Crisis Intervention in Depressed Patients with and without DSM-III-R Personality Disorders

Andréoli, A.; Frances, Allen; Gex‐Fabry, Marianne; Aapro, Nicoletta; Gérin, P; Dazord, A.

doi:10.1097/00005053-199312000-00004

Cited by 21 publications

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“…Most studies have found no or few differences between various types of disorders or diagnostic variables and the helping alliance (18)(19)(20), even if there are indications that patients with borderline and other personality disorders tend to have greater difficulties in establishing a good therapeutic alliance (18,21). Concerning personality and interpersonal variables, studies have shown that the patient's past object relations influenced the establishment of the therapeutic alliance, as did current interpersonal relations (18,20,22,23).…”

Section: Helping Alliance and Client Factors In Psychotherapeutic Andmentioning

confidence: 99%

Helping alliance and early dropout from psychiatric out-patient care

Johansson

Eklund

2006

Soc Psychiat Epidemiol

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This is an author produced version of a paper published in Social Psychiatry Psychiatric Epidemiology. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Abstract:Background: The study examined client factors of relevance for the establishment of the helping alliance and for dropout in a routine psychiatric setting, admitting a variety of diagnoses and staffed with a multi-professional team. Method: Newly-admitted patients (n= 122) and staff completed questionnaires regarding the helping alliance, and the patients also regarding motivation, symptoms and interpersonal problems. The patients were also diagnosed according to the ICD-10 and followed up concerning early dropout. Results: Several variables correlated with the helping alliance and multivariate analyses showed that the cold/distant factor, motivation and the interpersonal sensitivity factor were the most important factors in establishing the helping alliance. Moreover, it was the alliance as perceived by the patients and not the staff that proved to be the most essential variable. A logistic regression analysis showed that early dropout was predicted by low helping alliance, low age and cold/distant. Conclusion:The most important client factors for establishing the helping alliance and for predicting early dropout seem to be those relevant to interpersonal processes. Further, the therapists'/staff's responsiveness to these client factors seems to be of decisive importance.

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Section: Helping Alliance and Client Factors In Psychotherapeutic Andmentioning

confidence: 99%

Helping alliance and early dropout from psychiatric out-patient care

Johansson

Eklund

2006

Soc Psychiat Epidemiol

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“…Two standardized interviews were used: the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient version (SCID-I/P, Version 2.0; First, Spitzer, Gibbon, & William, 1996) and the International Personality Disorder Examination (IPDE; Loranger et al, 1994) DSM-IV module. Patients were also assessed on a battery of instruments, including the Global Assessment Scale (GAS: Endicott, Spitzer, & Fleiss, 1976), the Hamilton Depression Rating Scale 17 items (HDRS-17: Hamilton, 1960), the Clinical Global Impression (CGI; Guy, 1976), and a modified version of the Health Sickness Rating Scale (HSRS; Andreoli et al, 1993). Severe substance dependence was assessed using the SCID-III-P interview.…”

Section: Assessmentsmentioning

confidence: 99%

Disappointed Love and Suicide: A Randomized Controlled Trial of “Abandonment Psychotherapy” Among Borderline Patients

Andréoli

Burnand

Cochennec

et al. 2016

Journal of Personality Disorders

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To determine whether ambulatory psychotherapy targeted to abandonment experiences and fears can reduce suicidality and improve outcome in borderline patients referred to the emergency room with major depressive disorder and self-destructive behavior severe enough to require medical/ surgical treatment and a brief psychiatric hospitalization. A total of 170 subjects were randomized at hospital discharge into three treatment groups: treatment as usual (TAU), abandonment psychotherapy delivered by certified psychotherapists, and abandonment psychotherapy delivered by nurses. Assessments were performed before randomization and at 3-month followup. Continued suicidality and other outcome measures were significantly worse in the treatment-as-usual as compared to both abandonment psychotherapy groups, but there were no differences between the two psychotherapy groups. These results suggest the efficacy of manualized psychotherapy that specifically targets the abandonment fears and experiences that are so common as precipitants to suicidal and self-destructive acts in borderline patients. It does not appear that formal psychotherapy training is associated with better outcomes.

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“…Or le principe thérapeutique de la crise est de profiter de l'occasion pour faire Santé mentale au Québec, 2004, XXIX, 2, 241-252 241 évoluer le patient vers un stade de développement personnel plus avancé. Andreoli et al (1993) ont démontré que dans le contexte d'une crise dépressive, les patients avec un trouble de personnalité sont ceux qui profitent le plus d'un traitement multimodal, si une alliance théra-peutique est acquise et s'il y a un niveau acceptable d'introspection. D'autres auteurs suggèrent d'établir une hiérarchie d'intervention en fonction des progrès du patient dans une démarche thérapeutique (Gunderson et Gabbard, 2000 ;Linehan, 1991 ;Livesley, 2000).…”

Section: Interventions De Crise Auprès Des Patients Souffrant D'un Trunclassified

Interventions de crise auprès des patients souffrant d’un trouble de personnalité limite.

Renaud

2005

smq

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Résumé Les patients aux prises avec un trouble de personnalité limite ont par définition une personnalité non fonctionnelle sujette à réagir aux changements et aux stress psychosociaux par des états de crise récurrents. Un trouble de personnalité est indissociable d’une problématique interpersonnelle et celle-ci se développe forcément dans le cadre d’une psychothérapie psychodynamique individuelle. Cet article aborde les principes de base du cadre psychothérapique permettant de structurer l’intervention de crise adaptée au trouble de personnalité limite lors des incidents rencontrés au cours du traitement. Ce cadre sert de mesure préventive et/ou structurelle face aux crises et offre ainsi des stratégies générales de résolution. L’article détaille des problématiques cliniques fréquentes soit des menaces de suicide et même d’homicide, des conflits provoqués par les demandes du patient, l’absence du thérapeute ou des tentatives visant à perturber le cadre afin de décrire diverses modalités d’intervention pour solutionner ces crises.

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Crisis Intervention in Depressed Patients with and without DSM-III-R Personality Disorders

Cited by 21 publications

References 0 publications

Helping alliance and early dropout from psychiatric out-patient care

Helping alliance and early dropout from psychiatric out-patient care

Disappointed Love and Suicide: A Randomized Controlled Trial of “Abandonment Psychotherapy” Among Borderline Patients

Interventions de crise auprès des patients souffrant d’un trouble de personnalité limite.

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