ABSTRACT
In a review of the current literature on inpatient psychotherapy, the authors discuss shortened length of stay and the interdisciplinary team approach as factors affecting psychotherapy in the inpatient setting. They examine the literature in the frameworks of long-term intensive and short-term focused psychotherapy, including arguments presented in favor of each. Much of the current literature focuses on special problems posed by patients who have severe personality disorders and are treated by long-term inpatient care with intensive psychotherapy.
Subject(s)
Mental Disorders/therapy , Psychotherapy/methods , Combined Modality Therapy , Humans , Length of Stay , Psychiatric Department, Hospital/statistics & numerical dataABSTRACT
There is considerable disagreement about the relationship between borderline personality disorder and the affective disorders. The authors report the results of a study of the relationship between dexamethasone suppression and depressive subtype in hospitalized depressed borderline patients. Twenty-three patients met research criteria for unipolar major depressive episode without psychosis of at least moderate severity. Thirteen patients also met criteria for borderline personality disorder. Dexamethasone suppression test (DST) results showed no significant correlation with either melancholia or borderline personality disorder alone. However, of the 13 borderlines, eight failed to suppress and six of those eight were not melancholic. The authors conclude that abnormal response to dexamethasone in nonmelancholic borderlines casts some doubt on the specificity of the DST for melancholia.
Subject(s)
Borderline Personality Disorder/diagnosis , Depressive Disorder/diagnosis , Dexamethasone , Hospitalization , Personality Disorders/diagnosis , Adolescent , Adult , Aged , Borderline Personality Disorder/blood , Borderline Personality Disorder/complications , Depressive Disorder/blood , Depressive Disorder/complications , Evaluation Studies as Topic , Humans , Hydrocortisone/blood , Middle AgedABSTRACT
Hysteroid dysphoria has been described in outpatient populations and is thought to be a subtype of atypical depression involving rejection sensitivity and therapeutic response to monoamine oxidase inhibitors. The presence of hysteroid dysphoria was assessed, using a semistructured interview, in 18 depressed inpatients. The 6 patients who met the criteria for hysteroid dysphoria did not differ from other depressed patients in severity, premorbid adjustment, number of atypical features, or presence of melancholia. Implications for treatment are discussed.
