King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Clinical Psychology, Addiction Sciences Building, 4 Windsor Walk, London, SE5 8AF, UK.
Southwark Psychological Therapies Service, South London and Maudsley NHS Foundation Trust, Eileen Skellern House, Denmark Hill, SE5 8AZ, London, UK.
Behav Res Ther. 2015 Oct;73:1-7. doi: 10.1016/j.brat.2015.07.006. Epub 2015 Jul 16.
The UK's Improving Access to Psychological Therapies (IAPT) initiative provides evidence-based psychological interventions for mild to moderate common mental health problems in a primary care setting. Predictors of treatment response are unclear. This study examined the impact of personality disorder status on outcome in a large IAPT service. We hypothesised that the presence of probable personality disorder would adversely affect treatment response.
We used a prospective cohort design to study a consecutive sample of individuals (n = 1249).
Higher scores on a screening measure for personality disorder were associated with poorer outcome on measures of depression, anxiety and social functioning, and reduced recovery rates at the end of treatment. These associations were not confounded by demographic status, initial symptom severity nor number of treatment sessions. The presence of personality difficulties independently predicted reduced absolute change on all outcome measures.
The presence of co-morbid personality difficulties adversely affects treatment outcome among individuals attending for treatment in an IAPT service. There is a need to routinely assess for the presence of personality difficulties on all individuals referred to IAPT services. This information will provide important prognostic data and could lead to the provision of more effective, personalised treatment in IAPT.
英国的改善心理治疗机会（IAPT）计划在初级保健环境中为轻度至中度常见心理健康问题提供基于证据的心理干预。治疗反应的预测因素尚不清楚。这项研究在大型 IAPT 服务中检查了人格障碍状况对结果的影响。我们假设可能存在人格障碍会对治疗反应产生不利影响。
我们使用前瞻性队列设计研究了连续样本的个体（n=1249）。
人格障碍筛查量表得分较高与抑郁、焦虑和社会功能的测量结果较差以及治疗结束时恢复率降低相关。这些关联不受人口统计学状况、初始症状严重程度或治疗次数的混杂。人格障碍的存在独立预测所有结局指标的绝对变化减少。
在 IAPT 服务中接受治疗的个体中，共病人格障碍的存在会对治疗结果产生不利影响。有必要在所有转介至 IAPT 服务的个体中常规评估人格障碍的存在。这些信息将提供重要的预后数据，并可能导致 IAPT 中提供更有效、个性化的治疗。
