The Nottingham study of neurotic disorder. Effect of personality status on response to drug treatment, cognitive therapy and self-help over two years.
Repeated assessments of psychopathology, together with personality status, were made over two years on 181 psychiatric out-patients with generalised anxiety disorder (59), panic disorder (66), or dysthymic disorder (56) diagnosed using an interview schedule for DSM-III. Patients were randomly allocated to drug treatment, cognitive and behaviour therapy, or a self-help treatment programme. Although there were no overall differences in compliance rate and efficacy between the three modes of treatment, the psychological treatment methods, particularly self-help, were more effective in patients without personality disorder, and those with personality disorder responded better to drug treatment, primarily antidepressants. The findings suggest that assessment of personality status could be a valuable aid to selection of treatment in neurotic disorders and that self-help approaches are particularly valuable once personality disorder has been excluded.
Tyrer
P
P
St. Mary's Hospital Medical School, St Charles Hospital, London.
Seivewright
N
N
Ferguson
B
B
Murphy
S
S
Johnson
A L
AL
D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D003975:Diazepam / Q000627:therapeutic use*; D004308:Dothiepin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009497:Neurotic Disorders / Q000523:psychology / Q000628:therapy*; D016584:Panic Disorder / Q000523:psychology / Q000628:therapy; D010552:Personality Assessment; D012657:Self-Help Groups
D003975:Diazepam; D004308:Dothiepin