Personality traits and treatment outcome in obsessive-compulsive disorder

Corchs, Felipe; Corregiari, Fábio; Ferrão, Ygor Arzeno; Takakura, T; Mathis, Maria Eugênia de; Lopes, Antônio Carlos; Miguel, Eurí­pedes Constantino; Bernik, Márcio

doi:10.1590/s1516-44462008000300012

Cited by 24 publications

(17 citation statements)

References 21 publications

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“…Finally, it has been postulated that persons with an immature defense style will respond less effectively to both pharmacological (49) and psychological (48,51,52) treatment. Lower scores on SD was also previously related with less response to treatment (53,54). Consistent with this, in a previous study SD was found to be lower in short-term abstinence patients who may be perceiving higher levels of stress and use non-adaptive coping strategies than long-term abstinence group (55).…”

Section: Discussionsupporting

confidence: 80%

Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents

Evren¹,

Yiğiter²,

Bozkurt³

et al. 2013

Dusunen Adam

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Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents Objective: The aim of this study was to evaluate the defense styles and the personality dimensions that are related with relapse to alcohol use 12 months after inpatient treatment in male alcohol dependents.Methods: Participants were 70 consecutively admitted male alcohol dependents. Among these patients 44 were available to examine after 1 year. Patients were investigated with the Temperament and Character Inventory (TCI) and Defense Styles Q (DSQ) at baseline.Results: Among 44 alcohol dependent inpatients 61.4% (n=27) were considered as relapsed to alcohol use. Current age was lower in relapsed group. Age at regular alcohol use, duration of education, regular income did not differ between groups. Rate of history of self-mutilation and/or suicide attempt at baseline were higher in relapsed group. Rate of changing social environment during 12 months after inpatient treatment was lower in the relapsed group, whereas using drugs and spending time with substance using friends were higher in this group. Mean scores of "acting-out", "devaluation" and "displacement" were higher in the relapsed group. Also same immature defense styles predicted relapse together with self-directedness (SD).When current age was included in the analysis, being younger and high acting-out predicted relapse in alcohol dependents after inpatient treatment.Conclusions: Clinicians must be careful for younger alcohol dependents with lower SD and for those who use immature defense styles (particularly acting-out) since these variables may be related with relapse.Key words: Alcohol dependence, character, defense styles, relapse, temperament ÖZET Erkek alkol bağımlılarında 12 aylık takip süresindeki depreşme ile ilişkili savunma mekanizmaları ve kişilik boyutları Amaç: Bu çalışmanın amacı, erkek alkol bağımlılarında yatarak tedaviden sonraki 12 ay içinde alkol kullanımında depreşme ile ilişkili olabilecek savunma mekanizmaları ve kişilik boyutlarını değerlendirmektir. ayda sosyal çevreyi değiştirme oranı depreşen grupta düşükken, alkol dışı madde kullanmış olma ve madde kullanan arkadaşlarıyla görüşmeye devam etme oranları yüksekti. Depreşen grupta "eyleme dökme", "değersizleştirme" ve "yer değiştirme" ortalama puanları daha yüksekti. Ayrıca aynı savunma mekanizmaları, düşük düzeyde kendi kendini yönetme (KY) ile birlikte depreşmeyi belirleyen değişkenler olmuştur. Analize o anki yaş eklendiğinde ise, alkol bağımlılarında yatarak tedavi sonrası depreşmeyi genç olma ve yüksek eyleme dökme belirlemiştir.Sonuç: Klinisyenler düşük KY ve olgunlaşmamış savunma biçimlerine (özellikle eyleme dökme) sahip genç alkol bağımlıları için dikkatli olmalıdırlar, çünkü bu değişkenler depreşme ile ilişkili görünmektedir.

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Section: Discussionsupporting

confidence: 80%

Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents

Evren¹,

Yiğiter²,

Bozkurt³

et al. 2013

Dusunen Adam

View full text Add to dashboard Cite

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“…OCD sufferers also vary in cooccurrence of categorical personality disorders and in how they vary along personality dimensions . These are the factors that may influence resilience in the face of severe chronic illness, likelihood of treatment response (Corchs et al, 2008), and, in terms of DBS particularly, in the propensity to conscientiously adhere to the treatment regimens that must include close follow-up over the long term.…”

Section: Potential Relevance Of Ocd Subtypes To Neurosurgerymentioning

confidence: 99%

Invasive Circuitry-Based Neurotherapeutics: Stereotactic Ablation and Deep Brain Stimulation for OCD

Greenberg

Rauch

Haber

2009

Neuropsychopharmacol

327

229

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Psychiatric neurosurgery, specifically stereotactic ablation, has continued since the 1940s, mainly at a few centers in Europe and the US. Since the late 1990s, the resurgence of interest in this field has been remarkable; reports of both lesion procedures and the newer technique of deep brain stimulation (DBS) have increased rapidly. In early 2009, the US FDA granted limited humanitarian approval for DBS for otherwise intractable obsessive-compulsive disorder (OCD), the first such approval for a psychiatric illness. Several factors explain the emergence of DBS and continued small-scale use of refined lesion procedures. DBS and stereotactic ablation have been successful and widely used for movement disorders. There remains an unmet clinical need: current drug and behavioral treatments offer limited benefit to some seriously ill people. Understandings of the neurocircuitry underlying psychopathology and the response to treatment, while still works in progress, are much enhanced. Here, we review modern lesion procedures and DBS for OCD in the context of neurocircuitry. A key issue is that clinical benefit can be obtained after surgeries targeting different brain structures. This fits well with anatomical models, in which circuits connecting orbitofrontal cortex (OFC), medial prefrontal cortex (mPFC), basal ganglia, and thalamus are central to OCD pathophysiology and treatment response. As in movement disorders, dedicated interdisciplinary teams, here led by psychiatrists, are required to implement these procedures and maintain care for patients so treated. Available data, although limited, support the promise of stereotactic ablation or DBS in carefully selected patients. Benefit in such cases appears not to be confined to obsessions and compulsions, but includes changes in affective state. Caution is imperative, and key issues in long-term management of psychiatric neurosurgery patients deserve focused attention. DBS and contemporary ablation also present different patterns of potential benefits and burdens. Translational research to elucidate how targeting specific nodes in putative OCD circuitry might lead to therapeutic gains is accelerating in tandem with clinical use.

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“…[27][28][29] A cross-sectional study aimed to compare possible differences in personality traits between responder and non-responder OCD patients found positive associations, especially for low self-directedness, with poor treatment response in obsessive-compulsive patients 27 : patients with low self-directedness were more susceptible to engaging in responses aimed at allaying the anxiety (compulsions) rather than responses with delayed but healthier consequences (preventing compulsions).…”

Section: Comorbiditiesmentioning

confidence: 99%

Treating refractory obsessive-compulsive disorder: what to do when conventional treatment fails?

Franz

Paim

Araújo

et al. 2013

Trends Psychiatry Psychother.

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Tratando o transtorno obsessivo-compulsivo refratário: o que fazer quando tratamentos convencionais falham? Treating refractory obsessive-compulsive disorder:what to do when conventional treatment fails? AbstractObsessive-compulsive disorder (OCD) is a chronic and impairing condition. A very small percentage of patients become asymptomatic after treatment. The purpose of this paper was to review the alternative therapies available for OCD when conventional treatment fails. Data were extracted from controlled clinical studies (evidence-based medicine) published on the MEDLINE and Science Citation Index/Web of Science databases between 1975 and 2012. Findings are discussed and suggest that clinicians dealing with refractory OCD patients should: 1) review intrinsic phenomenological aspects of OCD, which could lead to different interpretations and treatment choices; 2) review extrinsic phenomenological aspects of OCD, especially family accommodation, which may be a risk factor for non-response; 3) consider non-conventional pharmacological approaches; 4) consider non--conventional psychotherapeutic approaches; and 5) consider neurobiological approaches.

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Personality traits and treatment outcome in obsessive-compulsive disorder

Cited by 24 publications

References 21 publications

Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents

Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents

Invasive Circuitry-Based Neurotherapeutics: Stereotactic Ablation and Deep Brain Stimulation for OCD

Treating refractory obsessive-compulsive disorder: what to do when conventional treatment fails?

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