Personalized treatment for patients with personality disorders and depression

 

Submission type

Symposium

Scheduled

Parallel Session VI: Veilingzaal, 09-06-2018, 13:00 - 14:30

Kernwoorden

personality disorders depression

Onderzoeksgebied

Personality disorders

Beknopte samenvatting van de totale bijdrage

This symposium offers new insights in the tailored treatment of personality disorders and depression, using both quantitative and qualitative methods. A staging approach for BPD, as well as effectiveness studies of individual and group psychotherapy for co-morbid patients, and helpful factors for recovery from a patient perspective are presented.

Auteurs

Impact of co-morbid depression after schema-focused group therapy for personality disorders

Koppers, D (David), Van, R (Rien), Peen, J (Jaap), Dekker, J J M (Jack)

 

Abstract ID

1161

Submission type

Oral only

Introductie

Several studies demonstrated the efficacy of schema-focused therapy for borderline patients. However, in clinical practice most personality pathology presents itself in mixed forms, and the evidence of schema-focused therapy in these types is scarce.

Materiaal en methodes

In a cohort study, (follow-up) effectiveness of short-term schema cognitive-behavioural therapy in groups (SCBT-g) was investigated. The total sample (n=247) had at least one cluster B and/or cluster C personality disorder, with a co-morbid depression (PD-MDD) or without (PD). The aim of this study was to determine the impact of co-morbid depression on recovery after SCBT-g, measured by the Symptom Checklist (SCL-90) and the Young Schema Questionnaire (YSQ).

Resultaten

Symptom reduction after SCBT-g for PD and PD-MDD was significant, with medium effect sizes (ES= 0.48 and ES= 0.53, respectively). Difference in outcome between the two patient groups was not significant. Reduction of dysfunctional schema’s was also significant, with medium effect sizes for both patient groups, respectively ES=0.59 and ES=0.53. Results remained stable during follow-up.

Conclusie

Effect sizes of SCBT-g were medium and significant for both patient groups. This indicates that this form of short-term group therapy can be successfully offered to a broad group of PD patients, with and without depressive co-morbidity.

Auteurs

What works in the treatment of depression? Learning from the patient's, carer's and professional's perspective

Grieken, R A van (Roos), Verburg, H F, Koeter, M W J † (Maarten), Stricker, J (Jessica), Nabitz, U W (Udo), Schene, A H (Aart)

 

Abstract ID

1162

Submission type

Oral only

Introductie

Unfortunately, more than two-thirds of all depressed patients experience insufficient improvement. Therefore, a better understanding of what patients, carers and professionals perceive as most helpful in the treatment of depression is needed.

Materiaal en methodes

Concept mapping, a mixed-method design, was used to identify the patients (n=33), carers (n=22) and professionals (n=50) perspectives. In six brainstorm sessions, the patients, carers and professionals generated 55 statements, which were successively clustered in a two-dimensional concept map.

Resultaten

The 55 statements were clustered into 10 clusters and further grouped into four meta-clusters: ‘Professional therapist’, ‘Treatment content’, ‘Structured treatment process’ and ‘Treatment organisation’. Patients and carers prioritized ‘Treatment organisation’ higher than professionals, but overall there was considerable agreement about the factors of treatment the participants perceived most helpful, including factors related to the therapeutic relationship and the ‘creation of hope’.

Conclusie

Our study identified factors of depression treatment perceived as helpful according to patients, carers and professionals. Findings suggest that in a scientific era with emphasis on biological psychiatry, not only patients and carers, but also professionals consider aspecific factors the most helpful. Further studies might show that the factors we found will be helpful in the treatment for personality disorders as well.

Auteurs

Staging and profiling of borderline personality disorder as a framework for precision care

Dil, L M (Linda), Noteboom, A (Annemieke)

 

Abstract ID

1158

Submission type

Oral only

Introductie

Borderline personality disorder (BPD) seems to have a progressive course, starting from childhood or adolescence. The symptom profile and severity change during its course. The objective of this lecture is to present a new and clinical useful model of staging and profiling of BPD.

Materiaal en methodes

Review of the literature for evidence of clinical stages and risk factors for BPD.

Resultaten

BPD can be described in different stages, ranging from a symptom-free stage with a higher risk of developing BPD to a chronic therapy resistant stage. Although there are no specific predictors of BPD, there are several factors that enhance the risk of developing BPD. Depending on the stage of BPD, specific interventions can be used.

Conclusie

Clinical staging and profiling can contribute to a more personalized approach and treatment selection. More research is needed to further develop this model.

Auteurs

Early gains of patients with personality disorders and co-morbid depression

Eshof, J W van den (Hannah), Kool, M (Marit), Bartak, A (Anna), Peen, J (Jaap), Van, R (Rien), Dekker, J J M (Jack)

 

Abstract ID

1159

Submission type

Oral only

Introductie

Patients with co-occurring depression and personality disorders account for a high psychological and economic burden while tailored treatment options are limited. An RCT on psychotherapy dosage and theoretical orientation for this co-morbid group is being conducted. Patients are randomized over therapy dosage (25 vs 50 sessions) and type of therapy (ST vs SPSP). Recruitment of participants is ongoing aiming for a total of N=200. Preliminary data on early gains in the first six months of therapy (N=76) will be presented.

Materiaal en methodes

Preliminary data are analyzed comparing mean-scores of depression (BDI-II at inclusion and after 1–6 months of treatment) and personality pathology (SIPP at inclusion and after 6 months), independent of condition.

Resultaten

Improvement in BDI-II-scores was achieved within the first two months (ES=.26, p=.002) and six months (ES=.48, p=.0000). Improvement in SIPP-scores was found after six months for the domains Social concordance (ES.34, p=.000), Self control (ES=.39, p=.000) and Relational capacities (ES=.21, p=.028).

Conclusie

Results indicate that depressive symptoms as well as three personality domains of patients with depression and personality pathology improved during the first six months of therapy. Findings are based on preliminary data and a larger sample is needed to support these conclusions.

Auteurs