Neuroleptic treatment of schizotypal personality disorders

Hymowitz, Paul; Frances, Allen; Jacobsberg, Lawrence B.; Sickles, Mary; Hoyt, Robert S.

doi:10.1016/0010-440x(86)90001-5

Cited by 48 publications

(13 citation statements)

References 6 publications

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“…The study by Goldberg and colleagues further demonstrated that it was the more impaired subjects who tended to respond better to the medication (66). Consistent with these findings, less disturbed patients were found to be more reactive with side effects (67). These results generally support the careful and cautious employment of neuroleptics for patients suffering from SPD.…”

Section: Psychopharmacology Studiesmentioning

confidence: 69%

“…This subgroup of patients expressing symptoms such as ideas of reference, paranoid ideation, or dissociative reactions to stress apparently respond to neuroleptic medication (66). Those patients who do not exhibit more severe (such as psychotic spectrum) symptoms do not appear to benefit and may suffer a negative impact stemming from neuroleptic side effects (67). Positive findings from an open label trial of an atypical neuroleptic (clozapine), however, deserve further exploration (79).…”

Section: Psychopharmacology Studiesmentioning

confidence: 99%

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Treatment Outcome of Personality Disorders

1998

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Objective: To review the treatment outcome of personality disorders. Method: A literature search of studies pertaining to personality disorder and outcome was conducted, and studies that focused primarily on Axis II were retained. Of these, naturalistic outcome studies were distinguished from those that addressed treatment outcome specifically. The treatment outcome studies were examined in terms of type of treatment intervention, dependent variables, and outcome. Results: Contrary to contemporary assumptions about Axis II, a substantial number of treatment outcome studies were identified. Trends in the assumptions underlying psychosocial and pharmacologic approaches were identified on the basis of dependent variables. Conclusion: There is evidence that effective treatments exist to alleviate symptoms and reduce symptomatic behaviours that accompany personality disorders. What these results hold for the idea of remission from personality disorder is considered.

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Section: Psychopharmacology Studiesmentioning

confidence: 69%

Section: Psychopharmacology Studiesmentioning

confidence: 99%

Treatment Outcome of Personality Disorders

1998

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“…It has been shown in these studies that the presence of cluster A PD, especially schizotypal PD, has a negative influence on the outcome of axis I treatments of both medical and psychotherapeutic kind [15,16,17,18,19]. Medication studies of schizotypal PD have shown that typical and atypical antipsychotics, and possibly antidepressants, can have a positive influence on distinguished symptoms , such as cognitive disturbance, derealisation, ideas of reference, anxiety, self-image, social and overall functioning, odd communication, obsessive-compulsive symptoms and self-injury [20,21,22,23,24,25,26,27,28,29]. The influence of medication on depressive symptoms in schizotypal patients is still controversial [20,22,24,25].…”

Section: Introductionmentioning

confidence: 99%

“…The influence of medication on depressive symptoms in schizotypal patients is still controversial [20,22,24,25]. There is no ‘agent of choice’ [30], and medication side effects are common, especially in typical neuroleptics [21]. Moreover, it is repeatedly stated that whatever the value of pharmacological treatment may be, the quality of the therapeutic relationship is one of the most crucial aspects in the treatment of cluster A PD patients [26].…”

Section: Introductionmentioning

confidence: 99%

Patients with Cluster A Personality Disorders in Psychotherapy: An Effectiveness Study

Bartak

Andrea²,

Spreeuwenberg

et al. 2010

Psychother Psychosom

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Background: While psychopharmacological studies are common in patients with cluster A personality disorders, the effects of psychotherapy have received little attention. The aim of this study is to explore whether psychotherapeutic treatment yields health gains for these patients. Methods: The study was conducted between March 2003 and June 2008 in 6 mental health care centres in the Netherlands, with a sample of 57 patients with a DSM-IV-TR axis II cluster A diagnosis. Patients were assigned to 3 settings of psychotherapeutic treatment (outpatient, day hospital, inpatient), and effectiveness was assessed at 18 months after baseline. An intention-to-treat analysis was conducted for psychiatric symptoms (Brief Symptom Inventory), psychosocial functioning (Outcome Questionnaire-45) and quality of life (EQ-5D), using multilevel statistical modelling. As the study was non-randomised, the propensity score method was used to control for initial differences. Results: Patients in the day hospital and inpatient group improved substantially in terms of psychiatric symptoms, social and interpersonal functioning, and quality of life. Patients in the outpatient group showed less improvement. Direct comparison of the improvement of psychiatric symptoms showed significant results in favour of day hospital (p = 0.046) and inpatient (p = 0.01) treatment, as compared to outpatient treatment. However, due to substantial baseline differences, this direct comparison should be judged carefully. Conclusions: Cluster A psychopathology is not a contraindication to benefit from psychotherapy. This is especially true for more intensive forms like inpatient and day hospital treatment. Future research should focus more on psychotherapeutic treatment to gain further insight into effective treatment options for this patient group.

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“…Medication might enhance the patient's responsiveness to other forms of psychotherapy. Few controlled treatment studies of Schizotypal PD exist, but Hymnowitz et al (1986) treated seventeen schizotypal outpatients with haloperidol in a single-blind trial and noted improvement on overall schizotypal symptoms, particularly on the scales that measure ideas of reference, odd communication, and social isolation. Unfortunately, half of their patients dropped out of the study complaining of side effects, particularly sedation.…”

Section: Treatment Of Cluster a Personality Disordersmentioning

confidence: 97%