Accurate recording of personality disorder in clinical practice

Tyrer, Peter

doi:10.1192/bjb.2018.40

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…Instead, patients reported recalling being given diagnoses of depression, anxiety, post traumatic stress disorder and bipolar disorders in the past by health care practitioners. Not being communicated a clear and accurate diagnosis of personality disorder may be because of lack of awareness, poor diagnostic practices, clinicians lacking time for thorough diagnostic assessments, or lingering stigma in the mental health community [ 62 , 84 ]. Regardless of the reasons, the lack of correct communication of diagnosis can create barriers for obtaining correct treatment which may contribute to non-response.…”

Section: Discussionmentioning

confidence: 99%

Patient perspectives on non-response to psychotherapy for borderline personality disorder: a qualitative study

Woodbridge

Townsend

Reis

et al. 2023

bord personal disord emot dysregul

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Background Despite increasing evidence for the effectiveness of psychotherapy for Borderline Personality Disorder (BPD), estimates show that approximately half of those in treatment do not clinically improve or reach reliable change criteria. There are limited qualitative descriptions of treatment factors associated with non-response from the perspectives of those struggling to improve. Method Eighteen people (72.2% female, mean age 29.4 (SD = 8)) with experience of receiving psychotherapeutic treatment for BPD were interviewed to obtain their perspectives on hindering factors in treatment and what may be helpful to reduce non-response. The data in this qualitative study was analysed thematically. Results Four domains were created from the insights patients shared on non-response and what may be needed to mitigate it. The focus of Domain 1 was that therapy cannot be effective until two factors are in place. First, the patient needs sufficient safety and stability in their environment in order to face the challenges of therapy. Second, they need to be able to access therapy. Domain 2 described factors the patients themselves contribute. The themes in this domain were described as phases that need to be progressed through before therapy can be effective. These phases were ceasing denial that help is warranted and deserved, taking responsibility for behaviours that contribute to unwellness, and committing to the hard work that is required for change. Domain 3 described how the lack of a safe alliance and ruptures in the safety of the relationship with the therapist can contribute to non-response. Domain 4 was comprised of factors that patients identified as supportive of moving through the barriers to response. The first theme in this domain was prioritising the safety of the therapy relationship. The second theme was giving a clear diagnosis and taking a collaborative approach in sessions. The final theme described the importance of focusing on practical goals with the patient to create tangible life changes. Conclusion This study found that non-response is complex and multifaceted. First, it is clear that systems need to be in place to support access to adequate care and foster life stability. Second, considerable effort may be needed at the engagement phase of therapy to clarify expectations. Third, attention to specific interpersonal challenges between patients and therapists is an important focus. Finally, structured work to improve relationships and vocational outcomes is indicated.

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Section: Discussionmentioning

confidence: 99%

Patient perspectives on non-response to psychotherapy for borderline personality disorder: a qualitative study

Woodbridge

Townsend

Reis

et al. 2023

bord personal disord emot dysregul

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“…Pemeriksaan dan pencarian jaminan yang berlebihan (tidak perlu secara medis) adalah ciri khas orang yang terlalu khawatir tentang kesehatan mereka (Taylor & Asmundson, 2017). Perilaku seperti itu dapat menjadi beban yang signifikan pada sistem perawatan kesehatan (Tyrer, 2018).…”

Section: Komunikasi Risikounclassified

Mengenal Dasar-Dasar Emosi Dalam Menghadapi Pandemi

Permana

2021

PLAKAT

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Artikel ini membahas pentingnya mengenali dan memahami dasar emosi dalam diri, khususnya dalam konteks pandemi. Mengenal emosi, merupakan upaya individu untuk merespon apa yang terjadi pada dirinya. Respon ini bersifat alamiah dan natural terjadi pada manusia, tetapi jika kita bisa mengenali dan mengelolanya maka akan besar dampaknya terhadap kehidupan kesehatan mental sehari-hari. Artikel ini merupakan bagian dari upaya mengedukasi masyarakat dalam betuk pengabdian masyarakat menggunakan metode service learning. Diharapkan dengan mengenali dan memahami dasar-dasar psikologis individu dalam merespon melalui emosi, masyarakat Indonesia bisa lebih sejahtera dan bahagia walaupun dalam kondisi pandemi.

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Impact of congenital heart disease on personality disorders in adulthood

Stapel,

Winter,

Heitland

et al. 2024

European Journal of Preventive Cardiology

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Background and Aims Adults with congenital heart disease (ACHD) constitute an ever-growing patient population characterized by high risks for cardiovascular- and mental disorders. Personality disorders (PDs) are associated with adverse physical and mental health. Studies assessing PD prevalence in ACHD are lacking. Methods PD point prevalence was assessed in 210 ACHD by Structured Clinical Interview for Axis-II Personality Disorders (SCID-II) and compared to meta-analytical data from the general population. Depression and anxiety were measured by self-report (Hospital Anxiety and Depression Scale, HADS) and clinician-rating (Montgomery–Åsberg depression rating scale, MADRS). Childhood maltreatment was assessed with the Childhood Trauma Questionnaire and quality-of-life (QOL) with the World Health Organization QOL Scale. Results PD prevalence was markedly higher in ACHD compared to general population (28.1% vs. 7.7%). Particularly borderline (4.8% vs. 0.9%) and cluster C (i.e. anxious or fearful; 17.1% vs. 3.0%) PDs were overrepresented. PD diagnosis was associated with a surgery age ≤12 years (χ²(1)=7.861, φ=.195, p=.005) and higher childhood trauma levels (U=2583.5, Z=-3.585, p<.001). ACHD with PD reported higher anxiety (HADS-A: U=2116.0, Z=-5.723, p<.001) and depression (HADS-D: U=2254.5, Z=-5.392, p<.001; MADRS: U=2645.0, Z=-4.554, p<.001) levels and lower QOL (U=2538.5, Z=-4.723, p<.001). Conclusions PDs, particularly borderline- and cluster C, are significantly more frequent in ACHD compared to general population and associated with depression, anxiety and decreased QOL. Data from the general population suggest an association with adverse cardiometabolic and mental health. To ensure guideline-based treatment, clinicians should be aware of the increased PD risk in ACHD.

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Accurate recording of personality disorder in clinical practice

Cited by 5 publications

References 14 publications

Patient perspectives on non-response to psychotherapy for borderline personality disorder: a qualitative study

Patient perspectives on non-response to psychotherapy for borderline personality disorder: a qualitative study

Mengenal Dasar-Dasar Emosi Dalam Menghadapi Pandemi

Impact of congenital heart disease on personality disorders in adulthood

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