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Biomedical subjects

G Kullgren

Publications and source records attributed to G Kullgren.

49 records · Page 3Linked to original sources
PubMed1993

Personality disorders in DSM-III-R as categorical or dimensional.

Despite the atheoretical approach of the DSM-III-R, the personality disorders have their roots in specific theoretical schools. Due to clinical tradition, analogies with Axis I and the tradition in psychiatry and medicine, the personality disorders are presented as categories although there is more empirical support for a dimensional approach. This study attempted to determine whether the separate personality disorders meet Kendell's criteria for distinct entities, i.e., bimodality with distinct points of rarity. None of the personality disorders met the criteria for a distinct disease entity. Instead, all of the personality disorders presented as continuous, dimensional personality traits present among healthy subjects and more pronounced in patients with mental disorders.

Adult↗
PubMed1993

Personality traits and disorders among transsexuals.

A group of transsexuals, 9 biological men and 10 women, was assessed according to clinical DSM-III-R diagnosis and a self-report instrument for Axis II diagnoses based on the Structured Clinical Interview for DSM-III-R (SCID screen). A control group of 133 individuals was assessed by the same instrument. Combined with a functional criterion according to the Global Assessment of Functioning, the SCID screen showed good agreement with clinical Axis II diagnoses. The overall proportion of Axis II criteria fulfilled, proportion of criteria fulfilled for every single personality disorder and number of personality disorders were calculated from the modified version of the SCID screen. Personality disorders, mainly within cluster B, were identified among 5 of 19 transsexuals, and a majority had multiple personality disorders. Among controls, no personality disorder was identified. Personality traits as measured by the SCID screen revealed significantly more subthreshold pathology among transsexuals than controls in 8 of 12 personality categories. The proportion of overall Axis II criteria fulfilled was 29% among transsexuals versus 17% among controls. Sex differences among transsexuals, the usefulness of the SCID screen and diagnostic problems in DSM-III-R with respect to gender identity disorders are discussed.

Adult↗
PubMed1992

Multivariate modelling and the Defence Mechanism Test: a comparative study of defensive structures in borderline, other personality disorders and schizophrenic disorder.

The study aims at discerning discriminating patterns in the perceptual responses according to the projective percept-genetic method Defence Mechanism Test (DMT) among 45 subjects with the diagnoses borderline personality disorder (BPD), other personality disorders (OPD), schizophrenic disorder (SD) and a non-patient group. The overall results show that, by means of partial least squares (PLS) discriminant analysis of 130 DMT variables, it is possible to separate these groups. Patients with a BPD or a SD diagnosis and the non-patient group are clearly separated, whereas the OPD group shows a less homogeneous pattern. The findings support both the validity of the DMT as a method to measure personality features and the psychodynamic validity of BPD. The most characteristic properties of the BPD group are responses of emotional expressions, especially introaggression and frequent distortions of the stimulus picture. Regarding the SD/OPD group, a pattern of high threshold values for perception emerges as a discriminating feature as well as different variants of introjection. The non-patients are characterized by very few DMT distortions and consequently show a good reality orientation. The conclusion is that the DMT and the PLS discriminant analysis are powerful methods in the assessment of personality pathology.

Borderline Personality Disorder↗
PubMed1992

[Changes in psychiatric care. Reform or revolution? The experience of the Swedish model].

Reforms to psychiatric practice in Sweden are discussed, expecting that the Scandinavian experience be of assistance as regards changes that are being implemented for a re-structuration of psychiatric care in Latin America. The following points are enhanced: (a) epidemiological studies as an important basis for planning and action in mental health; (b) a progressive closing of mental hospitals while, at the same time, more institutionalization capacities are being created at general health services, and (c) organizing non-hospital care by sectors with community mental health teams being in charge of. As far as negative aspects are concerned, a tendency towards a "psychologization" so to speak of social issues, and a certain lack of attention of patients with severer disorders are pointed out.

Delivery of Health Care↗
PubMed1990

Personality organization defined by DMT and the Structural Interview.

The psychoanalytic concept of Personality Organization (PO) may be operationalized by means of a Structural Interview as well as by means of psychological tests. The present study utilized the Structural Interview and a projective test called the Defence Mechanism Test (DMT) to operationalize the PO concept on a sample of 50 psychiatric inpatients. The reliability of the PO judgements were found to be acceptable for both the Structural Interview and the DMT. The validity, which was estimated as the correlation between the two methods, was also found to be substantial. The conclusion is that the concept of PO may be reliably operationalized for psychiatric patients and seems to have concurrent validity. Both the DMT and the Structural Interview may be used for differential diagnosis of PO.

Adult↗
PubMed1990

Mental disorders among primary health care patients in Nicaragua.

The objective of this study was to validate the Self Report Questionnaire (SRQ-20) as a screening instrument to identify probable psychiatric cases in the general population in Nicaragua and to study the prevalence and identification of mental disorders in primary health care. In the general population 576 people were screened using SRQ-20. A subsample was further interviewed using the Present State Examination (PSE). In primary health care centers 781 patients were screened according to SRQ-20 and staff indicated whether a mental disorder was identified or not. In the general population study, 9/10 turned out an adequate cut-off for SRQ-20, identifying 23% as probable cases. Using the same cut-off, 47% of the primary health care patients were identified as probable cases. Among male probable cases only 7% were identified as cases by health care staff, and among female probable cases health care staff identified 13% as cases. When the results are compared with previous studies, it becomes evident that the general level of psycho-emotional complaints and accordingly the cut-off for caseness differ in different parts of the world. SRQ must be calibrated for each cultural setting. Among primary health care patients, mental disorders were overrepresented and frequently overlooked by the physicians. Educational programs with training in psychiatry should be implemented for primary health care staff.

Adolescent↗
PubMed1989

Psychodynamic features in borderline personality disorder identified by a subliminal test, the Defense Mechanism Test.

Twenty-seven psychiatric inpatients, diagnosed according to DSM-III and the Diagnostic Interview for Borderline (DIB), and 7 healthy controls were tested with the Defense Mechanism Test (DMT), a test of subliminal perception based on psychoanalytic theory. In the test a specific stimulus is presented subliminally in a tachistoscope and the patient's perceptual distortions are registered. Patients with borderline personality disorder (BPD) were compared with patients with other personality disorders, patients with schizophrenic disorders and healthy controls. Specific perceptual distortions were identified among patients with BPD. Some individual DMT signs correlated with some deviant behaviors as identified by the DIB. The findings supported the psychodynamic validity of the concept of borderline personality disorder. It is concluded that DMT is a promising research instrument that provides an empirical approach to crucial psychodynamic phenomena.

Adult↗
PubMed1988

Factors associated with completed suicide in borderline personality disorder.

Fifteen patients with a diagnosis of borderline personality disorder (BPD) who had committed suicide while under inpatient care or within a month after discharge were compared with a group of 13 inpatients with a diagnosis of BPD who did not kill themselves. Suicides occurred in all ages from 20 to 49 years. Age, sex, and age when first in contact with psychiatry did not differ between groups. DIB profiles differed only with respect to slightly higher scores on the affect section among patients who committed suicide. Axis I affective disorders were equally frequent. The patients who committed suicide had been more often hospitalized and they had made more suicide attempts in their lifetime. Male patients who killed themselves showed a more extensive suicidal behavior at admission than did their matched control subjects. Earlier suicide attempts during inpatient treatment were only identified among the patients who committed suicide. An imminent mandatory discharge preceded the inpatient suicides in five of 11 cases.

Adult↗
PubMed1987

An empirical comparison of three different borderline concepts.

Forty-six inpatients were independently diagnosed according to the DSM-III concept of borderline personality disorder, the diagnostic interview for borderlines (DIB) and the concept of borderline personality organization, which is linked to Kernbergs structural interview. The interviews were videotaped. Satisfactory inter-rater reliability was demonstrated for the DIB, which furthermore showed high sensitivity and specificity in identifying patients with a clinical DSM-III diagnosis of borderline personality disorder from patients with a other personality disorders or schizophrenic disorders. Discriminant features, demographic profile and earlier treatment history for the patients with a borderline personality disorder are described and discussed. The structural interviews were scored according to a specified format. Inter-rater reliability was satisfactory but not too impressive. Borderline personality organization turned out to be a very broad concept and only half of the patients within this concept received a syndrome diagnosis of borderline personality disorder. A general conclusion was that borderline personality organization should not be considered as a diagnostic entity but rather as a different diagnostic dimension representing an intermediate level of personality structure.

Adult↗
PubMed1986

An empirical study of borderline personality disorder and psychiatric suicides.

Borderline personality disorder (BPD) is closely related to suicidal behavior, and suicide attempts per se are considered a diagnostic criterion. However, there has been no previous study of completed suicides and BPD. The present study is based on a population of 134 consecutive psychiatric suicides from 1961 to 1980 in a catchment area of 250,000 inhabitants. Clinical records were retrospectively diagnosed according to the Diagnostic Interview for Borderlines and DSM-III. There was a progressive increase in proportion of borderline suicides during the time period. The overall proportion of BPD, however, was only 12%, indicating that borderline patients are not seriously overrepresented among patients committing psychiatric suicides. Demographic variables, earlier psychiatric care, and suicidal behavior in the borderline group are described and analyzed.

Adult↗
PubMed1985

Borderline diagnosis from hospital records. Reliability and validity of Gunderson's Diagnostic Interview for Borderlines (DIB).

Two trained and experienced clinical psychologists and two nontrained students rated the sections in Gunderson's Diagnostic Interview for Borderlines (DIB) on the basis of hospital records for 16 patients (DIB-R). The results showed that both reliability and validity, i.e., correlations with an actual interview, were unexpectedly high, around .80 for the trained judges and around .55 for the nontrained judges. The conclusion is that the DIB may be used for retrospective diagnosis of borderline patients from hospital records.

Adult↗
PubMedDate not supplied

Motor conversion disorder. A prospective 2- to 5-year follow-up study.

In this prospective study, 30 patients with motor conversion disorder were assessed for key psychiatric and demographic variables. At reassessment 2 to 5 years later, 19 patients had completely recovered and 8 patients had improved, whereas only 3 were unchanged or worse. Contrary to other follow-up studies, none of the patients received a rediagnosis of neurological disease. The presence of a personality disorder and overall personality pathology, particularly within cluster C, the presence of a concomitant somatic disease, low DSM-IV Axis V score, and high score on the Becks Hopelessness Scale proved to be associated with poor outcome.

Adolescent↗