Diagnosis of DSM-III-R personality disorders by two structured interviews: patterns of comorbidity

Tonn, Mona K.; Thomas, Philipp; Barahona, Mauricio; Oyarzún, Diego A.

doi:10.1176/ajp.149.2.213

Cited by 267 publications

(28 citation statements)

References 26 publications

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“…There is significant co-morbidity between different PDs [28, 29]. To evaluate the unique effect of each PD we adjusted for co-occurring traits of other PDs (Table 3, model 3).…”

Section: Discussionmentioning

confidence: 99%

Personality disorders are important risk factors for disability pensioning

Østby

Czajkowski

Knudsen

et al. 2014

Soc Psychiatry Psychiatr Epidemiol

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Purpose To determine whether personality disorders (PDs) are associated with increased risk of disability pensioning in young adults, independent of other common mental disorders. Methods 2,770 young adults from the general population were assessed for PDs by the Structured Interview for DSM-IV Personality, and for common mental disorders by the Composite of International Diagnostic Interview. These data were linked to the Norwegian National Insurance Administration’s recordings of disability benefits for a 10-year period. Logistic regression analyses were applied to investigate the association between PDs and disability pensioning. The analyses were conducted for three types of PD measures: categorical diagnoses (any PD), dimensional scores of individual PDs and higher order components retrieved by principal component analyses. Results Having any PD was strongly associated with disability pensioning, regardless of disability diagnosis. The estimated odds ratio (OR) was substantially higher for PDs [OR 4.69 (95 % confidence interval (CI) 2.6–8.5)] than for mood disorders [OR 1.3 (CI 0.7–2.3)] and anxiety disorders [OR 2.3 (CI 1.3–4.3)]. Measured dimensionally, all PD traits except antisocial traits were significantly associated with disability pensioning. After adjusting for co-occurring traits of other PDs, only schizoid, dependent and borderline PD traits showed a significant positive association with disability pension, while antisocial traits showed a significant negative association. The principal component analyses showed that negative affectivity, psychoticism, and detachment was associated with an increased risk of disability pensioning, while antagonism/disinhibition and obsessivity were not. Conclusions PDs are strongly associated with disability pensioning in young adults, and might be more important predictors of work disability than anxiety and depressive disorders. Certain aspects of pathologic personalities are particularly important predictors of disability.

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“…There is significant co-morbidity between different PDs [28, 29]. To evaluate the unique effect of each PD we adjusted for co-occurring traits of other PDs (Table 3, model 3).…”

Section: Discussionmentioning

confidence: 99%

Personality disorders are important risk factors for disability pensioning

Østby

Czajkowski

Knudsen

et al. 2014

Soc Psychiatry Psychiatr Epidemiol

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“…Within-PD comorbidity rates are high (1) in non-patient as well as patient samples (Zimmerman & Coryell, 1989), (2) using different assessment instruments (Oldham et al, 1992), and (3) across various Western cultures (Marinangeli et al, 2000). This excessive comorbidity undermines the validity and utility of the DSM-5 -II PD diagnostic system, in which the 10 PD criterion sets are intended to reflect “qualitatively distinct clinical syndromes” (APA, 2013, p. 646).…”

Section: Problems With the Current Categorical Pd Diagnostic Systemmentioning

confidence: 99%

The Brave New World of Personality Disorder-Trait Specified: Effects of Additional Definitions on Coverage, Prevalence, and Comorbidity

Clark

Vanderbleek

Shapiro

et al. 2015

Psychopathology Review

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The alternative dimensional model for personality disorder (PD) in DSM-5, Section III (DSM-5-III) includes two main criteria: (A) personality-functioning impairment, and (B) personality-trait pathology; provides specific functioning-and-trait criteria for six PD-type diagnoses; and introduces PD-trait specified (PD-TS), which requires meeting the general PD criteria and not meeting criteria for any specific PD type. We termed this Simple PD-TS and developed two additional definitions: Mixed PD-TS, meeting criteria for one or two PD types and having five or more additional pathological traits; and Complex PD-TS, meeting criteria for three or more PD types. In a mixed sample of 165 outpatients and 215 community adults screened to be at high-risk for PD, we investigated the effect of these additional definitions on prevalence, coverage, comorbidity, and within-diagnosis heterogeneity, and conclude that eliminating the PD-type diagnoses and thus having PD-TS as the only PD diagnosis would be both more parsimonious and more useful clinically.

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“…The categorical perspective, such as presented in DSM-IV-TR (American Psychiatric Association [APA], 2002), which remains in force in the DSM until today, sees PDs as distinct qualitative clinical syndromes; however, the clinical situations have shown that there are no clear limits between the different pathological aspects of personality (Hopwood et al, 2011;Millon, Millon, Meagher, Grossman, & Ramnath, 2004;Oldham et al, 1992;Widiger & Samuel, 2005).…”

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confidence: 99%

Validity Evidences for the Dimensional Clinical Personality Inventory in Outpatient Psychiatric Sample

Abela

Carvalho

Cho

et al. 2015

Paidéia (Ribeirão Preto)

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The Dimensional Clinical Personality Inventory (IDCP) was developed in Brazil for the assessment of pathological personality traits. This study aimed to seek validity evidence for the dimensions of IDCP based on external criteria, psychiatric diagnosis. We examined the profile in IDCP of 105 psychotherapy outpatients, previously diagnosed with personality disorders. The profiles were compared with the profile of the normative non-clinical sample and we conducted the repeated measures analysis to investigate whether the IDCP is able to discriminate consistent profiles for different diagnoses and compared the general population. The results suggest validity evidence based on external criteria for the IDCP dimensions and points to the clinical effectiveness of the instrument.

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Diagnosis of DSM-III-R personality disorders by two structured interviews: patterns of comorbidity

Cited by 267 publications

References 26 publications

Personality disorders are important risk factors for disability pensioning

Personality disorders are important risk factors for disability pensioning

The Brave New World of Personality Disorder-Trait Specified: Effects of Additional Definitions on Coverage, Prevalence, and Comorbidity

Validity Evidences for the Dimensional Clinical Personality Inventory in Outpatient Psychiatric Sample

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