[A multi-centre ROM study of the Guideline-Informed Treatment for Personality Disorders]. / Een ROM-studie van de Guideline-Informed Treatment for Personality Disorders in vier behandelcentra.

BACKGROUND: The Guideline-Informed Treatment for Personality Disorders (GIT-PD) is widely used in the Netherlands and Belgium in the care of people with personality disorders. To date, no evidence existed for the possible efficacy of this treatment framework.  METHOD: In an observational cohort study in four institutions, based on Routine Outcome Monitoring-data, improvements in symptom burden (BSI/OQ-45) and personality functioning (SIPP-SF) in 470 patients were examined.  RESULTS: Significant improvements were observed in each of the settings for both symptom burden and personality functioning. Effect sizes for improvement in overall symptom burden ranged from d = 0.55 to 1.05.  CONCLUSION: Treatment outcomes for GIT-PD are in line with treatment outcomes also seen for specialized treatments for personality disorders in similar practice studies. Possible differences between settings could be related to the intensity, structure and coherence of the GIT-PD program in question. .

[How evidence-based is the guideline-informed treatment for personality disorders (GIT-PD)?] / Hoe bewezen effectief is de guideline-informed treatment for personality disorders (GIT-PD)?

BACKGROUND: The guideline-informed treatment for personality disorders (GIT-PD) was developed as an alternative to the specific treatments for personality disorders. Even though this form of treatment is widely used in health care and has been included in the Health Care Standard for Personality Disorders, its scientific evidence remains unclear. AIM: To review the indirect evidence for GIT-PD and compare it with the evidence for specific treatments. METHOD: Literature review including reviews and meta-analyses in the field of personality disorders. RESULTS: Although there is increasing evidence for specific treatments, the amount of studies remains limited and the quality of the evidence is rather low. There are indications that specific treatments are poorly implemented in clinical practice, which may detract from their efficacy. There is no clear evidence that specific treatments are on average no more effective than well-designed generic treatments that are similar to GIT-PD. There is considerable evidence for the role of the common factors on which GIT-PD is based. CONCLUSION: There is indirect evidence for the efficacy of GIT-PD. Good care on a broad scale needs both specific and generic forms of treatment, whereby the most relevant question becomes how clients can be optimally allocated to both forms of treatment.

Case report. Intra-uterine demonstration of bowel duplication by ultrasound.

In this case report a patient is presented, showing large sonolucent areas inside the fetal abdomen at 20 wk of gestation. Gastrointestinal (GI) tract obstruction was suspected. There was no polyhydramnios. After premature delivery the child showed marked abdominal distention, but stayed in good condition without signs of GI tract obstruction. At laparotomy, a 30 cm long, distended duplication of the terminal ileum was removed. Postoperative course was uneventful.

Lactation-inhibiting and prolactin-lowering effect of lisuride and bromocriptine: a comparative study.

The prolactin-lowering and lactation-inhibiting effects of lisuride and bromocriptine, two dopaminergic drugs, were compared in a double-blind study. Twenty-six women took lisuride, 0.2 mg b.i.d., and 24 women took bromocriptine, 2.5 mg b.i.d., during 14 days postpartum. Though both drugs gave satisfactory inhibition of puerperal milk production, in these dosages bromocriptine was a more effective lactation inhibitor and prolactin suppressor. After discontinuation of treatment rebound symptoms were more pronounced in the bromocriptine group than in the lisuride group.