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Table 3 Essential features of Personality Disorder severity

From: Application of the ICD-11 classification of personality disorders

Mild Personality Disorder Moderate Personality Disorder Severe Personality Disorder
Disturbances affect some areas of personality functioning but not others (e.g., problems with self-direction in the absence of problems with stability and coherence of identity or self-worth; see Table 2), and may not be apparent in some contexts. Disturbances affect multiple areas of personality functioning (e.g., identity or sense of self, ability to form intimate relationships, ability to control impulses and modulate behaviour; see Table 2). However, some areas of personality functioning may be relatively less affected. There are severe disturbances in functioning of the self (e.g., sense of self may be so unstable that individuals report not having a sense of who they are or so rigid that they refuse to participate in any but an extremely narrow range of situations; self view may be characterized by self-contempt or be grandiose or highly eccentric; see Table 2).
There are problems in many interpersonal relationships and/or in performance of expected occupational and social roles, but some relationships are maintained and/or some roles carried out. There are marked problems in most interpersonal relationships and the performance of most expected social and occupational roles are compromised to some degree. Relationships are likely to be characterized by conflict, avoidance, withdrawal, or extreme dependency (e.g., few friendships maintained, persistent conflict in work relationships and consequent occupational problems, romantic relationships characterized by serious disruption or inappropriate submissiveness). Problems in interpersonal functioning seriously affect virtually all relationships and the ability and willingness to perform expected social and occupational roles is absent or severely compromised.
Specific manifestations of personality disturbances are generally of mild severity (see examples in Table 4). Specific manifestations of personality disturbance are generally of moderate severity (see examples in Table 4). Specific manifestations of personality disturbance are severe (see examples in Table 4) and affect most, if not all, areas of personality functioning.
Is typically not associated with substantial harm to self or others. Is sometimes associated with harm to self or others. Is often associated with harm to self or others.
May be associated with substantial distress or with impairment in personal, family, social, educational, occupational or other important areas of functioning that is either limited to circumscribed areas (e.g., romantic relationships; employment) or present in more areas but milder. Is associated with marked impairment in personal, family, social, educational, occupational or other important areas of functioning, although functioning in circumscribed areas may be maintained. Is associated with severe impairment in all or nearly all areas of life, including personal, family, social, educational, occupational, and other important areas of functioning.
  1. Note. The diagnostic guideline should be accompanied with the examples provided in Table 4. Adapted from the ICD-11 Clinical Descriptions and Diagnostic Guidelines for Personality Disorder. All five levels of personality functioning are described and exemplified in Additional file 1