Abstract
In a previous medical record review study we identified a subset of chronic schizophrenic patients with comorbid Axis II personality disorder diagnoses, who had significantly longer lengths of inpatient stay as compared to schizophrenic patients without Axis II diagnoses. This study describes a detailed review of a subset of these records. Eighteen records of schizophrenic patients with comorbid Axis II diagnoses were matched with records of patients without comorbid diagnoses. Demographic and premorbid data revealed no differences between the groups, indicating that the Axis II diagnoses were markers for current as opposed to past psychopathology. Negative symptoms were lower in the cohortwith comorbid Axis II personality disorder diagnoses on admission only, while affective symptomatology was increased in this group throughout treatment. Ratings of personality pathology showed a trend towards significance, with the comorbid group demonstrating greater amounts of maladaptive personality traits. These data support the notion that personality traits may be independent of Axis I symptomatology in chronic schizophrenia, and can influence the course of treatment.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bachrach LL: Psychosocial rehabilitation and psychiatry in the care of long-term patients. American Journal of Psychiatry 149:1455–1463, 1992.
Bellack AS, Turner SM, Hersen M, et al: An examination of the efficacy of social skills training for chronic schizophrenic, patients. Hospital and Community Psychiatry 35:1023–1028, 1984.
Liberman RP, Massel HK, Mosk MD, et al: Social skills training for chronic mental patients. Hospital and Community Psychiatry 36:396–403, 1985.
Hogarty GE, Anderson CM, Reiss DJ, et al: Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two-year effects of a controlled study on relapse and adjustment. Archives of General Psychiatry 48:340–347, 1991.
Strauss JS, Carpenter WT, Bartko JJ: The diagnosis and understanding of schizophrenia. Part III. Speculations on the processes that underlie schizophrenic signs and symptoms. Schizophrenia Bulletin 1:61–69, 1974.
Bellack AS, Morrison RL, Wixted JT, et al: An analysis of social competence in schizophrenia. British Journal of Psychiatry 156:809–818, 1990.
Mueser KT, Bellack AS, Douglas MS, et al: Prevalence and stability of social skill deficits in schizophrenia. Schizophrenia Research 5:167–176, 1991.
Wallace CJ: Functional assessment in rehabilitation. Schizophrenia Bulletin 12:604–630, 1986.
Bellack AS, Morrison RL, Mueser KT: Social problem solving in schizophrenia. Schizophrenia Bulletin 15:101–116, 1989.
Estroff SE: Self, identity, and subjective experiences of schizophrenia: In search of the subject. Schizophrenia Bulletin 15:189–196, 1989.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev. Washington, DC: American Psychiatric Association, 1987.
Smith TE, Deutsch A, Schwartz F, et al: The role of personality in the treatment of schizophrenic and schizoaffective disorder inpatients: A pilot study. Bulletin of the Menninger Clinic 57:88–99, 1993.
Docherty JP, Fiester SJ, Shea MT: Syndrome diagnosis and personality disorder, in Psychiatric Update: The American Psychiatric Association Annual Review, Vol. 5, pp. 315–355. Edited by Frances A, Hales R. Washington, DC, American Psychiatric Press, 1985.
Widiger TA: The categorical distinction between personality and affective disorders. Journal of Personality Disorders 3:77–91, 1989.
Cannon-Spoor HE, Potkin SG, Wyatt RJ: Measurement of premorbid adjustment in chronic schizophrenia. Schizophrenia Bulletin 8:470–484, 1982.
Lukoff D, Liberman RP, Nuechterlein KH: Symptom monitoring in the rehabilitation of schizophrenic patients. Schizophrenia Bulletin 12:578–593, 1986.
Andreasen NC: Scale for the Assessment of Negative Symptoms. Iowa City, University of Iowa, 1984.
Author information
Authors and Affiliations
Additional information
Eric Grabstein is affiliated with the Dubois Center. Susan Borgaro is affiliated with Farleigh Dickenson University.
Rights and permissions
About this article
Cite this article
Smith, T.E., Grabstein, E., Kentros, M. et al. Axis II diagnoses and treatment refractoriness in schizophrenia. Psych Quart 67, 51–64 (1996). https://doi.org/10.1007/BF02244275
Issue Date:
DOI: https://doi.org/10.1007/BF02244275