This study compares two self-report instruments--the Dutch version of Cloninger's Temperament and Character Inventory (TCI) and the Questionnaire on Personality Traits (VKP)--in a Dutch sample of 148 people in a healthy population. The aims of this study are to create a norm group for the Dutch TCI, to investigate the psychometric properties of the TCI, and to examine the relationship between temperament, character (as measured by the TCI), and personality disorders (as measured by the VKP). The Dutch TCI has a good internal consistency. Some scales do intercorrelate. Seven factors can be identified with principal components analysis. T-tests show differences between the mean score of this Dutch population and Cloninger's community sample. According to the results of correlations and multiple regression of the TCI and the VKP, the self-directedness scale can predict the presence or absence of a personality disorder. Other scales might predict the type of personality disorder. It is concluded that the TCI can be a useful aid in the assessment of personality disorders.
In general, depressed patients with personality pathology--Axis II disorders--respond less well or less quickly to the various kinds of individual treatment that are available, whether pharmacotherapy, psychotherapy, or both combined. This article sets forth the results of a six-month, randomized clinical trial of antidepressants and combined therapy in ambulatory patients with major depression and a baseline score of at least 14 on the 17-item Hamilton Rating Scale for Depression (HAM-D-17). The presence or absence of Axis II pathology was determined on the basis of a self-report version of the International Personality Disorder Examination. The study's antidepressant protocol provided for three successive steps in case of intolerance or inefficacy: fluoxetine, amitriptyline, and moclobemide. In addition to pharmacotherapy, the combined-therapy condition included 16 sessions of Short Psychodynamic Supportive Psychotherapy. Efficacy of the therapy provided was assessed using the HAM-D-17 and also other instruments. According to the results in secondary analyses, it emerged that combined therapy was more effective than pharmacotherapy for depressed patients with personality disorders. Combined therapy was not more effective than pharmacotherapy alone for depressed patients without personality disorders. It is recommended that depressed patients with comorbid personality pathology should be treated with combined therapy, with the focus of psychotherapy being not on the patient's symptoms and complaints, but on all aspects of the patient's actual relationships.
It is likely that suffering from epileptic seizures negatively influences personality development and can result in the development of maladaptive PD traits. The results also support the idea that PD traits are not (completely) covered by axis I psychopathology and therefore should be separately investigated.
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