[Decisions of the National Insurance Court related to personality disorders 1986-2001].

BACKGROUND

During the past decades, much clinical research in psychiatry has been devoted to personality disorders. The aim of the present study was to examine whether recent experience in this area has influenced the decisions in cases appealed to the National Insurance Court.

MATERIAL AND

METHODS

The study includes cases recorded in the court database over the period 1986-2001. This database contains information on decisions with diagnoses classified according to ICD-9 and ICD-10.

RESULTS

The court issued 159 decisions in cases with personality disorder as the main diagnosis, some associated with other psychiatric co-morbidity (19%), with alcohol and drug abuse (25%), and with somatic illness (16%). 57% of the cases were related to disability pension claims. The proportion of rulings in favour of the complaining party increased from 18% to 79%. The total number of court rulings rose from 2,386 in 1986 to 5,762 in 2001. The proportion of decisions in favour of the complaining party increased more for personality disorders than for other diagnostic groups such as neurosis and somatic conditions.

INTERPRETATION: In recent years a broader concept of illness has won acceptance and a clearer clinical definition of personality disorders has been developed. The National Insurance Court has contributed to the definition of legal guidelines at the crossroads of medicine and social dysfunction.