Psychiatric comorbidity of bulimia nervosa inpatients: relationship to clinical variables and treatment outcome

1993 ◽  
Vol 8 (1) ◽  
pp. 15-23 ◽  
Author(s):  
S Bossert-Zaudig ◽  
M Zaudig ◽  
M Junker ◽  
M Wiegand ◽  
J-C Krieg
Keyword(s):  
Bulimia Nervosa ◽  
Psychiatric Comorbidity ◽  
Negative Impact ◽  
Therapy Outcome ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Axis I Disorders ◽  
Axis I ◽  
Prognostic Implications ◽  
Selection Of

SummaryExperimental evidence suggesting that psychiatric comorbidity has important clinical and prognostic implications in bulimia nervosa has mostly been based on outpatient studies investigating a selection of co-existing psychopathological features with rather unstructured and not standardized diagnostic instruments. Using structured instruments (SCID-P, MDCL) for the diagnoses of DSM III-R axis I disorders and clinical interviews for the diagnosis of DSM III-R axis II disorders in 24 hospitalized bulimics, the present study demonstrated that more than half of the patients had two or three axis I disorders in addition to bulimia nervosa and almost half of the patients met criteria of at least one personality disorder. Subgroups of patients classified according to the type of psychiatric comorbidity did not differ significantly with respect to clinical features; regarding measures of hospital behavior therapy outcome. However, the findings provided evidence for a negative impact of anxiety disorder in addition to bulimia nervosa on the improvement of bulimic behavior and possibly also on self-rated depression.

Co-morbidity and disorder-related distress and impairment in purging disorder

2007 ◽  
Vol 38 (10) ◽  
pp. 1435-1442 ◽  
Author(s):  
P. K. Keel ◽  
B. E. Wolfe ◽  
J. A. Gravener ◽  
D. C. Jimerson
Keyword(s):  
Eating Disorder ◽  
Normal Weight ◽  
Self Report ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Diagnostic And Statistical Manual ◽  
Purging Disorder ◽  
Co Morbidity ◽  
Axis I ◽  
Clinically Significant

BackgroundRecent studies suggest that purging disorder (PD) may be a common eating disorder that is associated with clinically significant levels of distress and high levels of psychiatric co-morbidity. However, no study has established evidence of disorder-related impairment or whether distress is specifically related to PD rather than to co-morbid disorders.MethodThree groups of normal-weight women [non-eating disorder controls (n=38), with PD (n=24), and with bulimia nervosa (BN)-purging subtype (n=57)] completed structured clinical interviews and self-report assessments.ResultsBoth PD and BN were associated with significant co-morbidity and elevations on indicators of distress and impairment compared to controls. Compared to BN, PD was associated with lower rates of current and lifetime mood disorders but higher rates of current anxiety disorders. Elevated distress and impairment were maintained in PD and BN after controlling for Axis I and Axis II disorders.ConclusionsPD is associated with elevated distress and impairment and should be considered for inclusion as a provisional disorder in nosological schemes such as the Diagnostic and Statistical Manual to facilitate much-needed research on this clinically significant syndrome.

scholarly journals DSM-IV Axis II personality disorders and suicide and attempted suicide in China

2016 ◽  
Vol 209 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Kenneth R. Conner
Keyword(s):  
Personality Disorders ◽  
Suicidal Behaviour ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Control Group ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Increased Risk ◽  
Axis I ◽  
Dsm Iv

BackgroundThere are meagre data on Axis II personality disorders and suicidal behaviour in China.AimsTo describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders.MethodPeople who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders.ResultsAxis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7–8.0 for suicide and for suicide attempts.ConclusionsAxis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China.

Clinically diagnosed axis II co-morbidity and the short term outcome of CBT for axis I disorders

2006 ◽  
Vol 13 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Marcel van den Hout ◽  
Chantal Brouwers ◽  
Jacques Oomen
Keyword(s):  
Short Term ◽  
Term Outcome ◽  
Axis Ii ◽  
Short Term Outcome ◽  
Co Morbidity ◽  
Axis I Disorders ◽  
Axis I

Cognitive Therapy for Personality Disorders

2012 ◽  
pp. 726-750
Author(s):  
Robert L. Leahy ◽  
Lata K. McGinn
Keyword(s):  
Personality Disorders ◽  
Cognitive Therapy ◽  
Dialectical Behavior Therapy ◽  
Negative Impact ◽  
Cognitive Model ◽  
Theoretical Models ◽  
Axis I Disorders ◽  
Treatment Research ◽  
Axis I ◽  
Schema Model

Personality disorders are prevalent and common among patients presenting for treatment. Research suggests that personality disorders are associated with significant impairment and can exert a negative impact on psychological and pharmacological treatments for Axis I disorders. Despite this, treatment development and research for personality disorders has lagged behind those of Axis I disorders. The present chapter describes two major cognitive models of personality disorder—the cognitive model advanced by Beck, Freeman, and colleagues and the schema model advanced by Young and colleagues (a brief review of the dialectical behavior therapy model is also provided). The chapter presents research on both theoretical models and outlines similarities and differences between the two theoretical formulations. A description of the therapeutic relationship in cognitive therapy is also provided. The components of treatment are presented followed by a case example for purposes of illustration. Finally, the chapter summarizes the extant research on the treatment of personality disorders. Although the data are encouraging, suggesting that personality disorders are responsive to treatment, further controlled trials are still needed.

scholarly journals Biopsychosocial Aspects of Atypical Odontalgia

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
A. Ciaramella ◽  
M. Paroli ◽  
L. Lonia ◽  
M. Bosco ◽  
P. Poli
Keyword(s):  
Pain Perception ◽  
Temporomandibular Disorder ◽  
Control Group ◽  
Self Assessment ◽  
Perception Threshold ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Atypical Odontalgia ◽  
C Fibers ◽  
Axis I

Background. A few studies have found somatosensory abnormalities in atypical odontalgia (AO) patients. The aim of the study is to explore the presence of specific abnormalities in facial pain patients that can be considered as psychophysical factors predisposing to AO. Materials and Methods. The AO subjects () have been compared to pain-free (), trigeminal neuralgia (), migraine (), and temporomandibular disorder (). The neurometer current perception threshold (CPT) was used to investigate somatosensory perception. Structured clinical interviews based on the DSM-IV axis I and DSM III-R axis II criteria for psychiatric disorders and self-assessment questionnaires were used to evaluate psychopathology and aggressive behavior among subjects. Results. Subjects with AO showed a lower Aβ, Aδ, and C trigeminal fiber pain perception threshold when compared to a pain-free control group. Resentment was determined to be inversely related to Aβ (rho: 0.62, ), Aδ (rho: 0.53, ) and C fibers (rho: 0.54, ), and depression was inversely related with C fiber (rho: 0.52, ) perception threshold only in AO subjects. Conclusion. High levels of depression and resentment can be considered predictive psychophysical factors for the development of AO after dental extraction.

A personality disorders prevalence study among inpatients with mood disorders, psychoactive substance use disorders and anxiety disorders

2000 ◽  
Vol 9 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Maria Grazia Marinangeli ◽  
Giancarlo Butti ◽  
Antonella Scinto ◽  
Loredana Di Cicco ◽  
Artemis Kalyvoka ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Mood Disorders ◽  
Clinical Sample ◽  
Psychiatric Inpatients ◽  
Self Report ◽  
Exact Nature ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Axis I Disorders ◽  
Axis I

SummaryObjective- The aim of this study was to asses type and prevalence of Personality Disorders (PDs) and their patterns of comorbidity with Axis I disorders in a sample of psychiatric inpatients.Setting- The sample consisted of 300 subjects admitted to a psychiatric unit on a voluntary bases for an index episode. The study was conducted over a period of 12 months, from 1.11.1997 to 31.10.1998.Main outcome measures- The Italian version of SCID-II-PQ (Structured Clinical Interview for DSM-III-R personality disorders, with Personality Questionnaire-PQ- a self report questionnaire).Results- More than half the patients had at least one personality disorder. The mean of disorders per patient was 2.83±1.93 (±SD). The most prevalent Axis II disorders were Borderline PD (30.7%), Obsessive-compulsive PD (30.7%) and Avoidant PD (25.3%). Women were significantly more likely than men to meet criteria for Dependent PD and Avoidant PD. Man showed significantly more frequently than women Antisocial PD. Significant associations (p<0.05) were found for comorbidity of Mood Disorders and Avoidant PD, and for Psicoactive Use Disorders and Antisocial PD.Conclusions- Our study confirms the high prevalence of PDs in psychiatric inpatients and showes some interesting associations between Axis I and Axis II disorders. These results can't be generalized to outpatients because our clinical sample involved mainly severely ill inpatients, but they raise questions about the exact nature of PDs and of the relationship with Axis I disorders. Further research involving outpatients and general population is needed to examine factors that could affect development and course of Personality Disorders.

Course of multi-impulsive bulimia

1994 ◽  
Vol 24 (3) ◽  
pp. 591-604 ◽  
Author(s):  
M. M. Fichter ◽  
N. Quadflieg ◽  
W. Rief
Keyword(s):  
Bulimia Nervosa ◽  
Life Time ◽  
General Psychopathology ◽  
Course Of Illness ◽  
Axis Ii ◽  
Axis I ◽  
Dsm Iv ◽  
Anxiety Depression ◽  
Sexual Promiscuity

SynopsisThirty-two consecutively admitted females with bulimia nervosa (purging type) according to DSM-IV and additional impulsive behaviours (multi-impulsive bulimia (MIB)) and 32 age-matched female controls with DSM-IV bulimia nervosa (purging type) (uni-impulsive bulimia (UIB)) were assessed longitudinally on admission and at discharge following in-patient therapy and at a 2-year follow-up. Multi-impulsive bulimics were defined as presenting at least three of the six of the following impulsive behaviours in their life-time in addition to their bulimic symptoms at admission: (a) suicidal attempts, (b) severe autoaggression, (c) shop lifting (other than food), (d) alcohol abuse, (e) drug abuse, or (f) sexual promiscuity. Multi-impulsive bulimics were more frequently separated or divorced, had less schooling and held less-skilled jobs. Except for interoceptive awareness (EDI), which was more disturbed in multi-impulsive bulimics, there were no differences concerning scales measuring eating disturbances and related areas. Multi-impulsive bulimics showed more general psychopathology – anxiety, depression, anger and hostility, psychoticism – differed in several personality scales from uni-impulsive bulimics (e.g. increased excitability and anger/hostility) and had overall a less favourable course of illness. Multi-impulsive bulimics also received more in- and out-patient therapy previous to the index treatment and during the follow-up period. The data support the notion that ‘multi-impulsive bulimia’ or ‘multi-impulsive disorder’ should be classified as a distinct diagnostic group on axis I or that an ‘Impulsive Personality Disorder’ should be introduced on axis II. The development of more effective treatment for multi-impulsive bulimia is warranted.

Interviewing and Case Formulation

2010 ◽  
pp. 223-254
Author(s):  
Naomi Koerner ◽  
Heather K. Hood ◽  
Martin M. Antony
Keyword(s):  
General Structure ◽  
Clinical Interview ◽  
Case Formulation ◽  
Core Component ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Clinical Interviewing ◽  
Axis I ◽  
The Impact

The main objective of this chapter is to provide an overview of clinical interviewing. Although clinical interviewing is often referred to as an art (Shea, 2007), the information in this chapter highlights the science of clinical interviewing as well. The chapter opens with a discussion of the general structure and content of clinical interviews that are typically conducted in mental health contexts. The reader is introduced to a variety of interviews that are used in the assessment of Axis I and Axis II conditions, including their psychometric properties; guidelines for the assessment of suicidality are also presented. This is followed by an overview of interviewing skills. Specifically discussed are ways in which information processing limitations, verbal and nonverbal cues, and style of questions can influence the clinical interview. We then turn to a discussion of case formulation, a core component of the clinical interview. Empirical research on the impact of training on quality of case conceptualization and on the association between case formulation and treatment outcome is summarized. The chapter closes with a brief overview of issues that may arise when interviewing certain populations, in particular, couples, individuals from diverse populations, and young individuals.

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