Related Experiment Videos
Comorbidity of axis I and axis II disorders
J M Oldham1, A E Skodol, H D Kellman
1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York.
The American Journal of Psychiatry
|April 1, 1995
Summary
This study investigated the links between Axis I and Axis II disorders, finding significant comorbidities between various mental health conditions and personality disorders. These associations were consistent across different diagnostic thresholds, highlighting complex diagnostic relationships.
Area of Science:
- Psychiatry
- Clinical Psychology
- Mental Health Research
Background:
- Controversies exist regarding the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R) for personality disorders.
- Questions persist about the construct validity and axis assignment of personality disorders.
- Understanding Axis I-Axis II comorbidity is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To investigate patterns of comorbidity between Axis I and Axis II disorders.
- To examine the relationship between classes of Axis I disorders and Axis II personality disorders.
- To compare the distribution of personality disorder traits in patients with and without Axis I disorders.
Main Methods:
- Semistructured interviews were conducted with 200 inpatients and outpatients.
- Axis I and Axis II disorders were assessed.
- Odds ratios were calculated to determine significant comorbidities between current Axis I disorders and Axis II personality disorders, using two diagnostic methods and thresholds.
Main Results:
- Significant comorbidity was found between mood disorders and avoidant/dependent personality disorders.
- Anxiety disorders showed comorbidity with borderline, avoidant, and dependent personality disorders.
- Psychoactive substance use disorders were comorbid with borderline and histrionic personality disorders.
- Eating disorders were comorbid with schizotypal, borderline, and avoidant personality disorders.
- These associations remained consistent across conservative and liberal diagnostic definitions.
Conclusions:
- Most Axis I disorder classes showed significant associations with Axis II disorders and traits.
- Borderline personality disorder was comorbid with all Axis I classes except mood disorders, which showed elevated borderline traits.
- The presence of any personality disorder increased the likelihood of Axis I disorders like mood, anxiety, psychotic, or eating disorders.
- Psychoactive substance use disorders specifically co-occurred with borderline and histrionic personality disorders.