The prediction of recovery using a multivariate model in 1471 depressed inpatients
Stepwise multiple logistic regression was used in an attempt to develop a statistical model which would predict "recovery" in a group of 1471 depressives admitted to a tertiary care hospital. Six variables identified by this approach included: Electroconvulsive therapy, personality disorder, chronicity, anxiety disorder, organic mental disorder, and dysthymia. The meaning and significance of the findings are discussed.
Available from: Morten Hesse
- "Personality disorders and personality traits represent a major challenge to many professionals dealing with psychiatric patients. Personality disorders impact treatment for substance use disorders [1,2], and mood disorders [3-6], bipolar disorder , and increase the risk of violence and other crime , as well as increase the risk of family conflict . "
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ABSTRACT: Tools for training professionals in rating personality disorders are few. We present one such tool: rating of fictional persons. However, before ratings of fictional persons can be useful, we need to know whether raters get the same results, when rating fictional characters.
Psychology students at the University of Copenhagen (N = 8) rated four different movie characters from four movies based on three systems: Global rating scales representing each of the 10 personality disorders in the DSM-IV, a criterion list of all criteria for all DSM-IV personality disorders in random order, and the Ten Item Personality Inventory for rating the five-factor model. Agreement was estimated based on intraclass-correlation.
Agreement for rating scales for personality disorders ranged from 0.04 to 0.54. For personality disorder features based on DSM-IV criteria, agreement ranged from 0.24 to 0.89, and agreement for the five-factor model ranged from 0.05 to 0.88. The largest multivariate effect was observed for criteria count followed by the TIPI, followed by rating scales. Raters experienced personality disorder criteria as the easiest, and global personality disorder scales as the most difficult, but with significant variation between movies.
Psychology students with limited or no clinical experience can agree well on the personality traits of movie characters based on watching the movie. Rating movie characters may be a way to practice assessment of personality.
BMC Psychiatry 02/2005; 5(1):45. DOI:10.1186/1471-244X-5-45 · 2.21 Impact Factor
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ABSTRACT: The object of the present survey was to examine whether the health conditions, social contacts, and personality traits of depressed patients were stable or had altered 12 months after their first admittance for depression. A cohort consisting of 31 first-admittance depressed patients from the catchment area of the Psychiatric Hospital in Aarhus were examined at admittance and 12 months later. The diagnostic assessment was carried out with the Present State Examination, 10th version; the social conditions were examined with a questionnaire on social class affiliation and selected living conditions, and the personality assessment was carried out using the questionnaire Karolinska Scales of Personality. The follow-up was carried out by mailing a letter with the two questionnaires exactly 12 months after admission. The examination yielded the following results: The presence of simultaneous anxiety appears to be quite constant. The patient group as such has become less isolated, but the total number of people living alone and being unemployed increased, and there have been many broken marriages/cohabitation relationships. The personality traits of the patients were remarkably uniform at the two examinations. The personality dysfunctions were anxiety and muscular tension, psychasthenia, impaired social conduct, and irritability. The personality dysfunction at index admission did not predict the social contacts 1 year after, and the only changes seen were a lowering of muscular tension and inhibition of aggression. From the survey it can be concluded that some of the depressed patients suffer under the strains of anxiety, social isolation, and personality dysfunction. These factors were present at first admittance and also 12 months later. Most likely these factors impair the prognosis.
Nordic Journal of Psychiatry 01/1993; 47(2):101-107. DOI:10.3109/08039489309095020 · 1.34 Impact Factor
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ABSTRACT: This report reviews 21 recent empirical investigations of the relationship between personality pathology and patient response to somatic treatments for major depression. The literature review reveals robust evidence, on the basis of 14 studies employing DSM-III criteria for the diagnosis of Axis II personality disorders, that Axis II co-morbidity predicts negative outcomes, both acute and longer-term, among both inpatients and outpatients receiving pharmacological treatment for depression; seven studies utilizing non-DSM III measures of personality pathology also generally corroborate this finding. A meta-analysis of three reported studies of ECT response also reveals significantly poorer outcomes among personality disordered inpatients receiving ECT. There is insufficient evidence to conclude whether or not specific Axis II disorders, or clusters of disorders, are associated with particularly poor acute somatic treatment response, though there is modest evidence that Cluster C disorders are differentially predictive of poor acute response among outpatients. Dimensional scores reflecting the total number of Axis II criteria met by the patient are significantly negatively correlated with acute and long-term somatic treatment response. Numerous methodological difficulties inherent in the study of personality and treatment outcome are addressed. Specific methodological recommendations include the use of structured interviews for personality assessment, the use of continuous rather than dichotomous measures of personality pathology, controlling statistically for differences in initial depression severity among subjects, and ensuring homogeneity of somatic treatment within each evaluated treatment condition. Several possible explanations of the observed relationship between personality pathology and somatic treatment response are also explored. Depression 2:200–217 (1994/1995). © 1995 Wiley-Liss, Inc.
Depression 01/1994; 2(4):200 - 217. DOI:10.1002/depr.3050020404
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