Biomedical subjects

P Pilkonis

Publications and source records attributed to P Pilkonis.

3 recordsLinked to original sources

PubMed1992

Are personality assessments valid in acute major depression?

A number of recent studies indicate that identification of Axis II comorbidity in depressed patients may influence both the initial treatment plan and subsequent prognosis. Nevertheless, the validity of personality disorder diagnoses may be compromised by the effects of the patients' depression on historical recall, which distort presentation of their premorbid strengths and liabilities. These problems are illustrated in this study of 53 acutely depressed unipolar outpatients, with (N = 14) or without (N = 39) personality disorder diagnoses as defined by the Personality Disorder Examination (PDE). We found that: 1) pretreatment PDE diagnoses had no significant associations with any measure of demography, symptomatic status, illness course, or treatment response; and 2) pretreatment PDE diagnoses typically were not confirmed when patients were reassessed following effective treatment with cognitive behavior therapy. These findings provide strong empirical support for the wisdom of deferring definitive assessment of Axis II until an acute depressive disorder has been optimally treated.

Acute Disease↗

PubMedDate not supplied

Explaining diagnostic complexity in an intake setting.

A one patient-one illness paradigm is implicit in the history and theory of psychiatry, and in basic research. Yet, in clinical practice and treatment populations in general, more than one diagnosis per patient is frequently encountered. How clinicians formulate comorbidity by means of DSM-III has rarely been investigated. In this study, the ideas of clinical condition and that of its diagnostic complexity are used to analyze descriptive features of a large number of patients seen in an intake setting. Axis I of DSM-III is used to measure diagnostic complexity. Complexity is analyzed in relation to demographic variables, to ratings entered in the remaining axes of DSM-III formulations, to symptom levels of patients, and to decisions involving disposition. Results indicate that analysis of diagnostic complexity by means of DSM-III yields a definable structure and that it can be related meaningfully to clinical factors. The idea of information uncertainty in diagnosis, i.e., the opacity versus transparency of a clinical condition, is also used to explain results. The ideas introduced and studied are shown to have value for social psychiatric research.

Adaptation, Psychological↗

PubMedDate not supplied

On the homogeneity of personality disorder clusters.

This study was conducted using as subjects persons seeking psychiatric care in a public intake facility. Patients who received a diagnosis of a personality disorder (PD) on axis II constituted the study sample. The study is unique in that it attempts to analyze in a treatment population the relationships between all of the personality disorders (PD) stipulated in DSM-III with emphasis on their relationships to the associated features recorded in the remaining axes of DSM-III. The specific aim of the study was to determine the variation that exists with respect to clinical and demographic variables across the PD clusters categorized in DSM-III and across the PD types of each of the DSM-III PD clusters. In general, considerable inhomogeneity was shown within and across clusters in both demographic and clinical variables, although differences among clusters were noted as well. Cluster B differs prominently from its cohorts with respect to demographic and clinical characteristics. Some of the limitations of these results are emphasized.

Adult↗