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Clinical importance of personality difficulties: diagnostically sub-threshold personality disorders

Overview of attention for article published in BMC Psychiatry, January 2017
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Title
Clinical importance of personality difficulties: diagnostically sub-threshold personality disorders
Published in
BMC Psychiatry, January 2017
DOI 10.1186/s12888-017-1200-y
Pubmed ID
Authors

Max Karukivi, Tero Vahlberg, Kalle Horjamo, Minna Nevalainen, Jyrki Korkeila

Abstract

Current categorical classification of personality disorders has been criticized for overlooking the dimensional nature of personality and that it may miss some sub-threshold personality disturbances of clinical significance. We aimed to evaluate the clinical importance of these conditions. For this, we used a simple four-level dimensional categorization based on the severity of personality disturbance. The sample consisted of 352 patients admitted to mental health services. All underwent diagnostic assessments (SCID-I and SCID-II) and filled in questionnaires concerning their social situation and childhood adversities, and other validated tools, including the Beck Depression Inventory (BDI), Alcohol Use Disorders Identification Test (AUDIT), health-related quality of life (15D), and the five-item Mental Health Index (MHI-5). The patients were categorized into four groups according to the level of personality disturbance: 0 = No personality disturbance, 1 = Personality difficulty (one criterion less than threshold for one or more personality disorders), 2 = Simple personality disorder (one personality disorder), and 3 = Complex/Severe personality disorder (two or more personality disorders or any borderline and antisocial personality disorder). The proportions of the groups were as follows: no personality disturbance 38.4% (n = 135), personality difficulty 14.5% (n = 51), simple personality disorder 19.9% (n = 70), and complex/severe personality disorder 24.4% (n = 86). Patients with no personality disturbance were significantly differentiated (p < 0.05) from the other groups regarding the BDI, 15D, and MHI-5 scores as well as the number of Axis I diagnoses. Patients with complex/severe personality disorders stood out as being worst off. Social dysfunction was related to the severity of the personality disturbance. Patients with a personality difficulty or a simple personality disorder had prominent symptoms and difficulties, but the differences between these groups were mostly non-significant. An elevated severity level of personality disturbance is associated with an increase in psychiatric morbidity and social dysfunction. Diagnostically sub-threshold personality difficulties are of clinical significance and the degree of impairment corresponds to actual personality disorders. Since these two groups did not significantly differ from each other, our findings also highlight the complexity related to the use of diagnostic thresholds for separate personality disorders.

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Mendeley readers

The data shown below were compiled from readership statistics for 44 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Denmark 1 2%
Unknown 43 98%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 6 14%
Student > Postgraduate 5 11%
Student > Master 5 11%
Researcher 4 9%
Other 4 9%
Other 8 18%
Unknown 12 27%
Readers by discipline Count As %
Psychology 17 39%
Medicine and Dentistry 6 14%
Arts and Humanities 2 5%
Social Sciences 2 5%
Nursing and Health Professions 2 5%
Other 4 9%
Unknown 11 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 January 2017.
All research outputs
#11,519,796
of 14,537,474 outputs
Outputs from BMC Psychiatry
#2,733
of 3,390 outputs
Outputs of similar age
#303,028
of 425,800 outputs
Outputs of similar age from BMC Psychiatry
#331
of 441 outputs
Altmetric has tracked 14,537,474 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,390 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.1. This one is in the 10th percentile – i.e., 10% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 425,800 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 16th percentile – i.e., 16% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 441 others from the same source and published within six weeks on either side of this one. This one is in the 14th percentile – i.e., 14% of its contemporaries scored the same or lower than it.