Personality disorder is a common disorder affecting upwards of one in ten of the general population. Of these people, around a quarter will be treatment-seeking, while about three quarters while be treatment-resisting (will not seek treatment or will actively avoid treatment). Most treatment of people with personality disorder occurs in the community.

 

As with most conditions, large numbers of people with milder forms of the disorder will be managed within primary care, smaller numbers with more severe difficulties will be managed in secondary care and a yet smaller number with the most severe difficulties will receive input from specialist tertiary services. Even at the most severe end of the spectrum of difficulties, community treatment is generally preferred to hospital treatment for the reasons outlined in the Inpatient Section.

General issues relating to care and treatment of personality disorder within Primary Care and Community Mental Health Teams (CMHTs) are discussed in this section. Specific psychosocial and pharmacological interventions are discussed in their respective sections.

People with personality disorder are heavy users of primary care services. Typically, around a quarter of people in a general practice clinic fulfil the diagnostic criteria for personality disorder. Although personality disorder may not be the given reason for attendance, the condition appears to be associated with increased rates of other mental health and physical health problems, substance use conditions, medically unexplained symptoms and frequent attendance in primary care settings.
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