Validation of the self-report questionnaire DIP-Q in diagnosing DSM-IV personality disorders: a comparison of three psychiatric samples
The DSM‐IV section of the DSM‐IV and ICD‐10 Personality Questionnaire (DIP‐Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences betw...
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Published in | Acta psychiatrica Scandinavica Vol. 97; no. 6; pp. 433 - 439 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.06.1998
Blackwell |
Subjects | |
Online Access | Get full text |
ISSN | 0001-690X 1600-0447 1600-0447 |
DOI | 10.1111/j.1600-0447.1998.tb10028.x |
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Abstract | The DSM‐IV section of the DSM‐IV and ICD‐10 Personality Questionnaire (DIP‐Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences between the samples with regard to patterns of personality pathology in relation to concurrent Axis I disorders and sociodemographic variables were analysed. The prevalence of personality disorders according to DIP‐Q was 14% among the healthy volunteers, compared to 59% in the general psychiatric sample, 68% in the forensic psychiatric sample and up to 90% among psychotherapy candidates. Moreover, from a dimensional perspective (i.e. the number of fulfilled Axis II criteria), all clinical groups differed significantly from the control group in all specified personality dimensions and clusters. Dimensional DIP‐Q cluster scores also discriminated significantly between the three clinical samples. Unexpectedly, the odds ratio for an Axis II disorder was nearly five times higher among psychotherapy applicants than among general psychiatric patients, independent of concomitant Axis II disorders, gender or age. The strongest association between DIP‐Q score and Axis I disorders was found for depressive disorders, which more than doubled the odds ratio for a personality disorder diagnosis. This association could result from high true comorbidity, but could also be due to the fact that a concomitant depressive state can increase self‐reported personality difficulties. The high prevalence among psychotherapy candidates may to some extent reflect help‐seeking exaggeration of problems. These are aspects to consider when using the DIP‐Q, which overall appears to discriminate well between different samples. |
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AbstractList | The DSM‐IV section of the DSM‐IV and ICD‐10 Personality Questionnaire (DIP‐Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences between the samples with regard to patterns of personality pathology in relation to concurrent Axis I disorders and sociodemographic variables were analysed. The prevalence of personality disorders according to DIP‐Q was 14% among the healthy volunteers, compared to 59% in the general psychiatric sample, 68% in the forensic psychiatric sample and up to 90% among psychotherapy candidates. Moreover, from a dimensional perspective (i.e. the number of fulfilled Axis II criteria), all clinical groups differed significantly from the control group in all specified personality dimensions and clusters. Dimensional DIP‐Q cluster scores also discriminated significantly between the three clinical samples. Unexpectedly, the odds ratio for an Axis II disorder was nearly five times higher among psychotherapy applicants than among general psychiatric patients, independent of concomitant Axis II disorders, gender or age. The strongest association between DIP‐Q score and Axis I disorders was found for depressive disorders, which more than doubled the odds ratio for a personality disorder diagnosis. This association could result from high true comorbidity, but could also be due to the fact that a concomitant depressive state can increase self‐reported personality difficulties. The high prevalence among psychotherapy candidates may to some extent reflect help‐seeking exaggeration of problems. These are aspects to consider when using the DIP‐Q, which overall appears to discriminate well between different samples. The DSM-IV section of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences between the samples with regard to patterns of personality pathology in relation to concurrent Axis I disorders and sociodemographic variables were analysed. The prevalence of personality disorders according to DIP-Q was 14% among the healthy volunteers, compared to 59% in the general psychiatric sample, 68% in the forensic psychiatric sample and up to 90% among psychotherapy candidates. Moreover, from a dimensional perspective (i.e. the number of fulfilled Axis II criteria), all clinical groups differed significantly from the control group in all specified personality dimensions and clusters. Dimensional DIP-Q cluster scores also discriminated significantly between the three clinical samples. Unexpectedly, the odds ratio for an Axis II disorder was nearly five times higher among psychotherapy applicants than among general psychiatric patients, independent of concomitant Axis I disorders, gender or age. The strongest association between DIP-Q score and Axis I disorders was found for depressive disorders, which more than doubled the odds ratio for a personality disorder diagnosis. This association could result from high true comorbidity, but could also be due to the fact that a concomitant depressive state can increase self-reported personality difficulties. The high prevalence among psychotherapy candidates may to some extent reflect help-seeking exaggeration of problems. These are aspects to consider when using the DIP-Q, which overall appears to discriminate well between different samples. The DSM-IV section of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences between the samples with regard to patterns of personality pathology in relation to concurrent Axis I disorders and sociodemographic variables were analysed. The prevalence of personality disorders according to DIP-Q was 14% among the healthy volunteers, compared to 59% in the general psychiatric sample, 68% in the forensic psychiatric sample and up to 90% among psychotherapy candidates. Moreover, from a dimensional perspective (i.e. the number of fulfilled Axis II criteria), all clinical groups differed significantly from the control group in all specified personality dimensions and clusters. Dimensional DIP-Q cluster scores also discriminated significantly between the three clinical samples. Unexpectedly, the odds ratio for an Axis II disorder was nearly five times higher among psychotherapy applicants than among general psychiatric patients, independent of concomitant Axis I disorders, gender or age. The strongest association between DIP-Q score and Axis I disorders was found for depressive disorders, which more than doubled the odds ratio for a personality disorder diagnosis. This association could result from high true comorbidity, but could also be due to the fact that a concomitant depressive state can increase self-reported personality difficulties. The high prevalence among psychotherapy candidates may to some extent reflect help-seeking exaggeration of problems. These are aspects to consider when using the DIP-Q, which overall appears to discriminate well between different samples.The DSM-IV section of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences between the samples with regard to patterns of personality pathology in relation to concurrent Axis I disorders and sociodemographic variables were analysed. The prevalence of personality disorders according to DIP-Q was 14% among the healthy volunteers, compared to 59% in the general psychiatric sample, 68% in the forensic psychiatric sample and up to 90% among psychotherapy candidates. Moreover, from a dimensional perspective (i.e. the number of fulfilled Axis II criteria), all clinical groups differed significantly from the control group in all specified personality dimensions and clusters. Dimensional DIP-Q cluster scores also discriminated significantly between the three clinical samples. Unexpectedly, the odds ratio for an Axis II disorder was nearly five times higher among psychotherapy applicants than among general psychiatric patients, independent of concomitant Axis I disorders, gender or age. The strongest association between DIP-Q score and Axis I disorders was found for depressive disorders, which more than doubled the odds ratio for a personality disorder diagnosis. This association could result from high true comorbidity, but could also be due to the fact that a concomitant depressive state can increase self-reported personality difficulties. The high prevalence among psychotherapy candidates may to some extent reflect help-seeking exaggeration of problems. These are aspects to consider when using the DIP-Q, which overall appears to discriminate well between different samples. |
Author | Svanborg, C. Bodlund, O. Grann, M. Ottosson, H. |
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Cites_doi | 10.1111/j.1600-0447.1994.tb01604.x 10.1111/j.1600-0447.1991.tb05526.x 10.1016/S0924-9338(98)80013-8 10.1176/ajp.140.6.695 10.1007/BF01788194 10.1521/pedi.1992.6.4.287 10.1176/ajp.147.8.1043 10.1111/j.1600-0447.1994.tb01566.x 10.3109/08039489209106179 10.3109/08039489309104111 10.1111/j.1600-0447.1993.tb03436.x 10.1176/ajp.149.12.1645 10.3109/08039489509011918 10.1007/BF02438167 10.1001/archpsyc.1994.03950030061006 10.1111/j.1600-0447.1988.tb06346.x 10.1097/00005053-199011000-00004 10.1176/ajp.144.2.181 10.1027/1192-5604.21.1.30 |
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References | Ekselius L, Lindström E, Von Knorring L, Bodlund O, Kullgren G. Personality disorders in DSM-III-R as categorical or dimensional. Acta Psychiatr Scand 1993: 88: 183-187. Hirschfeldt RM, Klerman GL, Clayton PJ et al. Assessing personality: effect of the depressive state on trait measurement. Am J Psychiatry 1983: 140: 695-699. Kullgren G. Personality disorders among psychiatric inpatients. Nord J Psychiatry 1992: 46: 27-32. Jackson HJ, Whiteside HL, Bates GW, Bell R, Rudd RP, Edwards J. Diagnosing personality disorders in psychiatric in-patients. Acta Psychiatr Scand 1991: 83: 206-213. Zimmerman M. Diagnosing personality disorders - A review of issues and research methods. Arch Gen Psychiatry 1994: 51: 225-245. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edn. Washington , DC : American Psychiatric Association, 1994. Bodlund O, Kullgren G. Transsexualism: general outcome and prognostic factors. A five-year follow-up study of 19 transsexuals in the process of changing sex. Arch Sex Behav 1996: 25: 303-316. Reich J, Yates W, Nduaguba M. Prevalence of DSM-III personality disorders in the community. Soc Psychiatry Psychiatr Epidemiol 1989: 24: 12-16. Bodlund O, Ekselius L, Lindström E. Personality traits and disorders among psychiatric out-patients and normal subjects on the basis of the SCID screen questionnaire. Nord J Psychiatry 1993: 47: 425-433. Ottosson H, Bodlund O, Ekselius L et al. The DSM-IV and ICD-10 Personality Questionnaire (DIP-Q): construction and preliminary validation. Nord J Psychiatry 1995: 49: 285-291. Perry JC. Problems and considerations in the valid assessment of personality disorders. Am J Psychiatry 1992: 149: 1645-1653. Carlsson AM, Nygren M, Clinton D, Bihlár B. The Stockholm Comparative Psychotherapy Study (COMPASS): project presentation and preliminary Rorschach findings. Rorschachiana 1996: 21: 30-43. Bodlund O, Kullgren G, Ekselius L, Lindström E, Von Knorring L Axis V - global assessment of functioning scale: evaluation of a self-report version. Acta Psychiatr Scand 1994: 90: 342-347. Widiger TA. Categorical versus dimensional classification: implications from and for research. J Pers Disord 1992: 6: 287-300. Alnaes R, Torgersen S. DSM-III personality disorders among patients with major depression, anxiety disorders and mixed conditions. J Nerv Ment Dis 1990:178: 693-698. Alnaes R, Torgersen S. DSM-III symptom disorders (Axis I) and personality disorders (Axis II) in an outpatient population. Acta Psychiatr Scand 1988: 78: 348-355. Ekselius L, Lindström E, Von Knorring L, Bodlund O, Kullgren G. SCID-II interviews and the SCID screen questionnaire as diagnostic tools for personality disorders in DSM-III-R. Acta Psychiatr Scand 1994: 90: 120-123. Hyler SE, Skodol AE, Kellman HD, Oldham JM, Rosnick L. Validity of the Personality Diagnostic Questionnaire - Revised: comparison with two structured interviews. Am J Psychiatry 1990: 147: 1043-1048. Reich J, Noyes R, Hirschfeldt R, Coryell W, O'Gorman T. State and personality in depressed and panic patients. Am J Psychiatry 1987: 144: 181-187. 1992; 6 1993; 47 1994; 90 1990; 147 1987; 144 1995; 49 1983; 140 1993; 88 1991; 83 1992; 149 1998 1988; 78 1994 1992; 46 1990; 178 1996; 25 1989; 24 1996; 21 1994; 51 Alnaes R (e_1_2_1_12_2) 1988; 78 e_1_2_1_6_2 e_1_2_1_7_2 e_1_2_1_4_2 e_1_2_1_5_2 e_1_2_1_11_2 e_1_2_1_3_2 e_1_2_1_20_2 e_1_2_1_10_2 e_1_2_1_21_2 e_1_2_1_15_2 American Psychiatric Association. (e_1_2_1_2_2) 1994 e_1_2_1_16_2 e_1_2_1_13_2 e_1_2_1_14_2 e_1_2_1_19_2 e_1_2_1_8_2 e_1_2_1_17_2 e_1_2_1_9_2 e_1_2_1_18_2 |
References_xml | – reference: Ottosson H, Bodlund O, Ekselius L et al. The DSM-IV and ICD-10 Personality Questionnaire (DIP-Q): construction and preliminary validation. Nord J Psychiatry 1995: 49: 285-291. – reference: Kullgren G. Personality disorders among psychiatric inpatients. Nord J Psychiatry 1992: 46: 27-32. – reference: Alnaes R, Torgersen S. DSM-III symptom disorders (Axis I) and personality disorders (Axis II) in an outpatient population. Acta Psychiatr Scand 1988: 78: 348-355. – reference: Bodlund O, Kullgren G, Ekselius L, Lindström E, Von Knorring L Axis V - global assessment of functioning scale: evaluation of a self-report version. Acta Psychiatr Scand 1994: 90: 342-347. – reference: Ekselius L, Lindström E, Von Knorring L, Bodlund O, Kullgren G. SCID-II interviews and the SCID screen questionnaire as diagnostic tools for personality disorders in DSM-III-R. Acta Psychiatr Scand 1994: 90: 120-123. – reference: Widiger TA. Categorical versus dimensional classification: implications from and for research. J Pers Disord 1992: 6: 287-300. – reference: Reich J, Yates W, Nduaguba M. Prevalence of DSM-III personality disorders in the community. Soc Psychiatry Psychiatr Epidemiol 1989: 24: 12-16. – reference: Bodlund O, Kullgren G. Transsexualism: general outcome and prognostic factors. A five-year follow-up study of 19 transsexuals in the process of changing sex. Arch Sex Behav 1996: 25: 303-316. – reference: American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edn. Washington , DC : American Psychiatric Association, 1994. – reference: Hirschfeldt RM, Klerman GL, Clayton PJ et al. Assessing personality: effect of the depressive state on trait measurement. Am J Psychiatry 1983: 140: 695-699. – reference: Carlsson AM, Nygren M, Clinton D, Bihlár B. The Stockholm Comparative Psychotherapy Study (COMPASS): project presentation and preliminary Rorschach findings. Rorschachiana 1996: 21: 30-43. – reference: Bodlund O, Ekselius L, Lindström E. Personality traits and disorders among psychiatric out-patients and normal subjects on the basis of the SCID screen questionnaire. Nord J Psychiatry 1993: 47: 425-433. – reference: Zimmerman M. Diagnosing personality disorders - A review of issues and research methods. Arch Gen Psychiatry 1994: 51: 225-245. – reference: Perry JC. Problems and considerations in the valid assessment of personality disorders. Am J Psychiatry 1992: 149: 1645-1653. – reference: Reich J, Noyes R, Hirschfeldt R, Coryell W, O'Gorman T. State and personality in depressed and panic patients. Am J Psychiatry 1987: 144: 181-187. – reference: Hyler SE, Skodol AE, Kellman HD, Oldham JM, Rosnick L. Validity of the Personality Diagnostic Questionnaire - Revised: comparison with two structured interviews. Am J Psychiatry 1990: 147: 1043-1048. – reference: Jackson HJ, Whiteside HL, Bates GW, Bell R, Rudd RP, Edwards J. Diagnosing personality disorders in psychiatric in-patients. Acta Psychiatr Scand 1991: 83: 206-213. – reference: Alnaes R, Torgersen S. DSM-III personality disorders among patients with major depression, anxiety disorders and mixed conditions. J Nerv Ment Dis 1990:178: 693-698. – reference: Ekselius L, Lindström E, Von Knorring L, Bodlund O, Kullgren G. Personality disorders in DSM-III-R as categorical or dimensional. 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SubjectTerms | Adolescent Adult Biological and medical sciences Chi-Square Distribution Comorbidity Confidence Intervals Evaluation Studies as Topic Female Humans Logistic Models Male Manuals as Topic - standards Medical sciences Middle Aged Odds Ratio personality disorder Personality Disorders - classification Personality Disorders - diagnosis Personality Disorders - epidemiology Personality Tests - standards Prevalence Psychiatric Status Rating Scales - standards Psychiatry - standards Psychology. Psychoanalysis. Psychiatry Psychometrics - standards Psychometrics. Diagnostic aid systems Psychopathology. Psychiatry Reproducibility of Results Sampling Studies self-report questionnaire Surveys and Questionnaires - standards Sweden - epidemiology Techniques and methods |
Title | Validation of the self-report questionnaire DIP-Q in diagnosing DSM-IV personality disorders: a comparison of three psychiatric samples |
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