ABSTRACT
The CGI-BPD scale is an adaptation of the Clinical Global Impression (CGI) scale designed to assess severity and post-intervention changes in patients with Borderline Personality Disorder (BPD). It contains 10 items that score the nine relevant psychopathological domains of BPD, plus an additional global score. The CGI-BPD has two formats, the CGI-BPD-S, to evaluate the present severity, and the CGIBPD- I to evaluate improvement. To establish the psychometric properties of the CGI-BPD, the test was administered to 78 BPD patients, 11 men and 67 women, within the framework of a 4-month therapeutic intervention. The modified scale showed good validity and reliability (alpha 0.85 and 0.89; CCI: 0.86 and 0.78), adequate sensitivity to change, and a two-factor structure accounting for 67.4 % of total variance. While remaining simple to administer, the CGI-BPD may correct the excessive generalisation contained in its original version and is a useful tool to evaluate severity and change in BPD patients.
Subject(s)
Borderline Personality Disorder/diagnosis , Surveys and Questionnaires , Adult , Female , Humans , Male , Reproducibility of Results , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
Agitation is relatively common among Borderline Personality Disorder (BPD) patients in Psychiatric Emergency Services (PES). New injectable atypical antipsychotics are indicated for treatment in agitated psychotic or maniac patients but not for agitated BDP patients. Twenty agitated BPD patients were treated with intramuscular atypical antipsychotics (olanzapine or ziprasidone). Results suggest intramuscular atypical antipsychotics may be effective, fast and safe for treating acute BPD patients.
Subject(s)
Antipsychotic Agents/administration & dosage , Borderline Personality Disorder/drug therapy , Piperazines/administration & dosage , Psychomotor Agitation/drug therapy , Thiazoles/administration & dosage , Adult , Benzodiazepines/administration & dosage , Bipolar Disorder/diagnosis , Bipolar Disorder/drug therapy , Comorbidity , Emergency Services, Psychiatric , Female , Humans , Injections, Intramuscular , Male , Middle Aged , Olanzapine , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Schizophrenia/diagnosis , Schizophrenia/drug therapy , Treatment OutcomeABSTRACT
INTRODUCTION: Borderline Personality Disorder (BPD) is the most studied Axis II disorders. However, there are no Spanish versions of specific interviews. The Diagnostic Interview for Borderlines-Revised (DIB-R) is a semistructured interview used to determine the diagnosis and severity of BPD patients. The aim of this study was to validate the DIB-R for use in a Spanish-speaking sample. METHOD: The psychometric characteristics of the DIB-R Spanish version were assessed in a sample of 156 patients with the possible diagnosis of borderline personality disorder. There were 29 men and 127 women with a mean age of 27.6 years (SD: 6.5; range: 18-45). The Spanish adaptation of the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) was used as gold standard. RESULTS: The DIB-R showed good total internal consistency (Cronbach's alpha: 0.89) and high inter-rater reliability (within-class correlation: 0.94). Using logistic regression analyses the best cut-off was judged to be 6 or more, obtaining high sensitivity (0.81), specificity (0.94) and moderate convergent validity of the diagnosis with the SCID-II (kappa: 0.59). CONCLUSIONS: The Spanish version of the DIB-R showed psychometric characteristics similar to those in the original interview and may be useful to determine BPD presence and severity.
Subject(s)
Borderline Personality Disorder/diagnosis , Interview, Psychological , Language , Adolescent , Adult , Female , Humans , Male , Middle Aged , Psychometrics , Reproducibility of ResultsABSTRACT
INTRODUCTION: Borderline Personality Disorder (BPD) is considered one of the most difficult psychiatric conditions to treat, neither psychological nor pharmacological treatments have been shown to be particularly effective. We present a proposal for the treatment of patients diagnosed with BPD which uses an atypical neuroleptic, olanzapine, and cognitive-behavioural group therapy aimed at dealing with the following problems: Interpersonal Conflict, Affective Instability, Impulsiveness, and Confused Identity. METHODS: Six patients diagnosed with BPD using the International Personality Disorder Evaluation (IPDE) were treated during 6 months with olanzapine (at dosages of 5-20mg/day) and dialectical behaviour therapy, with weekly 2-hour sessions. RESULTS: All of these patients followed the programme during the first 2 months, and 3 of the 6 completed it, showing an improvement in their behavioural disorder, as indicated by a decrease in parasuicidal episodes (i.e. suicide attempts and self-mutilative acts) and fewer visits to the emergency department. One of the patients dropped out due to side effects. DISCUSSION: The possibility of using a combined therapeutic approach enables us to project controlled clinical trials over a longer period of time, thus making it possible to assess behavioural changes which are difficult to observe in conventional clinical trials.
Subject(s)
Antipsychotic Agents/therapeutic use , Borderline Personality Disorder/therapy , Cognitive Behavioral Therapy , Pirenzepine/analogs & derivatives , Pirenzepine/therapeutic use , Psychotherapy, Group , Adult , Benzodiazepines , Borderline Personality Disorder/drug therapy , Combined Modality Therapy , Female , Humans , Male , Olanzapine , Patient Compliance , Pilot ProjectsABSTRACT
Introducción: El Trastorno Límite de la Personalidad (TLP), es considerado como uno de los trastornos mentales más difíciles de abordar. Ni los tratamientos psicológicos ni los farmacológicos han demostrado ser suficientemente eficaces en esta patología. El objetivo de este trabajo es ensayar una propuesta de tratamiento combinado en pacientes diagnosticados de TLP utilizando un neuroléptico atípico, la olanzapina, y psicoterapia grupal cognitivo-conductual orientada a los siguientes objetivos específicos: conflictos interpersonales, labilidad afectiva, impulsividad, baja tolerancia a la frustración y confusión de la identidad. Material y métodos: Seis pacientes diagnosticados de TLP mediante la International Personality Dissorder Evaluation (IPDE) recibieron tratamiento con olanzapina a dosis de 5 a 20 mg/día y Terapia Conductual Dialéctica en sesiones semanales de dos horas de duración, durante seis meses. Resultados: Todos los pacientes siguieron el progra m a durante los dos primeros meses, tres de los seis pacientes finalizaron la terapia mostrando mejoría en los trastornos conductuales, lo cual se evidencia por una disminución del número de intentos de autolisis y la menor frecuencia de visitas a urgencias. Uno de los pacientes abandonó la terapia por efectos secundarios. Discusión: La posibilidad de utilizar una terapéutica combinada nos puede permitir plantear ensayos clínicos controlados, durante periodos prolongados de tiempo, valorando cambios conductuales difíciles de observar en los ensayos clínicos más convencionales (AU)
