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Advances in Psychiatric Treatment (2004) 10: 378-388
© 2004 The Royal College of Psychiatrists

Psychological treatment for personality disorders

Anthony W. Bateman and Peter Tyrer

Anthony Bateman is Clinical Head and Research Lead of Psychotherapy Services at the Halliwick Unit, St Ann’s Hospital (St Ann’s Road, London N15 3TH, UK. Tel: 020 8442 6093, fax: 020 8442 6545, e-mail: anthony{at}abate.org.uk) and Visiting Professor at University College London. His interests include treatment of personality disorder and the integration of psychotherapy and psychiatry. Professor Peter Tyrer is Head of the Department of Psychological Medicine at Imperial College, London, honorary consultant in rehabilitation psychiatry, Central North West London Mental Health NHS Trust and consultant to an assertive outreach team in Hammersmith and Fulham. He has been interested in personality disorders since 1965. He is the Editor of the British Journal of Psychiatry, Past President of the European Branch of the International Society for the Study of Personality Disorders, Co-chair of the Section of Personality Disorders of the World Psychiatric Association and the Founder President of the British and Irish Group for the Study of Personality Disorders.

There is encouraging evidence that some patients with personality disorder are treatable. Psychotherapeutic interventions show promise, although interpretation of the literature is problematic: the number of patients in most trials is small, outcome measures are questionable, follow-up is limited, and treatments are multifaceted, complex interventions in which the effective components are unclear. The evidence base can be assessed according to efficacy and generalisability, and when both are taken into account the best verification is for psychodynamic therapy. However, there is inadequate evidence to make specific recommendations for any particular therapy.




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