Personality Changes In Patients Research Articles

Personality changes in patients with schizoaffective disorder (a review)

The aim of the work is to study the world experience and views on the clinic and systematics of non-psychotic manifestations in schizoaffective disorder (SAD) by analyzing modern scientific literary sources. The relevance of study on SAD is determined by the significant prevalence in the population (0.2–0.6 %) and negative socio-economic consequences of the disease. Significant problems in SAD are family and work maladjustment, suicidality and states of psychoactive substance use comorbidity. The nosological independence of the disease was put into question and it was reflected in diagnostic approaches and classifications. In the clinical practice, SAD is considered independently and as a variant of schizophrenia or affective disorders. Diagnostics and prognostic criteria regarding personality changes in SAD are still at the stage of determining. Conclusions. Understanding of definitions “prognosis”, “outcome”, and “maladjustment” in SAD is not unified. Signs of SAD in remission and intermission is the most recent aspect of the SAD clinic, which dictates the need to assess personality changes and the level of social adaptation and functioning.

Personality Changes After Subthalamic Nucleus Stimulation in Parkinson's Disease.

Background:While deep brain stimulation of the subthalamic nucleus (STN-DBS) significantly improves motor deficits in patients with Parkinson’s disease (PD), it is still unclear whether it affects personality functioning.Objective:The objective of the present study was to examine personality changes in patients with PD after STN-DBS from the perspectives of both the patients and caregivers. Moreover, by assessing the premorbid personalities of the patients, we tried to determine individual vulnerability to STN-DBS-induced personality changes.Methods:In total, 27 patients and their caregivers participated in our retrospective observational study. They were asked to assess the patients’ personality changes with the Iowa Scale of Personality Changes (ISPC) and the patients’ premorbid personalities with the Big Five Inventory (BFI).Results:Caregivers reported significant personality changes in the ISPC domains of Executive Disturbance (p = 0.01) and Disturbed Social Behavior (p = 0.02). Most of the ISPC domains were positively correlated with Conscientiousness, while Executive Disturbance was negatively correlated with Neuroticism of the BFI scale.Conclusion:Our results show that executive and social functioning are the two most vulnerable domains in patients with PD after STN-DBS, especially in those patients who score higher for neuroticism and lower for conscientiousness on the BFI scale. The results of our study may provide movement disorder specialists with better counseling options and better selection of DBS candidates. Caregivers’ perspective might contribute significantly in understanding postoperative personality changes.

Personality changes in patients suffering from drug-resistant epilepsy after surgical treatment: a 1-year follow-up study

ObjectiveTo determine changes in dimensions of personality in a sample of patients suffering from drug-resistant epilepsy at the 1-year follow-up following surgery, compared to non-surgically treated controls. MethodsWe conducted a prospective comparative controlled study, including drug-resistant epilepsy surgery candidates. Demographic, psychiatric, neurological, and psychological data were recorded. Presurgical and 12-months follow-up evaluations were performed. Personality dimensions were measured by the NEO Five-Factor Inventory, Revised version (NEO-FFI-R), anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS: HADA-Anxiety and HADD-Depression), psychiatric evaluations were performed using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Axis-I disorders classification. Statistical analysis consisted of comparative tests, correlation analysis, and the stepwise multiple regression test (ANOVA). ResultsA 1-year follow-up was completed by 70 out of 80 patients. Through the study, the surgical group decreased in neuroticism and increased in agreeableness. The controls increased in consciousness, and these changes were predicted by the earlier age of epilepsy onset and lesser score in HADD at the baseline. No personality changes were associated with seizure frequency. The presurgical evaluation concluded that both groups had no differences in demographic, psychiatric, or neurological variables with the only exception being for the number of seizures per month, which was higher in the surgical group. Psychiatric comorbidity in patients was associated with their higher degree of neuroticism and agreeableness at the baseline.Comparing control and surgical groups at the one-year follow-up, the agreeableness personality variable was higher in the surgical group, and as expected, HADS scores were higher in the control group, and seizure frequency was also higher in the control group. SignificanceHigher agreeableness was the most relevant difference in personality dimensions in patients who underwent surgical treatment compared with the non-surgical treatment group. After surgery patients decreased in neuroticism and increased in agreeableness scores.

The Relationship Between Patients' Personality Traits and Breast Reconstruction Process.

Breast reconstruction after mastectomy is a part of breast cancer treatment. There is a lack of data regarding the impact of reconstruction over psychological traits and quality of life. The aim of this study is to evaluate personality changes in patients who underwent reconstructive surgery. Thirty-seven women underwent breast reconstruction. These women took the Crown-Crisp Experiential Index before and after the different procedures. The questionnaire analyzes: (a) the satisfaction level with personal relationships before and after surgery, and the level of satisfaction with surgical results and (b) personality index. Comparisons of preoperative and postoperative personality traits were made by using the Crown-Crisp test and analyzed by Chi-square test. Correlations between preoperative concerns and CCEI traits and correlations between physical aspects and Crown-Crisp, both preoperatively and postoperatively, were performed using the Spearman test. We found statistically significant differences in the following traits: anxiety anticipating possible technique failures (p=0.01); cancer recurrence (p=0.04); dissatisfaction with results (p=0.02); phobic anxiety for possible technique failure (p=0.03); obsessionality with possible technique failure (p=0.01); preoccupations around cancer recurrence (p=0.01) and dissatisfaction with results (p=0.03); somatic of technique failure (p=0.05); and finally, depression and hysteria traits in response to surgical procedures except anesthesia. This prospective study suggests that personality traits define perceptions of body image, which has an influence over quality of life and satisfaction with results. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Fronto-temporal Dementia with Early Onset

IntroductionEven though it is not the most common type of dementia, frontotemporal dementia (FTD) is a major health problem. It affects people younger than 65 with similar frequency as Alzheimer's dementia (AD) and has a progressive course that leads to inevitable deterioration in functioning. Still, FTD is not a unique entity in ICD- 10 classification.ObjectivesTo investigate the diagnostic and treatment difficulties in FTD.AimsTo show very rapid and progressive deterioration in people with early onset FTD.MethodsWe will present a series of cases showing progressive cognitive deterioration and prominent personality changes in patients with FTD hospitalised at University Psychiatric Hospital Vrapce since 2013 to 2015. Collected data included anamnestic and heteroanamnestic information, blood tests and neroimaging.ResultsOur findings showed a significance of early onset FTD, with subtle, untypical symptoms at the beginning, and galloping deterioration during the course of illness.ConclusionsPresented patients with FTD showed rapid and progressive nature of disease with infaust prognosis. Even though early onset patients make 20% of overall number of patients with FTD, we consider that it is necessary to separate them from late onset patients in future classification systems.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Personality Changes Following Brain Artery Aneurysm Surgery

Neuropsychological testing of patients in the course of their recovery from brain injuries enables analysis of cognitive deficiencies and/or emotional changes. The principle study objective was to define organic and/or reactive personality changes and the course of these changes in the function of the time span following brain artery aneurysm surgery in both female and male patients. The study was carried out at the Clinical Department of Neurosurgery, Zagreb University Hospital Center in Zagreb. The data refer to the period from 1989 to 2012 collected in two time intervals, i.e. 11 months and 12-48 months following brain artery aneurysm surgery. Of 72 patients included in the study, there were 28 male and 44 female patients. Neuropsychological testing consisted of clinical interview, clinical assessment of frontal lobe syndrome, Cornell personality questionnaire and Emotional Profile Index. Study results showed evidence of frontal lobe syndrome in 32% of patients on first testing and significant recovery on retesting, when only 17% of patients presented with frontal lobe syndrome. The reactive personality changes found in both testing intervals indicated increased neuroticism. In the first testing period, asthenic syndrome occurred most often, followed by conversion and aggressive-antisocial syndromes, while in the second testing interval asthenic syndrome was most pronounced and conversion and antisocial syndromes showed the same level of expression. The results also showed higher depressive and disorganizing states, which were even more pronounced in the second testing interval. As regards sex differences, the inclination toward cardiovascular somatization and destructiveness was more expressed in females than in males, showing a tendency of aggravation with increasing the time span following surgery. It may be concluded that the study has contributed to better understanding of organic and/or reactive personality changes in patients undergoing brain artery aneurysm surgery.

Enduring personality changes in patients living at home and challenges for community nursing

Introduction: Personality and behaviour disorders include enduring personality changes which cannot be attributed to brain injury or disease. Traumatic experiences can cause personality vulnerability. The research aimed to determine the characteristic enduring personality changes, the risk factors and the quality of life of patients living in their home environment. Methods: The field research is based on a quantitative method. The data were gathered through a structured questionnaire. The sample consisted n = 606 of patients (18.56 %) from the Central Slovenia region, aged between 20 and 92 years. The data were processed using descriptive statistics, the χ2 test, group classification and discriminant analysis. Results: The enduring personality changes are present in 9 % (n = 53) of the patients who tend to be older, with lesser educational attainment. Only a quarter of the enduring personality changes patients (n = 10) are receiving psychiatric treatment. Among the groups of patients with or without enduring personality changes statistically significant differences have been observed in relation to their past experiences with a traumatic event (p < 0.001), level of independence in the performance of the activities of daily living (p < 0.001), incidence rate of chronic pain (p = 0.002), social integration (p = 0.016), suicidal thoughts (p < 0.001) and incidence rate of comorbidity of somatic illnesses and psychological disorders (p < 0.001). Discussion and conclusion: Results of the study point to the share of enduring personality changes patients living at home in which the condition remains largely unrecognized, untreated and shadowed by other mental and physical health issues. Community nurses play a crucial role in timely recognition and detection of the changes and the patients' referral to multidisciplinary treatment. A national research project conducted by community nurses is needed to highlight the prevalence, treatment and good practice in the delivery of pertinent services.

Prevalence and Predictors of Personality Change After Severe Brain Injury

ObjectivesTo investigate the prevalence of personality change after severe brain injury; to identify predictors of personality change; and to investigate whether personality change is associated with distress in family members. DesignA longitudinal study of personality change. SettingRehabilitation unit. ParticipantsThe study sample was composed of 22 pairs of patients with traumatic brain injury or nontraumatic brain injury (N=22) and their significant others (SOs). InterventionsNot applicable. Main Outcome MeasuresAn SO completed the observer version of the NEO Five Factor Inventory rating the patient at discharge from hospital and 1 year after injury. The SOs were also asked to complete the anxiety and depression scales of the Symptom Checklist-90-Revised, rating their own emotional condition and health-related quality of life (HRQOL) as assessed by the 4 mental scales of the Medical Outcomes Study 36-Item Short-Form Health Survey. ResultsOf the sample, 59.1% experienced personality change after acquired brain injury, and the most dominant changes were observed in the personality traits of neuroticism, extraversion, and conscientiousness. Changes in neuroticism were most often observed in patients with frontal or temporal lesions. Generally, personality changes in patients were not associated with more distress and lower HRQOL in family members; however, change in patient agreeableness was associated with lower HRQOL on the role limitations-emotional scale. ConclusionsPersonality change was observed in most patients with severe brain injury. Change in neuroticism was associated with frontal and temporal lesions. Generally, personality change was not associated with more distress and lower HRQOL in SOs.

Personality changes in patients with vestibular dysfunction

The vestibular system is a sensory system that has evolved to detect linear and angular acceleration of the head in all planes so that the brain is not predominantly reliant on visual information to determine self-motion. Since the vestibular system first evolved in invertebrate species in order to detect gravitational vertical, it is likely that the central nervous system has developed a special dependence upon vestibular input. In addition to the deficits in eye movement and postural reflexes that occur following vestibular dysfunction, there is convincing evidence that vestibular loss also causes cognitive and emotional disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in the sense of spatial orientation. Beyond this, however, patients with vestibular disorders have been reported to experience other personality changes that suggest that vestibular sensation is implicated in the sense of self. These are depersonalization and derealization symptoms such as feeling “spaced out”, “body feeling strange” and “not feeling in control of self”. We propose in this review that these symptoms suggest that the vestibular system may make a unique contribution to the concept of self through information regarding self-motion and self-location that it transmits, albeit indirectly, to areas of the brain such as the temporo-parietal junction (TPJ).

CCL3 correlates with the number of mood disturbances and personality changes in patients with Alzheimer's disease

Although Alzheimer's disease (AD) is a primary degenerative disorder, a microglial-mediated inflammatory response, provoked by amyloid β (Aβ), contributes to the neurodegeneration and subsequently to the cell loss. Since such an inflammatory contribution to neurodegeneration may influence disease progression, a basic question arises concerning the mechanisms of possible clinical signs dependent on inflammatory reactions. In the present study we investigated the levels of CCL3 in the peripheral blood of AD patients and correlated findings with the results of clinical tests such as the Mini-Mental State Examination (MMSE) and the Global Deterioration Scale (GDS), as well as with disturbances of behaviour, mood and personality, thereby extending the spectrum of clinical symptoms to ones not assessed by the MMSE or the GDS. CCL3 levels were lower in patients with AD but correlated positively with such noncognitive symptoms as mood disturbances and personality changes. We found that CCL3 did not correlate with the severity of dementia as assessed by the MMSE or with the degree of disease deterioration as assessed by the GDS. The results from our study on CCL3 levels in AD may, in part, explain the mechanisms of some concomitant, noncognitive clinical features of the disease.

Personality changes in Alzheimer's disease

Background: Assessment of personality changes in patients with dementia has received little systematic investigation, although caregivers report personality modifications in every phase of dementia. Methods: A group of 52 patients with probable Alzheimer's disease (AD) vs. a group of fifteen control subjects were selected for these personality tests before and after the manifestation of dementia using an Italian version of Brooks and McKinaly's Personality Inventory (PI). Results: After the onset of AD, a significant shift from positive to negative characteristics in PI was observed in 12 of 18 bipolar pairs of adjectives constituting the instrument and the total mean PI score decreased significantly (p < 0.001), indicating a substantial worsening of personality profile. In the control group however, evaluated before and after retirement, personality traits and total mean PI score did not show a significant change. The association of personality traits and total PI score with demographic, cognitive and functional characteristics of AD patients was calculated. Conclusion: Personality changes have been depicted to be influenced by severity of cognitive, functional and behavioural complaints rather than age, sex, education and disease duration. These first applications of the Italian version of PI confirmed that personality modifications make a consistent aspect of the phenomenology of AD although in the negative direction. Further studies are needed to understand the nature of personality changes in dementia and the utility of PI to investigate these changes.

Assessing Personality Change in Psychotherapy With the SWAP–200: A Case Study

Many studies document the efficacy of psychotherapy for acute syndromes such as depression, but less is known about personality change in patients treated for personality pathology. The Shedler–Westen Assessment Procedure (SWAP–200; Westen & Shedler, 1999a, 1999b) is an assessment tool that measures a broad spectrum of personality constructs and is designed to bridge the gap between the clinical and empirical traditions in personality assessment. In this article, we demonstrate the use of the SWAP–200 as a measure of change in a case study of a patient diagnosed with borderline personality disorder. We collected assessment data at the start of treatment and after 2 years of psychotherapy. The findings illustrate the personality processes targeted in intensive psychotherapy for borderline personality.

Cerebral Metabolism and Personality in Patients with Epilepsy of the Temporal Lobe

Extratension and introversion are stable personality styles in adult subjects. Mental functioning of the former is especially influenced by the emotions and of the latter by ideation. The aim of the present work is to analyze, using positron emission tomography with [18F]fluorodeoxyglucose (18FDG-PET), possible differences in cerebral metabolism in patients with intractable temporal lobe epilepsy (TLE) in relation to different personality styles assessed with the Rorschach test.Twenty-eight drug-resistant TLE patients with complex partial seizures were assessed by means of FDG-PET and the Rorschach test. According to location of the epileptogenic area in the dominant hemisphere and the personality style of the subject, a table of contingencies was drawn up (χ² and contingency coefficient). Finally, an analysis was made of the personality changes in patients that had received neurosurgical treatment.The results show a clear differentiation with FDG-PET as regards location of the temporal lobe affected. In 80% of subjects personality style coincided with a cerebral metabolic pattern: introversives had predominant hypometabolism in the left hemisphere and extratensives in the right. The tendency toward introversion or extratension in ambitents showed this metabolic pattern only in 38% of subjects, with 54% presenting the opposite pattern. The Rorschach test was carried out for a second time after surgical temporal resection (n = 13), and it was observed that some patients maintained their personality style while others modified it.These results suggest the existence of different hemispheric metabolic patterns in the personality styles assessed by the Rorschach test in TLE patients.

Treatment of interictal psychiatric disorder in epilepsy. III. Personality disorder, aggression and mental retardation.

Personality disorder, mental retardation and aggression are frequently encountered therapeutic problems in epilepsy patients. This paper gives an overview of symptomatology and treatment of personality disorder, interictal aggression and mental retardation in epilepsy. Literature review supplemented by clinical experience. Personality changes in patients with epilepsy are often symptoms of an organic psychosyndrome. Aggression is not more frequent among epilepsy patients than in the general population, but if it does happen it is often more severe. There is a need for controlled treatment studies. A treatment strategy is suggested. In the mentally retarded, diagnostic instruments should be used to overcome diagnostic difficulties. Prevalence studies based on DSM-IV personality disorder, conducted in the community, are needed, as well as systematic research on diagnosis and treatment of personality disorder in epilepsy patients. Randomized controlled trials (RCTs) considering the effectiveness and adverse effects of antidepressants and neuroleptics in epileptic patients with mental retardation are seriously needed. In the meantime, the Expert Consensus Guideline Series on Treatment of Psychiatric and Behavioural Problems in Mental Retardation is useful. The use of neuroleptics for the treatment of aggressive or destructive behaviour in nonpsychotic mentally retarded patients remains controversial.

Premorbid Personality Predicts Level of Rated Personality Change in Patients with Alzheimer Disease

Multiple studies of individuals with Alzheimer disease have substantiated significant levels of informant-rated change in several domains and facets of the Neuroticism-Extraversion-Openness Personality Inventory, including increases in Neuroticism and decreases in Extraversion and Conscientiousness relative to premorbid personality traits. Decline in Openness was cited in some reports, and replicable changes were identified in several facets. Current and premorbid personality of 50 patients with Alzheimer disease were rated by informants using the Neuroticism-Extraversion-Openness Personality Inventory. Multiple regression analysis was used to assess possible relationships of levels of reported change with covariates, including premorbid rating, education, duration of dementia, age, gender, and Mini-Mental State Examination score. Premorbid rating was the only significant predictor of reported change for Neuroticism, Extraversion, Conscientiousness, and the facets Anxiety (N1), Assertiveness (E3), and Activity (E4). Rated change in Depression was also found to be related to duration of dementia, change in Vulnerability was influenced by gender, and reported change in both Openness and Ideas showed a relationship to level of education.

Pattern of neurobehavioral deficits associated with interferon alfa therapy for leukemia

We evaluated the neuropsychological and personality profiles of 25 patients with chronic myelogenous leukemia treated with interferon alfa (IFN-alpha). This group of persons performed well below expectation on tests of cognitive speed, verbal memory, and executive functions. Personality changes included depression, increased somatic concern, and stress reactions. A control group of leukemia patients not treated with IFN-alpha had significantly better cognitive speed and mood. The pattern of cognitive and personality changes in patients receiving IFN-alpha is highly suggestive of frontal-subcortical brain dysfunction.

A Clinical Study on Premorbid Personality and Personality Change in Patients with Age Associated Dementia

Abstract: A survey was made on 502 elderly people living at home in Tokyo, and reliable data were obtained from 486 (96.8%) of them. A total of 198 persons who were judged to have dementia according to our clinical diagnostic criteria were subjected to the present study as the demented group (Group D). Other people who had no dementia or mental disorder were studied as controls (Group C); they were subdivided into two groups, i. e., a group of 83 persons who had a decline in ADL (Group C1) and a group of 181 persons who had no decline in ADL (Group Cn). Their personalities were classified in terms of the personality trend and personality type according to SPI. 1. According to the classification by SPI, 28.2% of people who were syntonic in their younger days were in Group D. The corresponding rate was 11.6% for the nervous type, 45.3% for the immodithymic type, 1.7% for the viscous type, 5.5% for the autistic type, and 7.7% for the hysterical type. Thus, people who were syntonic, immodithymic or nervous in younger days were less likely to develop dementia, while those who were autistic or hysterical were more likely to develop dementia. The viscous type was associated with a low incidence of dementia in the present study. 2. Personality change was found more frequently in Group D (55.6%) than in Groups CI and CII (39.4%). 3. A personality change was either to nonadaptive personality (selfish, obstinate, suspicious or hot‐tempered) or to adaptive personality (mellow or extroverted). In particular, the former four types of nonadaptive personality change were significantly more frequent in Group D. A change toward selfishness, obstinateness, suspi‐ciousness or hot‐tempcredness was closely related to the development of dementia rather than to ADL. There was no consistent relationship between the severity of dementia and nonadaptive personality change. Thus, among the personality in younger days, personality change and age associated dementia, we found a certain relationship between the personality in younger days and dementia. However, a relationship between the personality in younger days and later personality change was found in only a small group of subjects. However, the personality change toward selfishness, obstinateness, suspiciousness or hot‐temperedness was closely related to the development of dementia.

Ratings of Personality Change in Patients Being Evaluated for Memory Disorders

Caregivers of 35 mildly to moderately memory-impaired patients rated current and premorbid personalities with the NEO Personality Inventory. We then examined changes in the five domains of personality tapped by the NEO. There were significant changes in four of the five domains of normal personality functioning toward less conscientiousness, lower extraversion, higher neuroticism, and lower openness. The difference toward lower agreeableness was not significant when controlling for multiple comparisons. Spearman rank correlation coefficients indicated that changes in conscientiousness and vulnerability were not related to rated premorbid personality patterns and thus appear to describe shifts for all patients evaluated for memory disorders. These data suggest that personality inventories may be helpful in characterizing caregivers' observations of memory-impaired patients and thus represent a critical source of information for the clinician in charge of care.

Illness behavior and personality changes in patients with chronic prostatitis during a two-year follow-up period.

Illness behavior and personality changes during a 2-year follow-up period were studied in 40 patients with chronic prostatitis. In the first study, the existence of psychic problems among the subjects was high. Sexual problems were striking. During the follow-up period the personality of the patients did not change, but subjective well-being, both psychosocial and somatic, was impaired. Sexual problems and homosexual behavior also increased. In addition, the cooperation of the patients markedly decreased and their illness behavior became problematic. The results indicate a strong need for psychic support of these patients.

Personality changes in patients with periodic psychoses.

The author studied some personality changes in 35 patients with psychoses of periodical development (affective and schizoaffective psychoses), which are important for the rehabilitation period. It was demonstrated that following acute psychotic states there may be a significant distortion of the personality traits giving ground to qualify this state as "a defect", which in the opinion of the author is not justified. Adequate treatment to a large degree removes the personality changes. However, during the remission period there may be some irreversible changes of the personality. The author believes that in some cases there may be peculiar postpsychotic reactions and personality development.