Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years
Background. A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality di...
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| Veröffentlicht in: | Psychological medicine 2005-03, Vol.35 (3), p.443-451 |
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| creator | SKODOL, ANDREW E. PAGANO, MARIA E. BENDER, DONNA S. TRACIE SHEA, M. GUNDERSON, JOHN G. YEN, SHIRLEY STOUT, ROBERT L. MOREY, LESLIE C. SANISLOW, CHARLES A. GRILO, CARLOS M. ZANARINI, MARY C. McGLASHAN, THOMAS H. |
| description | Background. A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period. Method. Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas of the Northeastern USA. Patients were assigned to one of five diagnostic groups: schizotypal (STPD) (n=81), borderline (BPD) (n=155), avoidant (AVPD) (n=137), or obsessive–compulsive (OCPD) (n=142) personality disorders or MDD and no PD (n=85), based on the results of semi-structured interview assessments and self-report measures. Impairment in psychosocial functioning was measured using the Longitudinal Interval Follow-up Evaluation (LIFE) at baseline and at three follow-up assessments. Results. Significant improvement in psychosocial functioning occurred in only three of seven domains of functioning and was largely the result of improvements in the MDD and no PD group. Patients with BPD or OCPD showed no improvement in functioning overall, but patients with BPD who experienced change in personality psychopathology showed some improvement in functioning. Impairment in social relationships appeared most stable in patients with PDs. Conclusion. Impairment in functioning, especially social functioning, may be an enduring component of personality disorder. |
| doi_str_mv | 10.1017/S003329170400354X |
| format | Article |
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A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period. Method. Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas of the Northeastern USA. Patients were assigned to one of five diagnostic groups: schizotypal (STPD) (n=81), borderline (BPD) (n=155), avoidant (AVPD) (n=137), or obsessive–compulsive (OCPD) (n=142) personality disorders or MDD and no PD (n=85), based on the results of semi-structured interview assessments and self-report measures. Impairment in psychosocial functioning was measured using the Longitudinal Interval Follow-up Evaluation (LIFE) at baseline and at three follow-up assessments. Results. Significant improvement in psychosocial functioning occurred in only three of seven domains of functioning and was largely the result of improvements in the MDD and no PD group. Patients with BPD or OCPD showed no improvement in functioning overall, but patients with BPD who experienced change in personality psychopathology showed some improvement in functioning. Impairment in social relationships appeared most stable in patients with PDs. Conclusion. Impairment in functioning, especially social functioning, may be an enduring component of personality disorder.</description><identifier>ISSN: 0033-2917</identifier><identifier>EISSN: 1469-8978</identifier><identifier>DOI: 10.1017/S003329170400354X</identifier><identifier>PMID: 15841879</identifier><identifier>CODEN: PSMDCO</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Activities of Daily Living ; Adolescent ; Adult ; Adult and adolescent clinical studies ; Behavior ; Biological and medical sciences ; Female ; Follow-Up Studies ; Functional impairment ; Humans ; Male ; Medical sciences ; Middle Aged ; Obsessive compulsive disorder ; Patients ; Personality disorders ; Personality Disorders - psychology ; Prognosis ; Psychiatric disorders ; Psychiatric Status Rating Scales ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Social Behavior ; Social interaction ; Stability ; USA</subject><ispartof>Psychological medicine, 2005-03, Vol.35 (3), p.443-451</ispartof><rights>2004 Cambridge University Press</rights><rights>2005 INIST-CNRS</rights><rights>Copyright Cambridge University Press, Publishing Division Mar 2005</rights><rights>2004 Cambridge University Press 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c615t-5985e90cdf1e9880c4cbd66e0d027343aa1bc600dacd4d8811d8624886c01fdd3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S003329170400354X/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,230,314,777,781,882,12827,27905,27906,30980,30981,55609</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16590684$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15841879$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SKODOL, ANDREW E.</creatorcontrib><creatorcontrib>PAGANO, MARIA E.</creatorcontrib><creatorcontrib>BENDER, DONNA S.</creatorcontrib><creatorcontrib>TRACIE SHEA, M.</creatorcontrib><creatorcontrib>GUNDERSON, JOHN G.</creatorcontrib><creatorcontrib>YEN, SHIRLEY</creatorcontrib><creatorcontrib>STOUT, ROBERT L.</creatorcontrib><creatorcontrib>MOREY, LESLIE C.</creatorcontrib><creatorcontrib>SANISLOW, CHARLES A.</creatorcontrib><creatorcontrib>GRILO, CARLOS M.</creatorcontrib><creatorcontrib>ZANARINI, MARY C.</creatorcontrib><creatorcontrib>McGLASHAN, THOMAS H.</creatorcontrib><title>Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years</title><title>Psychological medicine</title><addtitle>Psychol. Med</addtitle><description>Background. A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period. Method. Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas of the Northeastern USA. Patients were assigned to one of five diagnostic groups: schizotypal (STPD) (n=81), borderline (BPD) (n=155), avoidant (AVPD) (n=137), or obsessive–compulsive (OCPD) (n=142) personality disorders or MDD and no PD (n=85), based on the results of semi-structured interview assessments and self-report measures. Impairment in psychosocial functioning was measured using the Longitudinal Interval Follow-up Evaluation (LIFE) at baseline and at three follow-up assessments. Results. Significant improvement in psychosocial functioning occurred in only three of seven domains of functioning and was largely the result of improvements in the MDD and no PD group. Patients with BPD or OCPD showed no improvement in functioning overall, but patients with BPD who experienced change in personality psychopathology showed some improvement in functioning. Impairment in social relationships appeared most stable in patients with PDs. Conclusion. Impairment in functioning, especially social functioning, may be an enduring component of personality disorder.</description><subject>Activities of Daily Living</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Behavior</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Functional impairment</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Obsessive compulsive disorder</subject><subject>Patients</subject><subject>Personality disorders</subject><subject>Personality Disorders - psychology</subject><subject>Prognosis</subject><subject>Psychiatric disorders</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Social Behavior</subject><subject>Social interaction</subject><subject>Stability</subject><subject>USA</subject><issn>0033-2917</issn><issn>1469-8978</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkstu1DAUhiMEotPCA7BBFhJdTcCOHdvZVIIptEgVCBUEO8uxnY5LEgfbmTKseAd4Qp4Ehxl1uAixsY_1f-fyWyfL7iH4CEHEHp9DiHFRIQZJikry_kY2Q4RWOa8Yv5nNJjmf9L1sP4RLCBFGpLid7aGSE8RZNcu-nUdZ29bGNXANaMZeRet62QLbDdL6zvQR2B4MMtoUBnBl4xIEtbSfXVwPsp2D2nltfGt7Mwdy5ayWfZwD54GrgwnBrsz3L1-V64axnR5gMD5MHaaW2oaf2cCt0hGvHFgb6cOd7FYj22Dubu-D7O3zZ28Wp_nZq5MXiydnuaKojHlZ8dJUUOkGmYpzqIiqNaUGalgwTLCUqFYUQi2VJppzhDSnBeGcKogarfFBdrSpO4x1Z7RKDr1sxeBtJ_1aOGnF70pvl-LCrQQuWMEoTAUOtwW8-ziaEEVngzJtK3vjxiAoYxSjovwvWDKEMaYsgQ_-AC_d6NN3BVFAQnhFK5IgtIGUdyF401yPjKCYNkP8tRkp5_6vXncZ21VIwMMtIIOSbeNlr2zYcbSsIOVT83zD2RDNp2td-g_JLmaloCevxWl1_PTlu-OFwInH22FlV3urL8zO0r_H_QHM-OTy</recordid><startdate>20050301</startdate><enddate>20050301</enddate><creator>SKODOL, ANDREW E.</creator><creator>PAGANO, MARIA E.</creator><creator>BENDER, DONNA S.</creator><creator>TRACIE SHEA, M.</creator><creator>GUNDERSON, JOHN G.</creator><creator>YEN, SHIRLEY</creator><creator>STOUT, ROBERT L.</creator><creator>MOREY, LESLIE C.</creator><creator>SANISLOW, CHARLES A.</creator><creator>GRILO, CARLOS M.</creator><creator>ZANARINI, MARY C.</creator><creator>McGLASHAN, THOMAS H.</creator><general>Cambridge University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7QP</scope><scope>7QR</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20050301</creationdate><title>Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years</title><author>SKODOL, ANDREW E. ; PAGANO, MARIA E. ; BENDER, DONNA S. ; TRACIE SHEA, M. ; GUNDERSON, JOHN G. ; YEN, SHIRLEY ; STOUT, ROBERT L. ; MOREY, LESLIE C. ; SANISLOW, CHARLES A. ; GRILO, CARLOS M. ; ZANARINI, MARY C. ; McGLASHAN, THOMAS H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c615t-5985e90cdf1e9880c4cbd66e0d027343aa1bc600dacd4d8811d8624886c01fdd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Activities of Daily Living</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Behavior</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Functional impairment</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Obsessive compulsive disorder</topic><topic>Patients</topic><topic>Personality disorders</topic><topic>Personality Disorders - psychology</topic><topic>Prognosis</topic><topic>Psychiatric disorders</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Social Behavior</topic><topic>Social interaction</topic><topic>Stability</topic><topic>USA</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SKODOL, ANDREW E.</creatorcontrib><creatorcontrib>PAGANO, MARIA E.</creatorcontrib><creatorcontrib>BENDER, DONNA S.</creatorcontrib><creatorcontrib>TRACIE SHEA, M.</creatorcontrib><creatorcontrib>GUNDERSON, JOHN G.</creatorcontrib><creatorcontrib>YEN, SHIRLEY</creatorcontrib><creatorcontrib>STOUT, ROBERT L.</creatorcontrib><creatorcontrib>MOREY, LESLIE C.</creatorcontrib><creatorcontrib>SANISLOW, CHARLES A.</creatorcontrib><creatorcontrib>GRILO, CARLOS M.</creatorcontrib><creatorcontrib>ZANARINI, MARY C.</creatorcontrib><creatorcontrib>McGLASHAN, THOMAS H.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Psychological medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SKODOL, ANDREW E.</au><au>PAGANO, MARIA E.</au><au>BENDER, DONNA S.</au><au>TRACIE SHEA, M.</au><au>GUNDERSON, JOHN G.</au><au>YEN, SHIRLEY</au><au>STOUT, ROBERT L.</au><au>MOREY, LESLIE C.</au><au>SANISLOW, CHARLES A.</au><au>GRILO, CARLOS M.</au><au>ZANARINI, MARY C.</au><au>McGLASHAN, THOMAS H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years</atitle><jtitle>Psychological medicine</jtitle><addtitle>Psychol. Med</addtitle><date>2005-03-01</date><risdate>2005</risdate><volume>35</volume><issue>3</issue><spage>443</spage><epage>451</epage><pages>443-451</pages><issn>0033-2917</issn><eissn>1469-8978</eissn><coden>PSMDCO</coden><abstract>Background. A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period. Method. Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas of the Northeastern USA. Patients were assigned to one of five diagnostic groups: schizotypal (STPD) (n=81), borderline (BPD) (n=155), avoidant (AVPD) (n=137), or obsessive–compulsive (OCPD) (n=142) personality disorders or MDD and no PD (n=85), based on the results of semi-structured interview assessments and self-report measures. Impairment in psychosocial functioning was measured using the Longitudinal Interval Follow-up Evaluation (LIFE) at baseline and at three follow-up assessments. Results. Significant improvement in psychosocial functioning occurred in only three of seven domains of functioning and was largely the result of improvements in the MDD and no PD group. Patients with BPD or OCPD showed no improvement in functioning overall, but patients with BPD who experienced change in personality psychopathology showed some improvement in functioning. Impairment in social relationships appeared most stable in patients with PDs. Conclusion. Impairment in functioning, especially social functioning, may be an enduring component of personality disorder.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>15841879</pmid><doi>10.1017/S003329170400354X</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Psychological medicine, 2005-03, Vol.35 (3), p.443-451 |
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| source | MEDLINE; Cambridge Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Activities of Daily Living Adolescent Adult Adult and adolescent clinical studies Behavior Biological and medical sciences Female Follow-Up Studies Functional impairment Humans Male Medical sciences Middle Aged Obsessive compulsive disorder Patients Personality disorders Personality Disorders - psychology Prognosis Psychiatric disorders Psychiatric Status Rating Scales Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Social Behavior Social interaction Stability USA |
| title | Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years |
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