Egosyntonic and Egodystonic: Accounting for Continuities and Discontinuities between Personality Traits and Personality Disorders

Abstract

Background

Egosyntonic and egodystonic features describe differences between trait-based and state-based mental disorders. Many diagnoses, most particularly personality disorder (PD), show both features. These complex forms of psychopathology are an amalgam of traits and symptoms in which both egosyntonicity and egodystonicity can be present but vary in prominence. This distinction might help resolve the long-standing controversy as to whether PDs are best classified using dimensions or categories.

Method

Narrative review.

Results

PDs in which egosyntonic features tend to predominate can be understood as amplified trait profiles. PDs associated with highly egodys-tonic clinical symptoms that more closely resemble major mental disorders may be usefully classified using both categories and dimensions.

Conclusions

PDs with stronger egosyntonic features are more suitable for dimensional diagnosis. When egodystonic symptoms are more prominent, categorical diagnoses can be useful.