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PubMed1992

MCMI-II personality disorders in recent-onset bipolar disorders.

This study investigated the personality disorders of 21 recent-onset Bipolar Disorder patients using the revised Million Clinical Multiaxial Inventory (MCMI-II; Millon, 1987). Personality disorder assessments, conducted after patients' clinical symptoms had settled, indicated that 17 patients received at least one MCMI-II personality disorder diagnosis with a trend toward multiple diagnoses. Narcissistic, Antisocial, and Histrionic personality disorders were diagnosed most frequently and were the scales most elevated. Schizoid and Compulsive personality disorders were the scales least elevated. Diagnostic concordance between the MCMI-II and the Structured Interview for DSM-III Personality (SIDP; Pfohl, Stangl, & Zimmerman, 1983) was poor; the MCMI-II made more multiple diagnoses. Implications of the discrepancies between these instruments and suggestions for future research are discussed.

Adult↗
PubMed1988

A comparison of adequately vs. inadequately treated depressed patients.

The authors reviewed the records of 201 nonbipolar depressed inpatients to a) determine the level of somatic therapies prescribed and b) compare the characteristics and global outcomes of patients given "adequate" vs. "inadequate" treatment. A stepwise multiple regression analysis revealed that patients given higher levels of somatic therapy were significantly (p less than .001) more likely to be older and have depression with psychotic features and less likely to have compulsive personality disorders. These patients also had significantly longer hospitalizations. A separate stepwise regression analysis showed that patients given higher levels of somatic therapy had superior outcomes (p less than .001). The proportion of this sample given no antidepressant medication or electroconvulsive therapy (18.4%) and the proportion given "adequate" treatment (45.3% to 63.7%, depending on the criteria applied) were comparable to the findings of other published reports.

Adolescent↗
PubMed1988

Phenomenological overlap of multiple personality disorder and obsessive-compulsive disorder.

Three patients with multiple personality disorder and three with obsessive-compulsive disorder were compared on a variety of self-report measures and on two structured interviews. Amytal Sodium interviews had been conducted on the obsessive patients; alter personality-like entities claiming responsibility for the obsessions and compulsions were contacted in two patients. The one obsessive patient with no alter personality differed markedly from the other five on the SCL-90, the Lynfield Inventory, and the Dissociative Experiences Scale. Structured interviews with the Anxiety Disorders Interview Schedule and the Dissociative Disorders Interview Schedule also clearly differentiated this patient from the other five. It appears that there is a phenomenological overlap between multiple personality disorder and some cases of obsessive-compulsive disorder. Obsessive patients with prominent dissociative features may be a psychologically and biologically distinct subgroup.

Adult↗
PubMed1978

Success of cathartic therapy as a function of patient variables.

Treated sample of 42 patients with cathartic psychotherapy and evaluated differential effectiveness on types of patients. Patients without mental disorders experienced more emotional catharsis than all others, and those with obsessive compulsive personality disorders improved more than all others as a result of emotive treatment. Contrary to popular notions, neither women nor hysterics experienced more catharsis or improved more in cathartic therapy. Although women and hysterics may cry more easily in daily life, obsessives are apparently more able to maintain focus on unhappy experiences and are therefore able to express more emotion in cathartic therapy. Furthermore, it seems that cathartic treatment is beneficial by disrupting long-standing defenses against emotional experiences, rather than by releasing stored-up affects.

Abreaction↗
PubMedDate not supplied

[Epidemiology of obsessive-compulsive disorder in children and adolescents].

Although obsessive-compulsive disorders are rarely found in young subjects seen in infantile psychiatry, anamnestic studies have shown that more than one third of obsessive patients seen at adult age agree that the onset of their disorder dates back to when they were under 15 years of age. The first direct epidemiological study on the prevalence of obsessive-compulsive disorder during adolescence was recently conducted in a New Jersey county, USA. Over 5,500 high school teenagers were asked to fill in a questionnaire dealing with different aspects of mental pathology and 356 of them were selected, on the basis of their answers, to be included in further clinical examinations. Thus, the current prevalence rate of obsessive-compulsive disorder was found to be 1 (+/- 0.5)% of the general adolescent population, and the lifetime prevalence rate, 1.9 (+/- 0.7)%. These results are close to the rates of prevalence observed in the U.S. general adult population during the same period. The obsessive-compulsive cases detected in this investigation showed the same characteristics as the clinical cases usually described, except for the absence of male predominance generally observed in consulting patients; 75% of obsessive patients also presented other associated psychopathological disorders, most often major depression, overanxious disorder and/or bulimia, but only 20% of them had already consulted mental health professionals. This study shows that obsessive-compulsive disorder during adolescence is more frequent than expected, but often remains undiagnosed and untreated.

Adolescent↗
PubMed1976

The facade compulsive: a diagnostic formulation derived from projective testing.

A psychological "type" characterized by repetitive and compulsive action tendencies but not by obsessive thoughts was delineated. It was shown how this syndrome could be identified through differential inter-test patterning on projective techniques. The possibility of improving psychodiagnostic accuracy by stipulating expected configurations among tests in a battery was noted.

Adult↗
PubMed1987

Compulsive hoarding.

Four cases of compulsive hoarding are described, all sharing the following characteristics: (1) onset in the twenties, (2) preoccupation with hoarding to the exclusion of work and family, (3) diminished insight, (4) little interest in receiving treatment, (5) no attempt to curb their compulsion. They do not show clear psychotic features. The implications of these characteristics for the diagnosis of hoarding are discussed.

Adult↗
PubMed1978

Review of the relationship between obsession and depersonalization.

Depersonalization is discussed and a brief outline of the primary symptoms is presented. The relationship between obsessionalism and depersonalization is reviewed in the literature, and subsequent similarities are presented. The intellectual obsessive depersonalization syndrome is postulated as a variant, and also as an exposition of what might occur in many other cases of depersonalization. Finally, a picture is presented which takes into account a strong component of obsessionalism in both the etiology and course of depersonalization.

Anxiety↗
PubMed1976

The relationships between obsessional personality, obsessions in depression, and symptoms of depression.

The relationships between obsessional personality, obsessions in depression, and symptoms of depression were investigated by means of a retrospective study of case notes and item sheets. One hundred and sixty-eight cases of depression, aged 20 to 29 years, were rated for obsessional personality as defined by Ingram (1961). The presence of previous obsessions, of obsessions in depression and of eight symptoms of depression was assessed from the item sheets. Obsessional personality was found to be significantly associated only with a decreased frequency of objective apathy, although it seemed to act to reduce the anxiety experienced by those with obsessions, in depression. Obsessions in depression were associated with rapid changes of mood, anxiety, agitation and overactivity and with a relative absence of retardation.

Adult↗
PubMed1987

Reactive-narcissistic character, obsessional personality and obsessive-compulsive behaviour: a study of the validity of Sandler and Hazari's typology.

Sandler & Hazari's (1960) questionnaire measuring reactive-narcissistic character and obsessional personality was filled in by 120 medical students. Principal components analysis was applied to their scores. The resulting factor structure is highly similar to Sandler & Hazari's. Both reactive-narcissistic character and obsessional personality can be measured in a reliable way. In support of the hypotheses, reactive-narcissism is correlated positively with achievement motivation, but shows no correlation with traits reflecting lack of self-confidence (external locus of control and negative fear of failure), nor with aggression. Contrary to expectation, a positive correlation was found with control uncertainty. According to expectation obsessionality is correlated negatively with achievement motivation and positively with traits reflecting lack of self-confidence and with aggression. The hypothesis that obsessional subjects exhibit more obsessive-compulsiveness in a decision-making task than reactive-narcissistic subjects could not be confirmed. Results are discussed in the light of previous findings. The conclusion is that the typology as measured by Sandler & Hazari's (1960) questionnaire has high construct validity. The question whether the typology is predictive of future obsessive-compulsive behaviour remains unanswered.

Achievement↗
PubMed1975

Are there two types of unipolar depression?

Personality traits and clinical characteristics in psychiatric outpatients with affective disorder were examined. Two groups of unipolar patients, divided on the basis of treatment response to tricyclic antidepressants, were compared to a bipolar group. While the unipolar-T (tricyclic responder) group showed premorbid personality traits of chronic anxiety and obsessiveness, neither the bipolar nor unipolar-L (tricyclic nonresponder, lithium carbonate responder) groups showed such findings. In fact, the unipolar-L and bipolar groups were similar not only with regard to personality variables, but also in terms of both drug response and certain family history features. These findings cast doubt on the homogeneity of unipolar depression and suggest the possibility of a subtype of unipolar depression with psychobiologic and personality features resembling bipolar disorder.

Adult↗
PubMed1987

Prototypicality ratings of DSM-III criteria for personality disorders.

Although DSM-III personality disorder criteria have demonstrated acceptable reliability, the question of validity has not been adequately addressed. A first step in establishing the validity of diagnoses is to establish the validity of the criteria used to assess each diagnosis. The content validity of diagnostic criteria was investigated in relation to the larger set of potential criteria culled from the psychiatric literature. For each DSM-III axis II diagnosis, a panel of clinicians rated how prototypical each potential criterion was of the diagnosis in question. The results reveal problems with the organization and content of the criteria for most diagnoses. Many DSM-III criteria are composed of several statements linked by conjunctions or disjunctions. These component statements often received markedly different ratings, suggesting that criteria should be single statements. For most diagnoses, traits not included in DSM-III received higher ratings than did some DSM-III criteria. Suggestions are made to improve the distinctiveness and content validity of paranoid, schizoid, antisocial, borderline, avoidant, dependent, and compulsive personality disorders. The results for schizotypal personality disorder suggest that many clinicians are uncertain about this diagnosis. These findings provide a systematic way to modify definitions that contrasts with the more arbitrary ways in which diagnoses have previously been defined and redefined.

Diagnosis, Differential↗
PubMed1977

Anorexia nervosa. An affective disorder?

Follow-up data on 26 patients hospitalized during adolescence for anorexia nervosa are presented. The mean length of follow-up was 4.9 years. There were no mortalities. Only one patient at the time of follow-up was still possibly anorexic. However, a substantial number of the patients did have other eating difficulties. Most striking was the clinical psychopathology present at follow-up, particularly the incidence of affective disorder. A large number of patients manifested depressive symptomatology in both the premorbid and the postmorbid states, as well as at the time of follow-up. A family history of affective disorder was particularly common in the mothers of the anorexic patients. Data from this study are consistent with the hypothesis that there is a strong relationship between anorexia nervosa and affective disorder.

Adolescent↗
PubMed1989

Psychosis proneness and clinical psychopathology: examination of the correlates of schizotypy.

The present report examined the associations between the Perceptual Aberration Scale (PAS), a prominent psychometric index of hypothetical psychosis proneness, and several measures of clinical psychopathology in a nonpsychotic psychiatric sample (N = 101). Patients were examined by experienced clinicians using structured psychiatric interviews to assess DSM-III-R Axis I and II conditions and rated for anxiety, depression, severity of illness, and current adult social competence. Elevated scores on the PAS were most closely associated with anxiety and depression as well as schizotypal, schizoid, avoidant, and obsessive-compulsive personality disorder symptomatology. Hierarchical regression analysis identified schizotypal symptoms and anxiety as the two underlying psychopathological processes most useful in explaining variance in PAS scores. Results are interpreted as supporting both the clinical relevance and research utility of the PAS and enhancing the construct validity of Meehl's model of schizotypy.

Adolescent↗