Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study
Fernando Lana,1–3 Carmen Sánchez-Gil,1–3 Núria D Adroher,4,5 Víctor Pérez,1–4 Guillem Feixas,6 Josep Martí-Bonany,1–3 Marta Torrens1–4 1Institute of Neuro...
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Dove Medical Press
2016-06-01
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| author | Lana F Sanchez-Gil C Adroher N Perez Sola V Feixas G Martí-Bonany J Torrens Melich M |
| author_facet | Lana F Sanchez-Gil C Adroher N Perez Sola V Feixas G Martí-Bonany J Torrens Melich M |
| author_sort | Lana F |
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| description | Fernando Lana,1–3 Carmen Sánchez-Gil,1–3 Núria D Adroher,4,5 Víctor Pérez,1–4 Guillem Feixas,6 Josep Martí-Bonany,1–3 Marta Torrens1–4 1Institute of Neuropsychiatry and Addictions (INAD), Centre Emili Mira and Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; 2Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; 3Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain; 4IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; 5Public Health and Epidemiology Research Networking Center (CIBERESP), Madrid, Spain; 6Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain Background: Concurrent personality disorder (PD) and substance use disorder (SUD) are common in clinical practice. However, SUD is the main criterion for study exclusion in most psychotherapeutic studies of PD. As a result, data on treatment outcomes in patients with concurrent PD/SUD are scarce.Methods: The study sample consisted of 51 patients diagnosed with severe PD and admitted for psychotherapeutic treatment as a part of routine mental health care. All patients were diagnosed with PD according to the Structured Clinical Interview for PD. Patients were further assessed (DSM-IV diagnostic criteria) to check for the presence of concurrent SUD, with 28 patients diagnosed with both disorders (PD-SUD). These 28 cases were then compared to the 23 patients without SUD (PD-nSUD) in terms of psychiatric hospitalizations and psychiatric emergency room (ER) visits before and during the 6-month therapeutic intervention and every 6 months thereafter for a total of 36 months.Results: The baseline clinical characteristics correspond to a sample of PD patients (78% met DSM-IV criteria for borderline PD) with poor general functioning and a high prevalence of suicide attempts and self-harm behaviors. Altogether, the five outcome variables – the proportion and the number of psychiatric inpatient admissions, the number of days hospitalized, and the proportion and the number of psychiatric ER visits – improved significantly during the treatment period, and this improvement was maintained throughout the follow-up period. Although PD-SUD patients had more psychiatric hospitalizations and ER visits than PD-nSUD patients during follow-up, the differences between these two groups remained stable over the study period indicating that the treatment was equally effective in both groups.Conclusion: Specialized psychotherapy for severe PD can be effectively applied in patients with concurrent PD-SUD under usual practice conditions. These findings suggest that exclusion of patients with dual disorders from specialized treatments is unjustified. Keywords: personality disorder, substance use disorder, borderline personality disorder, dual disorders, psychotherapy, pragmatic clinical study  |
| format | Article |
| id | doaj-art-42e384fb8fd049318068021edfb94db8 |
| institution | Kabale University |
| issn | 1178-2021 |
| language | English |
| publishDate | 2016-06-01 |
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| series | Neuropsychiatric Disease and Treatment |
| spelling | doaj-art-42e384fb8fd049318068021edfb94db82025-08-20T03:27:52ZengDove Medical PressNeuropsychiatric Disease and Treatment1178-20212016-06-01Volume 12Issue 11477148727540Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up studyLana F0Sanchez-Gil CAdroher NPerez Sola VFeixas G1Martí-Bonany JTorrens Melich MInstitute of Neuropsychiatry & Addictions (INAD)Department of Personality, Assessment and Psychological TreatmentsFernando Lana,1–3 Carmen Sánchez-Gil,1–3 Núria D Adroher,4,5 Víctor Pérez,1–4 Guillem Feixas,6 Josep Martí-Bonany,1–3 Marta Torrens1–4 1Institute of Neuropsychiatry and Addictions (INAD), Centre Emili Mira and Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; 2Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; 3Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain; 4IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; 5Public Health and Epidemiology Research Networking Center (CIBERESP), Madrid, Spain; 6Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain Background: Concurrent personality disorder (PD) and substance use disorder (SUD) are common in clinical practice. However, SUD is the main criterion for study exclusion in most psychotherapeutic studies of PD. As a result, data on treatment outcomes in patients with concurrent PD/SUD are scarce.Methods: The study sample consisted of 51 patients diagnosed with severe PD and admitted for psychotherapeutic treatment as a part of routine mental health care. All patients were diagnosed with PD according to the Structured Clinical Interview for PD. Patients were further assessed (DSM-IV diagnostic criteria) to check for the presence of concurrent SUD, with 28 patients diagnosed with both disorders (PD-SUD). These 28 cases were then compared to the 23 patients without SUD (PD-nSUD) in terms of psychiatric hospitalizations and psychiatric emergency room (ER) visits before and during the 6-month therapeutic intervention and every 6 months thereafter for a total of 36 months.Results: The baseline clinical characteristics correspond to a sample of PD patients (78% met DSM-IV criteria for borderline PD) with poor general functioning and a high prevalence of suicide attempts and self-harm behaviors. Altogether, the five outcome variables – the proportion and the number of psychiatric inpatient admissions, the number of days hospitalized, and the proportion and the number of psychiatric ER visits – improved significantly during the treatment period, and this improvement was maintained throughout the follow-up period. Although PD-SUD patients had more psychiatric hospitalizations and ER visits than PD-nSUD patients during follow-up, the differences between these two groups remained stable over the study period indicating that the treatment was equally effective in both groups.Conclusion: Specialized psychotherapy for severe PD can be effectively applied in patients with concurrent PD-SUD under usual practice conditions. These findings suggest that exclusion of patients with dual disorders from specialized treatments is unjustified. Keywords: personality disorder, substance use disorder, borderline personality disorder, dual disorders, psychotherapy, pragmatic clinical study https://www.dovepress.com/comparison-of-treatment-outcomes-in-severe-personality-disorder-patien-peer-reviewed-fulltext-article-NDTpersonality disordersubstance use disorderborderline personality disorderdual disorderspsychotherapypragmatic clinical study. |
| spellingShingle | Lana F Sanchez-Gil C Adroher N Perez Sola V Feixas G Martí-Bonany J Torrens Melich M Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study Neuropsychiatric Disease and Treatment personality disorder substance use disorder borderline personality disorder dual disorders psychotherapy pragmatic clinical study. |
| title | Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study |
| title_full | Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study |
| title_fullStr | Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study |
| title_full_unstemmed | Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study |
| title_short | Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study |
| title_sort | comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders a 36 month prospective pragmatic follow up study |
| topic | personality disorder substance use disorder borderline personality disorder dual disorders psychotherapy pragmatic clinical study. |
| url | https://www.dovepress.com/comparison-of-treatment-outcomes-in-severe-personality-disorder-patien-peer-reviewed-fulltext-article-NDT |
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