Psychometric Evidence That Paraphilia Is a Natural Kind.

Is the category paraphilia a natural kind? That is, do different paraphilias share anything scientifically interesting or are they classified together because they are unusual and sometimes problematic? We investigated this question systematically in 11 samples of paraphilic males (N = 4,617) and 11 samples of control males (N = 1,494). Primary data consisted of responses to the 11-item Paraphilic Interests Scale. Contrary to our initial hypothesis, the scale mean was similar for paraphilic and control samples. Using logistic regression and the same items, we derived three highly correlated measures that robustly discriminated paraphilic and control samples (ds ranging from 0.86 to 0.92). These successful measures capitalized on the unanticipated fact that some items (especially those assessing transvestism and masochistic humiliation) were positively associated with membership in paraphilic samples, while others (especially those assessing voyeurism) were negatively associated with such membership. Subsequent analyses focused on one of the measures, the Paraphilic Interests Scale Contrast (PISC). Consistent with prior findings distinguishing paraphilias and homosexual orientation, PISC was not elevated among homosexual males compared with heterosexual males among the control groups. Within four paraphilic samples, PISC was positively associated with additional paraphilic phenomena. Results provide tentative support for both the proposition that paraphilia is a natural kind and the usefulness of PISC as a measure of paraphilia.

A tradeoff between safety and freedom: Adults' lived experiences of ARFID.

BACKGROUND: Avoidant restrictive food intake disorder (ARFID) is characterized as a pattern of restrictive eating leading to significant medical and/or psychosocial impairment (American Psychiatric Association in Diagnostic and statistical manual of mental disorders, American Psychiatric Association, Washington, D.C., 2013). Most existing research on ARFID utilizes quantitative methodologies to study children and adolescents. As a result, the experiences of adults with ARFID have been underrepresented in research. To fill this gap, the current study examines the lived experiences of adults with a DSM-5 diagnosis of ARFID. METHOD: Participants (n = 9) included adult women aged 20-42 (M = 27, SD = 6.2) recruited from social media advertising. Open-ended, semi-structured interviews were conducted. Data were analyzed using interpretative phenomenological analysis (IPA). RESULTS: One of three overarching themes identified by IPA will be discussed in this study: "A tradeoff between safety and freedom," which consists of two subthemes: (a) Ensuring safety from food unknowns and (c) Longing for Freedom. This overarching theme explores the influence of ARFID on an individual's sense of safety and freedom. DISCUSSION: This study is one of few to qualitatively examine ARFID, and the only to do so using IPA. Findings offer novel insights relevant to researchers and clinicians who treat adults with ARFID and who wish to increase consideration and understanding of patient lived experience in their work.

Comparing the new concept of impairment in personality functioning with borderline personality disorder: differential psychosocial and psychopathological correlates in a clinical adolescent sample.

Borderline personality disorder (BPD) is an established diagnosis in adolescence with high comorbidity and psychosocial impairment. With the introduction of the alternative model for personality disorders in DSM-5 (AMPD), personality functioning is operationalized using the Level of Personality Functioning Scale (LPFS), which has been shown to be associated with severity of personality pathology. The present study aimed at examining differential psychopathological and psychosocial correlates of LPFS and BPD. A total of 526 adolescent in- and outpatients were interviewed with the STiP-5.1 (LPFS) and the SCID-II. Mixed linear regression was used to investigate the associations between the two interviews with measures of psychopathology and psychosocial impairment. 11.4% met the diagnostic threshold of both interviews, 16.1% only of the LPFS, and 64.1% were below the diagnostic threshold in both interviews (no PD). The BPD only group was larger than expected-8.4% of patients who met criteria for BPD did not fulfill criteria for significant impairment in the LPFS. The highest burden was found in individuals concurrently showing significant impairment in LPFS and fulfilling BPD diagnosis (LPFS + BPD). Differences between the LPFS only group and the BPD only group were found in risk behavior and traumatic experiences, with higher prevalence in the BPD group. Findings confirm the high psychopathological burden and psychosocial impairment associated with both BPD and LPFS. Those exceeding the diagnostic threshold of LPFS in combination with a BPD diagnosis are characterized by greatest disability. Not all adolescents fulfilling formal BPD diagnosis showed a clinically significant impairment in LPFS, which may refer to a distinct diagnostic group.

Distressing Problems with Sexual Function and Symptoms of Attention-Deficit/Hyperactivity Disorder.

Cognitive models of sexual dysfunction situate distraction as a core mechanism underlying difficulties with sexual function. It follows that individuals who have difficulties with inattention and distractibility (e.g., attention-deficit/hyperactivity disorder; ADHD) may be at increased risk of problems with their sexual function, though previous research is mixed, and no research has examined links with sexual distress despite distress being a necessary criterion for sexual dysfunction. The goals of the current study were to: (1) examine associations between ADHD symptoms, sexual function, and sexual distress; (2) examine group differences in sexual function and sexual distress as a function of presumptive ADHD diagnosis; and (3) establish whether individuals with presumptive ADHD are at greater risk of distressing problems with sexual function relative to controls. In a large mixed-gender community sample (N = 943: controls n = 837, presumptive ADHD n = 106), we found that ADHD symptoms were positively correlated with worse overall sexual function, as well as orgasm difficulties and greater sexual distress. Relative to controls, individuals with presumptive ADHD reported worse sexual function and greater sexual distress, controlling for age, biological sex, and sexual orientation. Individuals with presumptive ADHD were significantly more likely (OR = 2.16) to have distressing problems with sexual function than controls. Core difficulties related to ADHD, including inattention, distractibility, and emotion dysregulation, may make individuals more vulnerable to experiencing problems with sexual function and sexual distress, putting them at risk for developing sexual dysfunction. Taken together, these data support associations between ADHD and distressing sexual function problems, including possible mechanisms explaining these links such as difficulties with emotion regulation.

Causal Attributions of Low Sexual Desire in Women Partnered with Men.

Low sexual desire in women partnered with men has been the subject of controversy and research over the past decades, including both as construct and diagnosis. Despite discussion surrounding the causes of low desire, there is a gap in research about how women themselves understand the causes of their low desire and the potential consequences of these causal attributions. In the current study, we investigated this by asking 130 women who had low desire and were partnered with men about their attributions for low desire. Through content analysis, we identified five attribution categories: psychological/individual, relational, biological, sociocultural, and/or sexual orientation/identity/status. Many participants chose more than one category, indicating a multifaceted nature of women's causes of low desire. We then quantitatively assessed women's feelings of responsibility for, and emotions surrounding, their low desire. Our findings indicate that the majority-but not all-of women have negative feelings about their low desire. However, the specific emotions they experience are related to their attribution patterns. This underscores the significance of investigating various facets of women's attributions regarding low desire in order to gain a more comprehensive understanding of their emotional experiences and desire overall.

Clinicians' confidence in diagnosing atypical anorexia nervosa: An experimental study of the role of patient and clinician characteristics.

OBJECTIVE: This experimental study investigated the weight loss parameters and resulting end weight that influence clinician confidence in diagnosing atypical anorexia nervosa (AAN). METHODS: Clinicians (N = 67) read a series of vignettes where patient weight loss and end weight varied, then rated their confidence in an AAN diagnosis and alternatives. Using repeated measures ANOVAs, we examined patient (weight loss, end weight) and the possible relationship between clinician (e.g., age, profession) characteristics and confidence in diagnosing AAN. RESULTS: Clinicians were most confident in an AAN diagnosis when patients had lost 10% or 15% of their body weight, leaving them at a high or normal weight. Clinicians considered 5% as significant weight loss for AAN, but only when the patient ended at a high or normal weight. However, they did not clearly differentiate AAN from unspecified feeding and eating disorder (UFED) when there was a 5% weight loss resulting in high or normal end weight. Clinician characteristics did not impact on confidence in diagnoses. CONCLUSION: The DSM's 'significant weight loss' criterion leaves room for clinicians to interpret it idiosyncratically. The lack of a clear pattern of UFED and AAN diagnosis has important clinical implications, as UFED tends to be dismissed as being less serious.

Diagnostic accuracy of large language models in psychiatry.

INTRODUCTION: Medical decision-making is crucial for effective treatment, especially in psychiatry where diagnosis often relies on subjective patient reports and a lack of high-specificity symptoms. Artificial intelligence (AI), particularly Large Language Models (LLMs) like GPT, has emerged as a promising tool to enhance diagnostic accuracy in psychiatry. This comparative study explores the diagnostic capabilities of several AI models, including Aya, GPT-3.5, GPT-4, GPT-3.5 clinical assistant (CA), Nemotron, and Nemotron CA, using clinical cases from the DSM-5. METHODS: We curated 20 clinical cases from the DSM-5 Clinical Cases book, covering a wide range of psychiatric diagnoses. Four advanced AI models (GPT-3.5 Turbo, GPT-4, Aya, Nemotron) were tested using prompts to elicit detailed diagnoses and reasoning. The models' performances were evaluated based on accuracy and quality of reasoning, with additional analysis using the Retrieval Augmented Generation (RAG) methodology for models accessing the DSM-5 text. RESULTS: The AI models showed varied diagnostic accuracy, with GPT-3.5 and GPT-4 performing notably better than Aya and Nemotron in terms of both accuracy and reasoning quality. While models struggled with specific disorders such as cyclothymic and disruptive mood dysregulation disorders, others excelled, particularly in diagnosing psychotic and bipolar disorders. Statistical analysis highlighted significant differences in accuracy and reasoning, emphasizing the superiority of the GPT models. DISCUSSION: The application of AI in psychiatry offers potential improvements in diagnostic accuracy. The superior performance of the GPT models can be attributed to their advanced natural language processing capabilities and extensive training on diverse text data, enabling more effective interpretation of psychiatric language. However, models like Aya and Nemotron showed limitations in reasoning, indicating a need for further refinement in their training and application. CONCLUSION: AI holds significant promise for enhancing psychiatric diagnostics, with certain models demonstrating high potential in interpreting complex clinical descriptions accurately. Future research should focus on expanding the dataset and integrating multimodal data to further enhance the diagnostic capabilities of AI in psychiatry.

Controversies in Assessment, Diagnosis, and Treatment of Kratom Use Disorder.

PURPOSE OF REVIEW: We apply the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria for substance use disorders (SUDs) to the herbal product kratom. Similarities and differences between kratom use disorder (KUD) and other SUDs are explored, along with assessment, diagnostic, and therapeutic recommendations for KUD. RECENT FINDINGS: Literature reports of "kratom addiction" or KUD rarely specify the criteria by which patients were diagnosed. Individuals meeting DSM-5 KUD criteria typically do so via tolerance and withdrawal, using more than intended, and craving, not functional or ​psychosocial disruption, which occur rarely. Most clinicians who use medication to treat patients with isolated KUD select buprenorphine formulations, although there are no controlled studies showing that buprenorphine is safe or efficacious in this patient population. Diagnosis and treatment decisions for KUD should be systematic. We propose an algorithm that takes into consideration whether KUD occurs with comorbid opioid use disorder.

Anorexia Nervosa Across the Lifespan: A Review of Recent Literature.

In this review, the authors provide an update on the understanding of anorexia nervosa (AN) across the lifespan. Focusing on key pieces of literature from the past 5 years, this review summarizes recent updates to DSM-5 within the domain of AN, including the addition of a new AN diagnosis: atypical anorexia. Additional sections covered in this review include improvements in the epidemiological understanding of AN across the developmental spectrum, treatment approaches that have been established as gold standard as well as new directions recently explored in treatment, and recent advancements in the biopsychosocial underpinnings of AN. Altogether, although this review captures several advancements in the field's overall conceptualization of AN, several key areas of treatment and diagnostic capacity continue to require additional focus and research.

Prevalence and associated factors of developmental coordination disorder in primary school children.

Developmental coordination disorder (DCD) is one of the most frequently observed movement disorders in childhood, yet data on its prevalence are still unclear. This two-stage epidemiological study aims to determine the prevalence of DCD in children between 6 and 10 years of age according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). In the first stage, the Developmental Coordination Disorder Questionnaire (DCDQ'07) were given to primary school students. In the second stage, clinicians conducted psychiatric interviews with children who had an indication of DCD or were suspected of having DCD according to the DCDQ'07 and their parents. The interviews utilized the DSM-5 diagnostic criteria for DCD and applied the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Adaptation (K-SADS-PL) and Wechsler Intelligence Scale for Children (WISC-R) to identify co-occurring disorders. In the first stage, 2,306 children were evaluated, and 205 were invited for a clinical interview. Of the 198 children interviewed, 49 met the diagnostic criteria for DCD. The prevalence of DCD in Türkiye was found to be 2.1%. High parental education level, a previous psychiatric admission of the child, mother's postpartum depressive symptoms, co-occurring disorders, and co-occurring attention deficit hyperactivity disorder (ADHD) were significantly more common among children with DCD. Potentially associated factors were evaluated by logistic regression analysis. The mother's education level, the presence of postpartum depressive symptoms, and co-occurring disorders in the child were found to be associated factors.

The Treatment Needs and Experiences of Pedohebephiles: A Systematic Review.

People with a sexual interest in children face significant barriers to seeking and receiving mental health treatment. This review aims to bridge the gap between the treatment needs and experiences of pedohebephiles, and the services aiming to support them. Reviewers screened 1705 database hits and extracted findings from 22 qualitative, 15 quantitative, and 3 mixed-method studies on the treatment needs and experiences of pedohebephiles. Research suggests that this population experiences significant levels of distress, depression, and anxiety related to their sexual interest. Many individuals belonging to this population would seek (median = 42.3%), or have sought (median = 46.5%), treatment to cope with their sexual interest or with potential related mental health repercussions. Their experiences in treatment have been mixed, with some reporting positive experiences with empathic therapists and others reporting rejection. Most frequently, pedohebephiles report fear of exposure and rejection as barriers to seeking treatment, in addition to fear of the legal repercussions. The current study is the first to summarize and discuss previous findings on the treatment needs and experiences of pedohebephiles. The findings indicate that the treatment needs of pedohebephiles often remain unaddressed. Suggestions to increase the fit between treatment services and the needs of pedohebephiles are put forward.

Interest in and Willingness to Use PrEP: A Cross-Sectional Study of Individuals with Problematic Substance Use Residing in a High HIV Prevalence Jurisdiction.

Although it is an effective HIV prevention method, pre-exposure prophylaxis (PrEP) is underutilized in the Southern US. Many people who use drugs (PWUD) have increased susceptibility to HIV which could be lessened by using PrEP. Potential barriers to PrEP use include lack of awareness of PrEP, low knowledge about HIV prevention, low self-efficacy for HIV prevention, inaccurate risk perceptions, and anticipated stigma. The current study examined predisposing, enabling, and reinforcing factors that may predict interest in PrEP. The purpose of the current study was to explore factors associated with interest in and willingness to use daily oral and long acting injectable PrEP among sexually active adult PWUD. The data were collected from adult participants (n = 270) residing in Harris County, TX, who self-reported problematic substance use and who reported oral, anal, or vaginal sex in the six months prior to completing the survey. The survey was distributed and completed online via Qualtrics Panels in March of 2022 and included measures of PrEP and HIV knowledge, PrEP stigma, sexual health self-efficacy, experiences of discrimination, health literacy, and medical mistrust. The majority of participants reported circumstances or behaviors that increased their susceptibility to HIV. Findings indicated that PrEP user stereotypes and PrEP anticipated disapproval by others were associated with interest in using daily oral PrEP and willingness to use long acting injectable PrEP. These results provide insight into reasons for low PrEP uptake among PWUD who live in a high HIV prevalence jurisdiction. Implications for HIV prevention intervention are discussed.

Age of Onset and DSM-5 Alcohol Use Disorder in Late Adolescence - A Cohort Study From Sweden.

PURPOSE: To examine if the prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alcohol use disorder (AUD) differs between two groups with different age of onset of alcohol use and if endorsement of different AUD criteria differs between the two groups. METHODS: A two-wave longitudinal prospective cohort survey conducted in Sweden (2017-2019) with a nationwide sample of 3,999 adolescents aged 15/16 years at baseline (T1), and 17/18 years at follow-up (T2); 2,778 current drinkers at T2 were analysed. Participants were categorized into early onset of drinking (drinking already at T1 54.3%) or late onset (not drinking at T1 but at T2, 45.8%). AUD was measured with questions corresponding to the 11 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for AUD. Potential confounding factors measured at T1 were sex, sensation-seeking, impulsivity, emotional symptoms, peer problems, conduct problems, and hyperactivity. RESULTS: The early onset group had a higher prevalence of AUD at T2 compared to the late onset group (36.3% vs. 23.1%, p < .001). The higher risk of AUD remained significant in a linear probability model with control for additional confounding factors (ß = 0.080, p < .001). All individual criteria were reported more in the early onset group, and there was no evidence of differential item functioning. DISCUSSION: The age of onset of alcohol use was a significant predictor of AUD in late adolescence among Swedish adolescents. Those with an earlier onset of alcohol use had a higher prevalence of AUD and of all individual criteria. The items in the scale were similarly predictive of AUD in both groups.

Mental Health Evaluation of Younger and Older Adolescents Referred to the Center of Expertise on Gender Dysphoria in Amsterdam, The Netherlands.

The present study aimed to investigate whether differences exist between younger and older presenting adolescents at the Center of Expertise on Gender Dysphoria regarding psychological functioning and autistic traits. A total of 1487 consecutively assessed adolescents between 2000 and 2018 were divided in younger presenters (age ≤ 13.9 years) and older presenters (age ≥ 14 years). Of younger presenters, 227 (41.1%) were assigned male at birth and 325 (58.9%) assigned female at birth. In older presenters, 279 (29.8%) were assigned male at birth and 656 (70.2%) assigned female at birth. Behavioral and emotional problems were assessed with the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR). For autism traits, the Social Responsiveness Scale (SRS) was used. Compared to younger presenters, on both the CBCL and YSR older presenters had higher Total Problem (ß = 1.75, p = .005, CI 0.53-2.97, R2 = .04 and ß = 4.20, p < .001, CI 2.99-5.40, R2 = .07, respectively) and Internalizing Problem (ß = 4.43, p < .001, CI 3.13-5.74, R2 = .06 and ß = 6.69, p < .001, CI 5.31-8.07, R2 = .12, respectively) scores. Regarding autistic traits, a higher mean SRS total score was found in older presenting assigned males at birth (ß = 4.55, p = .036, CI 0.30-8.81, R2 = .34). In assigned females at birth, no statistically significant difference between older and younger presenters was found in mean SRS total score (ß = 1.19, p = .063, CI - 0.07 to 2.45, R2 = .39). Differences in mental health exist between younger and older presenting adolescents and call for an individualized approach in the clinical care of transgender adolescents.

Differences in Subjective Transition Outcomes Between Transgender and Gender-Diverse Individuals Who Completed Mandatory Psychiatric Assessment and Those Who Received Gender-Affirmative Medical Treatment in Croatia: A Cross-Sectional Online Survey.

The aim of this study was to evaluate different aspects of transition outcomes in groups of transgender and gender diverse (TGD) people based on their transition status. We divided the 70 TGD participants (19 individuals assigned male at birth and 51 assigned female at birth) into two groups: those who had completed their psychiatric and psychological evaluation (PPE), which is mandatory in Croatia, and those who had undergone gender-affirming medical treatment (GAMT) (both gender-affirming hormone treatment and gender-affirming surgery). The online survey included sociodemographic questions and a custom-designed nine-item scale. The items were specifically designed based on the DSM-5-TR criteria for gender dysphoria to assess subjectively perceived transition outcomes. We conducted a factor analysis of the scale followed by structural equation modeling for confirmation. Chi-squared and Mann-Whitney U tests were used to compare group differences. The following three-factor structure was confirmed: better functioning, reduced body dysphoria, and satisfaction with decision. A positive influence of better functioning on satisfaction with the decision was found. In addition, our results showed that TGD individuals who had undergone GAMT scored higher on better functioning than those who had just completed PPE. Both groups consistently scored high on satisfaction with the decision, with no statistically significant differences between them. Our findings suggest that TGD individuals view gender-affirming medical care as beneficial to their overall functioning.

Post-traumatic Stress Disorder in Veterans: A Concept Analysis.

Post-traumatic stress disorder (PTSD) occurs when an individual experiences a traumatic event that exceeds the limits of psychological endurance. Many veterans experience PTSD. PTSD can negatively impact veterans' quality of life, functioning, life satisfaction, and overall well-being. It is important to analyze the concept of PTSD in the veteran population. This concept analysis aimed to investigate the defining attributes, a model case, antecedents, consequences, and empirical referents related to the concept of PTSD among veterans. Walker and Avant's method was used to guide this concept analysis of PTSD. The results showed that three attributes were determined from the analysis: intrusive memories of traumatic events, feelings of isolation and estrangement, and negative cognitions. PTSD is conceptualized as a collection of symptoms that arise from highly traumatic experiences. The military environment predisposes veterans to traumatic events that should be identified or acknowledged. A better understanding of the concept of PTSD can facilitate the development of effective interventions for the veteran population and enhance their mental health.

Psychometric Properties of the Diagnostic Interview for Sexual Dysfunctions in Women in a Symptom-Reporting Sample.

While structured clinical interviews are considered the gold standard for diagnosing mental disorders, respective instruments are still lacking in the field of sexual dysfunctions. The study evaluates the psychometric properties of the new Diagnostic Interview for Sexual Dysfunctions in Women (DISEX-F), which is based on the eleventh edition of the International Statistical Classification of Diseases (ICD-11) and the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), in a sample of 100 women with self-reported sexual problems. Participants were interviewed twice by trained diagnosticians with the DISEX-F. A third diagnostician evaluated the audio records of the initial interview. Participants also completed self-report measures of sexual functioning/distress and interview acceptance. The DISEX-F demonstrates excellent inter-rater reliability, good test-retest reliability, and strong convergent and discriminant evidence of validity. Furthermore, it achieves high acceptance among participants. Discordant diagnostic outcomes were especially linked to false differential diagnostic decisions and information variance in participants reporting. The results strongly support using the DISEX-F for women presenting with self-reported sexual problems in practice and research.

The Youth Anxiety Measure for DSM-5 (YAM-5): An Updated Systematic Review of its Psychometric Properties.

The Youth Anxiety Measure for DSM-5 (YAM-5) is a self- and parent-report scale specifically developed to assess symptoms of major anxiety disorders (part 1 or YAM-5-I) and specific phobias/agoraphobia (part 2 or YAM-5-II) in children and adolescents in terms of the contemporary psychiatric classification system. Since its introduction, the measure has been increasingly used in research, making it feasible to provide a summary of its psychometric properties. The present article presents a systematic review of 20 studies that employed the YAM-5, involving 5325 young participants. Overall, the results supported the hypothesized factor structure of both parts of the measure, although there were also some studies that could not fully replicate the original five-factor model of YAM-5-I. The internal consistency of the YAM-5 was generally high for the total scores of both parts, while reliability coefficients for the subscales were more variable across studies. Research also obtained evidence for other psychometric properties, such as test-retest reliability, parent-child agreement, convergent/divergent validity, and discriminant validity. Results further revealed that girls tend to show significantly higher anxiety levels on the YAM-5 than boys. Overall, these findings indicate that the YAM-5 is a promising tool for assessing symptoms of anxiety disorders including specific phobias in young people. Some directions for future research with the YAM-5 and recommendations regarding the use of the measure are given.

Usefulness of the 4A's test for detecting delirium in critically ill patients: a multicenter prospective observation study.

The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is a robust and reliable instrument for discerning delirium within the specific context of the intensive care unit (ICU). Nonetheless, the CAM-ICU is burdened by various limitations, including a protracted learning curve and the need for frequent daily administration. The 4 A's Test (4AT) was formulated to assess delirium in hospitalized patients and may have distinct advantages over the CAM-ICU, particularly regarding practical applicability within the ICU bundle. This study was performed to assess the utility of the 4AT in detecting delirium in critically ill patients. This multicenter prospective observational study involved critically ill patients at four academic tertiary care hospitals in South Korea from June 2021 to September 2022. In total, 274 patients (median age, 64 years; 56.9% men) were included, and 75 (27.4%) developed delirium. The 4AT showed good performance in detecting ICU delirium (area under the curve, 0.879; P < 0.001). The 4AT showed a sensitivity of 74.0%, specificity of 95.4%, positive predictive value of 77.5%, negative predictive value of 94.6%, and accuracy of 91.7% for ICU detection of delirium. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CAM-ICU for detecting ICU delirium were 71.3%, 97.1%, 83.8%, 94.1%, and 92.6%, respectively. The 4AT showed acceptable reliability and validity for detecting ICU delirium in critically ill patients. Because the 4AT is simpler and easier to learn, this scale could be a useful alternative to the CAM-ICU for detecting delirium in critically ill patients.

Meta-Analysis of Internet Gaming Disorder Prevalence: Assessing the Impacts of DSM-5 and ICD-11 Diagnostic Criteria.

With the inclusion of Internet gaming disorder (IGD) in both the DSM-5 and ICD-11, understanding the prevalence and diagnostic discrepancies is crucial for developing appropriate interventions. This study presents a meta-analysis of the prevalence of IGD based on two diagnostic criteria. We systematically searched the PubMed and Web of Science databases. A total of 22 studies were included in the final analysis. The analysis incorporated studies employing the DSM-5 and ICD-11 criteria and focused on the impact of various factors, including study location, sample characteristics, sample size, and quality score, on the reported prevalence rates using a random-effects model. The pooled prevalence of IGD is 6.7% (95% CI: 5.7-7.7%). The subgroup analysis indicated significant differences in the prevalence rates of IGD (DSM-5 criteria) and GD (ICD-11 criteria) (Q b = 38.46, p < 0.01). There were also significant differences in IGD prevalence rates between different scales (Q b = 54.23, p < 0.001). Our findings indicate that different diagnostic criteria and different assessment scales have a significant impact on the prevalence of IGD. This underscores the importance of adopting standardized methodologies to guide public health interventions. However, given the limited research based on ICD-11 diagnostic criteria, further investigation is necessary to determine the variations in prevalence rates of IGD under different diagnostic standards.