Clinical assessment of personality

The importance of personality is recognised tacitly by the development of the multiaxial classifications of ICD–10 (World Health Organization, 1992) and DSM–IV (American Psychiatric Association, 1993). The separation of axis 1 or current mental state diagnosis from axis 2, on which personality is described, is a recognition that personality is separate from other aspects of the patient's diagnostic status. Nevertheless, many clinicians are sceptical that personality can be assessed reliably and some hold that the diagnosis should be abandoned as being merely judgemental and pejorative (Lewis & Appleby, 1988). There is some basis for scepticism in respect of reliability in view of the evidence that even with operational criteria the clinical assessment of personality is not transportable, and the level of agreement between practising clinicians is much less than that achieved during field trials (Mellsop et al , 1982).