Incidence and comorbidity of personality disorders among first ever admitted psychiatric patients

1994 ◽  
Vol 9 (4) ◽  
pp. 175-184 ◽  
Author(s):  
O Mors ◽  
LV Sørensen

SummaryDuring a period of one year, 157 first ever admitted psychiatric patients in the age group 18-49 years from a catchment area of 217,649 persons were interviewed with the Present State Examination 10th edition, development version and the Personality Disorder Examination, 1988 version. Of the sample, 23% received at least one DSM III-R personality disorder (PD) diagnosis. Rates avoidant PD, very few borderline PDs were found. Almost all patients with PDs also had major psychiatric disorders and the sample was biased towards younger individuals with more severe Axis I symptomatology compared with first ever admitted psychiatric patients aged 18-49 years in Denmark. Cluster A was associated with schizophrenia, cluster B with alcohol or other substance use disorders, and cluster C with anxiety disorders. Within Axis II, schizotypal PD was associated with avoidant and dependent PD, and paranoid with antisocial and dependent PD.

1993 ◽  
Vol 8 (4) ◽  
pp. 193-199 ◽  
Author(s):  
O Mors ◽  
L Vedel S∅rensen

SummaryThe incidences of major psychiatric syndromes (DSM III-R, axis I) in the age group 18–49 years were investigated. Incidence was defined as first ever admission rates during a period of 1 year.. The study base was a well-defined catchment area of 217,649 persons. Selection bias was analyzed by the use of a population-based psychiatric case register. Information bias was minimized by the use of a semi-structured interview, the Present State Examination, 10th edition. Comorbidity defined as significant cooccurrence of Axis I disorders was analyzed by multivariate statistics. One hundred and sixty-six patients were interviewed. PSE-10, now published by WHO, proved to be as reliable as its predecessors, and appropriate for the severely ill psychiatric patient. Incidences of schizophrenia, other psychoses stratified for the presence of psychoactive substance use disorders, and mood disorders stratified for anxiety disorders were reported. The sample was biased towards younger individuals with more severe psychopathology.


1994 ◽  
Vol 39 (5) ◽  
pp. 269-276 ◽  
Author(s):  
G.S. Truant

This paper reports on a continuation of previous research into the connection between childhood experience of relationships and adult relationships such as marriage. A group of 41 married, mixed psychiatric patients showed the strongest correlations between adult marital quality as measured by the Marital Adjustment Test and mother care, same sex parent care or lowest caring parent care, as measured by the Parental Bonding Instrument. There was little correlation between childhood care and adult marital quality in both subgroups; one group was composed of 24 patients with Axis I diagnosis alone and the other group was composed of 17 patients with personality disorder. Married patients with personality disorder, almost all of whom had an Axis I diagnosis as well, did report lower levels of both childhood care and adult marital quality compared with patients with Axis I diagnoses and no personality disorder. The possible significance of these findings is discussed.


Crisis ◽  
2001 ◽  
Vol 22 (3) ◽  
pp. 125-131 ◽  
Author(s):  
Ludmila Kryzhanovskaya ◽  
Randolph Canterbury

Summary: This retrospective study characterizes the suicidal behavior in 119 patients with Axis I adjustment disorders as assessed by psychiatrists at the University of Virginia Hospital. Results indicated that 72 patients (60.5%) had documented suicide attempts in the past, 96% had been suicidal during their admission to the hospital, and 50% had attempted suicide before their hospitalization. The most commonly used method of suicide attempts was overdosing. Of the sample group with suicide attempts in the past, 67% had Axis II diagnoses of borderline personality disorder and antisocial personality disorder. Adjustment disorder diagnosis in patients with the suicide attempts was associated with a high level of suicidality at admission, involuntary hospitalization and substance-abuse disorders. Axis II diagnoses in patients with adjustment disorders constituted risk factors for further suicidal behavior. Additional future prospective studies with reliability checks on diagnosis of adjustment disorders and suicidal behavior are needed.


1989 ◽  
Vol 34 (8) ◽  
pp. 785-790 ◽  
Author(s):  
James C. Overholser

A number of authors have questioned the rationale for subdividing the DSM-II schizoid diagnosis into three separate personality disorders in DSM-III, the schizoid, avoidant, and schizotypal. The present study was designed to explore differences between psychiatric patients with schizoid and avoidant personalities as compared to psychiatric controls with no personality disorder. Differences were examined on demographic data, self-report measures, and clinical information. A Multivariate Analysis of Variance (MANOVA) revealed a significant overall effect for groups across MMPI subscales. However, subsequent univariate Analyses of Variance (ANOVA's) revealed that almost all differences were between the two personality disorder groups as compared to the psychiatric controls. Contrary to expectations, schizoid and avoidant personalities were found to display equivalent levels of anxiety, depression, and psychotic tendencies as compared to psychiatric control patients. No meaningful distinctions were found between the avoidant and the schizoid personalities. Results are discussed in terms of problems with the assessment methods and the diagnostic criteria.


2009 ◽  
Vol 23 (4) ◽  
pp. 357-369 ◽  
Author(s):  
Mary C. Zanarini ◽  
Leah K. Barison ◽  
Frances R. Frankenburg ◽  
D. Bradford Reich ◽  
James I. Hudson

2016 ◽  
Vol 33 (S1) ◽  
pp. S23-S23
Author(s):  
A.R. Teo

IntroductionSince the 1990s the term “Hikikomori” has emerged as a way to describe a modern form of severe social withdrawal first described in Japan. Recently, there have been increasing reports of Hikikomori around the globe.ObjectivesTo describe operationalized research criteria for Hikikomori, as well as epidemiologic, diagnostic, and psychosocial features of the Hikikomori in international settings.MethodsParticipants were recruited from sites in India, Japan, Korea, and the US. Hikikomori was defined as a six-month or longer period of spending almost all time at home and avoiding social situations and social relationships, associated with significant distress/impairment. Lifetime history of psychiatric diagnosis was determined by the Structured Clinical Interview for the DSM-IV Axis-I and Axis-II Disorders. Additional measures included the Internet Addiction Test, UCLA Loneliness Scale, Lubben Social Network Scale (LSNS-6), and Sheehan Disability Scale (SDS).ResultsThirty-six participants meeting diagnostic criteria for Hikikomori were identified, with cases detected in all four countries. Avoidant personality disorder (41%), major depressive disorder (32%), paranoid personality disorder (32%), social anxiety disorder (27%), posttraumatic stress disorder (27%), and depressive personality disorder (27%) were the most common diagnoses. Sixty-eight percent had at least two psychiatric diagnoses. Individuals with Hikikomori had high levels of loneliness (UCLA Loneliness Scale M = 55.4, SD = 10.5), limited social networks (LSNS-6 M = 9.7, SD = 5.5), and moderate functional impairment (SDS M = 16.5, SD = 7.9).ConclusionsHikikomori exists cross-nationally and can be assessed with a standardized assessment tool. Individuals with Hikikomori have substantial psychosocial impairment and disability, and a history of multiple psychiatric disorders is common.Disclosure of interestThe author has not supplied his declaration of competing interest.


2008 ◽  
Vol 7 (S1) ◽  
Author(s):  
Ioannis Pantoularis ◽  
George Garyfallos ◽  
Martha Lobtzianidou ◽  
Aristidis Livanos ◽  
Ioannis Dasoukis ◽  
...  

CNS Spectrums ◽  
2000 ◽  
Vol 5 (9) ◽  
pp. 23-26 ◽  
Author(s):  
Alessandro Rossi ◽  
Maria Grazia Marinangeli ◽  
Giancarlo Butti ◽  
Artemis Kalyvoka ◽  
Concetta Petruzzi

AbstractThe aim of this study was to examine the pattern of comorbidity among obsessive-compulsive personality disorder (OCPD) and other personality disorders (PDs) in a sample of 400 psychiatric inpatients. PDs were assessed using the Semistructured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Odds ratios (ORs) were calculated to determine significant comorbidity among OCPD and other axis II disorders. The most elevated odds ratios were found for the cooccurrence of OCPD with cluster A PDs (the “odd” PDs, or paranoid and schizoid PDs). These results are consistent with those of previous studies showing a higher cooccurrence of OCPD with cluster A than with cluster C (“anxious”) PDs. In light of these observations, issues associated with the nosologic status of OCPD within the Diagnostic and Statistical Manual of Mental Disorders clustering system remain unsettled.


2007 ◽  
Vol 38 (1) ◽  
pp. 135-146 ◽  
Author(s):  
J. Hill ◽  
P. Pilkonis ◽  
J. Morse ◽  
U. Feske ◽  
S. Reynolds ◽  
...  

BackgroundSocial dysfunction in personality disorder is commonly ascribed to abnormal temperamental traits but may also reflect deficits in social processing. In this study, we examined whether borderline and avoidant personality disorders (BPD, APD) may be differentiated by deficits in different social domains and whether disorganization of social domain functioning uniquely characterizes BPD.MethodPatients were recruited from psychiatric clinics in Pittsburgh, USA, to provide a sample with BPD, APD and a no-personality disorder (no-PD) comparison group. Standardized assessments of Axis I and Axis II disorders and social domain dysfunction were conducted, including a new scale of ‘domain disorganization’ (DD).ResultsPervasive social dysfunction was associated with a 16-fold increase in the odds of an Axis II disorder. Both APD and BPD were associated with elevated social dysfunction. Romantic relationship dysfunction was associated specifically with BPD symptoms and diagnosis. DD was associated specifically with a categorical BPD diagnosis and with a dimensional BPD symptom count.ConclusionsA focus on the inherently interpersonal properties of personality disorders suggests specific mechanisms (within and across interpersonal domains) that may help to account for the origins and maintenance of some disorders. In particular, BPD reflects disturbances in romantic relationships, consistent with a role for attachment processes, and in the organization of functioning across social domains.


2015 ◽  
Vol 207 (4) ◽  
pp. 313-319 ◽  
Author(s):  
Eunice Ayodeji ◽  
Jonathan Green ◽  
Chris Roberts ◽  
Gemma Trainor ◽  
Justine Rothwell ◽  
...  

BackgroundLittle is currently known about the presence and impact of personality disorder in adolescents who self-harm.AimsTo evaluate personality disorder in repeated self-harm in adolescence and its impact on self-harm psychopathology and adaptation outcomes over 1 year.MethodA clinical referral sample (n= 366) of adolescents presenting with repeated self-harm aged 12–17 years, as part of a randomised controlled trial (Assessment of Treatment in Suicidal Teenagers study, ASSIST). Personality disorder was assessed using the Structured Clinical Interview for DSM-IV Axis II (SCID-II). One-year outcomes included frequency and severity of repeat self-harm, self-reported suicidality, mood and functional impairment.ResultsAbout 60% of the referred adolescents showed one or more forms of personality disorder. Personality disorder was associated with significantly greater severity of self-harm, overall psychopathology and impairment. There was a complex association with treatment adherence. Personality disorder predicted worse 1-year outcomes in relation to self-harm frequency and severity, as well as impairment, suicidality and depressive symptoms.ConclusionsPersonality disorder can be reliably measured in adolescence and showed high prevalence in this clinical self-harm sample. Controlling for other variables, it showed a strong independent association with self-harm severity at referral and predicted adherence to treatment and clinical outcomes (independent of treatment) over 1 year. Consideration of personality disorder diagnosis is indicated in the assessment and management of adolescents who repeatedly self-harm.


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