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PubMed2005

Testing the autogenous-reactive model of obsessions.

Two independent studies were conducted to examine the autogenous-reactive subtype model of obsessions [Lee and Kwon, 2003]. Study 1 demonstrated that 30 obsessive-compulsive (OCD) patients' responses to autogenous versus reactive obsessions differed significantly with respect to emotional reactions, cognitive appraisals, and control strategies. Study 2 compared OCD patients whose primary obsessions were of the autogenous subtype (n=13) with OCD patients whose primary obsessions were of the reactive subtype (n=14). Results revealed significant differences between these two groups on several OCD-related domains including OCD symptom profiles, perfectionistic personality features, and dysfunctional beliefs. Theoretical and clinical implications are discussed.

Adult↗
PubMed2005

Do personality disorders predict negative treatment outcome in obsessive-compulsive disorders? A prospective 6-month follow-up study.

BACKGROUND: Comorbid personality disorders (PDs) are discussed as risk factors for a negative treatment outcome in obsessive-compulsive disorder (OCD). However, studies published so far have produced conflicting results. The present study examined whether PDs affect treatment outcome in patients with OCD. METHOD: The treatment sample consisted of 55 patients with OCD who were consecutively referred to a Behaviour Therapy Unit for an in-patient or day-clinic treatment. Treatment consisted of an individualised and multimodal cognitive behaviour therapy (CBT, with or without antidepressive medication). Measurements were taken prior and after treatment and 6-month after admission. RESULTS: A large percentage of patients benefited from treatment irrespective of the presence of a PD and were able to maintain their improvement at follow-up. Duration of treatment was not prolonged in OCD patients with concomitant Axis II disorders. However, some specific personality traits (schizotypal, passive-aggressive) were baseline determinants for later treatment failure at trend level. CONCLUSIONS: Results are encouraging for therapists working with patients co-diagnosed with Axis II disorders since these patients are not necessarily non-responders. The results stress the importance of a specifically tailored treatment approach based on an individual case formulation in OCD patients with complex symptomatology and comorbid Axis II disorders.

Adolescent↗
PubMed1998

The influence of obsessive-compulsive neurosis patients' premorbid personality on obsessive-compulsive symptoms and efficacy of medication.

We conducted a survey with the Lynfield obsessive-compulsive symptom questionnaire (revised version) on 48 obsessive-compulsive neurotic patients as the survey subjects. In the factor analysis five factors of obsessions, were identified: (i) the desire for perfection; (ii) compulsive checking; (iii) washing; (iv) feelings of uncleanliness; and (v) anthropophobia. High correlations were noted between these factors. We also investigated the premorbid personalities of obsessive-compulsive neurotic patients with a multidimensional personality scale and obtained an extroversion dimension and neuroticism dimension. The influence of these premorbid personality dimensions on obsessive-compulsive symptoms became clear; (i) neuroticism is related to the levels of obsession after onset, but not related to compulsive behaviors; and (ii) No differences in premorbid personality dimensions were noted between compulsive checking and compulsive washing behaviors. We also studied whether it was possible to predict the efficacy of pharmacotherapy upon obsessive-compulsive symptoms. It was elucidated that the obsessions of those whose premorbid personalities are emotionally stable and extroversive are susceptible to antidepressants. Based on these results, we discussed the usefulness of premorbid personalities in predicting diversity of obsessive-compulsive symptoms, as well as in prediction the efficacy of medication.

Adolescent↗
PubMed2005

[Stalking: unwelcome company. The psychopathology of a modern phenomenon].

The term stalking describes a pattern of behavior in which the victim is pursued, pestered and threatened. In many cases, the stalker resorts to physical violence, and may even commit murder. In the German-speaking areas, the phenomenon is to date not much discussed in the psychiatric and psychological literature, despite the fact that it is a widespread occurrence. While stalkers are diagnosed as suffering from schizophrenia and/or narcissistic as well as borderline disorders, victims have no typical "victim personality". They do, however, respond to stalking with anxiety, depression and post-traumatic stress disorders, which need to be recognized and treated.

Adult↗
PubMed1976

Some personality characteristics of patients with anorexia nervosa.

Twenty-two female patients with anorexia nervosa were assessed by means of objective personality testing. The EPI, Leyton Obsessional Inventory, Cattell's 16 PF and Raven's Matrices were used for this purpose. The personality profile that emerged was of a highly neurotic and introverted person with moderately severe obsessional features and average intelligence.

Adolescent↗
PubMed1997

The prediction of length of major depressive episodes: results from an epidemiological sample of female twins.

In order to examine factors that influence the time to recovery (TTR) from depressive episodes in women, we examined members of 1030 female-female twin pairs of known zygosity, ascertained from a population-based twin registry. We predicted, in a Cox model, TTR in 235 women with an onset of an episode of major depression (MD) in the last year meeting DSM-III-R criteria. The median and mean TTR for episodes of MD was 42 and 82 days, respectively; only 2.2% of women had not recovered by 1 year. Four variables predicted TTR: financial difficulties, obsessive-compulsive symptoms, severe life events (SLEs), and genetic risk. Dividing all depressive episodes meeting symptomatic DSM-III-R criteria into early (5-28 days) and late (> 28 days) phases, significant predictors of TTR early in the course of illness (income, parental protectiveness and separation, personality, lifetime traumas and SLEs) differed from those that predicted TTR later in the depressive episode (health, social support, obsessive-compulsive symptoms, SLEs and genetic risk). Including cases with chronic MD increased the strength of personality, financial problems and genetic risk as predictors of slow TTR. These exploratory analyses suggest that TTR from MD in women is influenced by multiple environmental, temperamental and genetic factors. Predictors of TTR early and later in the course of MD may differ qualitatively, suggesting different processes in recovery from brief versus prolonged depressions.

Chronic Disease↗
PubMedDate not supplied

Dental management of the patient with obsessive-compulsive disorder.

Individuals with obsessive-compulsive disorder frequently manifest bizarre behaviors that contribute to the oral disease development. The medications used to manage the disorder can cause profound xerostomia and compound the magnitude of oral pathology. The patient's behavioral alterations and drug therapy might require dental treatment modifications.

Adolescent↗
PubMed1997

Alexithymia in anorexia nervosa: a controlled study using the 20-item Toronto Alexithymia Scale.

The 20-item Toronto Alexithymia Scale (TAS) was completed at the age of 22 years by individuals who had previously suffered from anorexia nervosa (AN), and also by members of a comparison group. The AN and comparison groups had been recruited from community samples. Overall, the TAS scores did not clearly discriminate between the two groups. However, the AN group was significantly more often represented among subjects with the highest TAS scores. A subgroup with empathy disorder tended to have particularly high scores. It is concluded that alexithymia, as defined using the TAS-20, is found only in a subgroup of individuals with AN, and possibly more often in those who are also clinically diagnosed as suffering from empathy disorder. The TAS-20 is not suitable for screening of AN in the general population.

Adolescent↗
PubMed1974

[Social and legal problems in the so-called poriomania, with special reference to desertion and AWOL].

Following a synopsis of the main bibliography and a number of own cases it could be pointed out that the so-called poriomania is accompanied with punishable acts in about one-third of all cases. An analysis of the different delicts yielded as result a clear preponderance of larcency of money, fraud and embezzlement - in comparison with desertion and absence without official leave. Only 20% of all cases with punishable acts were denounced. In former times, up to the first world war, about a percentage of 74 of all criminal cases in connection with poriomania was exonerated on the erroneous assumption that the behaviour of the so-called poriomania would be caused by epilepsy. About one third of all persons with poriomania are feebleminded. There is a high inclination to fraud, pseudologia, abuse of alcohol and prostitution. An enlarged inclination (15%) to suicide is also remarkable. A familiar accumulation of poriomania does not justify the supposition of an endogenous factor. Therefore criminal acts in connection with poriomania connot be exonerated. The personality of men with poriomania is characterised by unsteadiness, unstableness and velleity.

Adolescent↗
PubMed1976

Acculturation and psychopathology among Puerto Rican women in mainland United States.

This study explores relationships between the stress of acculturation and the existence of psychopathology among 72 Puerto Rican women in mainland United States. Significant correlations were found between level of acculturation and education and both personality adjustment and psychopathology. Implications for Puerto Rican family structure are discussed, and suggestions for further research are offered.

Acculturation↗
PubMed1990

Effect of DSM-III personality disorders on outcome of tricyclic antidepressant-treated nonpsychotic outpatients with major or minor depressive disorder.

This is the first outcome report of the effect of a personality disorder on nonhospitalized major depressive patients that used a standardized DSM-III measure and did not prescreen to eliminate certain personality disorders. Six-month outcome was compared for nonpsychotic patients with major depression and a DSM-III personality disorder (n = 26) and those who did not have a personality disorder (n = 11). Patients without a personality disorder had significantly better outcome as measured by the Global Assessment Scale and employment status. There was also a trend for less physician utilization in this group.

Adjustment Disorders↗
PubMed2002

The outcome of anorexia nervosa in the 20th century.

OBJECTIVE: The present review addresses the outcome of anorexia nervosa and whether it changed over the second half of the 20th century. METHOD: A total of 119 study series covering 5,590 patients suffering from anorexia nervosa that were published in the English and German literature were analyzed with regard to mortality, global outcome, and other psychiatric disorders at follow-up. RESULTS: There were large variations in the outcome parameters across studies. Mortality estimated on the basis of both crude and standardized rates was significantly high. Among the surviving patients, less than one-half recovered on average, whereas one-third improved, and 20% remained chronically ill. The normalization of the core symptoms, involving weight, menstruation, and eating behaviors, was slightly better when each symptom was analyzed in isolation. The presence of other psychiatric disorders at follow-up was very common. Longer duration of follow-up and, less strongly, younger age at onset of illness were associated with better outcome. There was no convincing evidence that the outcome of anorexia nervosa improved over the second half of the last century. Several prognostic features were isolated, but there is conflicting evidence. Most clearly, vomiting, bulimia, and purgative abuse, chronicity of illness, and obsessive-compulsive personality symptoms are unfavorable prognostic features. CONCLUSIONS: Anorexia nervosa did not lose its relatively poor prognosis in the 20th century. Advances in etiology and treatment may improve the course of patients with anorexia nervosa in the future.

Adolescent↗
PubMed2006

Long-term changes in self-reported personality following capsulotomy in anxiety patients.

The objective of the study was to describe changes in self-reported personality in anxiety patients undergoing capsulotomy. Sixteen patients with anxiety diagnoses undergoing capsulotomy were included. Ratings of personality characteristics with the Karolinska Scales of Personality (KSP), anxiety symptoms and adverse effects such as apathy and dysexecution were performed at baseline, at 1 year and 8-18 years post-operatively. Twelve patients had an anxiety reduction of at least 50%. Patients were significantly less anxiety prone at long-term follow-up as measured by KSP. Four patients suffered from adverse effects indicating frontal lobe dysfunction. There was no significant correlation between the reduction in BSA score and the KSP change from pre-operatively to long term in any of the KSP scales. In line with previous studies, high anxiety proneness normalizes after capsulotomy in anxiety patients. Adverse effects were more frequent than expected. The conclusion based on previous KSP findings that the incidence of adverse personality changes following capsulotomy is low and does not increase with time is challenged by the present study.

Adult↗
PubMed2002

A comparison of purging and non-purging eating disorder patients in comorbid personality disorders and psychopathology.

OBJECTIVE: We evaluated the significance of purging behavior in the diagnosis of eating disorders through an objective assessment of eating disorder psychopathology including personality disorders. METHODS: Subjects were 42 consecutive outpatients with eating disorders who visited the Outpatient Psychiatric Clinic at Tokai University Hospital (Kanagawa, Japan). Diagnosis of eating and personality disorders was established using the modified Structured Clinical Interviews for DSM-III-R and DSM-III-R-Axis II. Eating disorder symptoms and psychopathology were assessed with the Eating Disorder Examination, Eating Disorder Inventory 2, Beck Depression Inventory, and Leyton Obsessional Inventory Results were compared between purgers and non-purgers. RESULTS: Purgers had severe borderline or avoidant personality disorder, mixed personality disorder, eating attitude, depressive symptoms, and obsessive symptoms. CONCLUSION: Purging behavior in eating disorder patients is associated with personality disorders, depression, and obsessive symptoms. Assessment of this behavior is critical in the diagnosis and treatment of eating disorders.

Adult↗
PubMed2002

Clinical perfectionism: a cognitive-behavioural analysis.

This paper reviews the characteristics of clinical perfectionism and proposes a new definition of the phenomenon. It is suggested that the defining feature of clinically significant perfectionism is the overdependence of self-evaluation on the determined pursuit (and achievement) of self-imposed personally demanding standards of performance in at least one salient domain, despite the occurrence of adverse consequences. It is suggested that such clinical perfectionism is maintained by the biased evaluation of the pursuit and achievement of personally demanding standards. Specifically, it is suggested that people with perfectionism react to failure to meet their standards with self-criticism. If they do meet their standards, the standards are re-evaluated as being insufficiently demanding. Anorexia nervosa and bulimia nervosa are considered to have a particular relationship to perfectionism, with both disorders often being direct expressions of perfectionism. Under these circumstances self-evaluation is dependent on the pursuit and attainment of personally demanding standards in the domain of control over eating, shape and weight. The implications of this analysis for research and practice are considered.

Achievement↗
PubMed1990

The sexual addict: a challenge for the primary care provider.

Sexual compulsion is now recognized as a true addictive process that may manifest itself through a wide range of behaviors. Recognition of this disorder in primary care settings may be difficult because of the ego defenses of denial and rationalization that characterize this disorder. Cues in the medical and sexual history as well as behavioral cues may suggest the presence of sexual addiction. The alert primary care provider should play a significant role in the recognition of sexual addiction.

Adaptation, Psychological↗
PubMed1998

Divergent responses to fluoxetine from two compulsive, food-related conditions: bulimia nervosa and compulsive water drinking.

BACKGROUND: The association of compulsive water drinking with bulimia nervosa is rarely encountered. Nevertheless similar behavior patterns could involve a common pathophysiological mechanism. METHODS: A case report with the association of those two disorders is described. Treatment with fluoxetine was introduced to alleviate the compulsive aspects of those disorders. RESULTS: Fluoxetine had a positive effect on bulimia nervosa but none on compulsive water drinking. CONCLUSIONS: The different response to pharmacologic treatment could mean that bulimia nervosa and compulsive water drinking are based on different physiological mechanisms.

Adult↗