Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

Jan Prasko,1 Ales Grambal,1 Petra Kasalova,1 Dana Kamardova,1 Marie Ociskova,1 Michaela Holubova,1,2 Kristyna Vrbova,1 Zuzana Sigmundova,1 Klara Latalova,1 Milos Slepecky,3 Marta Zatkova3 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospita...

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Autores principales:	Prasko J, Grambal A, Kasalova P, Kamaradova D, Ociskova M, Holubova M, Vrbova K, Sigmundova Z, Latalova K, Slepecky M, Zatkova M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/12b5ccb5be44449e8919ed00e3957973
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spelling	oai:doaj.org-article:12b5ccb5be44449e8919ed00e39579732021-12-02T11:20:05ZImpact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders1178-2021https://doaj.org/article/12b5ccb5be44449e8919ed00e39579732016-10-01T00:00:00Zhttps://www.dovepress.com/impact-of-dissociation-on-treatment-of-depressive-and-anxiety-spectrum-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Jan Prasko,1 Ales Grambal,1 Petra Kasalova,1 Dana Kamardova,1 Marie Ociskova,1 Michaela Holubova,1,2 Kristyna Vrbova,1 Zuzana Sigmundova,1 Klara Latalova,1 Milos Slepecky,3 Marta Zatkova3 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital Olomouc, Olomouc, 2Psychiatric Department, Hospital Liberec, Liberec, Czech Republic; 3Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic Objective: The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders.Methods: The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety–depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program – Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale.Results: A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86%) patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the questionnaires). The patients’ mean ratings on all measurements were significantly reduced during the treatment. Also, 67.5% reached at least minimal improvement (42.4% showed moderate and more improvement, 35.3% of the patients reached remission). The patients without comorbid personality disorder improved more significantly in the reduction of depressive symptoms than those with comorbid personality disorder. However, there were no significant differences in change in anxiety levels and severity of the mental issues between the patients with and without personality disorders. Higher degree of dissociation at the beginning of the treatment predicted minor improvement, and also, higher therapeutic change was connected to greater reduction of the dissociation level.Conclusion: Dissociation is an important factor that influences the treatment effectiveness in anxiety/depression patients with or without personality disorders resistant to previous treatment. Targeting dissociation in the treatment of these disorders may be beneficial. Keywords: depression, anxiety disorders, treatment resistance, panic disorder, GAD, OCD, social phobia, PTSD, adjustment disorders, personality disordersPrasko JGrambal AKasalova PKamaradova DOciskova MHolubova MVrbova KSigmundova ZLatalova KSlepecky MZatkova MDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 12, Pp 2659-2676 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Prasko J Grambal A Kasalova P Kamaradova D Ociskova M Holubova M Vrbova K Sigmundova Z Latalova K Slepecky M Zatkova M Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders
description	Jan Prasko,1 Ales Grambal,1 Petra Kasalova,1 Dana Kamardova,1 Marie Ociskova,1 Michaela Holubova,1,2 Kristyna Vrbova,1 Zuzana Sigmundova,1 Klara Latalova,1 Milos Slepecky,3 Marta Zatkova3 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital Olomouc, Olomouc, 2Psychiatric Department, Hospital Liberec, Liberec, Czech Republic; 3Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic Objective: The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders.Methods: The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety–depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program – Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale.Results: A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86%) patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the questionnaires). The patients’ mean ratings on all measurements were significantly reduced during the treatment. Also, 67.5% reached at least minimal improvement (42.4% showed moderate and more improvement, 35.3% of the patients reached remission). The patients without comorbid personality disorder improved more significantly in the reduction of depressive symptoms than those with comorbid personality disorder. However, there were no significant differences in change in anxiety levels and severity of the mental issues between the patients with and without personality disorders. Higher degree of dissociation at the beginning of the treatment predicted minor improvement, and also, higher therapeutic change was connected to greater reduction of the dissociation level.Conclusion: Dissociation is an important factor that influences the treatment effectiveness in anxiety/depression patients with or without personality disorders resistant to previous treatment. Targeting dissociation in the treatment of these disorders may be beneficial. Keywords: depression, anxiety disorders, treatment resistance, panic disorder, GAD, OCD, social phobia, PTSD, adjustment disorders, personality disorders
format	article
author	Prasko J Grambal A Kasalova P Kamaradova D Ociskova M Holubova M Vrbova K Sigmundova Z Latalova K Slepecky M Zatkova M
author_facet	Prasko J Grambal A Kasalova P Kamaradova D Ociskova M Holubova M Vrbova K Sigmundova Z Latalova K Slepecky M Zatkova M
author_sort	Prasko J
title	Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders
title_short	Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders
title_full	Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders
title_fullStr	Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders
title_full_unstemmed	Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders
title_sort	impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/12b5ccb5be44449e8919ed00e3957973
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Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

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