Universität zu Köln

Schultze-Lutter, Frauke, Klosterkoetter, Joachim, Michel, Chantal ORCID: 0000-0003-1165-6681, Winkler, Karen and Ruhrmann, Stephan ORCID: 0000-0002-6022-2364 (2012). Personality disorders and accentuations in at-risk persons with and without conversion to first-episode psychosis. Early Interv. Psychiatry, 6 (4). S. 389 - 399. HOBOKEN: WILEY. ISSN 1751-7893

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Abstract

Aim: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Cluster A personality disorders (PDs), particularly schizotypal PD, are considered a part of the schizophrenia spectrum and a risk factor of psychosis. The role of PDs and personality accentuations (PAs) in predicting conversion to psychosis was studied in patients symptomatically considered at risk, assuming a major role of the schizotypal subtype. Methods: PDs and PAs, assessed at baseline with a self-report questionnaire, were compared between risk-, gender- and age-matched at-risk patients with (n = 50) and without conversion to psychosis (n = 50). Results: Overall, Cluster A-PDs were the least frequent cluster (14%), and schizotypal PD was rare (7%). Yet, PDs in general were frequent (46%), especially Cluster B- (31%) and C-PDs (23%). Groups did not differ in frequencies of PDs, yet converters tended to have a higher expression of schizoid (P = 0.057) and Cluster A-PAs (P = 0.027). In regression analyses, schizoid PA was selected as sole but weak predictor of conversion (OR = 1.685; 95% CIs: 1.134/2.504). Conclusions: Unexpectedly, schizotypal PD was infrequent and did not predict conversion. Conversion was best predicted by schizoid PA, indicating more severe, persistent social deficits already at baseline in later converters. This corresponds to premorbid social deficits reported for genetic high-risk children and low social functioning in at-risk patients later converting to psychosis. Further, PDs occurred frequently in at-risk patients irrespective of conversion. As psychopathology and personality relate closely to one another, this result highlights that, beyond the current narrow focus on schizotypal PD, personality-related factors should be considered more widely in the prevention of psychosis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schultze-Lutter, Frauke UNSPECIFIED UNSPECIFIED UNSPECIFIED Klosterkoetter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Michel, Chantal UNSPECIFIED orcid.org/0000-0003-1165-6681 UNSPECIFIED Winkler, Karen UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruhrmann, Stephan UNSPECIFIED orcid.org/0000-0002-6022-2364 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-479826
DOI:	10.1111/j.1751-7893.2011.00324.x
Journal or Publication Title:	Early Interv. Psychiatry
Volume:	6
Number:	4
Page Range:	S. 389 - 399
Date:	2012
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1751-7893
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INITIAL PRODROMAL PHASE; ULTRA-HIGH RISK; DSM-III-R; YOUNG-PEOPLE; GENDER DIFFERENCES; SCHIZOPHRENIA; FAMILY; ADOLESCENTS; PREVALENCE; PREDICTION Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47982