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Obsessive compulsive patients with comorbid personality disorder: associated problems and response to a comprehensive behavior therapy.
J Clin Psychiatry. 1994 Oct; 55(10):448-53.JC

Abstract

BACKGROUND

The present study examined a group of patients who have obsessive compulsive disorder (OCD) and certain comorbid personality disorders to provide data on types of clinical problems that complicate treatment. Data are presented on patient response to a comprehensive behavior therapy.

METHOD

Forty-one consecutively referred, adult, nonpsychotic patients with OCD were evaluated independently by their attending psychiatrist and a consulting psychologist for presence of DSM-III-R personality disorder. Thirty-one of these patients, for whom there was 100% agreement on presence or absence of a comorbid personality disorder, participated in a course of comprehensive behavior therapy. OCD patients with comorbid personality disorder (OCD+PD) were compared with a group of OCD patients without comorbid personality disorder (nonPD OCD) on pretreatment and treatment-related variables.

RESULTS

There was significantly high interrater reliability between psychiatrist and psychologist on diagnosis of personality disorder (p < .001). OCD+PD patients demonstrated poorer response to prior psychiatric treatments and greater psychosocial and psychiatric impairment at pretreatment than did nonPD OCD patients. The OCD+PD patients demonstrated a moderate response to comprehensive behavior therapy, but below that of nonPD OCD patients. OCD+PD patients were also rated as more difficult to treat, required more psychiatric hospitalizations during treatment, and were more likely to terminate behavior therapy prematurely than were nonPD OCD patients.

CONCLUSION

In modest samples of OCD+PD patients (N = 26), and nonPD OCD patients (N = 5), this study found that OCD patients with personality disorder had greater psychopathology, fewer coping and living skills, and were more resistant to psychiatric treatment than the nonPD OCD patients. In addition, when treated with a comprehensive behavior therapy that focuses on other clinical problems in addition to the OCD symptoms, the OCD+PD patients had an enhanced response to treatment.

Authors+Show Affiliations

Institute of Pennsylvania Hospital, Psychology Department, Philadelphia 19139.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7961523

Citation

AuBuchon, P G., and V J. Malatesta. "Obsessive Compulsive Patients With Comorbid Personality Disorder: Associated Problems and Response to a Comprehensive Behavior Therapy." The Journal of Clinical Psychiatry, vol. 55, no. 10, 1994, pp. 448-53.
AuBuchon PG, Malatesta VJ. Obsessive compulsive patients with comorbid personality disorder: associated problems and response to a comprehensive behavior therapy. J Clin Psychiatry. 1994;55(10):448-53.
AuBuchon, P. G., & Malatesta, V. J. (1994). Obsessive compulsive patients with comorbid personality disorder: associated problems and response to a comprehensive behavior therapy. The Journal of Clinical Psychiatry, 55(10), 448-53.
AuBuchon PG, Malatesta VJ. Obsessive Compulsive Patients With Comorbid Personality Disorder: Associated Problems and Response to a Comprehensive Behavior Therapy. J Clin Psychiatry. 1994;55(10):448-53. PubMed PMID: 7961523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obsessive compulsive patients with comorbid personality disorder: associated problems and response to a comprehensive behavior therapy. AU - AuBuchon,P G, AU - Malatesta,V J, PY - 1994/10/1/pubmed PY - 1994/10/1/medline PY - 1994/10/1/entrez SP - 448 EP - 53 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 55 IS - 10 N2 - BACKGROUND: The present study examined a group of patients who have obsessive compulsive disorder (OCD) and certain comorbid personality disorders to provide data on types of clinical problems that complicate treatment. Data are presented on patient response to a comprehensive behavior therapy. METHOD: Forty-one consecutively referred, adult, nonpsychotic patients with OCD were evaluated independently by their attending psychiatrist and a consulting psychologist for presence of DSM-III-R personality disorder. Thirty-one of these patients, for whom there was 100% agreement on presence or absence of a comorbid personality disorder, participated in a course of comprehensive behavior therapy. OCD patients with comorbid personality disorder (OCD+PD) were compared with a group of OCD patients without comorbid personality disorder (nonPD OCD) on pretreatment and treatment-related variables. RESULTS: There was significantly high interrater reliability between psychiatrist and psychologist on diagnosis of personality disorder (p < .001). OCD+PD patients demonstrated poorer response to prior psychiatric treatments and greater psychosocial and psychiatric impairment at pretreatment than did nonPD OCD patients. The OCD+PD patients demonstrated a moderate response to comprehensive behavior therapy, but below that of nonPD OCD patients. OCD+PD patients were also rated as more difficult to treat, required more psychiatric hospitalizations during treatment, and were more likely to terminate behavior therapy prematurely than were nonPD OCD patients. CONCLUSION: In modest samples of OCD+PD patients (N = 26), and nonPD OCD patients (N = 5), this study found that OCD patients with personality disorder had greater psychopathology, fewer coping and living skills, and were more resistant to psychiatric treatment than the nonPD OCD patients. In addition, when treated with a comprehensive behavior therapy that focuses on other clinical problems in addition to the OCD symptoms, the OCD+PD patients had an enhanced response to treatment. SN - 0160-6689 UR - https://www.unboundmedicine.com/medline/citation/7961523/Obsessive_compulsive_patients_with_comorbid_personality_disorder:_associated_problems_and_response_to_a_comprehensive_behavior_therapy_ L2 - http://www.diseaseinfosearch.org/result/5285 DB - PRIME DP - Unbound Medicine ER -