Patients with Cluster A Personality Disorders in Psychotherapy: An Effectiveness Study

Abstract BACKGROUND: While psychopharmacological studies are common in patients with cluster A personality disorders, the effects of psychotherapy have received little attention. The aim of this study is to explore whether psychotherapeutic treatment yields health gains for these patients. METHODS: The study was conducted between March 2003 and June 2008 in 6 mental health care centres in the Netherlands, with a sample of 57 patients with a DSM-IV-TR axis II cluster A diagnosis. Patients were assigned to 3 settings of psychotherapeutic treatment (outpatient, day hospital, inpatient), and effectiveness was assessed at 18 months after baseline. An intention-to-treat analysis was conducted for psychiatric symptoms (Brief Symptom Inventory), psychosocial functioning (Outcome Questionnaire-45) and quality of life (EQ-5D), using multilevel statistical modelling. As the study was non-randomised, the propensity score method was used to control for initial differences. RESULTS: Patients in the day hospital and inpatient group improved substantially in terms of psychiatric symptoms, social and interpersonal functioning, and quality of life. Patients in the outpatient group showed less improvement. Direct comparison of the improvement of psychiatric symptoms showed significant results in favour of day hospital (p = 0.046) and inpatient (p = 0.01) treatment, as compared to outpatient treatment. However, due to substantial baseline differences, this direct comparison should be judged carefully. CONCLUSIONS: Cluster A psychopathology is not a contraindication to benefit from psychotherapy. This is especially true for more intensive forms like inpatient and day hospital treatment. Future research should focus more on psychotherapeutic treatment to gain further insight into effective treatment options for this patient grou

Effectiveness of outpatient, day hospital, and inpatient psychotherapeutic treatment for patients with cluster B personality disorders

Abstract Background: For patients with cluster B personality disor- ders there is no consensus regarding the optimal treatment setting. The aim of this study was to compare the effective- ness of different psychotherapeutic settings for patient

Comparison and Implementation of a Rigid and a Flexible Multibody Planetary Gearbox Model

We propose algorithms for developing (1) a rigid (constrained) and (2) a flexible planetary gearbox model. The two methods are compared against each other and advantages/disadvantages of each method are discussed. The rigid model (1) has gear tooth reaction forces expressed by Lagrange multipliers. The flexible approach (2) is being compared with the gear tooth forces from the rigid approach, first without damping and second the influence of damping is examined. Variable stiffness as a function of base circle arc length is implemented in the flexible approach such that it handles the realistic switch between one and two gear teeth in mesh. The final results are from modelling the planetary gearbox in a 500 kW wind turbine which we also described in Jørgensen et.al (2013)

Associations of maternal diabetes during pregnancy with overweight in offspring: Results from the prospective TEDDY study.

Objective: This study aimed to determine the relationship between different forms of, and potential path-ways between, maternal diabetes and childhood obesity at different ages.Methods: Prospective cohort data from The Environmental Determinants of Diabetes in the Young (TEDDY) study, which was composed of 5,324 children examined from 0.25 to 6 years of age, were analyzed. Cross-sectional and longitudinal analyses taking into account potential confounders and effect modifiers such as maternal prepregnancy BMI and birth weight z scores were performed.Results: Offspring of mothers with gestational diabetes mellitus (GDM) or type 1 diabetes mellitus (TIDM) showed a higher BMI standard deviation score and increased risk for overweight and obesity at 5.5 years of age than offspring of mothers without diabetes. While these associations could be substantially explained by maternal pre-pregnancy BMI in offspring of mothers with GDM, significant associations disappeared after adjustment for birth weight z scores in offspring of T1DM mothers. Furthermore, overweight risk became stronger with increasing age in offspring of mothers with diabetes compared with offspring of mothers without diabetes.Conclusions: Maternal diabetes is associated with increased risk of offspring overweight, and the association appears to get stronger as children grow older. Indeed, intrauterine exposure to maternal T1DM may predispose children to later obesity through increased birth weight, while maternal BMI is more important in children exposed to GDM

EFFECTIVENESS OF SHORT-TERM INPATIENT PSYCHOTHERAPY BASED ON TRANSACTIONAL ANALYSIS WITH PATIENTS WITH PERSONALITY DISORDERS: A MATCHED CONTROL STUDY USING PROPENSITY SCORE

Development and application of statistical models for medical scientific researc

Cost-effectiveness of psychotherapy for cluster C personality disorders: A decision-analytic model in The Netherlands

Objective: To conduct a formal economic evaluation of various dosages of psychotherapy for patients with avoidant, dependent, and obsessive-compulsive (ie, cluster C) personality disorders (Structured Interview for DSM-IV Personality criteria). Method: We developed a decision-analytic model to assess the cost-effectiveness of 5 dosage