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The Nottingham Study of Neurotic Disorder

Effect of Personality Status on Response to Drug Treatment, Cognitive Therapy and Self-help over Two Years

Published online by Cambridge University Press:  02 January 2018

Peter Tyrer*
Affiliation:
St Charles Hospital, London W10 6DZ
Nicholas Seivewright
Affiliation:
University of Manchester, Department of Psychiatry
Brian Ferguson
Affiliation:
Mapperley Hospital, Nottingham
Siobhan Murphy
Affiliation:
St Thomas's Hospital, London
A. L. Johnson
Affiliation:
Medical Research Council Biostatistics Unit, Cambridge
*
Correspondence

Abstract

Repeated assessments of psychopathology, together with personality status, were made over two years on 181 psychiatric out-patients with generalised anxiety disorder (59), panic disorder (66), or dysthymic disorder (56) diagnosed using an interview schedule for DSM–III. Patients were randomly allocated to drug treatment, cognitive and behaviour therapy, or a self-help treatment programme. Although there were no overall differences in compliance rate and efficacy between the three modes of treatment, the psychological treatment methods, particularly self-help, were more effective in patients without personality disorder, and those with personality disorder responded better to drug treatment, primarily antidepressants. The findings suggest that assessment of personality status could be a valuable aid to selection of treatment in neurotic disorders and that self-help approaches are particularly valuable once personality disorder has been excluded.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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