Einfluss von persönlichkeitsstörungen auf den erfolg einer multimodalen verhaltenstherapie bei zwangserkrankungen - Teil II: ergebnisse einer empirischen studie

Aim: Comorbid personality disorders are discussed as risk factors for a negative treatment outcome in obsessive-compulsive disorder (OCD). However, existing studies have yielded controversial results. Prospective studies with OCD patients in clinical routine are warranted to shed further light on this issue. Method: 55 patients fulfilling criteria of OCD were investigated. Patients were consecutively referred to a behaviour therapy inpatient unit or day clinic. Treatment consisted of an individualized and multimodal cognitive behaviour therapy (with or without adjuvant drug therapy). Results: The presence of one or more personality disorders is not associated with the treatment outcome. Duration of treatment was not prolonged in OCD patients with concomitant axis II disorders. However, anxious and dissociative personality traits (assessed by a self-rating-questionnaire at the beginning of treatment) were identified as risk factors for a negative treatment outcome, whereas histrionic traits were identified as a positive factor. Conclusions: Results are encouraging for cognitive-behaviour therapists working with patients co-diagnosed with axis II disorders. Patients with personality disorders are not necessarily non-responders. Merely some specific personality traits were associated with a less favourable outcome. Recommendations for treatment of such patients are proposed.