Reliability of a Schedule for Rating Personality Disorders

Tyrer, Peter; Alexander, Marcalee; Cicchetti, Domenic V.; Cohen, Murray; Remington, Marina

doi:10.1192/bjp.135.2.168

Cited by 156 publications

(55 citation statements)

References 13 publications

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“…Personality was assessed in the majority of patients using the Personality Assessment Scale [24], which was completed with the patient and/or informant.…”

Section: Methodsmentioning

confidence: 99%

Neurosurgical Treatments for Patients with Chronic, Treatment-Refractory Depression: A Retrospective, Consecutive, Case Series Comparison of Anterior Capsulotomy, Anterior Cingulotomy and Vagus Nerve Stimulation

Christmas

Matthews²

2015

Stereotact Funct Neurosurg

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Background: The evidence base to guide therapeutic choices for patients with chronic and treatment-refractory depression (TRD) remains weak. There is limited comparative information available to guide the choice of intervention for patients with the most severe and disabling forms of illness. Objectives: The aim of this work was to describe the 12-month clinical outcomes of patients with chronic TRD treated with anterior capsulotomy (ACAPS; n = 5), anterior cingulotomy (ACING; n = 5) or vagus nerve stimulation (VNS; n = 5). Methods: We performed a retrospective, consecutive, case series comparison. Results: With clinical response defined as a ≥50% reduction from the baseline MADRS score, response rates were 40% for ACAPS, 60% for ACING and 20% for VNS. Adverse effects from all three procedures were relatively mild, consistent with previous reports and, in most cases, transient. Adverse effects from VNS were related to active stimulation, and were modifiable and diminished in severity over time. There were no deaths. Conclusions: Although based on a small sample, our data represent a unique comparison of ACAPS, ACING and VNS for chronic TRD. The three cohorts were broadly equivalent in terms of baseline clinical characteristics, indices of chronicity, illness severity and estimates of previous failed treatments. ACING and ACAPS, but not VNS, were associated with favourable response rates at 12 months.

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“…Personality was assessed in the majority of patients using the Personality Assessment Scale [24], which was completed with the patient and/or informant.…”

Section: Methodsmentioning

confidence: 99%

Neurosurgical Treatments for Patients with Chronic, Treatment-Refractory Depression: A Retrospective, Consecutive, Case Series Comparison of Anterior Capsulotomy, Anterior Cingulotomy and Vagus Nerve Stimulation

Christmas

Matthews²

2015

Stereotact Funct Neurosurg

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“…The first of these was that health anxietyfocused CBT (CBT-HA) would be less effective in patients who had additional comorbid pathology in the form of obsessional symptomatology [measured using the Short Obsessive-Compulsive disorder Screener (SOCS)]. 17 We also hypothesised that personality status would have an impact on the effectiveness of treatment, and that those with dependent personalities [measured using the Dependent Personality Questionnaire (DPQ)] 18 and other personality disorders 19 [measured using the Quick Personality Assessment Schedule (PAS-Q)], 20 which were subsequently converted into International Statistical Classification of Diseases, Eleventh Edition (ICD-11) 21 personality disorder categories, 22 would have a worse outcome with CBT-HA. We also expected that these comorbid disorders would be associated with increased costs.…”

Section: Research Objectivesmentioning

confidence: 99%

“…The following assessments were carried out at baseline only: l personality assessment using the PAS-Q, 20 followed by conversion to the ICD-11 personality levels 22 but also including the questions from the hypochondriasis subsection of the full schedule 19 l the SOCS 17 (a set of seven questions that identify the likely presence of obsessive-compulsive disorder); and l the DPQ, 18 an assessment of dependent personality traits (this was included because both dependent personality and obsessional symptoms are associated conditions that may handicap or complicate treatment).…”

Section: Assessmentsmentioning

confidence: 99%

Cognitive–behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years

Tyrer

Šalkovskis

Tyrer

et al. 2017

Health Technol Assess

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BackgroundHealth anxiety is an under-recognised but frequent cause of distress that is potentially treatable, but there are few studies in secondary care.ObjectiveTo determine the clinical effectiveness and cost-effectiveness of a modified form of cognitive–behaviour therapy (CBT) for health anxiety (CBT-HA) compared with standard care in medical outpatients.DesignRandomised controlled trial.SettingFive general hospitals in London, Middlesex and Nottinghamshire.ParticipantsA total of 444 patients aged 16–75 years seen in cardiology, endocrinology, gastroenterology, neurology and respiratory medicine clinics who scored ≥ 20 points on the Health Anxiety Inventory (HAI) and satisfied diagnostic requirements for hypochondriasis. Those with current psychiatric disorders were excluded, but those with concurrent medical illnesses were not.InterventionsCognitive–behaviour therapy for health anxiety – between 4 and 10 1-hour sessions of CBT-HA from a health professional or psychologist trained in the treatment. Standard care was normal practice in primary and secondary care.Main outcome measuresPrimary – researchers masked to allocation assessed patients at baseline, 3, 6, 12, 24 months and 5 years. The primary outcome was change in the HAI score between baseline and 12 months. Main secondary outcomes – costs of care in the two groups after 24 and 60 months, change in health anxiety (HAI), generalised anxiety and depression [Hospital Anxiety and Depression Scale (HADS)] scores, social functioning using the Social Functioning Questionnaire and quality of life using the EuroQol-5 Dimensions (EQ-5D), at 6, 12, 24 and 60 months, and deaths over 5 years.ResultsOf the 28,991 patients screened over 21 months, 5769 had HAI scores of ≥ 20 points. Improvement in HAI scores at 3 months was significantly greater in the CBT-HA group (mean number of sessions = 6) than in the standard care, and this was maintained over the 5-year period (overallp < 0.0001), with no loss of efficacy between 2 and 5 years. Differences in the generalised anxiety (p = 0.0018) and depression scores (p = 0.0065) on the HADS were similar in both groups over the 5-year period. Gastroenterology and cardiology patients showed the greatest CBT gains. The outcomes for nurses were superior to those of other therapists. Deaths (n = 24) were similar in both groups; those in standard care died earlier than those in CBT-HA. Patients with mild personality disturbance and higher dependence levels had the best outcome with CBT-HA. Total costs were similar in both groups over the 5-year period (£12,590.58 for CBT-HA; £13,334.94 for standard care). CBT-HA was not cost-effective in terms of quality-adjusted life-years, as measured using the EQ-5D, but was cost-effective in terms of HAI outcomes, and offset the cost of treatment.LimitationsMany eligible patients were not randomised and the population treated may not be representative.ConclusionsCBT-HA is a highly effective treatment for pathological health anxiety with lasting benefit over 5 years. It also improves generalised anxiety and depressive symptoms more than standard care. The presence of personality abnormality is not a bar to successful outcome. CBT-HA may also be cost-effective, but the high costs of concurrent medical illnesses obscure potential savings. This treatment deserves further research in medical settings.Trial registrationCurrent Controlled Trials ISRCTN14565822.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 50. See the NIHR Journals Library website for further project information.

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“…Test-tekrar test ve görüşmeciler arası güvenilirliğin yeterli düzeyde olduğu bulunmuştur. [56,57] Hızlı Kişilik Değerlendirme Çizelgesi (Rapid Personality Assessment Schedule; PAS-R)…”

Section: Dsm-iii-r'deki Kişilik Bozukluklarına Yönelik Yapısal Görüşmunclassified

Personality: Description, Classification and Evaluation

Taymur¹

2012

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychia

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ÖZETGeçmişten bu yana insanları anlamak ve tanımak adına kişilikle ilgili birçok tanım ve sınıflandırma yapılmıştır. Psikiyatrinin gelişim sürecindeki her kuram kişiliği kendi açısından tanımlamış ve değerlendirmiştir. Uluslararası sınıflama sistemleri, DSM ve ICD ile birlikte araştırmacılar daha yaygın ve ortak bir dil kullanımına yönelik çalışmalar içerine girmişlerdir. Kişiliğe yöne-lik çalışmalarda ve klinik uygulamada kategorik ve boyutsal yaklaşımlar en temel farklı yaklaşım biçimleridir. Kategorik yaklaşım kişiliğe birbirinden farklı sınıflardan oluşan dikotomilerle yaklaşırken, boyutsal yaklaşım kişiliğin belli boyutlardan oluşan bir yapı olduğunu öne sürerek bu boyutlar temelinde kişiliği anlama ve tanımlamayı amaçlamıştır. Kişiliğe ilişkin bu güne kadar oluşturulmuş tanımlar ve geliştirilmiş araçlar değerlendirildiğinde hepsinin bir takım avantaj ve dezavantajlara sahip oldukları görülmektedir. DSM-5 tanı sınıflamasının kişilik bozukluğuna ilişkin öneriler içeren bölümü incelendiğinde kişilik bozuklukları tanı grubunun yeni bulgular ve eleştiriler doğrultu-sunda yeniden yapılandırılmasının amaçlandığı görülmektedir. Bu yazıda kişiliğin tarihsel süreçteki tanımı, kişiliğe boyutsal, kategorik ve bilişsel yaklaşımlar, kişiliğin ölçüm ve değerlendirmesinde kullanılan araçların özellikleri gözden geçirilmeye çalışılmıştır.

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Reliability of a Schedule for Rating Personality Disorders

Cited by 156 publications

References 13 publications

Neurosurgical Treatments for Patients with Chronic, Treatment-Refractory Depression: A Retrospective, Consecutive, Case Series Comparison of Anterior Capsulotomy, Anterior Cingulotomy and Vagus Nerve Stimulation

Neurosurgical Treatments for Patients with Chronic, Treatment-Refractory Depression: A Retrospective, Consecutive, Case Series Comparison of Anterior Capsulotomy, Anterior Cingulotomy and Vagus Nerve Stimulation

Cognitive–behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years

Personality: Description, Classification and Evaluation

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