Relationship of comorbid personality disorders to prospective outcome in bipolar disorder

JOURNAL OF AFFECTIVE DISORDERS

卷:276

Article

Post, Robert M.¹  Leverich, Gabriele S.¹  McElroy, Susan^2,3  Kupka, Ralph⁴  Suppes, Trisha^5,6  Altshuler, Lori^7,8  Nolen, Willem⁹  Frye, Mark¹⁰  Keck, Paul¹¹  Grunze, Heinz¹²  Rowe, Michael¹ 

[1] Bipolar Collaborat Network, Bethesda, MD 20814 USA

[2] Linder Ctr Hope, Mason, OH USA

[3] Univ Cincinnati, Med Coll, Biol Psychiat Program, Cincinnati, OH USA

[4] Vrije Univ Amsterdam, Dept Psychiat, Med Ctr, Amsterdam, Netherlands

[5] Stanford Univ, Sch Med, Prof Psychiat & Behav Sci 11, Palo Alto, CA 94304 USA

[6] VA Palo Alto Hlth Care Syst, Palo Alto, CA 94304 USA

[7] UCLA Mood Disorders Res Program, Los Angeles, CA USA

[8] VA Med Ctr, Los Angeles, CA USA

[9] Univ Med Ctr Groningen UMCG, Groningen, Netherlands

[10] Mayo Clin, Rochester, MI USA

[11] Univ Cincinnati, Lindner Ctr Hope Mason, Coll Med Cincinnati, Cincinnati, OH 45221 USA

[12] Privat Dozent PMU Nurnberg, Allgemein Psychiat Ost Klinikum Weissenhof, Chefarzt, Nurnberg, Germany

关键词: Borderline personality disorders;    Long term response;    Early onset;    Childhood adversity;    Mood stabilization;   

DOI  :  10.1016/j.jad.2020.07.031

来源: Elsevier

【 摘 要 】

Introduction There is a high incidence of Axis II personality disorders (PDs) in patients with bipolar illness, but their influence on the prospectively measured course of bipolar disorder has been less well explicated. Methods 392 outpatients with bipolar disorder gave informed consent, completed the PDQ4 99 item personality disorder rating, and where clinically rated during at least one year of prospective naturalistic treatment. They were classified as Well on admission (N = 64) or Responders (N = 146) or Non-responders (N = 182) to treatment for at least six months. Results Patients who were positive for PDs were very infrequently represented in the category of Well on admission. In addition, patients with borderline, depressive, and schizoid PDs were significantly more likely to be Non-responders compared to Responders upon prospective naturalistic treatment in the network. Conclusions Patients with bipolar disorder and comorbid PDs were in general less likely to be Well from treatment in the community at network entry or to be a Responder to prospective treatment in the network. Therapeutic approaches to patients with PDs deserve specific study in an attempt to achieve a better long-term course of bipolar disorder.

【 授权许可】

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