Standardized assessment of personality disorders in obsessive-compulsive disorder.

Massachusetts General Hospital, Boston, MA 02114.
Archives of General Psychiatry (Impact Factor: 13.77). 10/1990; 47(9):826-30.
Source: PubMed

ABSTRACT We assessed 96 patients with obsessive-compulsive disorder for DSM-III personality disorder diagnoses with a standardized interview instrument (Structured Interview for the DSM-III Personality Disorders). Fifty patients (52%) met criteria for at least one personality disorder, with mixed, dependent, and histrionic personality disorders most frequently diagnosed. Compulsive personality disorder was diagnosed in only 6 patients (6%), 5 of whom had had onset of obsessive-compulsive symptoms before the age of 10 years, indicating that DSM-III compulsive personality disorder is not invariably a premorbid condition for the development of obsessive-compulsive disorder. Schizotypal personality disorder, at 5%, was found to be less common than in past samples, reflecting differences in either assessment methods or sampling.

  • [Show abstract] [Hide abstract]
    ABSTRACT: This review discusses augmentation strategies for patients with obsessive-compulsive disorder who fail to respond to treatment. A patient's failure to respond to treatment may be due to any of a number of factors, such as noncompliance with a behavioral program, concurrent severe depression or personality disorder, certain ritualistic behaviors, inaccurate diagnosis, and inadequate treatment. It is particularly important that comorbid psychiatric disorders be diagnosed and treated. A review of the literature and my experience with the use of augmenting agents such as lithium, buspirone, clonidine, fenfluramine, antidepressants, anxiolytic agents, and neuroleptics in treatment-resistant obsessive-compulsive disorder are presented. Existing evidence suggests that some of these approaches are useful for some patients. However, many questions remain, and much research remains to be done on this topic.
    Harvard Review of Psychiatry 01/1993; 1(1):17-26. · 3.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Forty-seven individuals (28 male and 19 female) referred for treatment of obsessive-compulsive disorder (OCD) in childhood were followed-up 15 years later (range 6–22 years) in respect of psychiatric and personality disorders. In early adulthood, the patients could be sub-divided into 4 groups of about equal size. One group had no later OCD, another had OCD on a sub-clinical level, a third group had an episodic course of OCD, and a final group had a chronic and often very disabling OCD. Outcome was similar in males and females, except that more girls had an episodic course. Eating disorder was diagnosed in 4 (21%) of the females, and Asperger syndrome in 2 (7%) of the males, at follow-up.47 Individuen (28 mnnlich, 19 weiblich), die zur Behandlung einer Zwangsstrung im Kindesalter berwiesen worden waren, wurden 15 Jahre spter (Spannbreite 6 bis 22 Jahre) nachuntersucht im Hinblick auf psychiatrische Strungen und Persnlichkeitsstrungen. Im frhen Erwachse-nenalter konnten die Patienten in etwa 4 gleich groe Gruppen unterteilt werden. Hiervon hatte eine Gruppe im Verlauf keine Zwangsstrung mehr. Die zweite Gruppe zeigte Zwangsphnomene im subklinischen Bereich. Die dritte Gruppe wies eine episodisch verlaufende Zwangsstrung auf. Die Individuen der letzten Gruppe litten an einer chronischen, oft stark beeintrchtigenden Zwangsstrung. Der Ausgang war zwischen beiden Geschlechtern hnlich, mit Ausnahme des hufigeren Vorkommens eines episodischen Verlaufs bei Mdchen. Estrungen wurden bei vier Frauen, ein Asperger-Syndrom bei zwei Mnnern zum Zeitpunkt der Nachuntersuchung diagnostiziert.47 individus (28 garcons et 19 filles) adresss pour traitement pour des troubles obsessifs-compulsifs (OCD) dans l'efance ont t suivis 15 ans plus tard (Moyenne 6 22 ans) dans la perspective des troubles psychiatriques et de la personnalit. Au d'but de leur tat d'adulte, les patients pouvaient tre subdiviss en 4 groupes de taille peu prs gale. Un groupe nvait plus d'OCD, l'autre avait un niveau sub-clinique d'OCD, un troisime groupe avait des pisodes intercurrents d'OCD, et un groupe final avait une forme chronique et souvent trs handicapante d'OCD. Le devenir tait similaire chez les filles et les garcons, sauf que plus de filles avaient des pisodes intercurrents. Les troubles alimentaires furent diagnostiqus chez 4 filles et le syndrome d'Asperger chez 2 garcons.
    European Child & Adolescent Psychiatry 03/1994; 3(2):82-96. · 3.70 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the potential beneficial and adverse effects of psychological interventions for people with obsessive-compulsive personality disorder and to make recommendations for future areas of research.