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Personality Functioning and Self-Disorders in different stages of Psychotic Disorders and Borderline Personality Disorder
- M. Gruber, J. Alexopoulos, K. Feichtinger, K. Parth, A. Wininger, N. Mossaheb, F. Friedrich, Z. Litvan, B. Hinterbuchinger, S. Doering, V. Blüml
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S449
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Introduction
Personality functioning, self-disorders and their relationship to psychotic symptoms on a continuum from mild attenuated experiences to manifest psychotic symptoms in psychotic disorders are highly relevant for psychopathology, course of illness and treatment planning in psychotic disorders, but empirical data is sparse.
ObjectivesThis study aims at exploring personality functioning and self-disorders in individuals at ultra-high risk for psychosis (UHR) and with first-episode psychosis (FEP), compared to a clinical control group of subjects with borderline personality disorder (BPD) and healthy controls (HC).
MethodsPersonality functioning was measured in 107 participants (24 UHR, 29 FEP, and 27 BPD and 27 HC) using the Structured Interview for Personality Organization (STIPO) and the Level of Personality Functioning Scale (LPFS), and self-disorders were assessed using the Examination of Anomalous Self-Experience (EASE). A hierarchical cluster analysis was performed based on the seven STIPO dimensions.
ResultsSignificant impairment in personality functioning was found in UHR (M = 4.29, SD = .908), FEP (M = 4.83, SD = 1.002), and BPD individuals (M=4.70, SD=.542) compared with HC (M = 1.63, SD = .565). FEP patients showed significantly worse overall personality functioning compared to UHR patients (p = .037). Patients with manifest psychosis (FEP) also exhibited significantly higher levels of self-disorders compared to BPD patients (p = .019). Self-disturbances in patients with milder forms of psychotic symptoms (UHR) were intermediate between the other diagnostic groups (FEP and BPD). Regardless of the main diagnoses, the three clusters of patients were found to differ in levels of personality functioning and self-disorder.
ConclusionsImpairment of personality functioning varies in different stages of psychotic disorders. The level of self-disorders may allow differentiation between manifest psychosis and borderline personality disorder. An in-depth assessment of personality functioning and self-disorders could be helpful in differentiating diagnoses, treatment planning, and establishing foci for psychotherapeutic treatment modalities.
Disclosure of InterestM. Gruber: None Declared, J. Alexopoulos: None Declared, K. Feichtinger: None Declared, K. Parth: None Declared, A. Wininger: None Declared, N. Mossaheb: None Declared, F. Friedrich: None Declared, Z. Litvan: None Declared, B. Hinterbuchinger: None Declared, S. Doering: None Declared, V. Blüml Grant / Research support from: Grant / Research support from: Heigl-Foundation, Köhler-Foundation, International Psychoanalytical Association (IPA)
Quantitative magnetic resonance imaging and neuropsychological functions in dementia of the Alzheimer type
- J. PANTEL, J. SCHRÖDER, L. R. SCHAD, M. FRIEDLINGER, M. V. KNOPP, R. SCHMITT, M. GEISSLER, S. BLÜML, M. ESSIG, H. SAUER
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- Journal:
- Psychological Medicine / Volume 27 / Issue 1 / January 1997
- Published online by Cambridge University Press:
- 01 January 1997, pp. 221-229
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Background. The aim of the present study was to investigate neuropsychological functions in dementia of the Alzheimer type (DAT) with respect to morphological changes that were revealed by quantitative magnetic resonance imaging (MRI).
Methods. Twenty patients with DAT (NINCDS-ADRDA criteria) and 10 healthy age and sex matched controls were included. The neuropsychological function was evaluated on a test battery covering the severity of dementia, verbal and visual memory, concentration and attention, language skills and general intelligence as well as activities of daily living. 3D MRI sequences were acquired using a 1.5 T Siemens MAGNETOM. Whole brain volume, total intracranial volume (TIV), volume of the frontal and temporal lobes and volumes of the amygdalahippocampus complex (AHC) were assessed using the newly developed software NMRWin.
Results. Apart from TIV all morphometric parameters differed significantly between the diagnostic groups. AHC volumes discriminated best between the groups, with only a small overlap. AHC atrophy exceeded generalized atrophy. These findings were confirmed when the data were reanalysed after dividing the DAT patients into a mildly and moderately affected group. The severity of dementia was significantly correlated with the volumes of the AHC and the volumes of the temporal lobes bilaterally, but not with the whole brain volume and the volumes of the frontal lobes.
Conclusions. These results underline the important role of the temporal substructures for aetiology and progression of DAT. They indicate that the volume of the AHC can be monitored by MRI and may be used to follow up the disease process.