McCrae and Costa since 1986 have proferred a five-factor personality model as a lingua franca among different psychometric test users, and they suggest that their operationalization of the five-factor model, the NEO Personality Inventory, may also be useful in the clinical assessment of the abnormal personality. The present study examined the inventory and its relationship to the 11 personality disorders of Axis II of DSM-III-R in a sample of 180 adults. Correlational multivariate analyses appear to indicate a limited usefulness of the five-factor model in the understanding of personality disorders, and four major objections are offered. Further research with clinical samples, other models of personality, and other measures of personality disorders are encouraged.
The coexistence of psychiatric and substance abuse problems within the same patient occurs with significant frequency. These patients present serious challenges to a health care system which has traditionally treated mental health and substance abuse in separate venues, with differing and sometimes contradictory treatment modalities. Few studies exist on the treatment of the "dual diagnosis" patient utilizing an integrated approach, where both problems are addressed by the same staff on a single inpatient ward. We describe such a program in which dual diagnosis patients on one ward are separated into two different treatment tracks based upon the severity of their psychiatric illness. Follow-up measures at 3 months after discharge are compared for patients from each treatment track, with no significant difference found for the five outcome variables studied. This suggests that chronically mentally ill inpatients may benefit from integration of attention to their substance abuse problems with psychiatric treatment.
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