Neither too much, nor too little. The dilemma of identifying personality disorders in adolescents patients with self-reports.

The study aimed to compare methods of identification of Personality Disorders (PD) in adolescent patients with psychiatric disorders. A sample of 120 Spanish adolescents with clinical disorders was assessed using the International Personality Disorder Examination (IPDE) interview, its Screening Questionnaires (IPDE-SQ) comprising the ICD-10 and DSM-IV modules, and also the Temperament Character Inventory (TCI) to identify risk of PD. The IPDE-SQ identified a risk of PD around 92-97% of the sample; 61.7% when adjusting the stricter cut-off points. The TCI showed a PD risk of 20%, whereas the prevalence of PD identified by the IPDE clinical interview was around 36-38%. The differences between the IPDE, IPDE-SQ and TCI were significant, and a low agreement among instruments was obtained. Large discrepancy between self-report instruments in identifying PD with regard to the clinical interview raises several questions concerning the use of these instruments in clinical settings on adolescents with psychiatric disorders.

Prevalence and severity of categorical and dimensional personality disorders in adolescents with eating disorders.

OBJECTIVE: The objective of this study is to explore and compare the prevalence of categorical and dimensional personality disorders (PDs) and their severity in Spanish adolescents with Eating Disorders (EDs). METHOD: Diagnostic and Statistical Manual of Mental Disorders Fourth Edition and International Classification of Diseases, Tenth Revision-10 modules of the International Personality Disorder Examination were administered to a sample of 100 female adolescents with EDs (mean age=15.8 years, SD=0.9). RESULTS: 'Thirty-three per cent of the sample had at least one PD, in most cases a simple PD. The rate of PDs was 64-76% in bulimia patients, 22-28% in anorexia and 25% in EDs not otherwise specified. The highest dimensional scores were observed in bulimia, [corrected] mainly in borderline and histrionic PDs, and higher scores for anankastic PD in anorexia than in the other ED diagnoses. Overall, purging type EDs had higher cluster B personality pathology scores than restrictive type.' [corrected] The Publisher would like to apologize for this error and any confusion it may have caused. [corrected]. DISCUSSION: Adolescent female patients with ED have a risk of presenting a comorbid PD, especially patients with bulimia and purging type EDs.

Usefulness of the International Personality Disorder Examination Screening Questionnaire for borderline and impulsive personality pathology in adolescents.

UNLABELLED: The aim of this study was to analyze the usefulness of the International Personality Disorder Examination Screening Questionnaire (IPDE-SQ) for identifying DSM-IV and ICD-10 Borderline and Impulsive personality disorders (PD) in Spanish adolescents. METHOD: The DSM-IV and ICD-10 IPDE-SQ screeners were used and compared with the diagnoses obtained with the IPDE semistructured interview in a sample of 125 adolescents treated in a psychiatric department. RESULTS: For primary screening, the cutoff point with the best combination of sensitivity and specificity for ICD-10 impulsive and borderline PDs was obtained with three positive items, whereas for DSM-IV borderline the best PD cut-off was five positive items. For secondary screening, the best option would be one item above the cut-off points proposed for primary screening. CONCLUSION: The 3-item cut-off point in the IPDE-SQ produces a high proportion of false positives on impulsive and borderline PDs in clinical adolescents. We propose several cut-off points, depending on whether the study is designed to perform primary or secondary screening.

Subtipos de adolescentes con trastornos por uso de sustancias y comorbilidad psiquiátrica utilizando los análisis de cluster y discriminante de perfiles MMPI-A / Subtypes of adolescents with substance use disorders and psychiatric comorbidity using cluster and discriminant analysis of MMPI-A profiles

El objetivo principal de este estudio fue replicar y ampliar los resultados de estudios previos sobre subtipos de adolescentes con trastorno por uso de sustancias (TUS), de acuerdo con sus perfiles de personalidad en el Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A). Sesenta pacientes con TUS y comorbilidad psiquiátrica (41.7% hombres, edad media = 15.9 años) completaron el MMPI-A, el Teen Addiction Severity Index (T-ASI), el Child Behaviour Checklist (CBCL), y entrevistas para obtener diagnósticos DSM-IV y medidas del nivel de uso de sustancias. El perfil general de personalidad MMPI-A mostró elevaciones moderadas en las escalas de Desviación Psicopática, Depresión e Histeria. El análisis de cluster jerárquico reveló cuatro perfiles (acting-out, 35% de la muestra; disorganized-conflictive, 15%; normative-impulsive, 15%; y deceptive-concealed, 35%). Se encontraron asociaciones entre el cluster 1, la sintomatología externalizante a nivel clínico del CBCL y los trastornos de conducta, así como entre el cluster 2 y un nivel clínico de síntomas internalizantes y externalizantes del CBCL. El análisis discriminante mostró que las escalas del MMPI-A Depresión, Desviación Psicopática y Psicastenia, clasificaron correctamente el 90% de los pacientes dentro de los subgrupos obtenidos (AU)

The main aim of this study was to replicate and extend previous results on subtypes of adolescents with substance use disorders (SUD), according to their Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A) profiles. Sixty patients with SUD and psychiatric comorbidity (41.7% male, mean age = 15.9 years old) completed the MMPI-A, the Teen Addiction Severity Index (T-ASI), the Child Behaviour Checklist (CBCL), and were interviewed in order to determine DSMIV diagnoses and level of substance use. Mean MMPI-A personality profile showed moderate peaks in Psychopathic Deviate, Depression and Hysteria scales. Hierarchical cluster analysis revealed four profiles (acting-out, 35% of the sample; disorganized-conflictive, 15%; normative-impulsive, 15%; and deceptive-concealed, 35%). External correlates were found between cluster 1, CBCL externalizing symptoms at a clinical level and conduct disorders, and between cluster 2 and mixed CBCL internalized/externalized symptoms at a clinical level. Discriminant analysis showed that Depression, Psychopathic Deviate and Psychasthenia MMPI-A scales correctly classified 90% of the patients into the clusters obtained (AU)

Subtypes of adolescents with substance use disorders and psychiatric comorbidity using cluster and discriminant analysis of MMPI-A profiles.

The main aim of this study was to replicate and extend previous results on subtypes of adolescents with substance use disorders (SUD), according to their Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A) profiles. Sixty patients with SUD and psychiatric comorbidity (41.7% male, mean age = 15.9 years old) completed the MMPI-A, the Teen Addiction Severity Index (T-ASI), the Child Behaviour Checklist (CBCL), and were interviewed in order to determine DSMIV diagnoses and level of substance use. Mean MMPI-A personality profile showed moderate peaks in Psychopathic Deviate, Depression and Hysteria scales. Hierarchical cluster analysis revealed four profiles (acting-out, 35% of the sample; disorganized-conflictive, 15%; normative-impulsive, 15%; and deceptive-concealed, 35%). External correlates were found between cluster 1, CBCL externalizing symptoms at a clinical level and conduct disorders, and between cluster 2 and mixed CBCL internalized/externalized symptoms at a clinical level. Discriminant analysis showed that Depression, Psychopathic Deviate and Psychasthenia MMPI-A scales correctly classified 90% of the patients into the clusters obtained.

The influence of personality disorders on the use of mental health services in adolescents with psychiatric disorders.

OBJECTIVE: The aims of this study were to explore the influence of personality disorders (PDs) in Spanish adolescents with Axis I psychiatric disorders on their use of mental health services and to analyze the risk of having a comorbid PD in relation to psychiatric service use. METHODS: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases, Tenth Revision (ICD-10) modules of the semistructured interview International Personality Disorders Examination were administered to a sample of 112 adolescent psychiatric patients (mean age = 15.8 years; SD, 0.8; range, 15-17; 79% women) at the point of initiating treatment. On the basis of the interview, subjects were divided into two groups: a PD group (PDG) and a non-PD group (NPDG). After 3 years of treatment, clinical records were retrospectively analyzed. RESULTS: The PDG showed a significantly higher number of psychiatric admissions (P < .001), days per psychiatric admission (P < .001), and psychiatric emergencies (P < .010) than the NPDG, although the number of outpatient consultations was not significantly higher. Logistic regression analysis showed that the probability of belonging to the PDG rather than the NPDG increased with each psychiatric admission (odds ratio [OR] = 1.67 for DSM-IV criteria and OR = 1.59 for ICD-10 criteria), after controlling by sex, age, and comorbidity (Axis I disorders). CONCLUSIONS: Patients with comorbid PD used more inpatient and emergency psychiatric services than did patients without a PD. Large number of psychiatric hospitalizations suggests the likelihood of a PD being present.