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"Comorbid personality disorders in CFS patients: a marker of psychopathological severity" (Calvo)

Dolphin

Senior Member
Messages
17,567
Free full text at: http://www.actaspsiquiatria.es/repositorio//17/94/ENG/17-94-ENG-58-65-735302.pdf

Actas Esp Psiquiatr. 2015 Mar;43(2):58-65. Epub 2015 Mar 1.
Comorbid personality disorders in Chronic Fatigue Syndrome patients: a marker of psychopathological severity.
Calvo N1, Sáez-Francàs N1, Valero S2, Alegre J3, Casas M1.

  • 1Departamento de Psiquiatría. Hospital Universitari Vall d’Hebron. CIBERSAM. Universitat Autònoma de Barcelona Departamento de Psiquiatría y Medicina Legal. Universitat Autònoma de Barcelona.
  • 2Departamento de Psiquiatría. Hospital Universitari Vall d’Hebron. CIBERSAM. Universitat Autònoma de Barcelona.
  • 3Departamento de Medicina Interna. Hospital Universitari Vall d’Hebron. Departamento de Medicina Interna. Universitat Autònoma de Barcelona.
Abstract

INTRODUCTION:

This study was designed to evaluate the presence of personality disorders (PDs) in Chronic Fatigue Syndrome (CFS) patients and to determine their influence on the severity of the associated psychopathology.

METHODS:

132 CFS patients were assessed using SCID-I, Personality Diagnostic Questionnaire-4+ (PDQ-4+) with its Clinical Significance Scale, and Fatigue Impact Scale.

The Beck Depression Inventory, Buss-Durkee Hostility Inventory and the State-Trait Anxiety Inventory were also administered.

RESULTS:

48.5% patients presented PDs, being the most frequent the Obsessive-Compulsive and Avoidant ones.

Patients with PDs had more depressive symptoms. Irritability, resentment, suspicion and guilt were the symptoms related with PDQ-4+ total score.

CONCLUSIONS:

According to these results, PDs may be frequent in CFS patients.

This comorbidity is associated with a complex clinical profile, secondary to more severe psychiatric symptoms.

PMID:

25812543

[PubMed - in process]
 

Never Give Up

Collecting improvements, until there's a cure.
Messages
971
Hmmm, sadness, irritability, resentment, suspicion, guilt, anxiety, and hostility all seem like healthy, rational responses to all that TOTALLY SUCKS about this disease!

The next step is to sedate them all so that they will stop expecting anything more from their health care providers.

Brilliant!
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
This kind of study suffers from severe participation/selection biases. Secondly, those questionnaires are not validated for chronically ill patients and thus their use is highly questionable.

Only a high quality prospective study (ie one that starts before patients are ill) can really show whether there is a link or not.
 

SOC

Senior Member
Messages
7,849
The problem isn't peer review, the problem is people who pay no attention to bias when designing a study.
Most certainly! But any degree of decent peer review should catch poor study design, especially one with obvious bias. You don't even need to be working in the field to recognize study design this poor. If papers at this low level of quality didn't make it past peer review, researchers would start paying attention to reducing bias in their studies.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Most certainly! But any degree of decent peer review should catch poor study design, especially one with obvious bias. You don't even need to be working in the field to recognize study design this poor. If papers at this low level of quality didn't make it past peer review, researchers would start paying attention to reducing bias in their studies.

I believe that all studies should be published, no matter how crap. Just that the discussion should be written in a way that is well aware of how crap the study was....
 

SOC

Senior Member
Messages
7,849
I believe that all studies should be published, no matter how crap. Just that the discussion should be written in a way that is well aware of how crap the study was....
We can agree to disagree on that one. :) I have a hard time imagining a researcher being clear in the discussion about what a piece of crap his/her research is. Therefore, I would rather the crap never got into the public record to add confusion and incorrect information into the knowledge pool.
 

Roy S

former DC ME/CFS lobbyist
Messages
1,376
Location
Illinois, USA
There is a thread on a previous paper on the same general subject here, with a relevant response that @Bob posted.
 
http://forums.phoenixrising.me/inde...hronic-fatigue-syndrome-a-controlled-s.19947/
 
ME Research UK
Breakthrough magazine
Issue 17
Spring 2013


BELGIUM.

Personality disorders not a factor.

CDSM-IV axis II personality disorders involve 'maladaptive personality traits', such as obsessive-compulsive disorder. A study from Belgium reports no increase in such personality disorders in ME/CFS patients compared with people in the community (prevalence 16.3% in each group, in contrast with 58.7% in a comparison group of psychiatric patients). No surprise there then, particularly as the results accord with a previous study in 2009 (prevalence 12% in both patients and controls).

The interesting thing is that both of these 'negative' investigations used the ADP-IV questionnaire to assess personality disorder, whereas other 'positive' studies (reporting moderate differences between ME/CFS patients and controls) have tended to use the PDQ questionnaire which, as the authors point out, gives high rates of false positives and overestimates the prevalence of personality disorder. Such matters are important, particularly when the results of research studies affect the lives of real people, and impact on healthcare professionals' views of the illness!

Source: Kempke et al., Int J Behav Med, 2012
 

wdb

Senior Member
Messages
1,392
Location
London
Most certainly! But any degree of decent peer review should catch poor study design, especially one with obvious bias. You don't even need to be working in the field to recognize study design this poor. If papers at this low level of quality didn't make it past peer review, researchers would start paying attention to reducing bias in their studies.

Trouble is where are you going to find psychologists who will accomplish any degree of decent peer review, most of them wouldn't catch poor study design if it came up and hit them in the face.
 

Sidereal

Senior Member
Messages
4,856
It was an observational cross-sectional study, including 132 patients referred to the Department of Internal Medicine at the University Hospital in Barcelona.

After verifying CFS diagnosis, participants were referred to the Department of Psychiatry, in order to complete a comprehensive assessment.

I'm not clear on whether these were 132 consecutive patients diagnosed with CFS by their internal medicine department or was there an unknown greater number of CFS patients seen by the internists from which these 132 were plucked by the authors (psychiatrists) because they were referred to their department for psychiatric assessment. If the latter, no bueno.

Still, even in a biased sample like this they found

Regarding to the presence of any past Axis I DSM-IV disorder (SCID I), the most frequent diagnosis for total sample were mood (57.6%) and anxiety disorders (36.4%).

This is lifetime diagnoses, not current. Quite low for a disorder which most doctors think is just a mood or anxiety disorder.

After an initial screening, the psychopathological evaluation was carried out in 4 sessions by a psychiatrist and a clinical psychologist, who interviewed the patient, recorded sociodemographic and clinical data, conducted a psychopathological examination, applied the Structured Clinical Interview for DSM IV (SCID-I)14 and administered the questionnaires.

Personality Diagnostic Questionnaire-4+ (PDQ-4+)15 is a 99-item self-report, true/false questionnaire, designed to assess the 10 PDs included in DSM-IV diagnostic criteria for axis II disorders.

Seeing as they had a psychiatrist and a clinical psychologist doing SCID-I for Axis I disorders I don't see why they didn't also administer SCID-II for personality disorders (aside from it taking a really long time to administer so it's easier to just photocopy some questionnaires for the patient to fill out) instead of going with a self-report measure of personality. Clinician-rated measures in psychiatry are not great but they are far less ludicrous than self-reported ones.