PMID- 19172500
OWN - NLM
STAT- MEDLINE
DCOM- 20090511
LR  - 20151119
IS  - 1502-4725 (Electronic)
IS  - 0803-9488 (Linking)
VI  - 63
IP  - 1
DP  - 2009
TI  - Substance use disorders among personality disordered patients admitted for day 
      hospital treatment. Implications for service developments.
PG  - 57-63
LID - 10.1080/08039480802298705 [doi]
AB  - Personality disorders (PD) and substance use disorders (SUD) are highly comorbid 
      conditions. However, their treatment services are often separated. The aims of 
      this study was to investigate how extensive this separation was prior to a 
      Norwegian health reform (2004) that promoted integration, and to discuss clinical 
      challenges for an integrated treatment of PD and SUD. All patients with a 
      diagnosis of PD (n=1783) admitted to 10 day hospital treatment programs 
      (1993-2003) were examined. Diagnoses were assessed by Mini International 
      Neuropsychiatric Interview and Structured Clinical Interview for DSM-IV 
      interviews. Socio-demographic data, psychosocial functioning (Global Assessment 
      of Functioning Scale), symptom distress (Symptom Check List-90-Revised), 
      interpersonal problems (Circumplex of Interpersonal Problems) and treatment 
      course were recorded. The majority of patients were females (72%) and the 
      prevalence of SUD was low (14%). SUD occurred among all PD categories. Patients 
      with borderline PD were over-represented and patients with cluster C disorders 
      were under-represented in the SUD sample. The SUD sample contained more men and 
      it was associated with more previous violence against self and others. The 
      reported violence was partly explained by gender (males) and diagnoses 
      (borderline and SUD). PD patients with SUD also displayed more aggression during 
      treatment and dropped out more frequently. The findings demonstrate that the 
      female dominated specialized psychiatric treatment services for PD to a large 
      extent had excluded PD patients who also had SUD. The reasons are probably 
      related to the surplus problems that characterized the SUD sample and gender 
      issues. Implications for the development of the PD and SUD services with respect 
      to an integrated treatment for these comorbid conditions are discussed.
FAU - Karterud, Sigmund
AU  - Karterud S
AD  - Institute of Psychiatry, University of Oslo, Department of Personality 
      Psychiatry, Ulleval University Hospital, Oslo, Norway.
FAU - Arefjord, Nina
AU  - Arefjord N
FAU - Andresen, Nina Elin
AU  - Andresen NE
FAU - Pedersen, Geir
AU  - Pedersen G
LA  - eng
PT  - Journal Article
PL  - England
TA  - Nord J Psychiatry
JT  - Nordic journal of psychiatry
JID - 100927567
SB  - IM
MH  - Aggression/psychology
MH  - Alcoholism/diagnosis/*epidemiology/rehabilitation
MH  - Borderline Personality Disorder/diagnosis/epidemiology/rehabilitation
MH  - Combined Modality Therapy
MH  - Comorbidity
MH  - Day Care, Medical/*statistics & numerical data
MH  - Delivery of Health Care, Integrated
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Female
MH  - Health Care Reform
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Mass Screening/statistics & numerical data
MH  - Norway
MH  - Patient Dropouts/psychology/statistics & numerical data
MH  - Personality Assessment
MH  - Personality Disorders/diagnosis/*epidemiology/rehabilitation
MH  - Psychotherapy/methods
MH  - Socioeconomic Factors
MH  - Substance-Related Disorders/diagnosis/*epidemiology/rehabilitation
MH  - Violence/prevention & control/psychology/statistics & numerical data
EDAT- 2009/01/28 09:00
MHDA- 2009/05/12 09:00
CRDT- 2009/01/28 09:00
PHST- 2009/01/28 09:00 [entrez]
PHST- 2009/01/28 09:00 [pubmed]
PHST- 2009/05/12 09:00 [medline]
AID - 908179556 [pii]
AID - 10.1080/08039480802298705 [doi]
PST - ppublish
SO  - Nord J Psychiatry. 2009;63(1):57-63. doi: 10.1080/08039480802298705.