scholarly journals What influences treatment satisfaction in patients with personality disorders? A naturalistic investigation in a hospitalization setting

2016 ◽  
Vol 8 (2) ◽  
pp. 47-53
Author(s):  
Stefan Gebhardt ◽  
Martin Tobias Huber
Keyword(s):  
Personality Disorders ◽  
Treatment Satisfaction ◽  
Symptom Improvement ◽  
Care Hospital ◽  
Global Functioning ◽  
Lower Treatment ◽  
Exploratory Approach ◽  
Exploratory Investigation ◽  
Clinical Interest ◽  
Functioning Level

Treatment satisfaction of different mental disorders is still poorly understood, but of high clinical interest. Inpatients of a general psychiatric care hospital were asked to fill out questionnaires on satisfaction and clinical variables at admission and discharge. On the basis of an exploratory approach, differences in treatment satisfaction among diagnostic groups were examined by means of one-way analysis of variance. Potential associated clinical and socio-demographic variables were studied using multi/univariate tests. Patients with personality disorders (n=18) showed a significantly lower treatment satisfaction (ZUF-8, Zurich Satisfaction Questionnaire) and a slightly lower improvement of symptoms (CGI, Clinical Global Impression) and global functioning (GAF, Global Assessment of Functioning scale) than that of other diagnostic groups (n=95). Satisfaction in patients with personality disorders correlated much stronger with the symptom improvement and slightly with the functioning level than in patients without personality disorders. Interestingly, in patients with personality disorders psychopharmacological treatment in general (present versus not present) was independent from satisfaction. This exploratory investigation suggests that a lower satisfaction of patients with personality disorders in a general psychiatric hospital is mainly based on a reduced improvement of the symptoms and of the global functioning level.

scholarly journals What influences treatment satisfaction in patients with personality disorders? A naturalistic investigation in a hospitalization setting

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Stefan Gebhardt ◽  
Martin Tobias Huber
Keyword(s):  
Personality Disorders ◽  
Treatment Satisfaction ◽  
Symptom Improvement ◽  
Care Hospital ◽  
Global Functioning ◽  
Lower Treatment ◽  
Exploratory Approach ◽  
Exploratory Investigation ◽  
Clinical Interest ◽  
Functioning Level

Treatment satisfaction of different mental disorders is still poorly understood, but of high clinical interest. Inpatients of a general psychiatric care hospital were asked to fill out questionnaires on satisfaction at discharge and clinical variables at admission and discharge were assessed. On the basis of an exploratory approach, differences in treatment satisfaction among diagnostic groups were examined by means of one-way analysis of variance. Potential associated clinical and socio-demographic variables were studied using multi/univariate tests. Patients with personality disorders (n=18) showed a significantly lower treatment satisfaction (ZUF-8, Zurich Satisfaction Questionnaire) and a slightly lower improvement of symptoms (CGI, Clinical Global Impression) and global functioning (GAF, Global Assessment of Functioning scale) than that of other diagnostic groups (n=95). Satisfaction in patients with personality disorders correlated much stronger with the symptom improvement and slightly with the functioning level than in patients without personality disorders. Interestingly, in patients with personality disorders psychopharmacological treatment in general (present versus not present) was independent from satisfaction. This exploratory investigation suggests that a lower satisfaction of patients with personality disorders in a general psychiatric hospital is mainly based on a reduced improvement of the symptoms and of the global functioning level.

scholarly journals Proportion of Psychiatry Outpatients with Borderline Personality and Associated Clinical Syndromes using the Millon Clinical Multiaxial Inventory-III: A Retrospective Study

2021 ◽  
Author(s):  
Shaunak Ajit Ajinkya ◽  
Pranita Shantanu Sharma ◽  
Aparna Ramakrishnan
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Borderline Personality ◽  
Personality Types ◽  
Care Hospital ◽  
Millon Clinical Multiaxial Inventory ◽  
Clinical Syndromes ◽  
Thought Disorders

Introduction: Personality disorders are a group of behavioural patterns associated with significant personal and socio-occupational disturbances. Numerous studies have demonstrated borderline personality to be one of the most common personality disorders. It’s less often diagnosed with just a clinical assessment. Aim: To examine the proportion of patients with Borderline Personality Disorder (BPD), and its associated personality types and clinical syndromes, using the Millon Clinical Multiaxial Inventory version-III (MCMI-III). Materials and Methods: A retrospective observational study was carried out on 450 adult patients who attended the psychiatry outpatient department of an urban tertiary care hospital. They had been administered the MCMI-III, a self-rating questionnaire commonly used to provide information on personality types and associated clinical syndromes. Statistical Package for the Social Sciences (IBM SPSS, Windows) version 20.0 was used for statistical analyses. Data was expressed in terms of actual number, mean and percentages. Chi-Square or Fisher’s-exact test, as appropriate, was used for categorical data to test for associations. Odds ratio was estimated to measure strength of the association. Results: Borderline was the most common personality type comprising nearly half (46.63%) of the study population. 25.5% had borderline traits while 21.1% had Borderline Personality Disorder (BPD). BPD was significantly higher in females (p<0.001), younger age group below the age of 40 years (p<0.001) and unmarried persons (p<0.001). It was comorbid most with Anxiety (90.91%; OR=4.05; p<0.001), Major Depression (85.23%; OR=18.39; p<0.001), Post Traumatic Stress Disorder (PTSD) (46.59%; OR=6.30; p<0.001) and Thought disorders (56.82%; OR=18.15; p<0.001). Alcohol (22.73%; OR=3.54; p<0.001) and Drug dependence (13.64%; OR=11.52; p<0.001) were also seen significantly higher in patients with BPD. Personality types significantly comorbid with BPD were Sadistic, Depressive, Masochistic, Negativistic, Schizotypal, Avoidant, Dependent, Antisocial and Paranoid types, with odds being most for Sadistic personality (OR=9.44). Conclusion: It is recommended that mental health professionals and clinicians should start to look for underlying symptoms of BPD in patients of anxiety and mood syndromes. If found these patients should be directed for psychotherapy as early as possible. The MCMI psychological test would be an important contribution to this area, given the need for systematic, quick, and objective testing methods that facilitate the diagnosis.

Low-FODMAP Diet for Irritable Bowel Syndrome: What We Know and What We Have Yet to Learn

2020 ◽  
Vol 71 (1) ◽  
pp. 303-314 ◽  
Author(s):  
Jerry Liu ◽  
William D. Chey ◽  
Emily Haller ◽  
Shanti Eswaran
Keyword(s):  
Irritable Bowel Syndrome ◽  
Treatment Strategy ◽  
Symptom Improvement ◽  
Dietary Manipulation ◽  
Diet Plan ◽  
Gi Symptoms ◽  
Clinical Interest ◽  
Irritable Bowel ◽  
Fodmap Diet

Irritable bowel syndrome (IBS) is the most prevalent of gastrointestinal (GI) conditions, affecting millions of people worldwide. Given that most IBS patients associate their GI symptoms with eating food, specific dietary manipulation has become an attractive treatment strategy. A diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) has generated the greatest level of scientific and clinical interest. Overall, 52–86% of patients report significant improvement of their IBS symptoms with elimination of dietary FODMAPs. Patients who experience symptom improvement with FODMAP elimination should undergo a structured reintroduction of foods containing individual FODMAPs to determine sensitivities and allow for personalization of the diet plan. This review discusses the literature surrounding the administration of the low-FODMAP diet and its efficacy in the treatment of IBS.

Assessment of Tamsulosin 0.2 mg for Symptomatic Bladder Outlet Obstruction Secondary to Benign Prostatic Enlargement: Data from a Korean Multicenter Cross-Sectional Study

2015 ◽  
Vol 95 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Hoon Choi ◽  
Ji Sung Sim ◽  
Jae Young Park ◽  
Jae Hyun Bae
Keyword(s):  
Treatment Satisfaction ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Symptomatic Improvement ◽  
Cross Sectional Study ◽  
Symptom Improvement ◽  
Benign Prostatic Enlargement ◽  
Cross Sectional ◽  
Patient Dissatisfaction ◽  
Prostatic Enlargement

Aims: To estimate efficacy and treatment satisfaction with tamsulosin 0.2 mg in patients with symptomatic bladder outlet obstruction secondary to benign prostatic enlargement and lower urinary tract symptoms in relation to personal satisfaction. Methods: The study was conducted in 1,260 subjects who were asked to fill in detailed questionnaires designed to evaluate their satisfaction with the treatment and symptom improvement 8 weeks after receiving tamsulosin 0.2 mg. Results: After being treated with tamsulosin 0.2 mg for 8 weeks, the International Prostate Symptom Score (IPSS) score improved significantly. Among the 1,260 patients, 813 (64.52%) were satisfied, while 447 (35.48%) were dissatisfied with tamsulosin 0.2 mg. The reasons for patient dissatisfaction were efficacy problems (79.87%) and side effects (4.25%). Treatment satisfaction was affected by age, underlying medical disease and baseline IPSS severity (p = 0.020, 0.0427 and <0.001, respectively), but only age and baseline IPSS were risk factors for dissatisfaction. Conclusions: Tamsulosin 0.2 mg was effective in symptomatic improvement, but a relatively high proportion of patients were dissatisfied with the treatment. Efficacy problems were selected by patients as the main reason for dissatisfaction. It is also significant to note that the degree of satisfaction was related to age and baseline IPSS severity.

scholarly journals Treatment satisfaction among diabetics attending a tertiary care hospital of Rohtak, Haryana: a cross-sectional study

2019 ◽  
Vol 6 (4) ◽  
pp. 1623
Author(s):  
Meena Rajput ◽  
Yashodha Arivarasan ◽  
Rajesh Rajput ◽  
Aereosonova Khongsit
Keyword(s):  
Treatment Satisfaction ◽  
Tertiary Care ◽  
Drug Regimen ◽  
Cross Sectional Study ◽  
Positive Influence ◽  
Care Hospital ◽  
Oral Hypoglycaemic Agents ◽  
Cross Sectional ◽  
Family History Of Diabetes ◽  
Vernacular Language

Background: The epidemic of diabetes mellitus is rising globally due to urbanization, population growth, aging, obesity and sedentary life style. Treatment satisfaction is defined as the individual’s rating of important attributes of the process and outcomes of his/her treatment experience and it represents an important outcome as it is related to adherence and willingness to continue treatment.Methods: A cross-sectional descriptive hospital-based study was conducted at endocrinology OPD attached to Pt. B.D. Sharma PGIMS Rohtak, Haryana from May 2014 to April 2015. Five hundred diabetics (type 1 and 2) were recruited for the study. Patients registered on the day of interview were selected using systematic random sampling. A predesigned, pretested, semi-structured schedule which included socio-demographic variables of the study subjects along with information about family history of diabetes was filled by interviewing the study subjects in their vernacular language individually. DiabMedSat was used to assess the treatment satisfaction.Results: Nearly two third of the study participants were treated on oral hypoglycaemic agents (76.2%) followed by subjects treated on insulin+OHA (21.4%). 2.4% of the study subjects were on treatment with insulin alone. 87.8% of female subjects were satisfied with their treatment as compared to 86.3% of their male counterparts.Conclusions: Treatment satisfaction has a positive influence on quality of life of the study subjects as those who are satisfied tend to better adhere to their drug regimen thereby achieving a desirable glycaemic control and averting the complications associated with the disease thereby leading to a healthier life.

scholarly journals Personality disorder and impaired functioning from adolescence to adulthood

2007 ◽  
Vol 190 (5) ◽  
pp. 415-420 ◽  
Author(s):  
Andrew E. Skodol ◽  
Jeffrey G. Johnson ◽  
Patricia Cohen ◽  
Joel R. Sneed ◽  
Thomas N. Crawford
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Epidemiological Data ◽  
Adult Onset ◽  
Global Functioning ◽  
Community Based ◽  
Axis I Disorders ◽  
Significant Impairment ◽  
Axis I

BackgroundLittle is currently known about functioning and impairment during adulthood associated with the course of personality disorders.AimsTo investigate the association of personality disorder stability from adolescence through middle adulthood with measures of global functioning and impairment, using prospective epidemiological data.MethodA community-based sample of 658 individuals was interviewed at mean ages 14, 16, 22 and 33 years.ResultsIndividuals with persistent personality disorder had markedly poorer functioning and greater impairment at mean age 33 years than did those who had never been identified as having such disorder or who had a personality disorder that was in remission, after co-occurring Axis I disorders at age 33 years were taken into account. Remitted disorder was associated with mild long-term impairment. Adult-onset personality disorders, however, were also associated with significant impairment.ConclusionsPersistent and adult-onset personality disorders are associated with functional impairment among adults in the community. These effects are independent of co-occurring Axis 1 disorders.

scholarly journals T43. PREDNISOLONE VERSUS PLACEBO AS AUGMENTATION THERAPY IN PSYCHOTIC DISORDERS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S248-S248
Author(s):  
Nasib Lyliana ◽  
Inge Winter ◽  
Rene Kahn ◽  
Iris Sommer
Keyword(s):  
Treatment Period ◽  
Psychotic Disorder ◽  
Symptom Severity ◽  
Psychotic Disorders ◽  
Symptom Improvement ◽  
Potential Candidate ◽  
Proof Of Concept ◽  
Augmentation Therapy ◽  
Global Functioning ◽  
Concept Study

Abstract Background An increasing body of evidence suggests that immune dysregulation is involved in the pathophysiology of psychotic disorders. Some, but not all, anti-inflammatory drugs have shown positive effects on symptom severity. Given the need for new treatment options in psychosis, anti-inflammatory medication should be explored as a potential treatment to improve outcome. Being a potent glucocorticosteroid that adequately passes through the blood-brain barrier, prednisolone qualifies as a potential candidate. This proof-of-concept study aims to explore the effect of prednisolone, compared to placebo, on symptom severity in patients with a psychotic disorder who are on a stable dose of antipsychotic medication. Methods The study was conducted from July 2015 until April 2019 in four centers in the Netherlands and Belgium. Patients with a psychotic disorder were randomized, double blind, 1:1 to prednisolone or placebo in addition to their antipsychotic treatment. Patients randomized to prednisolone started with 40 mg/day, tapered down to zero in six weeks. Several procedures were implemented to ensure patient safety during prednisolone exposure (e.g. regular safety labs). The primary objective was to compare change in symptom severity, measured through the Positive and Negative Syndrome Scale (PANSS), in patients treated with prednisolone versus placebo, in additional to a stable antipsychotic regimen. To this end, a mixed model repeated measures ANOVA was applied. Results 42 participants were randomized, equally divided across the treatment arms. The six week treatment period was completed by 20 patients randomized to placebo and 19 patients randomized to prednisolone. There were no baseline differences in demographics, symptom severity, depression or global functioning between the treatment groups. There was no difference in symptom improvement between patients treated with prednisolone compared to placebo at the end of the six week treatment period (p=.304). Global functioning and depression were not significantly different between treatment arms end of treatment. No Serious Adverse Events (SAEs) occurred during the treatment phase. Discussion The results of this proof-of-concept study do not support the immune hypothesis of psychosis: there was no difference in symptom improvement after a six week treatment with prednisolone compared to placebo, in addition to a stable regimen of antipsychotics. The small sample size is the main limitation of this trial. Even though prednisolone did not show to be a potential candidate for augmentation therapy in psychosis, it is of interest to note that patients did not deteriorate when using prednisolone nor were there more SAE’s in the active treatment arm. This argues against the general safety concerns for prescribing prednisolone in patients with psychosis for the treatment of immune disorder, although additional research is needed.

Personality Disorders and Long-Term Sick Leave: A Population-Based Study of Young Adult Norwegian Twins

2014 ◽  
Vol 17 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Line C. Gjerde ◽  
Espen Røysamb ◽  
Nikolai Czajkowski ◽  
Gun Peggy Knudsen ◽  
Kristian Østby ◽  
...  
Keyword(s):  
Young Adult ◽  
Sick Leave ◽  
Personality Disorders ◽  
Structured Interview ◽  
Population Based ◽  
Causal Association ◽  
Global Functioning ◽  
Dsm Iv ◽  
Age Range

Personality disorders (PDs) reduce global functioning, are associated with high levels of work disability, and are thus also likely to influence long-term sick leave (LTSL). Previous research has indicated significant genetic influence on both DSM-IV PDs and LTSL. To what degree genes contributing to PDs also influence LTSL has not been investigated. The aims of the current study were to investigate which PDs were significantly associated with LTSL, to what extent the genetic contributions to these PDs account for the heritability of LTSL, and to explore the hypothesis of a causal association between PDs and LTSL. The sample consisted of 2,771 young, adult Norwegian twins, born 1967–1979. PDs were assessed using the Structured Interview for DSM-IV Personality (SIDP-IV). The age range for the interview was 20–32. The data were subsequently linked to public records of LTSL (sick leave >16 days) up to 11 years later. The odds ratio for being in the highest LTSL category (>15% sick leave) when fulfilling the DSM-IV criteria for any PD diagnosis was 2.6 (1.8–3.8, 95% CI). Dimensional representations of schizotypal, paranoid, and borderline PD were independently and significantly associated with LTSL. The heritability of LTSL was 0.50. Genetic factors shared with the PDs accounted for 20% of this. The association between PDs and LTSL was due to shared genetic and not environmental influences, and was mainly explained by one common genetic factor. The hypothesis of a causal association was not supported, indicating that the association is explained by overlapping genetic liability between PDs and LTSL.

A three years follow-up of a group of «everyday patients» in a mental health centre

1997 ◽  
Vol 6 (2) ◽  
pp. 107-117 ◽  
Author(s):  
Marco Chiappelli ◽  
Francesca Pileggi ◽  
Giorgio Rosini ◽  
Giovanni Neri
Keyword(s):  
Mental Health ◽  
Discharge Rate ◽  
Health Centre ◽  
Drop Out ◽  
Community Mental Health Centre ◽  
Global Functioning ◽  
Chi Square ◽  
Mental Health Centre ◽  
Functioning Level ◽  
Concordance Measures

SUMMARYObjective — This research concerns those patients who most attend the community Mental Health Centre (CSM), hereby called «everyday patients». According to a previous research (Pileggi et al., 1992) a sample of patients mostly attending the Centre had been pointed out. Basing on the number of attendances, it emerged that some of those patients (57) had been on the average attending the Centre more than twice a week and, despite being only 10% of the total number of users, they had taken on a large share of the services offered by the Centre (30%). Therefore, those patients were the ones the Centre had been working for more intensely and continuously. Three years later, the object of this research is to check the assistance and clinical destiny of such patients and compare their patterns of attendances to those ones regarding the remainder of the CSM users. The hypothesis is that «everyday patients» are assisted by different and continuous treatments and that such a procedure prevents patients from dropping out and determines a strong reduction in relapses and less frequent attendances. Design — Longitudinal study on a 42 patient sample (19 males, 23 females) on therapy at CSM. Setting — Mental Health Centre, «Saragozza» District, Sanitary Unit of Bologna. Main outcome measures — The following elements have been examined: 1) social and demographic features; 2) duration of psychiatric history; 3) clinical diagnosis according to DSM-HI-R, set by patients personal psychiatrist; 4) global functioning level as examined by two psychiatrists or psychologists from the Centre, using DSM-III-R Global Functioning Scale (GFS); 5) actions carried out and patterns of using the CSM services over the past 12 months. Concordance measures among independent examiners (Cohen K) and non-parametric variability measures for comparison between groups (Chi-square and Kruskal-Wallis tests) have been used. Results and conclusion — Results partially confirm the original hypotheses. In particular, complicated services (psychological and pharmacological therapies and rehabilitation) are carried out for the most of «everyday patients» and much more intensely to them than to the remainder of the users. No drop-out has been found out, the global functioning level of the patients is good in most of cases and the number of necessary admissions to psychiatric wards has been reduced. However, the «attendance share» relevant to the sample of «everyday patients» is still high compared to the total number of the CSM users. Besides, discharge rate is nought.

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