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PubMed2005

Relationship between haemolytic and adjuvant activity and structure of protopanaxadiol-type saponins from the roots of Panax notoginseng.

Four protopanaxadiol-type saponins (PDS), ginsenosides-Rb(1), -Rd, notoginsenosides-K, -R(4) isolated from the roots of Panax notoginseng were evaluated for their haemolytic activities and adjuvant potentials on the cellular and humoral immune responses of ICR mice against ovalbumin (OVA). The effect of the substitution pattern of these PDS on their biological activities was investigated and structure-activity relationships were established. Among four PDS, the ranking of the haemolytic activity was K>R(4)>Rb(1)>Rd (P<0.01 or <0.001). Rd, Rb(1), and K could significantly enhance mitogen- and OVA-induced splenocyte proliferation in the OVA-immunized mice (P<0.001), with the order in terms of stimulation index being Rd>Rb(1)>K>R(4). OVA-specific IgG, IgG1, IgG2a and IgG2b antibody levels in the OVA-immunized mice were significantly enhanced by four PDS. Adjuvant potentials of Rd on antibody responses were higher than those of other three PDS. Meanwhile, Rd also significantly enhanced the production of the Th1 and Th2 cytokines in OVA-immunized mice (P<0.05 or <0.01). The structure-activity relationship studies suggested that the length of sugar side chains at position C-20 and the linkage of glucose moiety at position C-3 of protopanaxadiol could affect the haemolytic and adjuvant activities of PDS. The information about this structure/function relationship might be useful for developing semisynthetic tetracyclic triterpenoid saponin derivatives with immunological adjuvant activity, as well as a reference to the distribution of the functional groups composing the saponin molecule.

Adjuvants, Immunologic↗
PubMed1996

Stricture incidence related to suture material in hypospadias surgery.

PURPOSE: To report the complication rates after hypospadias surgery, with stratification according to the type of suture used for the urethral anastomosis (rapid/intermediate absorbable v prolonged absorbable.) MATERIAL AND METHODS: During a 7-year period (1986 to 1992), 117 boys aged 5 to 124 months (mean, 14) underwent surgical correction of hypospadias. The urethral anastomoses were performed with chromic sutures before 1987 (n = 15), with polydioxanone (PDS) between 1987 and 1990 (n = 46), and with polyglycolic acid (PgA) after 1990 (n = 56). The patients were separated into two groups: those whose operations were performed before 1987 and after 1990 (using chromic or PgA sutures), and those whose surgery occurred in the intervening 3 years (using PDS). A successful result was defined as good cosmesis without urethral stricture or urethrocutaneous fistula on long-term follow up (mean follow-up period, 15.9 months). RESULTS: Of the cases that had PgA or chromic sutures, 76.1% were corrected in a single operation, as opposed to 50.9% when PDS was used (P = .002). In the chromic/PgA group, 6.8% had strictures, compared with 23.6% of the PDS group (P < .02). This contrast was most evident in cases with pedicled tube flaps; strictures occurred in 43.8% of the PDS group but in only 9.5% of the chromic/ PgA group (P < .02). There was no significant difference in the incidence of postoperative fistulas between the two groups. In some patients, the PDS sutures remained present in the urethra, without absorption, up to 7 months after the initial repair. CONCLUSION: Sutures with rapid or intermediate absorption rates provide the best results for hypospadias surgery. The extreme delay in in vivo absorption of polydioxanone should preclude its use as an interrupted suture in small-caliber urethral anastomoses.

Absorption↗
PubMed2000

Coating effects on the glass adsorption of polychlorinated biphenyl (PCB) congeners.

The effects of coating materials on polychlorinated biphenyl (PCB) adsorption in aqueous solution were assessed in an attempt to minimize PCB sorption loss during sampling processes. A coating material, which enhances PCB adsorption and allows adsorbed PCBs to be readily extracted by solvents, can act as a sampling concentrator to reduce PCB losses from both adsorption and evaporation. Several coating materials were evaluated, including paraffin oil, silicone oil, dimethyldichlorosilane (Sylon-CT), Prosil 28 and polydimethylsiloxane (PDS) with viscosity 0.65, 50 (PDS 50), and 500 (PDS 500) cSt. PDS and silicone oil enhanced adsorption for all five congeners examined (IUPAC No. 28, 52, 101, 138, and 180). Sylon-CT, paraffin oil and Prosil 28 had inconsistent effects on adsorption of different congeners. Desorption of adsorbed PCBs onto all coating types was assessed. The recovery efficiency of extracting PCBs with solvents was enhanced greatly with all coatings as opposed to non-coated surfaces, with the exception of paraffin oil. Coating with silicon oil, PDS 50, and 500 resulted in virtually 100% recovery of adsorbed PCBs. It was also found that Teflon containers were poor substitutes for glass containers and failed to minimize PCB losses. Among the materials studied, the best coating that could be used as a sampling concentrator was PDS 500.

Adsorption↗
PubMed1996

Location of the iris insertion in pigment dispersion syndrome.

PURPOSE: To evaluate the position of the iris insertion into the ciliary body in persons with pigment dispersion syndrome (PDS) and control subjects. METHODS: Ultrasound biomicroscopy was performed on 19 eyes with PDS and on 21 eyes of control subjects. A radial, perpendicular image in the temporal meridian detailing Schwalbe line (SL), scleral spur (SS), and iris root insertion (IR) was obtained for each eye by a single examiner. The distances between these structures then was measured. RESULTS: There were no differences between the groups in refractive error (mean +/- standard error, -2.8 +/- 0.7 diopters for PDS eyes versus -2.2 +/- 0.6 for control subjects) (P=0.46), sex distribution (P=0.49), and trabecular meshwork height (SL to SS) (0.63 +/- 0.03 mm [PDS eyes] versus 0.59 +/- 0.03 [control eyes]; P = 0.24). The SS-to-IR distance was significantly greater in PDS eyes (0.04 +/- 0.04 mm) than in control eyes (0.28 +/- 0.04 mm) (P=0.01) as was the overall distance from SL to IR (0.98 +/- 0.04 mm versus +/- 0.04 mm) (P = 0.003). CONCLUSION: The insertion of the iris into the ciliary body is more posterior in PDS eyes than in control eyes. This anatomic variation places the iris pigment epithelium proximal to the zonular apparatus and may increase the likelihood of iridozonular contact and zonular pigment dispersion.

Adolescent↗
PubMed2003

The dimensional view of personality disorders: a review of the taxometric evidence.

The dimensional view of personality disorders (PDs) represents these conditions as extreme variants of normal personality continua. This widely held view underpins efforts to characterize PDs in terms of established systems of personality description and to overhaul classification of PDs along dimensional lines. A review of 21 taxometric studies of PDs and related variables calls an unqualified version of this view into question. Analyses of the three PDs investigated to date strongly support taxonic (i.e., categorical or discontinuous) models. Implications for the conceptualization and classification of PDs are drawn.

Humans↗
PubMed1986

[Analysis of the multi-unit activity of the cortex and subcortical structures during paroxysmal discharges and grand mal seizures in the photosensitive baboon].

Cortical and subcortical multiunitary activities (MUA) and EEG were simultaneously recorded in baboons rendered photosensitive by a subconvulsant dose of DL-allylglycine. Intermittent light stimulation (ILS) trains induce in those animals fronto-rolandic (FR) paroxysmal discharges (PDs, constituted as spikes and waves) and grand mal seizures. During the induction of FR PDs by ILS trains, the visual structures (occipital cortex, colliculi superioris, pulvinar) show a significant MUA increase which is not related to the PD spike or wave but is correlated to the flashes. The first structure showing bursts of MUA that frequently precede the PD appearance is the FR cortex. When PDs appear, the bursts are related to the spikes of PDs and are followed by an inhibition during the slow wave. The pontine and mesencephalic reticular formations and the facial nuclei are activated in bursts after the FR PDs have reached a certain amplitude. The thalamic nuclei ventralis lateralis, centrum medianum and lateralis posterior are activated only later, when the FR PDs have reached an even greater amplitude. It is suggested that the activation of visual structures is necessary for FR PD appearance. The secondary pontine and mesencephalic activation could reinforce that of the FR cortex and then the thalamus, and could determine the myoclonus observed in unparalyzed animals.

Allylglycine↗
PubMed1997

Difference in serum-induced prostacyclin production by cultured aortic and capillary endothelial cells.

Prostacyclin (PGl2) generated by vascular endothelial cells play an important role in the maintenance of vessel wall homeostasis. Human plasma-derived serum (PDS) stimulated PGl2 synthesis by both cultured bovine aortic endothelial cells (BAEC) and adrenal capillary endothelial cells (BCEC), but the PGl2 response of the latter cells was far smaller. When BAEC were cultured with a high concentration of glucose (400 mg/dl), the PGl2 synthesis induced by 20% PDS was significantly lower than in the culture with a physiological concentration of glucose (100 mg/dl) (258 +/- 45 pg/10(4) cells/h vs. 402 +/- 52 pg/10(4) cells/h, n = 4, P < 0.05). On the other hand, there was no significant difference in the PDS-induced PGl2 synthesis between BCEC cultured with high and physiological concentrations of glucose. Additionally, 10% PDS obtained from patients with non-insulin dependent diabetes mellitus (n = 6) stimulated significantly less PGl2 synthesis than that from healthy subjects (n = 4) in the case of both BAEC (133 +/- 27 pg/10(4) cells/h vs. 402 +/- 38 pg/10(4) cells/h, P < 0.05) and BCEC (72 +/- 15 pg/10(4) cells/h vs. 118 +/- 12 pg/10(4) cells/h, P < 0.05), with the difference in PGl2 synthesis being smaller for BCEC. These findings indicate that the PDS-induced PGl2 synthesis differs between cultured vascular endothelial cells from large and small vessels with the decrease in PGl2 by diabetic PDS and high glucose being more marked for BAEC than BCEC.

6-Ketoprostaglandin F1 alpha↗
PubMed1994

Assembly of the prothrombinase complex on lipid vesicles depends on the stereochemical configuration of the polar headgroup of phosphatidylserine.

The conversion of prothrombin into thrombin is an imperative step in the sequence of reactions leading to the formation of a hemostatic plug. This reaction is catalyzed by the prothrombinase complex, composed of factors Xa and Va, which is assembled on a phospholipid surface through Ca-mediated interactions with the lipid polar headgroups. In this paper we describe experiments indicative for a major role of the stereochemical configuration of phosphatidylserine in the binding of the prothrombinase complex to a phospholipid surface. Using two stereoisomers of phosphatidylserine, i.e., L-alpha-glycerophosphoryl-L-serine (PLS) and L-alpha-glycerophosphoryl-D-serine (PDS), we demonstrate that membranes containing PLS are appreciably more favorable than membranes containing PDS in promoting assembly of the prothrombinase complex and catalysis of prothrombin conversion. Ellipsometric analysis of the binding of factor Va and factor Xa to a surface composed of phosphatidylcholine and 10 mol % of either PLS or PDS reveals that the apparent Kd for factor Va increases about 25-fold when substituting PDS for PLS. For factor Xa a 5-fold increase in Kd was observed on replacing PDS for PLS. When PLS is replaced by phosphatidyl-beta-lactate (PLac), a phospholipid resembling PS but lacking the amino group, a similar decrease in prothrombinase activity is found as observed with PDS, implicating the importance of both the amino group and the stereoconfiguration of the serine moiety for the assembly of the prothrombinase complex.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2003

Phytoene desaturase inhibition by O-(2-phenoxy)ethyl-N-aralkylcarbamates.

O-[1-Ethyl-2-(3-trifluoromethylphenoxy)]ethyl-N-benzylcarbamate exhibits a marked inhibition of carotenoid biosynthesis. Forty-one analogues were synthesized and assayed for plant-type phytoene desaturase (PDS) and zeta-carotene desaturase (ZDS) inhibition in a cell-free system using recombinant enzymes obtained from Escherichia coli transformants. The target enzyme of all carbamates synthesized in this study is PDS and not ZDS; no inhibition of ZDS was observed using a 10(-4) M inhibitor concentration. Four compounds, O-[1-ethyl-2-(3-trifluoromethylphenoxy)]ethyl-N-(2-phenylethyl)carbamate (23), O-[1-ethyl-2-(3-trifluoromethylphenoxy)]ethyl-N-(2-chlorobenzyl)carbamate (25), O-[1-ethyl-2-(3-trifluoromethylphenoxy)]ethyl-N-(2-chlorobenzyl)carbamate (26), and O-[1-methyl-2-(3-trifluoromethylphenoxy)]ethyl-N-benzylcarbamate (30), were the most potent PDS inhibitors. Their pI(50) values, the negative logarithms of the molar concentration that produces a 50% inhibition, were 7.5, representing the same inhibitory activity as norflurazon. With respect to a structure-activity relationship the oxygen atom of the phenoxy group and a carbamate structure in O-(1-ethyl-2-phenoxy)ethyl-N-aralkylcarbamates studied were found to be essential for strong PDS inhibitors. Also, introduction of an ethyl group at the alpha-position of the ethylene bridge between the phenoxy group and the carbamate was important for a strong PDS inhibitor. Substituents at the 2- and/or 3-position of the phenoxybenzene ring were found to be favorable to a strong PDS inhibition of the analogues.

Carbamates↗
PubMed1998

Regulation of phytoene desaturase expression is independent of leaf pigment content in Arabidopsis thaliana.

Synthesis of carotenoids in higher plants occurs in the plastids, but all of the required enzymes are coded for in the nuclear genome and are post-transcriptionally imported into the plastid compartment. Regulation of the synthesis of the enzymes is poorly understood. The two-step desaturation of phytoene to zeta-carotene, carried out by the enzyme phytoene desaturase (PDS), is one of the earliest steps in the pathway and has been studied in several systems. Previous analyses of phytoene-accumulating tissue suggested that there may be feedback regulation of PDS gene transcription, with higher expression in white tissue. To investigate this regulation further, we examined phytoene-accumulating tissue in Arabidopsis thaliana (L.) Heynh. Two types of phytoene-accumulating tissue were studied: Norflurazon-bleached plants and white sectors from the immutans variegation mutant. Based on competitive RT-PCR measurements of PDS mRNA and immunochemical detection of PDS protein, we determined that there is no significant induction of PDS gene expression specific to white tissue, indicating that PDS expression is independent of the pigment status of the cells. Reasons why our results differ from those in other systems are discussed.

Arabidopsis↗
PubMed2000

Relation of factor-analyzed symptom dimensions of obsessive-compulsive disorder to personality disorders.

OBJECTIVE: To assess the relation between symptom dimensions of obsessive-compulsive disorder (OCD) and comorbid personality disorders (PDs). METHOD: The scores of 75 OCD outpatients on five previously identified symptom dimensions were entered into multiple regression models as predictors of: 1) the presence of any type of PD; 2) the number of PDs; 3) the presence of any cluster A, B or C PD; and 4) the presence of each individual PD. RESULTS: Twenty-eight patients (37.3%) met criteria for one or more PDs. High scores on the 'Hoarding' dimension were strongly related to the presence of any Axis II diagnosis, and to the number of PDs. Cluster C PDs (especially obsessive-compulsive and avoidant) had the highest partial correlations with 'Hoarding'. These results were independent of OCD symptom severity. CONCLUSION: Previous conflicting findings about the prevalence of certain PDs in OCD might be due in part to differences in the constitution of the particular patient groups studied.

Adolescent↗
PubMed2003

Geriatric medicine fellowship programs: a national study from the Association of Directors of Geriatric Academic Programs' Longitudinal Study of Training and Practice in Geriatric Medicine.

This report documents the development and growth of geriatric medicine fellowship training in the United States through 2002. A cross-sectional survey of geriatric medicine fellowship programs was conducted in the fall 2001. All allopathic (119) and osteopathic (7) accredited geriatric medicine fellowship-training programs in the United States were involved. Data were collected using self-administered mailed and Web-based survey instruments. Longitudinal data from the American Medical Association (AMA) and the Association of American Medical Colleges' (AAMC) National Graduate Medical Education (GME) Census, the Accreditation Council for Graduate Medical Education (ACGME), and the American Osteopathic Association (AOA) were also analyzed. The survey instrument was designed to gather data about faculty, fellows, program curricula, and program directors (PDs). In addition, annual AMA/AAMC data from 1991 to the present was compiled to examine trends in the number of fellowship programs and the number of fellows. The overall survey response rate was 76% (96 of 126 PDs). Most (54%) of the PDs had been in their current position 4 or more years (range: <1-20 years), and 59% of PDs reported that they had completed formal geriatric medicine fellowship training. The number of fellowship programs and the number of fellows entering programs has slowly increased over the past decade. During 2001-02, 338 fellows were training in allopathic programs and seven in osteopathic programs (all years of training). Forty-six percent (n = 44) of responding programs offered only 1-year fellowship-training experiences. PDs reported that application rates for fellowship positions were stable during the academic years (AYs) 1999-2002, with the median number of applications per first year position available in AY 2000-01 being 10 (range: 1-77). In 2001-02, data from the AMA/AAMC National GME Census indicated a fill rate for first-year geriatric medicine fellowship positions of 69% (259 first-year fellows for 373 positions). During 2001-02, more than half of programs (53%) reported having two or fewer first-year fellows, whereas 31% had three or four first-year fellows. Thirty-three programs (36%) reported having no U.S. medical school graduate first-year fellows, and another 25 (28%) reported having only one. Of the 51 programs offering second-year fellowship training, PDs reported 61 post-first-year fellows (median 1, range: 0-7). During the past 10 years, 27 new allopathic geriatric medicine fellowship programs opened; there are now 119 programs. There are also seven osteopathic programs. The recruitment of high-quality U.S. medical school graduates into these programs remains a challenge for the discipline. Furthermore, the retention of first-year fellows for additional years of academic training has been difficult. Incentives will be needed to attract the best graduates of U.S. family practice and internal medicine training programs into academic careers in geriatric medicine.

Career Choice↗
PubMedDate not supplied

A twin study of personality disorders.

No twin study has previously investigated the whole range of personality disorders (PDs) recorded by interviews. Based on twin and patient registries, 92 monozygotic (MZ) and 129 dizygotic (DZ) twin pairs were interviewed with the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Observed prevalence rates from a normal population study of more than 2,000 individuals were used in combination with data from the present study to generate statistics assumed to be valid for a normal twin population, and these statistics were used for structural equation modeling. The best-fitting models had a heritability of .60 for PDs generally, .37 for the eccentric (A) cluster, .60 for the emotional (B) cluster, and .62 for the fearful (C) cluster. Among the specific PDs, the heritability appeared to be .79 for narcissistic, .78 for obsessive-compulsive, .69 for borderline, .67 for histrionic, .61 for schizotypal, .57 for dependent, .54 for self-defeating, .29 for schizoid, .28 for paranoid, and .28 for avoidant PDs. The best-fitting models never included shared-in-families environmental effects. However, a model with only shared familial and unique environmental effects could not be ruled out for dependent PD. Shared familial environmental effects may also influence the development of any PD and borderline PD. Passive-aggressive PD did not seem to be affected by genes or family environment at all. The low occurrence of antisocial PD in the twin sample precluded any model for this disorder. PDs seem to be more strongly influenced by genetic effects than almost any axis I disorder, and more than most broad personality dimensions. However, we observed a large variation in heritability among the different PDs, probably partly because of a moderate sample size and low prevalence of the specific disorders.

Adult↗
PubMedDate not supplied

Frequency of comorbid personality disorders in bipolar and unipolar affective disorders.

One expression of the complex relationship between personality and affective disorder is the comorbidity of personality disorders (PDs) with affective disorders. In a sample of 117 patients with unipolar and 60 with bipolar affective disorders, we assessed DSM-III-R PDs with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) and compared them with personality factors as obtained by the five-factor model (FFM-NEO Five-Factor Inventory). Fifty-one percent of the unipolar and 38% of the bipolar disorders fulfilled criteria for a comorbid PD. The three most frequent PDs were obsessive-compulsive PD, borderline PD, and narcissistic (bipolar) or avoidant (unipolar) PD. Cluster C PDs and especially avoidant PD occurred significantly more frequently in unipolar than in bipolar patients, while narcissistic PD occurred significantly more often in bipolar than in unipolar patients. The FFM results supported the validity of our PD diagnoses. In a logistic regression analysis, higher depression score at the time of the SCID-II interview and shorter duration of the illness were weakly related to a higher frequency of PDs. Our results indicate that PDs are frequent in affective disorders and that there are subtle differences between unipolar and bipolar patients concerning such comorbid disorders.

Adult↗
PubMed2002

Increasing the effectiveness of radioactive iodine therapy in the treatment of thyroid cancer using Trichostatin A, a histone deacetylase inhibitor.

BACKGROUND: Radioactive iodine is used to identify and treat recurrent and metastatic thyroid cancer of follicular cell origin. Between 30% and 40% of thyroid cancers are either resistant or become resistant to radioactive iodine. Increased sodium-iodide symporter (NIS) and decreased Pendrin (PDS) activity may be associated with increased radioactive iodine effectiveness. In this investigation the effects of Trichostatin A (TSA), a histone deacetylating inhibitor, on human thyroid NIS and PDS gene expression was investigated. METHOD: Cell lines from papillary, Hürthle, and follicular cell carcinomas were treated with TSA for 72 hours at concentrations up to 100 ng/mL. NIS and PDS gene expression was determined using quantitative RT-polymerase chain reaction. RESULTS: . NIS messenger RNA expression in cell carcinomas was increased 107- (1.8-307) and 217- (5.7-408) fold in papillary, 39- (20-63) and 58- (37-80) fold in Hürthle, and 459- (178-810) and 781- (412-1229) fold in follicular after treatment with 50 and 100 ng/mL of TSA, respectively. PDS messenger RNA expression in cell carcinomas was decreased 0.22- (0.05-0.45) and 0.27- (0.09-0.47) fold in papillary, 0.53- (0.46-0.60) and 0.54- (0.44-0.64) fold in Hürthle, and 0.32- (0.26-0.39) and 0.56- (0.47-0.64) fold in follicular, after the same treatment. CONCLUSIONS: In thyroid cancer cell lines, TSA dramatically increased NIS gene expression and reduced PDS expression. The increased NIS expression and reduced PDS expression may make radioiodine therapy more effective in patients with thyroid cancer, especially when the tumors have no or low uptake of radioiodine.

Carcinoma, Papillary↗
PubMed1995

Repair of UV-induced (6-4) photoproducts in nucleosome core DNA.

Using radioimmunoassays, we examined rates of removal of UV-induced pyrimidine-pyrimidone (6-4) photoproducts ((6-4)PDs) and cyclobutane pyrimidine dimers (CPDs) from 146-base pair nucleosome core DNA (and 166-base pair chromatosome DNA) of confluent human diploid fibroblasts. Dose-response experiments indicate that the yield of (6-4)PDs in core DNA is about 30% that of CPDs in the UV dose range of 0-200 J/m2. Repair experiments indicate that, at 40 J/m2, (6-4)PDs are removed much faster (approximately 75% in 2 h) from nucleosome core (and chromatosome) DNA than CPDs (10-15% in 2 h). A slow rate of removal of CPDs is also observed when the UV dose is reduced to 10 J/m2 (i.e. even when the level of CPDs is less than that of (6-4)PDs at 40 J/m2). These results indicate that (a) the accessibility of repair proteins to (6-4)PDs in nucleosomes is markedly different than their accessibility to CPDs and/or (b) repair enzymes are much more efficient at incising and removing (6-4)PDs than CPDs in human chromatin.

Cells, Cultured↗
PubMed2003

The Patient Distress Scale questionnaire: factor structure and internal consistency.

PRIMARY OBJECTIVE: This study examined the factor structure and internal consistency of the Patient Distress Scale (PDS). The PDS is an 11-item questionnaire that was developed to assess acute neurological patients' awareness of emotional disturbances during early rehabilitation. RESEARCH DESIGN: A retrospective cohort of patients seen for inpatient rehabilitation following brain injury. PROCEDURES: The PDS was administered to patients and family members upon admission to the neurorehabilitation unit as part of their neuropsychological evaluation. OUTCOMES AND RESULTS: Subjects were heterogeneous sample of acute neurological inpatients (n = 84) and their relatives (n = 64). A principle components factor analysis with varimax rotation yielded a three factor solution, which together accounted for 62% of the variance. The factor solution provided partial support for the initial structure of the PDS. Analyses revealed relatively strong reliability coefficients for patients (r = 0.82) and relatives (r = 0.86) on the PDS total score. Acceptable reliability coefficients were also found for patients and relatives on each of the factor scores. CONCLUSIONS: Preliminary findings support the utility of the PDS as a measure of awareness in acute neurological patients.

Brain Injuries↗
PubMed2005

A comparison of gains after treatment at a psychiatric outpatient clinic in patients with cluster A + B, or cluster C personality disorders, and non-psychotic axis I disorders.

Few studies exist on the outcome of patients with personality disorders (PDs) treated at ordinary outpatient clinics. This study examines the gains of such patients 2 years after treatment start at an outpatient clinic. Three patient groups were sampled: cluster A + B PDs, cluster C PDs and axis I disorders. Fifty-eight patients (53%) were amenable to follow-up, and they did not show less psychopathology than the non-compliers. All patients had structured interviews and filled in questionnaires. Patients in the PDs cluster A + B group showed considerable gains, while that was not found for the PDs cluster C and Axis I disorder groups. Since almost all patients received long-term psychotherapy sometimes combined with antidepressant drugs, the finding that such a treatment mainly shows gains in more severely disturbed PDs patients should be replicated in larger samples at ordinary psychiatric outpatient clinics.

Adolescent↗