Symptomatic comorbidity

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The comorbidity of symptomatic and personality disorders may complicate treatment, result in higher rates of relapse, exacerbate the symptomatic disorder, increase treatment duration, and yield poorer outcomes. Clinicians need to prudently tailor manualized treatments based on a thorough case conceptualization, recognizing that personality disorders may increase the likelihood that treatment will be extended. Because outcome studies generally fail to incorporate case formulations that actually drive treatment in clinical practice, modifying treatment protocols for the presence of a personality disorder is often necessary. It is best to examine the specific characteristics of patients and to understand how their idiosyncratic cognitions relate to onset, maintenance, and relapse, and how to address these factors in treatment. Finally, it is important to remember that we do not treat disorders but, rather, individuals with their own unique patterns of cognition, emotion, and behavior. True to the cognitive model, the most efficient route to effective treatment appears to be identification and modification of maladaptive schema and skills deficits that underlie co-occurring disorders. (PsycINFO Database Record (c) 2015 APA, all rights reserved). (chapter)

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Cognitive therapy of personality disorders (3rd ed.).

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This chapter was published in Cognitive therapy of personality disorders (3rd ed.), Pages 393-408.

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