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I Disorders (i + disorders)
Kinds of I Disorders Selected AbstractsDepression in Croatian Type 2 diabetic patients: prevalence and risk factors.DIABETIC MEDICINE, Issue 7 2005A Croatian survey from the European Depression in Diabetes (EDID) Research Consortium Abstract Aims To determine the prevalence rate of and risk factors for depression in Croatian Type 2 diabetic patients. Methods Depressive mood was examined in 384 randomly selected outpatients with Type 2 diabetes. Center for Epidemiological Studies Depression Scale (CES-D) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) were used to identify depressive disturbances. The groups with CES-D , 16 and < 16 were compared with respect to demographic, psychological and clinical characteristics. Regression analysis was used to determine risk factors for depression. Results Of the examined patients, 22% had CES-D scores , 16, and in 33% of them clinical depression was confirmed by the psychiatric interview. Depressed patients compared with the non-depressed ones reported more diabetes-related problems and poorer well-being (t = 6.71, P < 0.001 and t = 11.98, P < 0.001, respectively). Multiple regression analysis indicated female gender, experienced support and the level of emotional well-being to predict depression (R = 0.74, F = 15.3, P < 0.001). Conclusions The obtained data indicate that the prevalence rate in Croatian Type 2 diabetic patients is comparable to findings from other cultural settings. Depressive symptoms can be predicted by psychological rather than disease-related variables. Psychological care for diabetic patients may be necessary to prevent depressive symptomatology. [source] New onsets of substance use disorders in borderline personality disorder over 7 years of follow-ups: findings from the Collaborative Longitudinal Personality Disorders StudyADDICTION, Issue 1 2009Marc Walter ABSTRACT Aims The purpose of this study was to examine whether patients with borderline personality disorder (BPD) have a higher rate of new onsets of substance use disorders (SUD) than do patients with other personality disorders (OPD). Design This study uses data from the Collaborative Longitudinal Personality Disorder Study (CLPS), a prospective naturalistic study with reliable repeated measures over 7 years of follow-up. Setting Multiple clinical sites in four northeastern US cities. Participants A total of 175 patients with BPD and 396 patients with OPD (mean age 32.5 years) were assessed at baseline and at 6, 12, 24, 36, 48, 60, 72 and 84 months. Measurements The Structured Clinical Interview for DSM-IV Axis I Disorders and the Diagnostic Interview for DSM-IV Personality Disorders were used at baseline, the Follow-Along version of the DIPD-IV and the Longitudinal Interval Follow-up Evaluation at the follow-up evaluations. Kaplan,Meier analyses were calculated to generate the time to new onsets. Findings BPD patients showed a shorter time to new onsets of SUD. Thirteen per cent of BPD patients developed a new alcohol use disorder and 11% developed a new drug use disorder, compared to rates of 6% and 4%, respectively, for OPD. Non-remitted BPD and remitted BPD patients did not differ significantly in rates of new onsets of SUD. Conclusions BPD patients have a high vulnerability for new onsets of SUDs even when their psychopathology improves. These findings indicate some shared etiological factors between BPD and SUD and underscore the clinical significance of treating SUD when it co-occurs in BPD patients. [source] Quality of life in chronic kidney disease: effects of treatment modality, depression, malnutrition and inflammationINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2007B. Kalender Summary In the present study, our aim is to investigate the effects of the treatment modality, depression, malnutrition and inflammation on quality of life (QoL) in chronic kidney disease (CKD). Twenty-six patients with CKD on conservative management, 68 patients on haemodialysis (HD), 47 patients on continuous ambulatory peritoneal dialysis (CAPD) and 66 healthy controls were enrolled in the study. QoL was measured by means of the Short Form-36 (SF-36) and subscale scores were calculated. All patients were evaluated for the presence of depression using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders , Clinician Version. The severity of depression was evaluated by means of the Beck Depression Inventory (BDI). Serum C-reactive protein (CRP), ferritin, albumin, haemoglobin and haematocrit (Hct) levels were measured. All the SF-36 subscale scores were lower in the patient groups compared with control group. The SF-36 scores were higher and BDI scores were lower in the CAPD group than CKD and HD groups. In patients with depression, all SF-36 subscale scores were lower than that of the patients without depression. There was a significant negative correlation between all the SF-36 subscale scores and the BDI scores. There was a significant positive correlation between the SF-36 physical and total summary scores and the Hct value and serum albumin levels, but an inverse correlation between the SF-36 physical, mental and total summary scores and the serum CRP level in the HD patients. The authors suggest that the treatment modality, depression, malnutrition and inflammation have an important role on QoL in CKD. [source] Attention-deficit hyperactivity symptoms and disorder in eating disorder inpatientsINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2009William R. Yates MD Abstract Objective: The objective of this study was to determine the prevalence of attention-deficit hyperactivity disorder (ADHD) symptoms and a DSM-IV ADHD diagnosis in women admitted for treatment of an eating disorder. Method: One hundred eighty-nine inpatient women with an eating disorder were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and ADHD interview from the Multi-international Psychiatric Interview (MINI). Results: Twenty-one percent of the sample reported at least six current ADHD symptoms, but the estimated prevalence rate for a diagnosis of ADHD in this population was only 5.8% (95% CI: 2.6%,9.5%). Most current ADHD inattentive symptoms appeared after childhood suggesting late-onset non-ADHD origins. Current inattention symptoms in those without a diagnosis of ADHD correlated with higher BMI (p < .0001), symptoms of bulimia nervosa and current level of depression symptoms (p = .025). Discussion: Although current ADHD symptoms were commonly endorsed in this population, clinicians should carefully examine for childhood symptom-onset of ADHD. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009 [source] Familial aggregation in the night eating syndromeINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 6 2006Jennifer D. Lundgren PhD Abstract Objective: This study examined the extent to which the night eating syndrome (NES) affects first-degree relatives of NES and control probands. Method: NES participants and controls were assessed with the Night Eating Questionnaire (NEQ), the Night Eating Syndrome History and Inventory (NESHI), 10 day sleep and food records, the Eating Disorder Examination (EDE), the Structured Clinical Interview for DSM IV Axis I Disorders (SCID I), and a Family History Questionnaire (FHQ) to assess the presence of NES among first-degree relatives. A proband predictive model, using logistic regression analyses and the generalized estimating equation to control for correlation among observations within families was used to assess familial aggregation. Results: The odds of an NES proband having an affected first-degree relative were significantly greater than that of a control proband (odds ratio = 4.9, p < .001). A number of covariates were included in the model: proband body mass index (BMI) (kg/m2), proband gender, proband age, proband ethnicity, first-degree relative gender, relationship to proband (i.e., mother, father, or sibling), and the interaction between relationship to proband and proband status (night eater or control); none was statistically significant (p > .05). Conclusion: The study showed a strong aggregation of NES in families. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006 [source] The Impact of Personality Disorders on Alcohol-Use Outcomes in a Pharmacotherapy Trial for Alcohol Dependence and Comorbid Axis I DisordersTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 6 2007Elizabeth Ralevski PhD Although antisocial and borderline personality disorders frequently co-occur with alcohol dependence and other Axis I disorders, their effect on alcohol use outcomes in context of pharmacotherapy remains unclear. Patients with Major Axis I disorders, including alcohol dependence, and diagnosis of antisocial (ASPD) or borderline personality disorder (BPD) were enrolled in a 12-week medication trial for treatment of their alcohol dependence. Everyone was randomized to one of four cells: naltrexone alone, placebo alone, open label disulfiram and naltrexone, or open label disulfiram and placebo. Outcome measures included scales for alcohol use and craving. Data were analyzed comparing patients with ASPD vs. those without, and patients with BPD vs. those without. Diagnosis of personality disorder did not adversely affect alcohol outcomes, and patients with ASPD or BPD did not have a poorer response to medication than patients without diagnosis of ASPD or BPD. The findings suggest that naltrexone and disulfiram can be safely and effectively used with patients who have comorbid diagnoses of Axis I and Axis II disorders. [source] The spectrum of substance abuse in bipolar disorder: reasons for use, sensation seeking and substance sensitivityBIPOLAR DISORDERS, Issue 3 2007Jacopo V Bizzarri Objectives:, To examine the spectrum of alcohol and substance abuse, including reasons for use, in patients with bipolar I disorder, compared with patients with substance use disorder and healthy controls, with a specific focus on the relationship between substance use, substance sensitivity, other comorbid psychiatric symptoms and traits related to sensation seeking. Methods:, This study included 104 patients with bipolar I disorder (BPD I), of whom 57 (54.8%) met DSM-IV criteria for lifetime alcohol or substance use disorder (BPD + SUD), 35 patients with substance use disorder (SUD) and no psychiatric disorder and 50 healthy controls. Assessments included the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS). Results:, Patients with BPD + SUD and SUD had significantly higher scores on the SCI-SUBS domains of self-medication, substance sensitivity and sensation seeking compared with patients with BPD and healthy controls. Reasons for substance use did not differ between patients with BPD + SUD and patients with SUD. Those most frequently cited were: improving mood; relieving tension; alleviating boredom; achieving/maintaining euphoria; and increasing energy. Conclusions:, Recourse to substances is associated with increased mood and anxiety symptoms, substance sensitivity, and sensation seeking among patients with BPD + SUD and SUD. Substance sensitivity and sensation seeking traits should be investigated in all patients with BPD as possible factors associated with a development of SUD, in order to warn patients of the specific risks related to improper use of medications and substances. [source] Psychotic features in borderline patients: is there a connection to mood dysregulation?BIPOLAR DISORDERS, Issue 4 2005Benvenuti A Objective:, To investigate the relationship between lifetime mood and psychotic spectrum features in patients with borderline personality disorder (BPD). Method:, The study sample consisted of BPD patients with (n = 39, BPD-M) or without (n = 21, BPD-noM) lifetime mood disorders. The diagnostic assessment was conducted with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). The diagnosis of BPD was made clinically and then confirmed by Gunderson's diagnostic interview for borderlines. Subjects were also administered the Structured Clinical Interview for Psychotic Spectrum (SCI-PSY) and the Mood Spectrum self-report questionnaire (MOODS-SR). Results:, BPD-M had significantly higher scores than BPD-noM on the ,lifetime' mood spectrum subdomains ,depressive mood' and ,depressive cognition'. The two groups did not differ on the scores of psychotic spectrum except for higher ,hypertrophic self-esteem' scores in BPD-noM. In BPD-noM both the depressive and the manic-hypomanic component of mood spectrum were significantly correlated with the ,delusion' subdomain of the psychotic spectrum. The depressive component was correlated with ,depersonalization/derealization' and the manic-hypomanic component was correlated with ,hypertrophic self-esteem'. In BPD-M, the manic-hypomanic component of mood spectrum was correlated with different subdomains of the psychotic spectrum: ,hypertrophic self-esteem', ,self-reference', ,interpretive attitude', ,anger/overreactivity, ,unusual and odd thoughts', ,illusions', ,delusions', ,hallucinations' and ,catatonia'. The depressive component of mood spectrum was ,uncorrelated' with the subdomains of the psychotic spectrum. Conclusions:, Our data support the hypothesis that ,lifetime' manic-hypomanic mood dysregulations are correlated with psychotic spectrum features in borderline patients. The assessment of these spectrum features in borderline patients may be useful to inform treatment choices. [source] Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disordersACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010S. Pini Pini S, Abelli M, Shear KM, Cardini A, Lari L, Gesi C, Muti M, Calugi S, Galderisi S, Troisi A, Bertolino A, Cassano GB. Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disorders. Objective:, To evaluate the frequency and clinical correlates of adult separation anxiety disorder in a large cohort of patients with mood and anxiety disorders. Method:, Overall, 508 outpatients with anxiety and mood disorders were assessed by the structured clinical interview for diagnostic and statistical manual (IV edition) axis I disorders for principal diagnosis and comorbidity and by other appropriate instruments for separation anxiety into adulthood or childhood. Results:, Overall, 105 subjects (20.7%) were assessed as having adult separation anxiety disorder without a history of childhood separation anxiety and 110 (21.7%) had adult separation anxiety disorder with a history of childhood separation anxiety. Adult separation anxiety was associated with severe role impairment in work and social relationships after controlling for potential confounding effect of anxiety comorbidity. Conclusion:, Adult separation anxiety disorder is likely to be much more common in adults than previously recognized. Research is needed to better understand the relationships of this condition with other co-occurring affective disorders. [source] Prevalence and correlates of comorbidity 8 years after a first psychotic episodeACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2007S. Farrelly Objective:, While rates and correlates of comorbidity have been investigated in the early course of psychosis, little is known about comorbidity in the medium-to-longer term or its relationship with outcome. Method:, A total of 182 first-episode psychosis (FEP) patients who met DSM-IV criteria for a current psychotic disorder 8 years after index presentation were grouped according to concurrent comorbidity [no concurrent axis I disorder; concurrent substance use disorder (SUD); other concurrent axis I disorder; concurrent SUD and other axis I disorder]. Outcomes were compared between groups controlling for relevant covariates. Results:, As much as 39% met criteria for one or more concurrent axis 1 diagnoses. Comorbidity was associated with greater severity of general psychopathology, but not with measures of functioning, treatment or negative symptoms. Conclusion:, Specific combinations of comorbid disorders may influence patterns of psychotic symptomatology. Routine examination of axis I disorders is warranted in the ongoing management of psychosis. [source] Maternal psychopathology and attachment in toddlers of heavy cocaine-using mothersINFANT MENTAL HEALTH JOURNAL, Issue 3 2001Michael Espinosa The purpose of this study is to examine the relationships among maternal psychopathology, early sensitive caregiving, and security of attachment in a sample of cocaine-using women from environments with high contextual risks that include poverty, low educational attainment, minority status, and single parenthood. Thirty-five women and their offspring participated in the study. Maternal psychopathology, including Axis I and Axis II disorders, was assessed during the prenatal period via a self-report clinical measure. Maternal sensitivity was assessed at 1 month and 6 months postdelivery through rating scales. At 18 months postdelivery, toddlers' attachment to their mothers was assessed via the Strange Situation procedure. Also at 18 months, mothers' level of depression was assessed via a depression inventory. Maternal psychopathology during pregnancy was found to be associated with both early caregiving and attachment. Mothers demonstrating clinical levels of particular Axis II disorders provided less sensitive caregiving, and had toddlers who were more likely to be disorganized/disoriented in their attachments. For Axis I disorders, only clinical levels of prenatal dysthymia were found to be associated with a greater likelihood of secure attachment. ©2001 Michigan Association for Infant Mental Health. [source] Relationships between features associated with vomiting in purging-type eating disordersINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2005Lauren Reba BA Abstract Objective Vomiting is a pernicious symptom of eating disorders. We explored the relation between the symptom of vomiting and features of eating disorder course and severity, personality traits, and Axis I and II comorbidity in individuals with purging-type eating disorders. Method The sample included participants from the multisite, international Price Foundation Genetic Studies, who had an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified) and had data available for the frequency of purging behaviors (n = 1,048). Axis I disorders, personality disorders, trait anxiety, perfectionism, and temperament and character dimensions were included as possible correlates. Results The presence of vomiting was associated with less regular laxative use, lower self-directedness, organization, personal standards, and higher novelty seeking. Conclusion Vomiting remains a prevalent and potentially destructive symptom of eating disorders, with significant dental and medical morbidity. Our findings suggest that certain clinical and personality variables distinguish individuals with purging-type eating disorders who vomit from those who do not, although there were no marked differences in Axis I or II comorbidity. Specifically targeting treatment to decrease duration of exposure to this dangerous symptom continues to be an important clinical objective. © 2005 by Wiley Periodicals, Inc. [source] Validation of a new diagnostic procedure for DSM IV axis I disordersINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2002Jean-Yves Loze Abstract Despite the fact that, in today's psychiatric research and especially in epidemiological studies, diagnostic assessments are made with reliable standardized clinical interviews, recent articles have shown discrepancies in prevalence rates of DSM IV axis I disorders assessed with different, yet reliable, clinical standardized interviews, raising the problem of the clinical relevance of some of these instruments. Within an epidemiological study, we developed a simple method for evaluating DSM IV axis I disorders with the aim of improving the clinical relevance of assessed diagnoses. This method is based on an evaluation performed by two clinicians. The first one used a short structured clinical interview (MINI v 5.0) and the second one completed the procedure with an open clinical interview, intended to be more clinically relevant. Finally, a consensus diagnosis is given by the two investigators. We conducted a survey in order to validate this method by measuring the agreement of diagnoses reported by two pairs of clinicians on a population of 20 inpatients. Results show that this double evaluation led to a high agreement (kappa ranging between 0.76 and 1.00) suggesting that the proposed evaluation procedure, which is intended to be more clinically relevant, is also highly reliable. Copyright © 2002 Whurr Publishers Ltd. [source] A Preliminary Investigation into the Utility of the Adult Behavior Checklist in the Assessment of Psychopathology in People with Low IQJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 5 2007Nienke H. Tenneij Background, Achenbach & Rescorla (2003) recently developed the Adult Behavior Checklist (ABCL) to assess psychopathology in the general population. The ABCL should be completed by a proxy informant. The use of proxy informants, instead of self-reporting, makes the ABCL potentially suitable for the assessment of psychopathology in adults with intellectual disability. The aim of the present study was to examine reliability and validity of the ABCL in 124 adults with mild intellectual disability or low IQ, and severe challenging behaviour referred for residential treatment. Methods, The ABCL was completed by two independent informants to assess inter-rater reliability. To examine the validity of the ABCL, its relationship with three measures of functioning was assessed. Furthermore, association between scales of the ABCL and DSM-IV axis I disorders was examined. Results, The ABCL was reliable in terms of internal consistency of its scales, and inter-rater reliability. Relationships between clusters of axis I DSM-IV disorders and scales of the ABCL were found as expected. Moreover, ABCL scales predicted different measures of functioning. Conclusions, The ABCL appears to be a reliable and valid measure to assess psychopathology in persons with mild intellectual disabilities or low IQ, admitted for treatment in facilities for adults with mild intellectual disability and severe challenging behaviour. [source] Psychopathy and Axis I psychiatric disorders among criminal offenders: relationships to impulsive and proactive aggressionAGGRESSIVE BEHAVIOR, Issue 1 2010Marc T. Swogger Abstract Both psychopathology and aggression are heterogeneous constructs. Determining which forms of psychopathology relate to risk for different classes of aggressive behavior has implications for risk recognition and management. This study examined the relationships of impulsive aggression (IA) and proactive aggression (PA) to psychopathy and symptoms of several Diagnostic and Statistical Manual Axis I disorders in a sample of criminal offenders. Results replicated prior findings from community samples of a broad relationship between psychopathology and IA. PA was related only to psychopathy. An interaction was found whereby IA was associated with impulsive,antisocial traits of psychopathy only for individuals with moderate to high levels of generalized anxiety. Results indicate that assessing and treating several Axis I disorders in offenders may decrease risk for IA. Moreover, current findings raise the possibility that generalized anxiety is a key, modifiable component of the relationship between IA and impulsive,antisocial traits. Aggr. Behav. 36:45,53, 2010. © 2009 Wiley-Liss, Inc. [source] Hormone Responses to Social Stress in Abstinent Alcohol-Dependent Subjects and Social Drinkers with No History of Alcohol DependenceALCOHOLISM, Issue 7 2005Cynthia A. Munro Background: Previous studies have described blunted stress hormone responses after pharmacological activation of the hypothalamic-pituitary-adrenal (HPA) axis in sober alcoholics. The aim of the present study was to compare ACTH, cortisol, and prolactin responses to a psychological stressor in abstinent alcohol-dependent subjects matched to healthy control subjects. Methods: Individuals who met DSM-IV diagnostic criteria for a history of alcohol dependence but not for other axis I disorders were included in the study (n= 18; mean duration of abstinence ± SEM, 3.5 ± 5.7 years). Social drinkers (n= 23) served as control subjects. The sober alcohol-dependent and control subjects were matched for demographic measures including levels of stress symptoms. All subjects underwent the Trier Social Stress Test (TSST), a laboratory-based psychological stressor. Prestress and poststress plasma ACTH, cortisol, and prolactin levels, as well as a self-report measure of anxiety (State-Trait Anxiety Inventory), were obtained. Results: Nondepressed, abstinent alcoholics and control subjects did not differ with regard to age, racial composition, or baseline or poststress ratings of anxiety. Whereas ACTH and cortisol levels increased in response to the TSST, prolactin levels did not. Stress hormone response curves for the three hormones did not differ between the alcoholics and control subjects. Conclusions: When matched for levels of stress, a laboratory-based psychological stress test did not induce differential hormone response curves for abstinent alcoholics and control subjects. [source] Serotonin, Impulsivity, and Alcohol Use Disorders in the Older Adolescent: A Psychobiological StudyALCOHOLISM, Issue 11 2000Paul H. Soloff Background: Alcohol use disorders (AUDs) among adolescents are associated with a high prevalence of conduct disorder (CD), much as type II alcoholism in adults is associated with impulsive-aggressive behavior and antisocial personality traits. Adults with impulsive personality disorders and AUD demonstrate diminished central serotonergic responsiveness to serotonergic agonists. Dysregulation of central serotonergic function may contribute to a vulnerability to impulsive-aggressive behavior, CD, and AUD. We studied older adolescents, both male and female, to examine the relationships between sex, dispositional impulsivity, aggressivity, CD, and responsiveness to serotonergic challenge with d,l fenfluramine (FEN) early in the development of AUD. Methods: Thirty-six adolescents between the ages of 16 and 21 years were assessed for DSM-IV AUD and other Axis I disorders by using the Psychoactive Substance Use Disorders section of the Structured Clinical Interview for DSM III-R, the Schedule for Affective Disorders and Schizophrenia for School-Age Children,Present and Lifetime Version, and CD interviews. Impulsivity and aggressivity were assessed by the Barratt Impulsiveness Scale, Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Eysenck Impulsiveness Questionnaire, Youth Self Report, and Multidimensional Personality Questionnaires. FEN was administered as 0.8 mg/kg to a maximum of 60 mg, and blood was sampled at fixed intervals for prolactin, cortisol, fenfluramine, and norfenfluramine levels. Results: Eighteen adolescents (12 male, 6 female) with AUD scored significantly higher on all measures of impulsivity and aggressivity compared with 18 healthy controls (12 male, 6 female). There were no significant differences between groups in peak prolactin or cortisol responses (minus baseline), or area-under-the-curve determinations (AUC); however, 9 subjects with AUD and comorbid CD had significantly elevated cortisol AUC levels compared with subjects with AUD and no CD or with normal controls. In the total sample, cortisol AUC was associated positively with measures of aggression. Conclusions: Adolescents with early-onset AUD are characterized by impulsivity and aggressivity compared with healthy peers but do not demonstrate the diminished prolactin or cortisol responses to FEN characteristic of adult alcoholics with impulsive-aggression. [source] Relationship of age to symptom severity, psychiatric comorbidity and health care utilization in persons with borderline personality disorderPERSONALITY AND MENTAL HEALTH, Issue 1 2008Nancee Blum Background,The objective of the study was to test the association of age with symptom severity, frequency and pattern of psychiatric comorbidity, health care utilization and quality of life in subjects with borderline personality disorder (BPD). Methods,The analysis is based on a sample of subjects with Diagnostic and Statistical Manual of Mental Disroders, Fourth Edition (DSM-IV) BPD (n = 163) recruited for participation in a clinical trial at an academic medical center. The subjects were assessed using structured and semi-structured instruments of known reliability. Results,Tests of trend with age showed relationships with important variables assessing symptom severity, comorbidity, quality of life and health care utilization. As expected, younger subjects were less likely to be married, to be employed or to receive disability payments. The frequency of most lifetime comorbid Axis I disorders was not related to age, although posttraumatic stress disorder was more frequent in the 35- to 44-year age group, and younger patients were more likely to have comorbid histrionic and narcissistic personality disorders. Baseline severity variables were mostly unrelated to age, with the exception of impulsivity, which was more common in younger patients, as were acts of deliberate self-harm. As expected, older patients reported poorer quality of life in categories indicating worse health perception and greater pain levels, and tended to use more health care resources than younger patients. Conclusion,Most characteristics of patients with BPD are unrelated to age, yet impulsivity and acts of deliberate self-harm were less frequent in older patients. Expected age-related changes, such as reports of worse physical health, greater pain levels and greater health care utilization, were observed in older subjects. Copyright © 2008 John Wiley & Sons, Ltd. [source] The Impact of Personality Disorders on Alcohol-Use Outcomes in a Pharmacotherapy Trial for Alcohol Dependence and Comorbid Axis I DisordersTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 6 2007Elizabeth Ralevski PhD Although antisocial and borderline personality disorders frequently co-occur with alcohol dependence and other Axis I disorders, their effect on alcohol use outcomes in context of pharmacotherapy remains unclear. Patients with Major Axis I disorders, including alcohol dependence, and diagnosis of antisocial (ASPD) or borderline personality disorder (BPD) were enrolled in a 12-week medication trial for treatment of their alcohol dependence. Everyone was randomized to one of four cells: naltrexone alone, placebo alone, open label disulfiram and naltrexone, or open label disulfiram and placebo. Outcome measures included scales for alcohol use and craving. Data were analyzed comparing patients with ASPD vs. those without, and patients with BPD vs. those without. Diagnosis of personality disorder did not adversely affect alcohol outcomes, and patients with ASPD or BPD did not have a poorer response to medication than patients without diagnosis of ASPD or BPD. The findings suggest that naltrexone and disulfiram can be safely and effectively used with patients who have comorbid diagnoses of Axis I and Axis II disorders. [source] | |||||||||||||