摘要:

The high prevalence of substance use, e.g., alcohol and illegal and nonprescribed drugs, in schizophrenia is widely recognized. One explanation for this high prevalence is that substance use may be a self-initiated method for managing symptoms. To test whether the intake of four substances—alcohol, cannabis, nicotine, and caffeine—would increase with increases in symptom distress, daily self-reports of symptom distress and substance intake over 12 weeks were analyzed with pooled time series analyses. Compliance with neuroleptic medication was added to the analyses to control for any changes in prescribed medication compliance while using nonprescribed drugs or alcohol. Of the four substances studied, only nicotine was significantly related to symptom distress. Higher distress with prodromal symptoms was related to decreases in nicotine use. Analysis of caffeine did not meet the criteria for significance but does provide direction for further research. Higher distress, with neurotic symptoms, was related to increases in caffeine use. Further research is needed to clarify the relationship between nicotine and symptoms.

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study examines the rationale for and relative effectiveness of three intervention models for treating people with severe mental illness and substance abuse disorders: Twelve Step recovery, behavioral skills training, and intensive case management. Using clinical trial methods, 132 dually diagnosed clients were assigned to three service approaches. Changes in client psychosocial outcomes, and psychiatric and substance abuse symptomatology were tracked over a 24-month period. Differential effectiveness was evident, with clients in the behavioral skills group demonstrating the most positive and significant differences in psychosocial functioning and symptomatology, compared with the Twelve Step recovery approach. However, the case management intervention also resulted in several positive and important differences compared with the Twelve Step recovery approach. We also found significant changes over time, not only at 6 months but increasingly positive changes in psychosocial functioning at 12 and 18 months as well. These results underscore the need for clinical trials to further examine the relative cost effectiveness of treatment approaches for dually disordered clients and to incorporate means of assessing subgroup differences so that the interventions being tested can be further refined and targeted to a broad set of needs among the dually diagnosed.

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study evaluated the relationship between traumatic brain injury (TBI) and borderline personality disorder (BPD). Forty-three males with BPD were compared with 49 age- and sex-matched controls with other psychiatric diagnoses. The occurrence of TBI was identified by chart review. Head injury was identified in 42% of patients meeting criteria for BPD but in only 4% of controls (p < 001). All patients but one had sustained a TBI prior to the diagnosis of BPD. The prevalence of TBI is higher in subjects with BPD than in controls. Since TBI occurred prior to the full expression of the BPD clinical syndrome, TBI appears to be a cause rather than the result of BPD.

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This prospective cohort study of patients with borderline psychopathology reports on the clinical disorders occurring during the course and at 7-year follow-up. Subjects with persistent versus remitted borderline personality disorder (BPD) are compared. The relationship between the initial levels of borderline psychopathology and the occurrence of clinical disorders on follow-up is examined. Consecutive admissions to inpatient units were screened for borderline characteristics. This resulted in a sample of 130 subjects, 88 of whom were positive for BPD based on the Diagnostic Interview for Borderlines. At 7-year follow-up, 81 (62.3%) subjects were reinterviewed in person, 6 (4.6%) suicided, 2 (1.6%) were deceased, 36 (27.7%) refused to participate, and 5 (3.8%) could not be located. Twenty-seven of 57 (47.4%) who initially were positive for BPD were rediagnosed at 7-year follow-up (the persistent group) and 30 (52.6%) were no longer diagnosed as BPD (the remitted group). The persistent individuals were significantly more likely to be diagnosed as having major depression, dysthymia, and other psychiatric disorders than the remitted group. The persistent group had significantly more episodes of substance abuse over the follow-up period compared with the remitted group. Individuals with persistent BPD suffered more episodes of clinical disorders over the follow-up period and the initial level of borderline psychopathology predicted the recurrence of major depression.

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Clinicians and researchers have noted that personality dysfunction related to borderline personality significantly predicts a poorer course in major depressive disorder. There is also some evidence that some aspects of personality are heritable. The goal of this report was to determine whether family history of dramatic personality disorder cluster indicated differences in functioning in patients with major depressive disorder. Patients with major depression were divided into two groups: those with a family history of dramatic personality disorder cluster (N = 49) and those without (N = 22). These were the clinical groups. A screened normal group was also added to determine how far the clinical groups differed from ordinary functioning (N = 31). Compared with the other clinical group, the group with the family history of dramatic personality disorder tended, in general, to have fewer personality traits as measured by the Personality Disorder Examination, similar Hamilton Anxiety and Depression scores and several significantly better functioning measures. It appears that a family history of dramatic personality disorder cluster identifies a group with different, but not necessarily lower, levels of functioning. Implications of these findings are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

In a sample of 76 women participating in a clinical treatment trial for bulimia nervosa, we examined the clinical differences between subjects with and without concurrent personality disorders and the ability of “self-directedness” (a character scale of Cloninger's Temperament and Character Inventory) to predict the presence of personality disorder. Sixty-three percent of the sample had at least one personality disorder diagnosis. Fifty-one percent of personality disorders were in cluster C, 41% were in cluster B, and 33% were in cluster A. The presence of personality disorder was associated with greater depressive symptoms, worse global functioning, laxative use, greater body dissatisfaction, higher harm avoidance, and lower self-directedness. As hypothesized, low self-directedness scores were associated with a markedly increased probability of a personality disorder.

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The reason for the wide variation in relapse rates in trials of the withdrawal of anticholiner-gic agents in patients maintained on neuroleptics is unclear and could be due to bias introduced through unblinding. Forced-choice guesses of whether patients had been receiving active or placebo medication were made in a clinical trial. Correctness of guessing was correlated with measures of Parkinsonism. Raters' guesses were better than chance expectation and correlated with ratings of Parkinsonism. Nurses' guesses correlated with their own global measure of side effects but not with raters' measures. Patients' guesses were no better than chance. Unblinding of raters is a significant factor in anticholinergic withdrawal studies and preconceived notions of the value of anticholinergics could therefore be affecting the results of trials, helping to produce the wide variation in relapse rates.

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1995

数据来源: OVID