The impact of comorbid personality difficulties on response to IAPT treatment for depression and anxiety
The impact of comorbid personality difficulties on response to IAPT treatment for depression and anxiety
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DOI：
10.1016/j.brat.2015.07.006
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发表时间：
2015-10-01
影响因子：
4.1
通讯作者：
Moran, Paul
中科院分区：
文献类型：
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作者：
Goddard, Elizabeth;Wingrove, Janet;Moran, Paul
英国的“改善心理治疗的可及性”(IAPT) 计划为初级保健机构中的轻度至中度常见心理健康问题提供循证心理干预措施。治疗反应的预测因素尚不清楚。本研究调查了人格障碍状态对大型 IAPT 服务结果的影响。我们假设可能存在的人格障碍会对治疗反应产生不利影响。方法：我们使用前瞻性队列设计来研究连续的个体样本（n = 1249）。结果：人格障碍筛查测量得分较高与抑郁、焦虑和社会功能测量结果较差相关，并且治疗结束时恢复率较低。这些关联不受人口状况、初始症状严重程度或治疗次数的影响。人格困难的存在独立地预测了所有结果测量的绝对变化的减少。结论：共病人格困难的存在对参加 IAPT 服务的个体的治疗结果产生不利影响。需要定期评估所有转介至 IAPT 服务的个人是否存在人格障碍。这些信息将提供重要的预后数据，并可能导致在 IAPT 中提供更有效、个性化的治疗。 (c) 2015 年作者。由爱思唯尔有限公司出版
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.Method: We used a prospective cohort design to study a consecutive sample of individuals (n = 1249).Results: 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.Conclusions: 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. (c) 2015 The Authors. Published by Elsevier Ltd.