Anxiety Disorders and Personality Disorders Comorbidity

Symptoms of all the major personality disorder (PD) clusters have been noted in higher than expected numbers in patients with anxiety disorders; however, Cluster C characteristics appear particularly common. High neuroticism and some personality disorder traits predict later onset of anxiety disorders; conversely, anxiety disorders in adolescence appear to predict onset of PDs by adulthood. Temperament/personality traits such as behavioral inhibition, neuroticism, and Cluster C characteristics also appear to relate to anxiety disorders familially/genetically, and it remains unclear whether inherited personality traits are causal risk factors versus markers of susceptibility for anxiety disorders. Patients with comorbid anxiety and PDs, including Cluster B disorders, appear to have more functional impairment and suicidality. Patients with anxiety disorders and PDs appear to be more ill than those without PDs, but both groups generally respond to treatment. In fact, successful treatment of panic disorder often results in partial "normalization" of personality.