Nonpsychotic personality disturbances: a re-evaluation and reclassification.

The classical notion of neurosis as the prototypical form of nonpsychotic personality disturbance must be rejected in favor of the categories of (a) personality pattern disturbance and disorder of life style, and most especially, (b) character disorder. Category (a) would include schizoid, paranoid, and cyclothymic personality pattern disturbances and compulsive and hysteroid personality as disorders of life style. Each of these would occupy one end of a 'psychotoid' continuum, at the other end of which would be a familiar type of psychosis such as paranoid schizophrenia or pseudoneurotic schizophrenia. The most numerous of the nonpsychotic disturbances (in the tens of millions in the USA alone) come under category (b), the character disorders, involving a special sort of failure to inhibit impulse and unsocialized self-seeking. Character disorders are seen by us as turning on an eccentric axis, alternating between the two foci of 'dependency' and 'aggression'.