Ninety-seven patients consecutively admitted to a day unit specializing in the treatment of personality disorders were included in a prospective follow-up study. At follow-up an average of 3 years after index admission, patients with borderline personality disorder (BPD) displayed a moderate symptom reduction and a fair global outcome. Patients with schizotypal personality disorder (STP) showed a similar reduction in symptoms but retained relatively poor global functioning. Individuals with cluster C personality disorders, in contrast, showed both a good global outcome and a marked symptom reduction. STP individuals were the least socially adjusted, employed and self-supporting of all diagnostic subgroups. STP and BPD individuals had far more inpatient treatment in the follow-up period than other groups. The overall suicide rate was low compared with most similar studies.
A random sample of female, nonalcoholic psychiatric outpatients, day and inpatients from one catchment area (n = 65; C group), was compared with female psychiatric patients with a DSM-III alcohol disorder (n = 64; A group). On DSM-III, axis, I, the frequency of additional symptom diagnoses, including depressions, was nearly equal. On axis II, the A group had an additional personality disorder significantly more often (81 vs. 46 %), borderline personality disorder being the most frequent (66 vs. 11 %). Among patients with depressive disorders, the differences between the A and the C group on axis II were the same. But alcoholic patients suffering from a major depressive disorder more frequently had a borderline personality disorder than other subgroups. The alcohol problems seem to be more related to ongoing personality problems than to episodic, symptomatic disorders. Female psychiatric patients with alcohol problems are diagnostically a heterogenous group and should not be offered a uniform therapy.
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