The Relationship between Personality Organization and Psychiatric Classification in Chronic Pain Patients

The assessment of PO is a crucial issue for diagnosis and treatment
planning in CPPs, since it represents a measure of structural
impairment that is to a considerable extent independent of axis I
and II diagnoses. Moreover, the STIPO dimensional rating focuses on
the most salient dysfunctions at a given time. Copyright (C) 2010
S. Karger AG, BaselBackground: The present study investigated the
relationship between psychiatric classification and personality
organization (PO) in a secondary/tertiary clinical sample of
chronic pain patients (CPPs). Sampling and Methods: Forty-three
patients were administered the Structured Clinical Interview for
DSM-IV (SCID I+II) and the Structured Interview of Personality
Organization (STIPO). The prevalence of axis I and axis II
disorders was correlated with the STIPO level of PO. The STIPO
dimensional ratings of patients without personality disorder (PD)
were compared to those of patients diagnosed with one or more PDs.
Results: Axis I comorbidity was high (93%), and 63% of the patients
met the criteria for at least one axis II diagnosis. Twenty-five
patients (58%) were diagnosed as borderline PO, with high-level
impairments in the dimensions `coping/rigidity', `primitive
defenses' and `identity'. Higher axis I and axis II comorbidity
corresponded with greater severity of PO impairment. No difference
was found between the dimensional ratings of patients without PD
and those of patients with one or more PDs. Conclusions: