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  • Title: [Personality disorders in an institution for ambulatory mental health care. Prevalence, type and severity, treatment indication and drop out].
    Author: Ten Kate CA, Eurelings-Bontekoe EH, Muller N, Spinhoven P.
    Journal: Tijdschr Psychiatr; 2007; 49(9):597-609. PubMed ID: 17853369.
    Abstract:
    BACKGROUND: Personality disorders occur frequently. The presence of one or more personality disorders can influence the severity of the symptoms and can affect coping, treatment indication and drop out. AIM: To study the prevalence of personality disorders in an ambulatory health care centre and to investigate the influence of both the severity and the nature of personality disorders on the following: symptomatology, interpersonal behaviour, coping and defence mechanisms, personality traits, treatment indication and drop out. METHOD: We studied the prevalence of personality disorders in 100 patients using the International Personality Disorder Examination (IPDE), a semi-structured interview. Symptoms, interpersonal behaviour, coping and defence mechanisms and personality traits were assessed by means of self-reports. Patients were assigned to specific types of treatment by their own doctors, who were not aware of the assessment results. results Most of the patients suffered from a personality disorder. Patients with cluster-A-type personality disorders were all assigned to treatment. The majority of patients with cluster- B-type personality disorders were assigned to Axis-ii-type treatment but most patients with cluster-A-and cluster-C personality disorders were assigned to Axis-I-type treatment. The dropout percentage was higher among patients with a personality disorder than among those without. Among patients with personality disorders the drop-out percentage was highest in those from the A and C clusters. Patients with personality pathology from the A cluster were 13 times more likely to drop out than those without A cluster pathology, patients with C cluster pathology were 11 times more likely to drop out than those without C cluster pathology. CONCLUSION: In ambulatory mental health care more attention needs to be given to the diagnosis of personality disorders. Results suggest that in the treatment of patients with A and C cluster pathology much effort must be directed at fostering therapeutic alliance and compliance to treatment.
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