R. Antikainen et J. Hintikka, SOMATIC COMORBIDITY IN PERSONALITY-DISORDER INPATIENTS - EFFECT ON TREATMENT OUTCOME IN A 3-YEAR FOLLOW-UP-STUDY, Nordic journal of psychiatry, 50(6), 1996, pp. 469-476
Few studies have been published on the effects of physical comorbidity
on the course or outcome of psychiatric inpatient treatment. In a psy
chiatric ward specializing in the psychotherapeutic treatment of borde
rline disorders, changes in symptoms and social management of 42 patie
nts were monitored during an average hospitalization period of 91 days
(range, 21-296 days) and a 3-year follow-up period. Physical health s
tatus was estimated during a follow-up interview on the basis of the m
edical records of the general hospital in question. Ages of the patien
ts Varied between 20 and 59 years (median, 41 years). Only 21% had no
diagnosed physical illness. The others had mild or temporary (62%) or
serious (17%) physical illnesses. During the entire study period, reli
ef of symptoms as assessed on the basis of the Hamilton Depression Rat
ing Scale (HDRS) or the Beck Depression Inventory (BDI) was most marke
d in patients without physical illness. Depression and anxiety continu
ed to decrease after the end of inpatient treatment. In patients with
mild physical symptoms the degree of depression on admission was simil
ar to that in otherwise healthy patients. Their depression decreased d
uring inpatient treatment. During follow-up, symptoms remained at the
levels observed at the end of inpatient treatment. Patients with serio
us illness had the mildest depression and anxiety at the beginning of
the treatment, but symptoms increased during the treatment. These diff
erences in treatment outcome were interpreted as consequences of diffe
rent levels of psychic energy available for psychic work in the groups
compared.