The impact of comorbid personality difficulties on response to IAPT treatment for depression and anxiety.
Open accessAbstract
UNLABELLED: The UK's Improving Access to Psychological Therapies (IAPT) initiative provides evidence-based psychological interventions for mild to moderate common mental health problems in a primary care setting. Predictors of treatment response are unclear. This study examined the impact of personality disorder status on outcome in a large IAPT service. We hypothesised that the presence of probable personality disorder would adversely affect treatment response. METHOD: We used a prospective cohort design to study a consecutive sample of individuals (n = 1249). RESULTS: Higher scores on a screening measure for personality disorder were associated with poorer outcome on measures of depression, anxiety and social functioning, and reduced recovery rates at the end of treatment. These associations were not confounded by demographic status, initial symptom severity nor number of treatment sessions. The presence of personality difficulties independently predicted reduced absolute change on all outcome measures. CONCLUSIONS: The presence of co-morbid personality difficulties adversely affects treatment outcome among individuals attending for treatment in an IAPT service. There is a need to routinely assess for the presence of personality difficulties on all individuals referred to IAPT services. This information will provide important prognostic data and could lead to the provision of more effective, personalised treatment in IAPT.
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High levels of complex psychiatric comorbidities may negatively affect treatment outcomes for people with PTSD.
“Indeed, high levels of complex psychiatric comorbidities may negatively affect treatment outcomes for people with PTSD [13].”
From Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis (2020) · cites this paper as [13]
The Abstract reports that comorbid personality difficulties were associated with poorer treatment outcomes in an IAPT cohort treated for depression and anxiety. The Methodological considerations section (page unavailable) says outcomes were not analysed by specific diagnosis. The paper therefore supports a possible adverse effect of personality difficulties, but not the claim specifically about people with PTSD or complex psychiatric comorbidities more broadly. (LLM, conf=0.88)
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- Authors
- Goddard, E., Wingrove, J., & Moran, P.
- Affiliations
- King's College London (GB)
- South London and Maudsley NHS Foundation Trust (GB)
- Corresponding author
- Moran, Paul
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 73
- Pages
- 1-7
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2161033338
- Cited by
- 96
- References
- 44
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 11 · 2023: 8 · 2022: 12 · 2021: 14 · 2020: 10 · 2019: 10 · 2018: 8 · 2017: 9 · 2016: 2
- FWCI
- 7.86
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Behaviour Research and Therapy (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Explore Bristol Research (submittedVersion, cc-by-nc-nd)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Bristol Research (University of Bristol) (submittedVersion, cc-by-nc-nd)
- Funders
- NIHR Biomedical Research Centre for Mental Health and Dementia Unit
- Maudsley NHS Foundation Trust and the Institute of Psychiatry, Psychology & Neuroscience, King's College London
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- personality disorders, comorbidities, Improving Access to Psychological Therapies, depression, anxiety, treatment outcomes, predictors of treatment response, social functioning, recovery, primary care mental health services
- MeSH terms
- Adult, Anxiety, Depression, Female, Humans, Male, Middle Aged, Personality Disorders, Prospective Studies, Psychotherapy, Treatment Outcome
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