Personality disorder is a controversial diagnosis. There are no blood tests or physical criteria confirming personality disorder. In fact there’s no real evidence to suggest that personality disorder is a medical condition at all. So why do psychiatrists diagnose personality disorder? More importantly… should they?

Here we consider the roots of personality disorder diagnoses from the Moral defective of a century ago to the 3 personality disorder clusters of today. We look at the way personality disorder is diagnosed through behaviours, emotions and enduring patterns of response to society and we consider the advantages of understanding a person’s personality traits. Knowledge is power.

The more we know the more likely we are to be able to help. But we must be careful. Too often the diagnosis of personality disorder is used as an excuse to write a person off as incurable, hopeless or even undeserving. That’s the legacy we’ve been left by our Edwardian and Victorian predecessors.

If we are to do right by the personality disordered patients of today and in the future we need to embrace the understanding this diagnosis can bring but reject the pejorative notions of undeservingness, incurability and hopelesness that all too often come along with it.

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