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Results for “Compulsive Personality Disorder”

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PubMedDate not supplied

Psychiatric comorbidity in Greek patients with generalized anxiety disorder.

From a total sample of 1,448 psychiatric outpatients, 81 (5.6%) received a diagnosis of generalized anxiety disorder (GAD) according to DSM-III-R criteria. Fifty-three (65%) of them had another Axis I diagnosis, while this percentage increased to 78% (63/81) when lifetime psychiatric diagnoses were recorded. The most frequent comorbid diagnoses were panic disorder, dysthymia, major depression and social phobia. Forty-three (53%) of the GAD patients met the criteria for personality disorder. They manifested obsessive-compulsive, avoidant personality and personalities of cluster C in general significantly more frequently than the rest of the total sample. The presence of a personality disorder was related to a significantly higher score on almost all the Minnesota Multiphasic Personality Inventory clinical and research scales, to a worse level of functioning and to an earlier age of onset of GAD. The results of the present study (1) support previous findings of high rates of comorbidity of clinical syndromes in GAD, (2) indicate that GAD co-occurs frequently with cluster C personality disorders, mainly avoidant and obsessive-compulsive, and (3) that the presence of a concomitant personality disorder is related to severer psychopathology and to a worse level of functioning.

Adult↗
PubMed2000

[Diagnosis of body dysmorphic disorder. A pilot study].

The assessment of body dysmorphic disorder (BDD) is complicated by poorly defined diagnostic criteria and a lack of valid instruments. The present pilot study examines the possible benefit of specific instruments in the discrimination of other body image disorders. Thirteen patients with BDD, 13 with disfiguring defects, and 21 with no significant impairment of appearance participated in the study. The participants were recruited from dermatological outpatients on the basis of semistructured diagnostic interviews and clinical ratings of disfigurement. Furthermore, structured interviews were conducted to determine comorbidity with depressive disorders and social phobia and to obtain a clinical rating of obsessive-compulsive symptoms using the modified version of the YBOCS for body dysmorphic disorders. In addition, the Beck depression inventory, the Social Phobia Scale, and the Social Interaction Anxiety Scale were completed. Patients with BDD differed significantly from disfigured and unimpaired patients in obsessive-compulsive symptoms, in particular obsessions, and the discrepancy between personal and clinical rating of disfigurement. However, depression and social phobia scores were only higher in comparison with unimpaired patients. Comorbidity with depressive disorders was significantly increased. Our results support the utility of the specific diagnostic instruments and indicate the particular importance of obsessive-compulsive symptoms in BDD.

Adult↗
PubMed1997

Study of compulsive buying in depressed patients.

BACKGROUND: Compulsive buying is defined by the presence of repetitive impulsive and excessive buying leading to personal and familial distress. Patients with this disorder also suffer from mood disorder in 50% to 100% of the cases studied, and antidepressants help to decrease the frequency and the severity of uncontrolled buying. To define the correlation between compulsive buying and depression, we assessed this behavior among 119 inpatients answering to DSM-III-R criteria for major depressive episode. Additionally, we evaluated for comorbidity in the patients suffering from compulsive buying and in those free from this disorder. Impulsivity and sensation seeking were also compared in the two groups. METHOD: Diagnosis of compulsive buying was made using standardized criteria and a specific rating scale. Diagnosis of depression and assessment of comorbidity were investigated using the Mini International Neuropsychiatric Interview and a modified version of the Minnesota Impulsive Disorders Interview. All patients answered the Zuckerman Sensation-Seeking Scale and the Barrat Impulsivity Rating Scale. RESULTS: The prevalence of the disorder was 31.9%; 38 of the 119 depressed patients were diagnosed as compulsive buyers. Patients from the compulsive buying group were younger in age, more often women than men, and more frequently unmarried. They presented more often than others with recurrent depression (relative risk = 1.4), disorders associated with deficits in impulse control such as kleptomania (relative risk = 8.5) or bulimia (relative risk = 2.8), benzodiazepine abuse or dependence disorder (relative risk = 4.7), and two or more dependence disorders (relative risk = 1.99). Subscores for experience seeking using the Zuckerman Sensation-Seeking Scale were significantly higher (p = .04) and scores of impulsivity were much higher (p < .0001) than corresponding scores in the group without compulsive buying behavior. CONCLUSION: Compulsive buying is frequent among depressed patients. In most cases, the behavior is associated with other impulse control disorders or dependence disorders and a high level of impulsivity.

Adult↗
PubMed1975

Lithium in treatment failures.

Thirty-five patients with chronic and incapacitating mental illness who had not responded to the usual pharmacological and interactional therapies were treated with lithium. None of these patients appeared to be suffering from manic-depressive illness. If a trial of lithium resulted in unexpected improvement, lithium's contribution was assessed by double blind substitution of a placebo followed by lithium in an A-B-A-B design in which the patient served as his own control. Five patients (14 per cent) improved dramatically; in retrospect, four of these five patients suffered from nonremitting forms of manic-depressive illness, and the fifth patient suffered from a severe obsessive compulsive neurosis. Six other chronically hospitalized patients improved to the point of unexpected discharge. A trial of lithium therapy is recommended for the "backward" or intractable patient.

Adult↗
PubMed1975

The role of intravenous clomipramine in the treatment of obsessional and phobic disorders.

The results of intravenous clomipramine therapy in 118 patients suffering from obsessional syndromes and phobic anxiety states are reviewed. A remarkable consistency of improvement was observed especially in those patients suffering from obsessional symptoms. Better results were obtained in patients lacking hysterical personality traits. A brief reference is made to a pilot study involving the use of the 16PF personality test in assessing the effect of clomipramine.

Adult↗
PubMed1999

[Tics disease (Gilles de la Tourette syndrome): clinical characteristics of 70 patients].

BACKGROUND: Tourette's syndrome is a childhood-onset hereditary neurobehavioural disorder believed to occur without geographical restrictions. Although there have been reports of this disorder worldwide just a few are from Latin America. AIM: To report a preliminary experience with a series of 70 patients and to review recent advances in this disorder. PATIENTS AND METHOD: We reviewed patients seen in pediatric and adult neurological clinics in Santiago, Chile, all of whom fulfilled clinical diagnostic criteria for Tourette Syndrome. RESULTS: Seventy patients were studied, 54 males (77.1%) and 16 females (22.8%), their mean age at first evaluation was 13.6 years (range 2-46). The mean age of onset of symptoms was 6.4 (range 2-20), the mean time of follow-up was 3 years. Fifty-eight patients showed simple motor tics (blinking, facial grimacing, shoulder shrugging), whereas dystonic tics like head jerking were seen in 38 patients, torticollis in 6 and oculogyric movements in 2. Complex motor tics like jumping, antics, trunk bending and head shaking were present in 16 subjects. Vocal tics were predominantly of the simple type: sniffing, throat clearing, blowing, and whistling. Complex vocal tics were seen in 12 patients, five cases showed palilalia, 3 echolalia and only six displayed coprolalia (8.5%). Tics were of mild to moderate severity in most patients. Obsessive-compulsive disorder was observed in 22.8% and attention deficit and hyperactivity disorder were present in 35.7%. Forty-five patients (64.2%) had a first degree relative with tics, nine patients (12.8%) had a family history of obsessive-compulsive disorder. The current evidence involving desinhibition of cortico-striatum-thalamic-cortical neuronal circuits in the pathogenesis of this disorder is analyzed. CONCLUSION: Our report supports the recognized clinical homogeneity and genetical basis of Tourette's syndrome regardless of geographical region and ethnic origin.

Adult↗
PubMed2006

Attachment as moderator of treatment outcome in major depression: a randomized control trial of interpersonal psychotherapy versus cognitive behavior therapy.

Anxiety and avoidance dimensions of adult attachment insecurity were tested as moderators of treatment outcome for interpersonal psychotherapy (IPT) and cognitive- behavioral therapy (CBT). Fifty-six participants with major depression were randomly assigned to these treatment conditions. Beck Depression Inventory--II, Six-Item Hamilton Rating Scale for Depression scores, and remission status served as outcome measures. Patients higher on attachment avoidance showed significantly greater reduction in depression severity and greater likelihood of symptom remission with CBT as compared with IPT, even after controlling for obsessive-compulsive and avoidant personality disorder symptoms. Results were replicated across treatment completers and intent-to-treat samples. These results suggest that it is important to consider the interaction between attachment insecurity and treatment type when comparing efficacy of treatments.

Adult↗
PubMedDate not supplied

[The glass woman].

The author recounts the case of history of a woman patient seeking psychoanalytic treatment for a variety of extremely severe symptoms. In the course of treatment the original symptom constellation changed, revealing new facets but never disappearing completely. Discussing the compulsive, phobic symptomatology of the patient in terms of the traumatic sexual conflicts underlying them and the attendant break with outward reality and psychotic fabrication of a world of the patient's own making, Zeul warns against premature nosological classification. She contends that, in a case like the present one, the diagnosis of the disturbance into a neat set of nosological compartments--borderline/hysteria/psychosis etc.--makes little sense and should be supplanted by an attempt to describe the psychic mechanisms of mental illness.

Adult↗
PubMed2006

A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder.

Intolerance of uncertainty has been defined as the unwillingness to tolerate the possibility that negative events may occur in the future, no matter how low the probability [Personality Individual Differences 17 (1994), 791-802]. Previous research suggests that intolerance of uncertainty may be more specific to worry and generalized anxiety disorder (GAD) than to other anxiety disorders [e.g., Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in the etiology and maintenance of generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 143-163). New York: Guilford Press]. However, Tolin et al. [J. Anxiety Disorders 17 (2003), 233-242] argued that intolerance of uncertainty may also play a central role in obsessive-compulsive disorder (OCD). Therefore, the current study compared intolerance of uncertainty in individuals with analogue GAD and/or OCD. Intolerance of uncertainty was strongly related to pathological worry, GAD symptoms, and OCD symptoms; however, neither worry nor GAD was found to be more strongly associated with intolerance of uncertainty than OCD. Further, individuals with analogue GAD or OCD reported more intolerance of uncertainty than controls, but they did not differ significantly from each other. These findings suggest that intolerance of uncertainty may be a central theme in a number of the anxiety disorders.

Adaptation, Psychological↗