521-04166-9 paperback
Contents
Contributors ix
Preface
Annand W .L oranger, Aleksandar Janca and Norman Sartorius xi
Acknowledgements xiii
I Background and Field Trial
Background
Problems in the field of personality disorders 3
Alv A. Dahl and Antonio Andreoli
Review of diagnostic instruments for tbe assessment of personality
disorders
h a n d W . Loranger 10
Epidemiology of DSM-111 personality disorders in the community
and in clinical populations
James H. Reich and Giovanni de Giolamo 18
International personality disorder examination (IPDE)
h a n d W . Loranger 43
Experiences with the IPDE
Alv A. Dahl and Antonio Andreoli
Field Trial
Sampling, interviewers, intemew procedures
Werner Mombour 58
...
v111 Contents
Description of centres participating in the IPDE field trial
Aleksandar Janca and Charles Pull 61
Results
h a n d W . Lorange~
Discussion and conclusions
Armand W. Loranger
Appendix
II International personality disorder examination (IPDE) ICD-10 module
Acknowledgemenrs 113
Manual 114
History of the IPDE 114
ICD-10 and DSM-IV 115
Translations of the IPDE 115
Structure of the IPDE 116
Scope of the IPDE 117
Appropriate subjects 118
Limitations of the IPDE 118
Examiner qualifications and training 120
Administration of the IPDE 121
Scoring conventions 122
Recording the scores 124
Computer scoring 124
Handscoring 125
Frequently asked questions about the administration of the IPDE 125
Abbreviating the IPDE 127
Reliability and validity of the IPDE 128
References 129
ICD-I0 criteria and corresponding IPDE items 130
IPDE ICD-I0 module screening questionnaire 134
IPDE ICD-10 module screening questionnaire scoring summary 137
IPDE ICD-I0 module interview schedule 138
IPDE ICD- 10 module answer sheet 205
IPDE ICD-l0 module handscoring algorithms and summary
scoresheet 206
Index 223
Contributors
Dr Antonio Andreoli
Hopital cantonal
Unit6 d'urgences psychiatriques
Rue Micheli-du-crest 24
1211 Geneva 14
Switzerland
Tel: [phone]: Fax: [phone]
Dr Alv A. Dahl
Department of Psychiatry
University of Oslo
P.O.B ox 85
Vinderen
0319 Oslo 3
Norway
Tel:[phone]; Fax: [phone]
Dr Giovanni de Girolamo
Servizio Salute Mentale
Viale Popoli 5
50123 Bologna
Italy
Tel: [phone]; Fax: [phone]
Dr Aleksandar Janca
Division of Mental Healh and Prevention of Substance Abuse
World Health Organization
20 Avenue Appia
1211 Geneva 27
Switzerland
Tel: [phone];Fax[phone]
X Contributors
Dr Armand W. Loranger
New York Hospital
Comell Medical Center
Westchester Division
21 Bloomingdale Road
White Plains,
New York 10605
USA
Tel: [phone]; Fax: [phone]
Dr Wemer Mombour
Leiter der Psychiatr. Poliklinik
Max-Planck Institut fiirpsychiatrie
Kraepelinstrasse 10
80804 Miinich
Germany
Tel: [phone]; Fax: [phone]
Dr Charles Pull
Centre hospitalier de Luxembourg
Service de Neuropsychiatrie
4 rue Barb16
1210 Luxembourg
Tel: [phone]; Fax: [phone]
DIJ ames H. Reich
2255 North Point St.
San Francisco
CA94123
USA
Fax: [phone]
Dr Norman Sartorius
Department of Psychiatry
University of Geneva
1205 Geneva
Switzerland
Tel: [phone]; Fax: [phone]
Preface
One of the major goals of the World Health Organization's (WHO)
Mental Health Programme has been the development of a common lan-
guage for worldwide use by psychiatrists and other mental health profes-
sionals. The WHONIH Joint Project on Diagnosis and Classification of
Mental Disorders, Alcohol- and Drug-related Problems is the most
recent endeavour in this programme. It has developed a number of diag-
nostic instruments for the assessment of mental disorders in different
cultures and tested them for their cross-cultural applicability, reliability
and
One of these instruments, the Composite International Diagnostic
Interview (CIDI)? is highly structured and intended for use by lay inter-
viewers in epidemiological studies. Another, the Schedules for Clinical
Assessment in Neuropsychiatry (SCAN),4i s a semi-structured interview
for use by clinicians, i.e., those capable of making independent psychi-
atric diagnoses. Since neither interview covers personality disorders, it
was necessary to develop an instrument to assess them according to cri-
teria in the latest classification systems.
The new instrument, the International Personality Disorder
Examination (IPDE), has been developed from the Personality Disorder
Examination (PDE).5 which was modified for international use and com-
patibility with the International Classification of Diseases, 10th revision
(ICD-10). and the American Psychiatric Association Diagnostic and
Statistical Manual of Mental Disorders, fourth edition (DSM-IV). The
current version of the IPDE has been produced in two modules, one for
ICD-10 and one for DSM-IV criteria for personality disorders.
The IPDE was tested in a major international field trial at 14 centres in
11 countries in North America, Europe, Africa and Asia. The primary
objectives were to determine its cultural acceptability, user-friendliness,
interrater reliability and temporal stability. In the course of the field uial
a large body of data on personality disorders in different cultures was
collected. This book describes the uial, and it also addresses several