2026-04-18T07:08:21Zhttps://recercat.cat/oai/request

oai:recercat.cat:10230/277822026-03-18T01:02:22Zcom_2072_6col_2072_452952

Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study. Lana, Fernando Sánchez-Gil, Carmen Adroher, Núria D. Pérez Solà, Víctor Feixas, Guillem Martí-Bonany, Josep Torrens, Marta Trastorn límit de la personalitat Psicoteràpia 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. 2016-12-16T11:10:34Z 2016-12-16T11:10:34Z 2016 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Lana F, Sánchez-Gil C, Adroher ND, Pérez V, Feixas G, Martí-Bonany J. et al. Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study. Neuropsychiatr Dis Treat. 2016 Jun 21;12:1477-87. doi: 10.2147/NDT.S106270 1176-6328 http://hdl.handle.net/10230/27782 http://dx.doi.org/10.2147/NDT.S106270 eng Neuropsychiatric Disease and Treatment. 2016 Jun 21;12:1477-87 © 2016 Lana et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. https://creativecommons.org/licenses/by-nc/3.0/ info:eu-repo/semantics/openAccess application/pdf application/pdf Dove Medical Press