Summary
A method for the assessment of six premorbid personality types from biographical data in psychiatric case histories is described. Trained raters have to fill in a list comprising 106 items as descriptors of a patient's premorbid behavioural development. The assignment to the types in question (the “manic type” and its rare variant, the “happy-go-lucky type”, the “melancholic type”, the “anxious insecure type” and its rare variant, the “unrealistic dreamy type”, and finally, the “nervous tense type”) is computed on the basis of the item scores by forming type scores and comparing their height intraindividually. The subject under study is assigned to the type reaching the comparatively highest value. Two raters independently analyzed 261 records from which all information on mental disorders in family members and the patient himself/herself as well as all biographical data from the first manifestation of a symptom disorder onwards had been erased by technical assistants. In 106 of the records, a global assignment to the types of premorbid personality had already been performed by one of the authors of the typology. The scores for the same type assessed by the two ratings correlated highly with each other (0.77 to 0.80), the concordance of types reached a kappa-value of 0.55 (P<0.001), and the results of the operationalized typing agreed in the same order with the result of global typing in the subsample ofn=106. The distributionof types over clinical groups (affective, schizoaffective, and schizophrenic psychoses, neurotic and personality disorders) deviated significantly from chance expectancy, well in accord with clinical expectancy and, as far as available, with results of prospective studies on premorbid personality. This points to the clinical validity of the procedure which can therefore be recommended as an adjunct to the questionnaire approach with its limitations regarding diagnostic and prognostic (predictive) validity.
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References
Asarnow JR (1988) Children at risk for schizophrenia: converging lines of evidence. Schizophr Bull 14:613–631
Barthelmes H, Pfister H (1980) The Statistical Method-Bank (STAMEB). Proceedings of the Digital Equipment Computer users society 7:327–332
Cohen RJ, Montague P, Nathanson LS, Swerdlik ME (1988) Psychological testing. An introduction to tests and measurement. Mayfield, Mountain View, Calif.
Gruben S (1993) Reliabilitäts- und Validitätsprüfung eines operationalisierten Ansatzes zur diagnostisch blinden Beurteilung der prämorbiden Persönlichkeit psychiatrischer Patienten anhand von Krankengeschichtsauszügen. Dissertation, University of Munich
Kretschmer E (1921) Körperbau und Charakter (26th edn 1977, edited by Kretschmer W). Springer, Berlin (English translation: (1936) Physique and character, 2nd edn. Miller and Routledge, London)
Kröber H-L (1988) Die Persönlichkeit bipolar manisch-depressiv Erkrankender. Nervenarzt 59:319–329
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
Lienert R (1991) Testaufbau und Testanalyse. 5. Aufl. Beltz, Weinheim
Marneros A, Deister A, Rohde A (1991) Affektive, schizoaffektive und schizophrene Psychosen. Eine vergleichende Langzeitstudie. Springer, Berlin Heidelberg New York
Möller H-J, Zerssen D von (1986) Der Verlauf schizophrener Psychosen unter den gegenwärtigen Behandlungsbedingungen. Springer, Berlin Heidelberg New York
Möller H-J, Hohe-Schramm M, Cording-Tömmel C, Schmid-Bode W, Wittchen H-U, Zaudig M, Zerssen D von (1989) The classification of functional psychoses and its implications for prognosis. Br J Psychiatry 154:467–472
Pössl J, Zerssen D von (1990a) A case history analysis of the “manic type” and the “melancholic type” of premorbid personality in affectively ill patients. Eur Arch Psychiatry Neurol Sci 239:347–355
Pössl J, Zerssen D von (1990b) Die prämorbide Entwicklung von Patienten mit verschiedenen Psychoseformen. Nervenarzt 61: 541–549
Tauscher R (1993) Operationalisierte Diagnostik prämorbider Persönlichkeitstypen und die Einschätzung abnormer Persönlichkeitsentwicklungen anhand von Krankengeschichtsdaten psychiatrischer Patienten. Dissertation, University of Munich
Tellenbach H (1961) Melancholie (4th edn. 1983). Springer, Berlin Heidelberg New York. [English translation of 3rd edn. by Eng E (1980) Melancholy. Duquesne University Press, Pittsburg]
Tölle R (1988) Beziehungen zwischen Persönlichkeit und Psychose. In: Janzarik W (ed) Persönlichkeit und Psychose. Enke, Stuttgart, pp 82–90
Tölle R, Peikert A, Rieke A (1987) Persönlichkeitsstörungen bei Melancholiekranken. Nervenarzt 58:227–236
Watt NF, Stolorow RD, Lubensky AW, McClelland DC (1970) School adjustment and behaviour of children hospitalized for schizophrenia as adults. Am J Orthopsychiatry 40:637–657
Wittchen H-U, Zerssen D von (1988) Verläufe behandelter und unbehandelter Depressionen und Angststörungen. Springer, Berlin Heidelberg New York
Zerssen D von (1977) Premorbid personality and affective psychoses. In: Burrows GD (ed) Handbook of studies on depression. Excerpta Medica, Amsterdam, pp 79–103
Zerssen D von (1980) Persönlichkeitsforschung bei Depressionen. In: Heimann H, Giedke H (eds) Neue Perspektiven in der Depressionsforschung. Huber, Bern, pp 155–178
Zerssen D von (1988) Der “Typus manicus” als Gegenstück zum “Typus melancholicus” in der prämorbiden Persönlichkeitsstruktur affektpsychotischer Patienten. In: Janzarik W (ed) Persönlichkeit und Psychose. Enke, Stuttgart, pp 150–171
Zerssen D von (1991) Zur prämorbiden Persönlichkeit des Melancholikers. In: Mundt C, Fiedler P, Lang H, Kraus A (eds) Depressionskonzepte heute: Psychopathologie oder Pathopsychologie? Springer, Berlin Heidelberg New York, pp 76–94
Zerssen D von (1992) Der “Typus manicus”—eine Variante der Zyklothymie? In: Marneros A, Philipp M (eds) Persönlichkeit und psychische Erkrankung. Springer, Berlin Heidelberg New York, pp 72–86
Zerssen D von (1993) Normal and abnormal variants of premorbid personality in functional mental disorders. Conceptual and methodological issues. J Pers Disord 7:116–136
Zerssen D von (1994a) Prämorbide Persönlichkeit. In: Stieglitz R-D, Baumann U (eds) Psychodiagnostik psychischer Störungen. Enke, Stuttgart, pp 216–229
Zerssen D von (1994b) Persönlichkeitszüge als Vulnerabilitätsindikatoren—Probleme ihrer Erfassung. Fortschr Neurol Psychiatr 62:1–13
Zerssen D von, Hecht H (1987) Gesundheit, Glück, Zufriedenheit im Licht einer katamnestischen Erhebung an psychiatrischen Patienten und gesunden Probanden. Psychother Psychosom Med Psychol 37:83–96
Zerssen D von, Pössl J (1990) The premorbid personality of patients with different subtypes of an affective illness: Statistical analysis of blind assignment of case history data to clinical diagnosis. J Affective Disord 18:39–50
Zerssen D von, Doerr P, Emrich HM, Lund R, Pirke KM (1987) Diurnal variation of mood and the cortisol rhythm in depression and normal states of mind. Eur Arch Psychiatry Neurol Sci 237:36–45
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von Zerssen, D., Pössl, J., Gruben, S. et al. An operationalized procedure for the recognition of premorbid personality types in biographical case notes on psychiatric patients. Eur Arch Psychiatry Clin Nuerosci 243, 256–272 (1994). https://doi.org/10.1007/BF02191584
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DOI: https://doi.org/10.1007/BF02191584