Axis II diagnoses and treatment refractoriness in schizophrenia.

In a previous medical record review study we identified a subset of chronic schizophrenic patients with comorbid Axis II personality disorder diagnoses, who had significantly longer lengths of inpatient stay as compared to schizophrenic patients without Axis II diagnoses. This study describes a detailed review of a subset of these records. Eighteen records of schizophrenic patients with comorbid Axis II diagnoses were matched with records of patients without comorbid diagnoses. Demographic and premorbid data revealed no differences between the groups, indicating that the Axis II diagnoses were markers for current as opposed to past psychopathology. Negative symptoms were lower in the cohort with comorbid Axis II personality disorder diagnoses on admission only, while affective symptomatology was increased in this group throughout treatment. Ratings of personality pathology showed a trend towards significance, with the comorbid group demonstrating greater amounts of maladaptive personality traits. These data support the notion that personality traits may be independent of Axis I symptomatology in chronic schizophrenia, and can influence the course of treatment.