BACKGROUND: Little is currently known about functioning and impairment during adulthood associated with the course of personality disorders. AIMS: To investigate the association of personality disorder stability from adolescence through middle adulthood with measures of global functioning and impairment, using prospective epidemiological data. METHOD: A community-based sample of 658 individuals was interviewed at mean ages 14, 16, 22 and 33 years. RESULTS: Individuals with persistent personality disorder had markedly poorer functioning and greater impairment at mean age 33 years than did those who had never been identified as having such disorder or who had a personality disorder that was in remission, after co-occurring Axis I disorders at age 33 years were taken into account. Remitted disorder was associated with mild long-term impairment. Adult-onset personality disorders, however, were also associated with significant impairment. CONCLUSIONS: Persistent and adult-onset personality disorders are associated with functional impairment among adults in the community. These effects are independent of co-occurring Axis I disorders.
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