Personality disorder prevalence in psychiatric outpatients: A systematic literature review

Beckwith, Helen; Moran, Paul; Reilly, Jacqueline

doi:10.1002/pmh.1252

Cited by 159 publications

(90 citation statements)

References 17 publications

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“…Esta estimativa pode ser ainda maior quando consideradas manifestações menos incapacitantes destes quadros. 14 A prevalência de desordens da personalidade sofre variações de acordo com o grupo sociodemográfico. 14 Uma maior prevalência é referida em homens na literatura, no entanto, tal informação pode ser confrontada com o que é visto nos sistemas de assistência à saúde mental, que computam mais casos de TP no sexo feminino em comparação ao masculino.…”

Section: Quadro 1 Critérios Diagnósticos Para Um Transtorno Da Persounclassified

“…14 A prevalência de desordens da personalidade sofre variações de acordo com o grupo sociodemográfico. 14 Uma maior prevalência é referida em homens na literatura, no entanto, tal informação pode ser confrontada com o que é visto nos sistemas de assistência à saúde mental, que computam mais casos de TP no sexo feminino em comparação ao masculino. Tal fato ocorre, supostamente, devido a ocorrência mais frequente de comportamento autoagressivos por parte das mulheres.…”

Section: Quadro 1 Critérios Diagnósticos Para Um Transtorno Da Persounclassified

“…16 Os resultados de estudos desenvolvidos com gêmeos têm apontado para interferência de fatores genéticos, sugerindo hereditariedade de traços ou TP com variância de 30% a 60%. 14,19,20 As interferências genéticas na manifestação de desordens da personalidade são moduladas de acordo com a especificidade de cada transtorno desta categoria. Além da interferência retratada, a sobreposição com fatores genéticos que predispõem outros transtornos mentais associados também pode ser identificada.…”

Section: Quadro 1 Critérios Diagnósticos Para Um Transtorno Da Persounclassified

“…34 Embora o diagnóstico de TP possa ser considerado, é importante evitar diagnosticar pacientes que se apresentam como de difícil manejo, despertam raiva ou outras emoções intensas e demandam muita atenção, em situações críticas, atendimentos de urgência e a partir de uma única avaliação, já que evidencia-se uma disparidade do diagnósti-co realizado nessas circunstâncias comparado ao estabelecido a partir de uma entrevista sistematizada apropriada. 14,35,36 As descrições e critérios diagnósticos para cada um dos tipos de TP, de acordo com o DSM-5, são reproduzidos nos quadros 2 e 3, que apresentam, respectivamente, o grupo A e B.…”

Section: Etiologia E Fatores De Riscounclassified

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Personality disorders

Mazer¹,

Macedo²,

Juruena³

2017

Medicina (Ribeirão Preto)

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RESUMOOs Transtornos da personalidade são padrões psicológicos de difícil diagnóstico que exigem uma avaliação criteriosa por parte do profissional da saúde mental. A relação médico-paciente também se configura como fator de extrema importância para o manejo destes quadros. Dentro deste contexto, é imprescindível orientar os alunos das áreas de graduação em saúde sobre a existência de tal categoria de transtornos. O presente artigo consiste em uma revisão descritiva, que busca elucidar a definição de transtornos da personalidade; além de discorrer sobre aspectos históricos, nosológicos e epidemiológi-cos. Nesta publicação ainda serão revisadas as particularidades referentes ao diagnóstico, as comorbidades, ao curso e tratamento destes transtornos. O enfoque maior será no manejo de indivíduos com transtorno da personalidade borderline, dada a maior procura destes por unidades de atendimento psiquiátrico. Palavras ABSTRACTPersonality disorders are psychological patterns of difficult diagnosis that require careful evaluations from mental health professionals. The physician-patient relationship is a crucial condition for the management of these disorders. On this view it must be important guide undergraduate students from health care areas through the existence of such a category of disorders. This article consists of a descriptive review aiming at clarifying the definition of personality disorders; furthermore discuss historical, physiological and epidemiological aspects. On this publication will be reviewed some particularities from diagnostic comorbidity, course and treatment of these disorders. The management of individuals with borderline personality disorder will be emphasized in this publication due to increased seek from this public for mental health care units.

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Section: Quadro 1 Critérios Diagnósticos Para Um Transtorno Da Persounclassified

Section: Etiologia E Fatores De Riscounclassified

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Personality disorders

Mazer¹,

Macedo²,

Juruena³

2017

Medicina (Ribeirão Preto)

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“…The prevalence of PD in mental health services in England is at least 40%. 89 Coid et al 1 have estimated a population prevalence of 4.4% in those aged 16-74 years and this would imply total health costs of around £16B per year.…”

Section: Observations About Participantsmentioning

confidence: 99%

Psychoeducation with problem-solving (PEPS) therapy for adults with personality disorder: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manualised intervention to improve social functioning

McMurran

Crawford

Reilly

et al. 2016

Health Technol Assess

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If effective, less intensive treatments for people with personality disorder have the potential to serve more people.To compare the clinical effectiveness and cost-effectiveness of psychoeducation with problem-solving (PEPS) therapy plus usual treatment against usual treatment alone in improving social problem-solving with adults with personality disorder.Multisite two-arm, parallel-group, pragmatic randomised controlled superiority trial.Community mental health services in three NHS trusts in England and Wales.Community-dwelling adults with any personality disorder recruited from community mental health services.Up to four individual sessions of psychoeducation, a collaborative dialogue about personality disorder, followed by 12 group sessions of problem-solving therapy to help participants learn a process for solving interpersonal problems.The primary outcome was measured by the Social Functioning Questionnaire (SFQ). Secondary outcomes were service use (general practitioner records), mood (measured via the Hospital Anxiety and Depression Scale) and client-specified three main problems rated by severity. We studied the mechanism of change using the Social Problem-Solving Inventory. Costs were identified using the Client Service Receipt Inventory and quality of life was identified by the European Quality of Life-5 Dimensions questionnaire. Research assistants blinded to treatment allocation collected follow-up information.There were 739 people referred for the trial and 444 were eligible. More adverse events in the PEPS arm led to a halt to recruitment after 306 people were randomised (90% of planned sample size); 154 participants received PEPS and 152 received usual treatment. The mean age was 38 years and 67% were women. Follow-up at 72 weeks after randomisation was completed for 62% of participants in the usual-treatment arm and 73% in the PEPS arm. Intention-to-treat analyses compared individuals as randomised, regardless of treatment received or availability of 72-week follow-up SFQ data. Median attendance at psychoeducation sessions was approximately 90% and for problem-solving sessions was approximately 50%. PEPS therapy plus usual treatment was no more effective than usual treatment alone for the primary outcome [adjusted difference in means for SFQ -0.73 points, 95% confidence interval (CI) -1.83 to 0.38 points; p = 0.19], any of the secondary outcomes or social problem-solving. Over the follow-up, PEPS costs were, on average, £182 less than for usual treatment. It also resulted in 0.0148 more quality-adjusted life-years. Neither difference was statistically significant. At the National Institute for Health and Care Excellence thresholds, the intervention had a 64% likelihood of being the more cost-effective option. More adverse events, mainly incidents of self-harm, occurred in the PEPS arm, but the difference was not significant (adjusted incidence rate ratio 1.24, 95% CI 0.93 to 1.64).There was possible bias in adverse event recording because of dependence on self-disclosure or reporting by the clini...

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