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Anona K, Olaomi O, Udegbe E, Uwumiro F, Tuaka EB, Okafor N, Adeyinka A, Obijuru C, Okpujie V, Bojerenu M, Opeyemi M. Co-occurrence of bipolar disorder and personality disorders in the United States: Prevalence, suicidality, and the impact of substance abuse. J Affect Disord 2024; 345:1-7. [PMID: 37848089 DOI: 10.1016/j.jad.2023.10.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/07/2023] [Accepted: 10/13/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND This study investigates prevalence rates of specific personality disorders (PDs) in individuals with bipolar disorder (BD) and their impact on substance abuse and suicidality, addressing existing gaps in the literature. METHODS Using Nationwide Inpatient Sample data (2016-2020), adult hospitalizations for BD with coexisting PDs were analyzed. Study variables were defined using ICD-10-CM codes. Prevalence of PD were reported as cases per 100,000 BD admissions. Regression models assessed the association between substance abuse and suicidality. RESULTS About 993,000 admissions for BD were analyzed. The cohort was predominantly Caucasian (70.5 %) with higher female representation (54.5 %). The mean age was 41 years. 89.4 % of individuals had a Charlson Comorbidity Index score ≤ 1. The most common diagnostic subtype was manic episode of BD with or without psychotic features (32.3 %). Coexisting PDs were observed in 12.2 % of the population, with borderline PD (8.2 %) and antisocial PD (2.6 %) being most prevalent. Substance abuse was common (44.8 %), with cannabis (23.8 %), alcohol (19.4 %), cocaine (10.5 %), and opioids (9.6 %) being most reported. Substance abuse was higher in individuals with BD and PD (50 %) compared to BD alone (44.1 %). 596 suicide attempts were recorded (60 per 100,000 BD admissions). Substance abuse and coexisting PD in bipolar individuals elevated the likelihood of attempts (P < 0.001). LIMITATIONS Use of administrative data (retrospective, inpatient); treatment not studied. CONCLUSION The study reveals a notable prevalence of PDs in individuals with BD, with increased likelihood of substance abuse and suicide attempts in those with coexisting BD and PD compared to BD alone.
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Affiliation(s)
- Kenechukwu Anona
- Greater Manchester Mental Health National Health Service Foundation Trust, UK
| | | | | | - Fidelis Uwumiro
- Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
| | - Ebere-Bank Tuaka
- Rivers State University Teaching Hospital, Port Harcourt, Nigeria
| | - Nnenna Okafor
- All Saints University College of Medicine, Belair Kingstown, Saint Vincent and the Grenadines
| | | | - Chinwendu Obijuru
- College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu State, Nigeria
| | - Victory Okpujie
- College of Medicine, University of Benin, Benin City, Edo State, Nigeria
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Jankovsky A, Zaboski B, Pittenger C. Pharmacotherapy for comorbid antisocial personality and obsessive-compulsive disorder: A case report. PSYCHIATRY RESEARCH CASE REPORTS 2023; 2:100139. [PMID: 38240012 PMCID: PMC10795765 DOI: 10.1016/j.psycr.2023.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Affiliation(s)
| | - Brian Zaboski
- Yale University, 34 Park St, New Haven, CT 06511, United States
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Cheli S, Cavalletti V, Lysaker PH, Dimaggio G, Petrocchi N, Chiarello F, Enzo C, Velicogna F, Mancini F, Goldzweig G. A pilot randomized controlled trial comparing a novel compassion and metacognition approach for schizotypal personality disorder with a combination of cognitive therapy and psychopharmacological treatment. BMC Psychiatry 2023; 23:113. [PMID: 36803673 PMCID: PMC9942388 DOI: 10.1186/s12888-023-04610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Schizotypal personality disorder is characterized by a pervasive pattern of maladaptive behavior that has been associated with the liability for schizophrenia. Little is known about effective psychosocial interventions. This pilot non-inferiority randomized controlled trial aimed to compare a novel form of psychotherapy tailored for this disorder and a combination of cognitive therapy and psychopharmacological treatment. The former treatment - namely, Evolutionary Systems Therapy for Schizotypy-integrated evolutionary, metacognitively oriented, and compassion focused approaches. METHODS Thirty-three participants were assessed for eligibility, twenty-four randomized on a 1:1 ratio, nineteen included in the final analysis. The treatments lasted 6 months (24 sessions). The primary outcome was change across nine measurements in personality pathology, the secondary outcomes were remission from diagnosis and pre-post changes in general symptomatology and metacognition. RESULTS Primary outcome suggested a non-inferiority of the experimental treatment in respect to control condition. Secondary outcomes reported mixed results. There was no significant difference in terms of remission, but experimental treatment showed a larger reduction of general symptomatology (η2 = 0.558) and a larger increase in metacognition (η2 = 0.734). CONCLUSIONS This pilot study reported promising results about the effectiveness of the proposed novel approach. A confirmatory trial on large sample size is needed to provide evidence about relative effectiveness of the two treatment conditions. TRIAL REGISTRATION ClinicalTrials.gov; NCT04764708; Registration day 21/02/2021.
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Affiliation(s)
- Simone Cheli
- School of Human Health Sciences, University of Florence, Florence, Italy. .,Center for Psychology and Health (Centro Di Psicologia e Psicoterapia), Tages Charity (Tages Onlus), Via Della Torretta 14, 50137, Florence, Italy.
| | - Veronica Cavalletti
- Center for Psychology and Health (Centro Di Psicologia e Psicoterapia), Tages Charity (Tages Onlus), Via Della Torretta 14, 50137 Florence, Italy
| | - Paul H. Lysaker
- grid.280828.80000 0000 9681 3540Department of Psychiatry, Richard L Roudebush VA Medical Center, Indianapolis, USA ,grid.257413.60000 0001 2287 3919Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
| | - Giancarlo Dimaggio
- grid.512576.20000 0004 7475 2686Centro Di Terapia Metacognitiva Interpersonale, Rome, Italy
| | - Nicola Petrocchi
- grid.449441.80000 0004 1789 8806John Cabot University, Rome, Italy
| | - Francesca Chiarello
- Center for Psychology and Health (Centro Di Psicologia e Psicoterapia), Tages Charity (Tages Onlus), Via Della Torretta 14, 50137 Florence, Italy
| | - Consuelo Enzo
- Center for Psychology and Health (Centro Di Psicologia e Psicoterapia), Tages Charity (Tages Onlus), Via Della Torretta 14, 50137 Florence, Italy
| | - Francesco Velicogna
- Center for Psychology and Health (Centro Di Psicologia e Psicoterapia), Tages Charity (Tages Onlus), Via Della Torretta 14, 50137 Florence, Italy
| | - Francesco Mancini
- grid.440899.80000 0004 1780 761XGuglielmo Marconi University, Rome, Italy
| | - Gil Goldzweig
- grid.430432.20000 0004 0604 7651The Academic College of Tel Aviv Yaffo, Tel Aviv, Israel
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Doctoral clinical psychology student commentary on common myths about CBT: lessons learned for competency-based training. COGNITIVE BEHAVIOUR THERAPIST 2023. [DOI: 10.1017/s1754470x23000016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Effective methods for training and education in the dissemination of evidence-based treatments is a priority. This commentary provides doctoral clinical psychology graduate student authors perspectives on common myths about cognitive behavioural therapy (CBT). Three myths were identified and considered: (1) CBT does not value the therapeutic relationship; (2) CBT is overly rigid; and (3) exposure techniques are cruel. Graduate students were engaged in a competency-based course in Cognitive Behavioural Approaches to Psychotherapy at an American Psychological Association (APA)-accredited doctoral clinical psychology program. The origins of common myths identified by graduate students included a lack of in-depth coverage of CBT and brief video segments provided during introductory courses, lived experience with CBT, and pre-determined views of manualized treatment and exposure techniques. Myth-addressing factors discussed by graduate students included holding space at the start of training for a discussion of attitudes about CBT, specific learning activities, and course content described in this commentary. Finally, self-reported changes in graduate students’ attitudes and behaviour following the course included a more favourable view of CBT as valuing the therapeutic relationship, as well as implementation of resources provided, and techniques learned and practised at practicum settings. Limitations and lessons learned are discussed through the lens of a model of adult learning that may be applied to future graduate training in evidence-based therapies like CBT.
Key learning aims
(1)
To understand common myths about cognitive behavioural therapy (CBT) that doctoral students in clinical psychology hold prior to entering a course in CBT.
(2)
To understand the possible origins of these myths, factors that may address their impacts, and changes in attitudes and behaviour among graduate students as a result.
(3)
To examine the lessons learned that can be applied to future training in evidence-based therapies like CBT.
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Angelakis I, Huggett C, Gooding P, Panagioti M, Hodkinson A. Effectiveness of cognitive-behavioural therapies of varying complexity in reducing depression in adults: systematic review and network meta-analysis. Br J Psychiatry 2022; 221:459-467. [PMID: 35346407 DOI: 10.1192/bjp.2022.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cognitive-behavioural therapy (CBT) is frequently used as an umbrella term to include a variety of psychological interventions. It remains unclear whether more complex CBT contributes to greater depression reduction. AIMS To (a) compare the effectiveness of core, complex and ultra-complex CBT against other psychological intervention, medication, treatment-as-usual and no treatment in reducing depression at post-treatment and in the long term and (b) explore important factors that could moderate the effectiveness of these interventions. METHOD MEDLINE, PsycInfo, Embase, Web of Science and the Cochrane Register of Controlled Trials were searched to November 2021. Only randomised controlled trials were eligible for the subsequent network meta-analysis. RESULTS We included 107 studies based on 15 248 participants. Core (s.m.d. = -1.14, 95% credible interval (CrI) -1.72 to -0.55 [m.d. = -8.44]), complex (s.m.d. = -1.24, 95% CrI -1.85 to -0.64 [m.d. = -9.18]) and ultra-complex CBT (s.m.d. = -1.45, 95% CrI -1.88 to -1.02 [m.d. = -10.73]) were all significant in reducing depression up to 6 months from treatment onset. The significant benefits of the ultra-complex (s.m.d. = -1.09, 95% CrI -1.61 to -0.56 [m.d. = -8.07]) and complex CBT (s.m.d. = -0.73, 95% CrI -1.36 to -0.11 [m.d. = -5.40]) extended beyond 6 months. Ultra-complex CBT was most effective in individuals presenting comorbid mental health problems and when delivered by non-mental health specialists. Ultra-complex and complex CBT were more effective for people younger than 59 years. CONCLUSIONS For people without comorbid conditions healthcare and policy organisations should invest in core CBT. For people <59 years of age with comorbid conditions investments should focus on ultra-complex and complex CBT delivered without the help of mental health professionals.
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Affiliation(s)
- Ioannis Angelakis
- PhD, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK; and School of Psychology, University of South Wales, Pontypridd, UK
| | - Charlotte Huggett
- MSc, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK; and Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, UK
| | - Patricia Gooding
- PhD, Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, UK
| | - Maria Panagioti
- PhD, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK; and National Institute for Health Research School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK
| | - Alexander Hodkinson
- PhD, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK; and National Institute for Health Research School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK
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A Pilot Study to Evaluate the Efficacy of Self-Attachment to Treat Chronic Anxiety and/or Depression in Iranian Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116376. [PMID: 35681959 PMCID: PMC9180546 DOI: 10.3390/ijerph19116376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/14/2022] [Accepted: 05/13/2022] [Indexed: 02/01/2023]
Abstract
The aim of this pilot study was to evaluate the efficacy of the new Self-Attachment Technique (SAT) in treating resistant anxiety and depression, lasting at least three years, among Iranian women from different social backgrounds. In this self-administrable and algorithmic intervention, the participant, using their childhood photos, imaginatively creates an affectional bond with their childhood self, vows to consistently support and lovingly re-raise this child to emotional well-being. We conducted a longitudinal study with repeated measurement to evaluate the efficacy of SAT using ANOVA. Thirty-eight women satisfying the inclusion and exclusion criteria were recruited from different parts of Tehran. To describe the SAT protocols, a total of eight one-to-one sessions were offered to the recruits, the first four were weekly while the last four were fortnightly. The participants were expected to practice the protocols for twenty minutes twice a day. Two questionnaires, GAD-7 and PHQ-9, were used to measure anxiety and depression levels before and after the intervention and in a three-month follow-up. Thirty women completed the course. The change in anxiety level between the pre-test and the post-test was significant at p < 0.001 with effect size 2.5. The change in anxiety between pre-test and follow-up test was also significant at p < 0.001 with effect size 3.5. The change in anxiety between the post-test and the follow-up was significant at p < 0.05 with effect size 0.6. For depression, the changes between pre-test and post-test as well as between pre-test and follow-up were significant at p < 0.001 with effect size 2.3 and 3.1 respectively.
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Borderline Personality Disorder “Discouraged Type”: A Case Report. Medicina (B Aires) 2022; 58:medicina58020162. [PMID: 35208485 PMCID: PMC8874928 DOI: 10.3390/medicina58020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 12/04/2022] Open
Abstract
Borderline Personality Disorder (BPD) is a mental illness associated with a significant degree of distress and impairment because of the difficulties in effectively regulating emotions. BPD is frequently associated with Depressive Disorders, most commonly Major Depressive Disorder and Dysthymia. Here, we present a case report of an 18-year-old female patient hospitalized with a severe depressive episode and psychotic symptoms. A few months after discharge, the interpersonal difficulties, unstable self-image, fear of chronic abandonment, feeling of emptiness, paranoid ideation, helplessness, obsessive-compulsive elements, perfectionism, and social retreat led to the patient’s impaired functionality. The spectrum of signs and symptoms presented were characteristic of BPD. The specific presentation of mixed dependent/avoidant pattern of personality, with persistent feelings of guilt and shame, social anxiety, emotional attachments, obsessions, and feelings of inadequacy have further narrowed the diagnosis to discouraged BPD, as described by Theodore Millon. In our case, this particular subtype of personality disorder can be understood as BPN associated with social perfectionism. Both BPD and perfectionism, as a trait personality, were thought to exacerbate issues with self-conception and identity formation in this patient.
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Crawford-Faucher A, Deaton D. Selected Behavioral and Psychiatric Problems. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Type D Personality and Stomatognathic System Disorders in Physiotherapy Students during the COVID-19 Pandemic. J Clin Med 2021; 10:jcm10214892. [PMID: 34768414 PMCID: PMC8584408 DOI: 10.3390/jcm10214892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/04/2022] Open
Abstract
Background: A person’s response to stressors is largely dependent on their personality traits that affect the way stress is controlled and relieved. This article is a quantitative analysis assessing the importance of the distressed personality in the development of stomatognathic system disorders (SSDs) in physiotherapy students during the COVID-19 pandemic. Objective: The goal of the research was to assess the presence of type D personality in students with symptoms of stomatognathic system disorders. Material and Method: The research was carried out among 300 physiotherapy students. The data were collected using the form of the occurrence of symptoms of SS disorders developed for the purpose of the study and the standardized psychological DS14 questionnaire. Results: In a group of 300 students, the presence of type D personality was found in 160 people (53.3%). People with type D personality had symptoms of SS disorders more often than the group without stressful personality traits. There was a significant difference between the groups regarding all the examined symptoms. In the group of people with type D personality, the most frequently reported symptoms of SS disorders included: headache (51.3%), pain in the neck and shoulder girdle (43.1%), and teeth clenching (35.6%). As many as 70% of the respondents in the group with symptoms of SS disorders (P1) had type D personality, whereas in the asymptomatic group (P2) this result was 23.3%. There was a significant difference between the groups (p = 0.00). Statistically significantly higher values of both D personality dimensions were observed in women than in men with symptoms of SS disorders. In people reporting symptoms of SS disorders, higher average values were observed in both dimensions of type D personality. There were significant differences between the groups. Conclusion: type D personality may contribute to the development of symptoms of stomatognathic disorders.
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Abstract
Transference-focused psychotherapy (TFP), developed and studied as an extended individual psychotherapy for patients with borderline personality disorder (BPD), rests on a rich theoretical foundation informed by psychoanalytic object relations theory. "Applied TFP" is a developing initiative using TFP principles in multiple clinical situations other than the standard extended individual psychotherapy, which has been empirically validated and is detailed in the TFP treatment manual. The growing application of TFP principles in innovative, overlapping ways has been focused primarily in three spheres: (1) the integration of TFP principles in pluralistic theoretical approaches to treatment of patients with personality disorder pathology; (2) the use of TFP elements in multiple teaching situations as part of curricula for trainees and practicing clinicians, and (3) the employment of TFP theory and interventions in settings across a continuum of patient acuity, tailored for patients with varying diagnoses. The use of TFP principles in the situations described directly addresses needs emerging in particular contexts that reflect specific requirements of clinician practice and training and of broader public health missions.
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Affiliation(s)
- Richard G Hersh
- Special Lecturer in Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York
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Bui NH, Pasalich DS. Insecure Attachment, Maladaptive Personality Traits, and the Perpetration of In-Person and Cyber Psychological Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:2117-2139. [PMID: 29475418 DOI: 10.1177/0886260518760332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although past findings show that insecure attachment and maladaptive personality traits confer risk for perpetrating intimate partner violence (IPV), little is known about how these factors may underpin psychological abuse (PA) committed in-person and via technology. This study examined whether borderline personality disorder (BPD) traits and psychopathic traits account for indirect effects of insecure attachment on the perpetration of face-to-face and cyber PA. Participants included a community-based sample (N = 200; Mage = 22.28 years) in Australia who completed a battery of online questionnaires. Results from bivariate correlations showed that elevated levels of attachment anxiety and avoidance, and higher scores on BPD traits and psychopathic traits, were significantly associated with the perpetration of both face-to-face and cyber PA. Findings from mediation analysis indicated that attachment anxiety was indirectly linked with the perpetration of both forms of PA via elevated scores on BPD traits and psychopathic traits. High levels of psychopathic traits accounted for the indirect effects of attachment avoidance on both forms of PA. Results support the theory that insecure attachment and maladaptive personality functioning might be involved in the development and/or maintenance of the perpetration of PA. These findings have implications for preventive and treatment programs for the perpetration of IPV in terms of shedding new light on potential risk factors for engagement in face-to-face and technology-based PA.
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Affiliation(s)
- Nghi H Bui
- Australian National University, Canberra, Australia
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Fordham B, Sugavanam T, Edwards K, Hemming K, Howick J, Copsey B, Lee H, Kaidesoja M, Kirtley S, Hopewell S, das Nair R, Howard R, Stallard P, Hamer-Hunt J, Cooper Z, Lamb SE. Cognitive-behavioural therapy for a variety of conditions: an overview of systematic reviews and panoramic meta-analysis. Health Technol Assess 2021; 25:1-378. [PMID: 33629950 PMCID: PMC7957459 DOI: 10.3310/hta25090] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cognitive-behavioural therapy aims to increase quality of life by changing cognitive and behavioural factors that maintain problematic symptoms. A previous overview of cognitive-behavioural therapy systematic reviews suggested that cognitive-behavioural therapy was effective for many conditions. However, few of the included reviews synthesised randomised controlled trials. OBJECTIVES This project was undertaken to map the quality and gaps in the cognitive-behavioural therapy systematic review of randomised controlled trial evidence base. Panoramic meta-analyses were also conducted to identify any across-condition general effects of cognitive-behavioural therapy. DATA SOURCES The overview was designed with cognitive-behavioural therapy patients, clinicians and researchers. The Cochrane Library, MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Child Development & Adolescent Studies, Database of Abstracts of Reviews of Effects and OpenGrey databases were searched from 1992 to January 2019. REVIEW METHODS Study inclusion criteria were as follows: (1) fulfil the Centre for Reviews and Dissemination criteria; (2) intervention reported as cognitive-behavioural therapy or including one cognitive and one behavioural element; (3) include a synthesis of cognitive-behavioural therapy trials; (4) include either health-related quality of life, depression, anxiety or pain outcome; and (5) available in English. Review quality was assessed with A MeaSurement Tool to Assess systematic Reviews (AMSTAR)-2. Reviews were quality assessed and data were extracted in duplicate by two independent researchers, and then mapped according to condition, population, context and quality. The effects from high-quality reviews were pooled within condition groups, using a random-effect panoramic meta-analysis. If the across-condition heterogeneity was I2 < 75%, we pooled across conditions. Subgroup analyses were conducted for age, delivery format, comparator type and length of follow-up, and a sensitivity analysis was performed for quality. RESULTS A total of 494 reviews were mapped, representing 68% (27/40) of the categories of the International Classification of Diseases, Eleventh Revision, Mortality and Morbidity Statistics. Most reviews (71%, 351/494) were of lower quality. Research on older adults, using cognitive-behavioural therapy preventatively, ethnic minorities and people living outside Europe, North America or Australasia was limited. Out of 494 reviews, 71 were included in the primary panoramic meta-analyses. A modest effect was found in favour of cognitive-behavioural therapy for health-related quality of life (standardised mean difference 0.23, 95% confidence interval 0.05 to 0.41, prediction interval -0.05 to 0.50, I2 = 32%), anxiety (standardised mean difference 0.30, 95% confidence interval 0.18 to 0.43, prediction interval -0.28 to 0.88, I2 = 62%) and pain (standardised mean difference 0.23, 95% confidence interval 0.05 to 0.41, prediction interval -0.28 to 0.74, I2 = 64%) outcomes. All condition, subgroup and sensitivity effect estimates remained consistent with the general effect. A statistically significant interaction effect was evident between the active and non-active comparator groups for the health-related quality-of-life outcome. A general effect for depression outcomes was not produced as a result of considerable heterogeneity across reviews and conditions. LIMITATIONS Data extraction and analysis were conducted at the review level, rather than returning to the individual trial data. This meant that the risk of bias of the individual trials could not be accounted for, but only the quality of the systematic reviews that synthesised them. CONCLUSION Owing to the consistency and homogeneity of the highest-quality evidence, it is proposed that cognitive-behavioural therapy can produce a modest general, across-condition benefit in health-related quality-of-life, anxiety and pain outcomes. FUTURE WORK Future research should focus on how the modest effect sizes seen with cognitive-behavioural therapy can be increased, for example identifying alternative delivery formats to increase adherence and reduce dropout, and pursuing novel methods to assess intervention fidelity and quality. STUDY REGISTRATION This study is registered as PROSPERO CRD42017078690. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Beth Fordham
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Thavapriya Sugavanam
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Katherine Edwards
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Karla Hemming
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jeremy Howick
- Faculty of Philosophy, University of Oxford, Oxford, UK
| | - Bethan Copsey
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Hopin Lee
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Milla Kaidesoja
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Shona Kirtley
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sally Hopewell
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Roshan das Nair
- Department of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
| | | | | | - Zafra Cooper
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sarah E Lamb
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
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Mullins-Sweatt SN, Hopwood CJ, Chmielewski M, Meyer NA, Min J, Helle AC, Walgren MD. Treatment of personality pathology through the lens of the hierarchical taxonomy of psychopathology: Developing a research agenda. Personal Ment Health 2020; 14:123-141. [PMID: 31364820 PMCID: PMC7053295 DOI: 10.1002/pmh.1464] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 12/19/2022]
Abstract
Despite the emphasis on evidence-based treatment for psychological disorders, to date, there has been limited research examining treatment for nine of the 10 categorical personality disorders in DSM-5 Section 2. This is perhaps not surprising given the complex heterogeneity and co-morbidity within personality pathology. The hierarchical taxonomy of psychopathology (HiTOP) was proposed to address limitations within the traditional categorical model of the diagnostic system. Within this system are five spectra: detachment, antagonistic externalizing, disinhibited externalizing, thought disorder and internalizing. These foundational personality traits potentially have direct and specific treatment implications. The purpose of this paper is to highlight potential psychotherapeutic and pharmacological treatment recommendations within the personality spectra. Additionally, we outline the advantages of considering the personality science found within dimensional models of psychopathology in clinical assessment and intervention to aid in treatment planning. © 2019 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | | | - Neil A Meyer
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Jiwon Min
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Ashley C Helle
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Maggie D Walgren
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
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Kim DY, Lee JS, Park SY, Kim SJ, Son CG. Systematic review of randomized controlled trials for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). J Transl Med 2020; 18:7. [PMID: 31906979 PMCID: PMC6943902 DOI: 10.1186/s12967-019-02196-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/24/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although medical requirements are urgent, no effective intervention has been proven for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). To facilitate the development of new therapeutics, we systematically reviewed the randomized controlled trials (RCTs) for CFS/ME to date. METHODS RCTs targeting CFS/ME were surveyed using two electronic databases, PubMed and the Cochrane library, through April 2019. We included only RCTs that targeted fatigue-related symptoms, and we analyzed the data in terms of the characteristics of the participants, case definitions, primary measurements, and interventions with overall outcomes. RESULTS Among 513 potentially relevant articles, 55 RCTs met our inclusion criteria; these included 25 RCTs of 22 different pharmacological interventions, 28 RCTs of 18 non-pharmacological interventions and 2 RCTs of combined interventions. These studies accounted for a total of 6316 participants (1568 males and 4748 females, 5859 adults and 457 adolescents). CDC 1994 (Fukuda) criteria were mostly used for case definitions (42 RCTs, 76.4%), and the primary measurement tools included the Checklist Individual Strength (CIS, 36.4%) and the 36-item Short Form health survey (SF-36, 30.9%). Eight interventions showed statistical significance: 3 pharmacological (Staphypan Berna, Poly(I):poly(C12U) and CoQ10 + NADH) and 5 non-pharmacological therapies (cognitive-behavior-therapy-related treatments, graded-exercise-related therapies, rehabilitation, acupuncture and abdominal tuina). However, there was no definitely effective intervention with coherence and reproducibility. CONCLUSIONS This systematic review integrates the comprehensive features of previous RCTs for CFS/ME and reflects on their limitations and perspectives in the process of developing new interventions.
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Affiliation(s)
- Do-Young Kim
- Korean Medical College of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, Republic of Korea
| | - Jin-Seok Lee
- Institute of Traditional Medicine and Bioscience, Dunsan Oriental Hospital of Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon, Republic of Korea
| | - Samuel-Young Park
- Korean Medical College of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, Republic of Korea
| | - Soo-Jin Kim
- Korean Medical College of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Institute of Traditional Medicine and Bioscience, Dunsan Oriental Hospital of Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon, Republic of Korea.
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Crawford-Faucher A, Deaton D. Selected Behavioral and Psychiatric Problems. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_36-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Examining the relationship between bright and dark personality traits in two management samples. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Silva S, Donato H, Madeira N. The outcomes of psychotherapy in mixed features personality disorders: a systematic review. ARCH CLIN PSYCHIAT 2018. [DOI: 10.1590/0101-60830000000180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Nitschke J, Sünkel Z, Mokros A. [Forensic preventive assertive community treatment : Pilot project to prevent violent crimes in the context of psychiatric disorders]. DER NERVENARZT 2018; 89:1054-1062. [PMID: 30051175 DOI: 10.1007/s00115-018-0573-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Since 2012, a forensic preventive outpatient clinic has been established at Ansbach District Hospital to fill a gap in general psychiatric care for patients with schizophrenia or severe personality disorders and having a high risk for violent behavior. An interdisciplinary team drawing on forensic psychiatric knowledge applies instruments for forensic risk prognosis and treatment or interventions to prevent violent crimes and to protect potential victims. Admissions depend on certain criteria, e.g., increased risk potential for violent crimes against the background of schizophrenia or severe personality disorders. OBJECTIVE How can a forensic psychiatric preventive treatment be organized, which helps to avoid detention in a forensic commitment and is complementary to general psychiatric treatment structures? Can such a model project reach the target group? MATERIAL AND METHOD In forensic preventive outpatient care the treatment is based on violence prevention (e.g., psychoeducation, group training, individual treatment on violence risk co-management). Data are collected using general psychiatric and forensic instruments on, e.g., risk of violence (HCR-20), global functional level (GAF), violent behavior (SDAS-9) on a regular basis. The values with respect to these instruments on admission were compared to published key factors from population samples with general and forensic psychiatric patients. RESULTS A total of 146 patients between the ages of 18 and 79 years have so far been treated. About 4,000,000 EUR could be saved during the duration of the project because of preventing involuntary admission to a forensic hospital apart from preventing violent crimes. In contrast 3,000,000 EUR had to be spent for the new outpatient service. CONCLUSION Indications for the efficacy of a forensic preventive care for patients with schizophrenia and severe personality disorders with a risk for violence are confirmed. Therefore, an institutionalization and a statewide implementation of forensic preventive care in terms of the forensic preventive out-patient clinic are recommended.
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Affiliation(s)
- J Nitschke
- Klinik für Forensische Psychiatrie, Bezirksklinikum Ansbach, Feuchtwanger Str. 38, 91522, Ansbach, Deutschland.
| | - Z Sünkel
- Klinik für Forensische Psychiatrie, Bezirksklinikum Ansbach, Feuchtwanger Str. 38, 91522, Ansbach, Deutschland
| | - A Mokros
- FernUniversität in Hagen, Hagen, Deutschland
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Clinical Necessity Guidelines for Psychotherapy, Insurance Medical Necessity and Utilization Review Protocols, and Mental Health Parity. J Psychiatr Pract 2018; 24:179-193. [PMID: 30015788 DOI: 10.1097/pra.0000000000000309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The founding members of the Coalition for Psychotherapy Parity present Clinical Necessity Guidelines for Psychotherapy, Insurance Medical Necessity and Utilization Review Protocols, and Mental Health Parity. These guidelines support access to psychotherapy as prescribed by the clinician without arbitrary limitations on duration or frequency. The authors of the guidelines first review the evidence that psychotherapy is effective, cost-effective, and often provides a cost-offset in decreased overall medical expenses, morbidity, mortality, and disability. They highlight the disparity between clinicians' knowledge of generally accepted standards of care for mental health and substance use disorders and the much more limited "crisis stabilization" focus of many insurance companies. The clinical trials that health insurers cite as justification for authorizing only brief treatment for all patients involve highly selected, atypical populations that are not representative of the general population of patients in need of mental health care, who typically have complex conditions and chronic, recurring symptoms requiring ongoing availability of treatment. The standard for other medical conditions reimbursed by insurance is continuation of effective treatment until meaningful recovery, which is therefore the standard required by the Mental Health Parity and Addiction Equity Act for mental health care. However, insurance companies frequently evade the legal requirement to cover treatment of mental illness at parity with other medical conditions. They do this by applying inaccurate proprietary definitions of medical necessity and imposing utilization review procedures much more restrictively for mental health treatment than for other medical care to block access to ongoing care, thus containing insurance company costs in the short term without consideration of the adverse sequelae of undertreated illness (eg, increased costs of other medical services and increased morbidity, mortality, and costs to society in increased disability). The authors of the guidelines conclude that, given appropriate medical necessity guidelines at parity with other medical care, consistent with provider expertise and a broad range of psychotherapy research, there would be no need or place for utilization review protocols. Individuals and psychotherapy organizations are invited to visit the website psychotherapyparity.org to sign on to the guidelines to indicate agreement and support.
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Selected Behavioral and Psychiatric Problems. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lengel GJ, Helle AC, DeShong HL, Meyer NA, Mullins-Sweatt SN. Translational applications of personality science for the conceptualization and treatment of psychopathology. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/cpsp.12166] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Békés V, Perry JC, Robertson BM. Psychological masochism: A systematic review of the literature on conflicts, defenses, and motives. Psychother Res 2016; 28:470-483. [PMID: 27248648 DOI: 10.1080/10503307.2016.1189618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Our aim was to conduct a systematic review of the literature on psychological masochism to identify hypotheses for examination in clinical studies. METHOD We identified defenses, conflicts, and motives using standardized measures in 23 psychoanalytic papers. RESULTS Three primary and three secondary subtypes of masochism emerged in the literature. Overall Gratification Inhibition (subtype I.1) was the "healthiest" form, associated with higher developmental level motives and neurotic defenses. The Global Conflict (I.2) was the least healthy form of masochism, consistent with personality disorder. It was associated with early developmental level motives and immature defenses, including depressive defenses, often associated with depression. Dominant Other (I.3) represented masochistic attachment problems, associated with early developmental level motives, object-related, image-distorting defenses, and narcissism. Of the secondary types, Separation-Abandonment (II.1) reflected object-related defenses, and separation-related motives. Rejection of Others (II.2) represented a sadistic-narcissistic form, associated with image-distorting and disavowal defenses, with both early and later developmental level motives. Finally, Sexual Pleasure vs. Guilt (II.3) was associated with autistic fantasy, and both early and later developmental level motives, suggesting a distinct traumatic origin and representing the juncture of sexual and psychological masochism. CONCLUSIONS Analysts described six distinguishable types of masochism. Future studies should examine their validity.
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Affiliation(s)
- Vera Békés
- a Psychiatry Department , McGill University , Montreal , QC , Canada.,b Institute of Community & Family Psychiatry, Jewish General Hospital , Montreal , QC , Canada
| | - J Christopher Perry
- a Psychiatry Department , McGill University , Montreal , QC , Canada.,b Institute of Community & Family Psychiatry, Jewish General Hospital , Montreal , QC , Canada
| | - Brian M Robertson
- a Psychiatry Department , McGill University , Montreal , QC , Canada.,b Institute of Community & Family Psychiatry, Jewish General Hospital , Montreal , QC , Canada.,c Canadian Psychoanalytic Society , Montreal , QC , Canada
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Abstract
Clinicians generally find individuals with personality disorders to be challenging to treat, especially compared to clients who have only a straightforward depression or anxiety disorder. In this article we will summarise research on the efficacy of cognitive behaviour therapy (CBT) for personality disorders. Then we will focus on the conceptualisation and treatment of CBT for personality disorders that is based on the work of Aaron Beck and colleagues; that is, it is predicated upon the cognitive model of psychopathology. Next, we will describe two other forms of treatment with cognitive behavioural roots: schema therapy and dialectical behaviour therapy. A final section will suggest future directions.
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Collado A, Lim AC, MacPherson L. A systematic review of depression psychotherapies among Latinos. Clin Psychol Rev 2016; 45:193-209. [PMID: 27113679 DOI: 10.1016/j.cpr.2016.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 04/01/2016] [Accepted: 04/05/2016] [Indexed: 01/28/2023]
Abstract
For decades, the literature has reported persistent treatment disparities among depressed Latinos. Fortunately, treatment development and evaluation in this underserved population has expanded in recent years. This review summarizes outcomes across 36 unique depression treatment studies that reported treatment outcomes for Latinos. Results indicated that there was significant variability in the quality of RCT and type/number of cultural adaptations. The review suggested that there might a relation between cultural adaptations with treatment outcomes; future studies are warranted to confirm this association. Cognitive Behavioral Therapy was the most evaluated treatment (CBT; n=18, 50% of all evaluations), followed by Problem Solving Therapy (PST; n=4), Interpersonal Therapy (IPT; n=4), and Behavioral Activation (BA; n=3). CBT seems to fare better when compared to usual care, but not when compared to a contact-time matched control condition or active treatment. There is growing support for PST and IPT as efficacious depression interventions among Latinos. IPT shows particularly positive results for perinatal depression. BA warrants additional examination in RCT. Although scarce, telephone and in-home counseling have shown efficacy in reducing depression and increasing retention. Promotora-assisted trials require formal assessment. Limitations and future directions of the depression psychotherapy research among Latinos are discussed.
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Affiliation(s)
- Anahí Collado
- Emory University, Department of Psychiatry and Behavioral Sciences, 12 Executive Park Drive NE, suite 300, Atlanta, GA 30329, United States.
| | - Aaron C Lim
- University of California - Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, United States.
| | - Laura MacPherson
- University of Maryland - College Park, Department of Psychology, 2103 Cole Activities Fieldhouse, College Park, MD 20742, United States.
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Ritter S, Platt LM. What's New in Treating Inpatients With Personality Disorders?: Dialectical Behavior Therapy and Old-Fashioned, Good Communication. J Psychosoc Nurs Ment Health Serv 2016; 54:38-45. [DOI: 10.3928/02793695-20151216-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/09/2015] [Indexed: 11/20/2022]
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Horn EK, Verheul R, Thunnissen M, Delimon J, Soons M, Meerman AMMA, Ziegler UM, Rossum BV, Andrea H, Stijnen T, Emmelkamp PMG, Busschbach JJV. Effectiveness of Short-Term Inpatient Psychotherapy Based on Transactional Analysis With Patients With Personality Disorders: A Matched Control Study Using Propensity Score. J Pers Disord 2015; 29:663-83. [PMID: 25248020 DOI: 10.1521/pedi_2014_28_166] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Controlled studies on the effectiveness of inpatient psychotherapy with patients with personality disorders (PD) are rare. This study aims to compare 3-month short-term inpatient psychotherapy based on transactional analysis (STIP-TA) with other psychotherapies (OP) up to 36-month follow-up. PD patients treated with STIP-TA were matched with OP patients using the propensity score. The primary outcome measure was general psychiatric symptomatology; secondary outcomes were psychosocial functioning and quality of life. In 67 pairs of patients, both STIP-TA and OP showed large symptomatic and functional improvements. However, STIP-TA patients showed more symptomatic improvement at all time points compared to OP patients. At 36 months, 68% of STIP-TA patients were symptomatically recovered compared to 48% of OP patients. STIP-TA outperformed OP in terms of improvements in general psychiatric symptomatology and quality of life. Superiority of STIP-TA was most pronounced at 12-month follow-up, but remained intact over the course of the 3-year follow-up.
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Affiliation(s)
| | | | | | - Jos Delimon
- De Viersprong Netherlands Institute for Personality Disorders, Halsteren
| | | | | | | | | | | | - Theo Stijnen
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden
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Crawford-Faucher A. Selected Behavioral and Psychiatric Problems. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_36-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yucens B, Kuru E, Safak Y, Karadere ME, Turkcapar MH. Comparison of personality beliefs between depressed patients and healthy controls. Compr Psychiatry 2014; 55:1900-5. [PMID: 25172443 DOI: 10.1016/j.comppsych.2014.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/25/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION According to the cognitive model, the common mechanism underlying all psychological disorders is distorted or dysfunctional thoughts that affect mood and behaviors. Dysfunctional thoughts predispose an individual to depression and are among the processes that form the basis of personality traits. Elucidating the personality beliefs associated with depression and dysfunctional thoughts is important to understanding and treating depression. The aim of the present study is to determine whether depressed patients exhibited pathological personality beliefs compared with healthy controls. Furthermore, we investigated which personality beliefs were more common among such depressed patients. METHODS A total of 70 patients who were admitted to the Department of Psychiatry at Ankara Diskapi Yildirim Beyazit Training and Research Hospital (Ankara, Turkey) and diagnosed with major depressive disorder according to The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnostic criteria were included in the study. Additionally, 70 healthy controls matched for age, marital status, and education were included in the study. The Sociodemographic Data Form and Personality Belief Questionnaire-Short form (PBQ-SF) were administered to the participants. RESULTS A comparison of the depression group with the healthy controls revealed higher scores in dependent, passive-aggressive, obsessive-compulsive, antisocial, histrionic, paranoid, borderline, and avoidant personality subscales in the depressive group. CONCLUSIONS These results suggest that personality beliefs at the pathological level are more common in depressive patients and that the detection of these beliefs would be useful for predicting the prognosis of the disease and determining appropriate treatment methods.
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Affiliation(s)
- Bengu Yucens
- Psychiatry Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey.
| | - Erkan Kuru
- Psychiatry Clinic, Ankara Diskapi YB Training and Research Hospital, Ankara, Turkey
| | - Yasir Safak
- Psychiatry Clinic, Ankara Diskapi YB Training and Research Hospital, Ankara, Turkey
| | - Mehmet Emrah Karadere
- Psychiatry Clinic, Hitit University Corum Training and Research Hospital, Corum, Turkey
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Krueger RF, Hopwood CJ, Wright AGC, Markon KE. DSM‐5 and the path toward empirically based and clinically useful conceptualization of personality and psychopathology. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/cpsp.12073] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Johnston ER. A preliminary follow-up study of patients treated at an inpatient psychotherapy unit. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2013. [DOI: 10.1177/0081246313498015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Inpatient psychotherapeutic services for patients experiencing high levels of psychological distress are scarce in South Africa. Furthermore, follow-up research with patients receiving this type of mental health care is also limited. This study focuses on patients treated at an inpatient psychotherapeutic unit offering individual and group psychotherapies to adults, by assessing their experiences following admission to the unit. Patients’ experiences during their admission and since discharge from the unit, mental health status since admission, compliance in terms of outpatient mental health care, current quality of relationships with family and friends, and the impact of the patients’ mental illness on their work situation are examined. The challenges encountered in such research are also explored.
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Magor-Blatch LE, Keen JL, Bhullar N. Personality factors as predictors of programme completion of drug therapeutic communities. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/17523281.2013.806345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mullins-Sweatt SN, Lengel GJ. Clinical Utility of the Five-Factor Model of Personality Disorder. J Pers 2012; 80:1615-39. [DOI: 10.1111/j.1467-6494.2012.00774.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Misserfolge in der stationären Therapie von Patienten mit Persönlichkeitsstörungen. PSYCHOTHERAPEUT 2012. [DOI: 10.1007/s00278-012-0930-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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