Dissociation and Therapy of Depressive and Anxiety Disorders with or Without Personality Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S111-S111
Author(s):  
J. Prasko ◽  
A. Grambal ◽  
Z. Sigmundova ◽  
P. Kasalova ◽  
D. Kamaradova ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Depressive Disorder ◽  
Personality Disorders ◽  
Depressive Disorders ◽  
Treatment Effectiveness ◽  
Somatoform Disorder ◽  
Degree Of Dissociation ◽  
Therapeutic Program ◽  
Conversion Disorders ◽  
The Impact

ObjectiveGoal of the study was to analyze the impact of dissociation on the treatment of the patients with anxiety/neurotic spectrum and depressive disorders, and with or without personality disorders.MethodsThe sample consisted of inpatients who met the ICD-10 criteria for the Depressive disorder, Panic disorder, GAD, Mixed anxiety-depressive disorder, Agoraphobia, Social phobia, OCD, PTSD, Adjustment disorders, dissociative/conversion disorders, Somatoform disorder or other anxiety/neurotic spectrum disorder. The participants completed Beck Depression Inventory, Beck Anxiety Inventory, subjective version of clinical global impression-severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale, at the start and the end of the therapeutic program.ResultsThe total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment in outpatients basis and were referred for hospitalization for the six-week complex therapeutic program, were enrolled in this study. Six hundred and six of them were statistically analyzed. The patients’ mean ratings on all measurements were significantly reduced during the treatment. The patients without comorbid personality disorder improved significantly more than patients with comorbid personality disorder in the reduction of depressive symptoms. However, there were no significant differences in change of anxiety levels and severity of the disorder between the patients with and without personality disorders. The higher degree of dissociation at the beginning of the treatment predicted minor improvement. The higher therapeutic change was connected to the greater reduction of the dissociation level.ConclusionsDissociation presents an important factor influencing treatment effectiveness in the treatment-resistant patients with anxiety/depression with or without personality disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Working with Personality Disorders in an Integrated Care Setting

2017 ◽  
Author(s):  
Robert E. Feinstein ◽  
Joseph V. Connelly
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Integrated Care ◽  
Care Pathway ◽  
Diagnostic Testing ◽  
Care Team ◽  
Obsessive Compulsive ◽  
Medical Settings ◽  
Obsessive Compulsive Personality Disorder ◽  
The Impact

Patients with personality disorders are common in primary care and medical settings. They can elicit intense problematic reactions from the members of an integrated care team, which can affect the team’s evaluation, diagnoses, diagnostic testing, medical orders, medications, laboratory tests, treatments, recommendations, and referrals. The four most common and challenging personality disorders are borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, and obsessive-compulsive personality disorder. This chapter reviews the classification, epidemiology, biological basis, psychosocial formulation, and co-occurring mental health disorders associated with these personality disorders. A personality disorder schema is presented for managing these difficult patients. The impact these patients can have on the integrated care team is described. A care pathway is outlined that can be used for management, brief treatment, and referral for treatment to a personality disorder specialist.

Suicidal behaviour among primary-care patients with depressive disorders

2005 ◽  
Vol 36 (2) ◽  
pp. 203-210 ◽  
Author(s):  
M. S. VUORILEHTO ◽  
T. K. MELARTIN ◽  
E. T. ISOMETSÄ
Keyword(s):  
Primary Care ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Suicidal Behaviour ◽  
Depressive Disorders ◽  
Psychiatric Treatment ◽  
Central Position ◽  
Primary Care Patients ◽  
Axis I

Background. Most national suicide prevention strategies set improved detection and management of depression in primary health care into a central position. However, suicidal behaviour among primary-care patients with depressive disorders has been seldom investigated.Method. In the Vantaa Primary Care Depression Study, a total of 1119 primary-care patients in the City of Vantaa, Finland, aged 20 to 69 years, were screened for depression with the Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaire. Depressive disorders were diagnosed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and the 137 patients with depressive disorder were included in the study. Suicidal behaviour was investigated cross-sectionally and retrospectively in three time-frames: current, current depressive episode, and lifetime. Current suicidal ideation was measured with the Scale for Suicidal Ideation (SSI), and previous ideation and suicide attempts were evaluated based on interviews plus medical and psychiatric records.Results. Within their lifetimes, 37% (51/137) of the patients had seriously considered suicide and 17% (23/137) attempted it. Lifetime suicidal behaviour was independently and strongly predicted by psychiatric treatment history and co-morbid personality disorder, and suicidal behaviour within the current episode was predicted most effectively by severity of depression.Conclusions. Based on these findings and their convergence with studies of completed suicides, prevention of suicidal behaviour in primary care should probably focus more on high-risk subgroups of depressed patients, including those with moderate to severe major depressive disorder, personality disorder or a history of psychiatric care. Recognition of suicidal behaviour should be improved. The complex psychopathology of these patients in primary care needs to be considered in targeting preventive efforts.

Personality disorders and depression

2002 ◽  
Vol 32 (6) ◽  
pp. 1049-1057 ◽  
Author(s):  
M. FAVA ◽  
A. H. FARABAUGH ◽  
A. H. SICKINGER ◽  
E. WRIGHT ◽  
J. E. ALPERT ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Personality Disorders ◽  
Antidepressant Treatment ◽  
Significant Proportion ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Before And After

Background. Personality disorders (PDs) were assessed among depressed out-patients by clinical interview before and after antidepressant treatment with fluoxetine to assess the degree of stability of PD diagnoses and determine whether changes in PD diagnoses across treatment are related to the degree of improvement in depressive symptoms.Method. Three hundred and eighty-four out-patients (55% women; mean age = 39.9±10.5) with major depressive disorder (MDD) diagnosed with the SCID-P were enrolled into an 8 week trial of open treatment with fluoxetine 20 mg/day. The SCID-II was administered to diagnose PDs at baseline and endpoint.Results. A significant proportion (64%) of our depressed out-patients met criteria for at least one co-morbid personality disorder. Following 8 weeks of fluoxetine treatment, there was a significant reduction in the proportion of patients meeting criteria for avoidant, dependent, passive-aggressive, paranoid and narcissistic PDs. From baseline to endpoint, there was also a significant reduction in the mean number of criteria met for paranoid, schizotypal, narcissistic, borderline, avoidant, dependent, obsessive–compulsive, passive aggressive and self-defeating personality disorders. While changes in cluster diagnoses were not significantly related to improvement in depressive symptoms, there were significant relationships between degree of reduction in depressive symptoms (percentage change in HAM-D-17 scores) and degree of change in the number of criteria met for paranoid, narcissistic, borderline and dependent personality disorders.Conclusions. Personality disorder diagnoses were found to be common among untreated out-patients with major depressive disorder. A significant proportion of these patients no longer met criteria for personality disorders following antidepressant treatment, and changes in personality disorder traits were significantly related to degree of improvement in depressive symptoms in some but not all personality disorders. These findings suggest that the lack of stability of PD diagnoses among patients with current MDD may be attributable in part to a direct effect of antidepressant treatment on behaviours and attitudes that comprise PDs.

scholarly journals Depressive Disorders and Incidence of COVID-19: Is There a Correlation and Management Interference?

2020 ◽  
pp. 1-7
Author(s):  
Nagwa Ali Sabri ◽  
Nagwa Ali Sabri ◽  
Mohamed Ahmed Raslan ◽  
Eslam Mansour Shehata ◽  
Sara Ahmed Raslan
Keyword(s):  
Insulin Resistance ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Virus Disease ◽  
The Other ◽  
Acute Pneumonia ◽  
Threatening Condition ◽  
Life Threatening ◽  
Respiratory Droplets ◽  
The Impact

Corona virus Disease-2019 is a new strain of Coronaviruses (COVID-19) causing an infection which has rapidly spread all over the Globe, where the primary pathways of infection spreading reported to be through large respiratory droplets and the disease severity has varied from mild self-limiting flu like illness to acute pneumonia, respiratory collapse and death. On the other hand, depression is a disease that could be progress to a life-threatening condition that affects globally hundreds of millions of people. The aim of this review is desired to investigate and find a correlation between depressive disorders and the incidence of COVID19, where, pathogeneses of depressive disorder and its effect on the immunity system was addressed, besides the impact of depression on individual food intake and its complications regarding weight gain, insulin resistance, and immune system disruption was also discussed which by turn might increase the risk for infection with COVID-19. Finally, the possible drug-drug interactions between drugs included in management protocols of both depressive disorder including antidepressants and anxiolytics and COVID19 with possible proposed alternatives.

scholarly journals Early Improvement in Eating Attitudes during Cognitive Behavioural Therapy for Eating Disorders: The Impact of Personality Disorder Cognitions

2013 ◽  
Vol 42 (2) ◽  
pp. 224-237 ◽  
Author(s):  
Emma C. Park ◽  
Glenn Waller ◽  
Kenneth Gannon
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Eating Attitudes ◽  
Drop Out ◽  
Cognitive Behavioural ◽  
The Impact

Background: The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. Aims: This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Method: Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. Results: CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. Conclusions: CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.

Postpartum Personality Disorders

2020 ◽  
pp. 69-80
Author(s):  
Gisele Apter ◽  
Gail Erlick Robinson
Keyword(s):  
Health Care ◽  
At Risk ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Negative Impact ◽  
Well Being ◽  
New Mothers ◽  
Dependent Personality ◽  
Paranoid Personality ◽  
The Impact

This chapter on personality disorders in the postpartum reviews the impact on the well-being of the mother and the infant if the mother suffers from a pre-existing personality disorder. Borderline personality disorders may have a negative impact on the new mother’s ability to form a healthy relationship with the infant and may become frustrated easily frustrated if the infant doesn’t obey. Women with dependent personality disorders may feel needy, helpless, and indecisive and therefore feel overwhelmed with motherhood. New mothers with paranoid personality disorders feel generally distrusting and suspicious. They may reject the health-care worker’s advice, thereby putting the infant at risk. Working with the mother–infant dyad is essential.

scholarly journals The impact of personality disorder pathology on the effectiveness of Cognitive Therapy and Interpersonal Psychotherapy for Major Depressive Disorder

2018 ◽  
Vol 225 ◽  
pp. 530-538 ◽  
Author(s):  
Suzanne C. van Bronswijk ◽  
Lotte H.J.M. Lemmens ◽  
Wolfgang Viechtbauer ◽  
Marcus J.H. Huibers ◽  
Arnoud Arntz ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Cognitive Therapy ◽  
Interpersonal Psychotherapy ◽  
Major Depressive ◽  
The Impact

Editorial: Stress and development: Biological and psychological consequences

2001 ◽  
Vol 13 (3) ◽  
pp. 413-418 ◽  
Author(s):  
DANTE CICCHETTI ◽  
ELAINE F. WALKER
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Stress Disorder ◽  
Developmental Outcomes ◽  
Schizotypal Personality Disorder ◽  
Psychological Consequences ◽  
Special Issue ◽  
Schizotypal Personality ◽  
The Impact

This Special Issue of Development and Psychopathology is devoted to the psychological and biological consequences of stress across the developmental course. Contributions in this Special Issue address topics that are central to elucidating the impact that stress exerts on developmental outcomes. These issues are investigated through examining a diverse array of populations, including rodent and nonhuman primate samples, as well as cohorts of maltreated children and adolescents with and without posttraumatic stress disorder (PTSD), children who were adopted from Romanian orphanages at differing points during infancy, aging Holocaust survivors and their offspring, children with depressive disorder, adolescents with schizotypal personality disorder, and adults with bipolar and unipolar mood disorders.

Personality and personality disorder

2017 ◽  
pp. 391-414
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Diagnostic Criteria ◽  
Personality Development ◽  
Management Strategies ◽  
Ethical Problems ◽  
Wide Range ◽  
The Impact

‘Personality and personality disorders’ covers how personality influences and is influenced by psychiatric disorders, and also the disorders of personality. Personality refers to the wide range of ensuring qualities and behaviours that characterize an individual and that we generally use to recognize them. This chapter covers the varied theories of personality, both of personality types and personality development. It covers the classification of abnormal personalities and the range of personality disorders, along with their diagnostic criteria and how this classification is currently being subject to potentially radical reorganization. While the diagnosis of personality disorders remains controversial it is an essential tool in clinical psychiatry. Its course, impact, and treatment and management strategies are outlined, with particular attention paid to the impact of personality disorders on the outcome of other psychiatric and medical conditions and the ethical problems such disorders present.

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