Pro Persona Research, Wolfheze, The Netherlands.
Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
Adm Policy Ment Health. 2024 Sep;51(5):780-791. doi: 10.1007/s10488-024-01401-2. Epub 2024 Aug 7.
A significant proportion of patients with a personality disorder do not benefit from treatment. Monitoring treatment progress can help adjust ineffective treatments. This study examined whether early changes in symptoms and personality dysfunction during the first phase of therapy could predict treatment outcomes. Data from 841 patients who received specialized treatment for personality disorders were analyzed. The study focused on whether changes in the Outcome Questionnaire-45.2 (OQ-45.2) symptom distress scale (SD), the General Assessment of Personality Disorder (GAPD), and Severity Indices of Personality Problems (SIPP) in the early phase of therapy predicted post-treatment personality dysfunction, as measured by the SIPP and GAPD. Early changes within a specific SIPP domain were the strongest predictors of post-treatment outcomes in that same domain. Early changes in symptoms significantly predicted outcomes in Self-Control, Relational Functioning, and Identity Integration, while the GAPD predicted outcomes in Self-Control and Social Attunement on the SIPP. For the GAPD, early changes on the GAPD itself, followed by early changes on the OQ-45 SD and the SIPP domain Social Attunement, were significant predictors. Thus, when it comes to personality dysfunction, early changes in a specific domain or measure are the best predictors of outcomes in that same domain. While the OQ-45 predicted some aspects of personality dysfunction, it should not replace disorder-specific measures. Additionally, the SIPP domains and the GAPD should not be used interchangeably to predict each other. In sum, considering these factors, monitoring early change can be useful in assessing progress in the treatment of patients with personality disorders.
相当一部分人格障碍患者的治疗效果并不理想。监测治疗进展有助于调整无效的治疗方法。本研究旨在探讨治疗初期症状和人格功能障碍的变化是否可以预测治疗结果。分析了 841 名接受人格障碍专业治疗的患者的数据。该研究主要关注治疗初期 OQ-45.2 症状困扰量表（SD）、人格障碍总体评估（GAPD）和人格问题严重程度量表（SIPP）的变化是否可以预测治疗后的人格功能障碍，用 SIPP 和 GAPD 进行评估。治疗初期特定 SIPP 领域内的变化是预测该领域治疗后结果的最强预测因素。症状的早期变化显著预测了自我控制、人际关系和身份认同方面的结果，而 GAPD 则预测了 SIPP 中自我控制和社会协调方面的结果。对于 GAPD，GAPD 本身的早期变化、OQ-45 SD 的早期变化和 SIPP 领域社会协调的早期变化是显著的预测因素。因此，在人格功能障碍方面，特定领域或测量的早期变化是同一领域结果的最佳预测因素。虽然 OQ-45 预测了人格功能障碍的某些方面，但它不能替代特定于障碍的测量方法。此外，SIPP 领域和 GAPD 不应该相互替代来预测彼此。总之，考虑到这些因素，监测早期变化可以有助于评估人格障碍患者治疗进展。
