Clinical approaches to Axis II comorbidity: Commentary

Abstract

In a review of six clinical cases involving the treatment of a patient with two or more personality disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSM-IV; American Psychiatric Association, 1994), five key decisions that have an impact on treatment emerged. The clinical cases are discussed and compared from the vantage points of the nature of personality disorder, extent and content of patient assessment, treatment focus and sequence, and the role of the patient - therapist relationship. The cases illuminate the complexity of these patients and the need for careful treatment construction. © 2008 Wiley Periodicals, Inc.