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1.
Am Psychol ; 75(5): 729-730, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32673018

RESUMO

Bleidorn et al. (2019) argued that personality traits, as important determinants of life outcomes, should be the object of treatment interventions. They suggested that self-reports on standard personality questionnaires provide necessary and sufficient evidence of trait change. However, the self-concept-on which self-reports are based-may change without any alteration in the underlying trait. Additional evidence, such as that provided by independent informant ratings, is needed, and multimethod assessments should be a feature of all studies of trait change. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Transtornos da Personalidade , Personalidade , Humanos , Determinação da Personalidade , Encaminhamento e Consulta , Autorrelato
2.
Am Psychol ; 75(5): 731-732, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32673019

RESUMO

McCrae (2020) argues that it is premature to explore interventions focused on personality change. In his commentary, he suggests that interventions should be promoted only if their effects in self-report data are confirmed by the additional opinion of informants. We agree with the essence of his position and would go further by envisioning a new framework for rigorous collaborative research on personality change (Bleidorn et al., 2020). We nevertheless maintain that policymakers would benefit from considering the additional opinion of personality scientists. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Transtornos da Personalidade , Personalidade , Humanos , Masculino , Políticas , Projetos de Pesquisa , Comportamento Social
3.
Crim Behav Ment Health ; 30(2-3): 105-116, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32515096

RESUMO

BACKGROUND: Case formulation plays a key role in effective management of offenders' needs, particularly on the Offender Personality Disorder Pathway (OPDP). AIMS: To validate a method of investigating formulations with offenders still in prison but in the OPD Pathway and investigate agreement over the content of formulations between each of the main dyadic pairs: offender-clinician, offender-key worker and clinician-key worker. METHODS: We developed a checklist of the main features of a formulation from a review of initial formulations in the files of prisoners in two prisons which operate within the OPD Pathway system. We then recruited 30 violent offenders in each OPD wing of two prisons, and asked each of them, their clinically qualified worker (usually a psychologist) and the criminal justice system key worker to complete a formulation summary according to a card-sort process based on this checklist. We calculated the level of agreement between pairs of raters (e.g. offender and key worker) about the importance of aspects of each domain to the case using intraclass correlation coefficients. RESULTS: The rating tool showed good internal validity. Analysis of inter-rater ratings showed agreement among teams on aspects relating to prisoners' observable actions, experiences and external support domains, but little agreement on cognitions, feelings, risky situations or staff/self-support, mainly affecting the prisoner-key worker dyad. There were, however, significant differences in agreement rates between the two sites. CONCLUSIONS: Agreement within teams about formulations is strong where content relates to overt behaviours and points of fact, but weaker on risk, cognitions and support. The appropriateness of this approach to formulation across cultural groups may need further evaluation as the main measured difference between the prisons was in distribution of ethnic and cultural groups.


Assuntos
Criminosos , Transtornos da Personalidade/psicologia , Prisioneiros , Prisões/organização & administração , Humanos , Masculino
4.
Crim Behav Ment Health ; 30(2-3): 95-104, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32383313

RESUMO

BACKGROUND: Indeterminate sentences for Public Protection (IPPs) were introduced in England and Wales under the Criminal Justice Act 2003 for offenders not eligible for a life sentence but considered to pose a serious risk to the public. In 2012, new IPPs became illegal, in part after the European Court of Human Rights ruled in three cases that failure to make appropriate provision for rehabilitation services while the men were in prison breached their rights under Article 5 of the Convention and thus from arbitrary detention. People already sentenced under this provision, however, remained in the system. Humberside Indeterminate Public Protection Project (HIPPP) supports intensive case management of male IPP offenders still serving this sentence. AIMS: To examine variables associated with pathway outcome among men under IPPs in one English region-Humberside. Our primary hypothesis was that programme engagement in prison would be significantly associated with release. METHODS: The HM Prison and Probation Services National Delius (nDelius) and Offender Assessment System (OASys) were used to identify all men from the region subject to IPPs and beyond tariff (the fixed, punishment part of their sentence) and to retrieve data on the sentence, pathway status and specific risk factors. We used content analysis to identify variables of interest, and logistic regression models to explore associations of variables with different types of pathway outcome. RESULTS: A total of 82 men were identified, 34 of whom had ever been recorded as having been given a diagnosis of anti-social personality disorder (ASPD). Men experiencing relationship difficulties with professionals were significantly more likely to be denied release [Odds Ratio (OR) = 7.75, Confidence Interval (CI) 2.08-28.57], have a deferred parole (OR = 7.81, CI 1.59-38.46) or be awaiting parole (OR = 4.46, CI 1.09-18.18) compared with men released to the community or serving in an open prison. Completion of programmes was not associated with pathway outcome. A modest association between diagnosis of anti-social personality disorder and pathway outcome association was confounded by other variables. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: While programme completion did not have the expected association with release, relational difficulties with professionals proved significant barriers to release. This suggests that ambitions for the Offender Personality Disorder (OPD) pathway in supporting professionals to develop collaborative relationships with offenders are well founded. Part of this approach lies in sophisticated, psychologically informed case formulations which may help to discriminate between risk factors and personality disorder traits which have social rather than risk implications.


Assuntos
Transtorno da Personalidade Antissocial/psicologia , Direito Penal , Criminosos , Direitos Humanos , Prisioneiros , Adulto , Inglaterra , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade , Prisões , Estudos Retrospectivos , País de Gales
6.
BMJ ; 369: m853, 2020 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-32269017

RESUMO

OBJECTIVE: To determine the association between parental mental illness and the risk of injuries among offspring. DESIGN: Retrospective cohort study. SETTING: Swedish population based registers. PARTICIPANTS: 1 542 000 children born in 1996-2011 linked to 893 334 mothers and 873 935 fathers. EXPOSURES: Maternal or paternal mental illness (non-affective psychosis, affective psychosis, alcohol or drug misuse, mood disorders, anxiety and stress related disorders, eating disorders, personality disorders) identified through linkage to inpatient or outpatient healthcare registers. MAIN OUTCOME MEASURES: Risk of injuries (transport injury, fall, burn, drowning and suffocation, poisoning, violence) at ages 0-1, 2-5, 6-9, 10-12, and 13-17 years, comparing children of parents with mental illness and children of parents without mental illness, calculated as the rate difference and rate ratio adjusted for confounders. RESULTS: Children with parental mental illness contributed to 201 670.5 person years of follow-up, while children without parental mental illness contributed to 2 434 161.5 person years. Children of parents with mental illness had higher rates of injuries than children of parents without mental illness (for any injury at age 0-1, these children had an additional 2088 injuries per 100 000 person years; number of injuries for children with and without parental mental illness was 10 235 and 72 723, respectively). At age 0-1, the rate differences ranged from 18 additional transport injuries to 1716 additional fall injuries per 100 000 person years among children with parental mental illness compared with children without parental mental illness. A higher adjusted rate ratio for injuries was observed from birth through adolescence and the risk was highest during the first year of life (adjusted rate ratio at age 0-1 for the overall association between any parental mental illness that has been recorded in the registers and injuries 1.30, 95% confidence interval 1.26 to 1.33). Adjusted rate ratios at age 0-1 ranged from 1.28 (1.24 to 1.32) for fall injuries to 3.54 (2.28 to 5.48) for violence related injuries. Common and serious maternal and paternal mental illness was associated with increased risk of injuries in children, and estimates were slightly higher for common mental disorders. CONCLUSIONS: Parental mental illness is associated with increased risk of injuries among offspring, particularly during the first years of the child's life. Efforts to increase access to parental support for parents with mental illness, and to recognise and treat perinatal mental morbidity in parents in secondary care might prevent child injury.


Assuntos
Transtornos Mentais/epidemiologia , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Pai/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Transtornos do Humor/epidemiologia , Mães/psicologia , Pais/psicologia , Transtornos da Personalidade/epidemiologia , Sistema de Registros , Fatores de Risco , Suécia/epidemiologia , Violência , Adulto Jovem
8.
PLoS One ; 15(4): e0229470, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32251476

RESUMO

The present study used exploratory structural equation modelling (ESEM) to examine the theorized dimension structure of the brief version of the Multidimensional Personality Questionnaire (MPQ-BR) at the scale-level (i.e., 11 lower-order primary factors loading on four higher-order factors) and item-level (sets of 12 items loading on 11 lower-order primary factors). A total of 214 adults from the community addressed the MPQ-BR and the Behavioral Inhibition System (BIS)/Behavioral Approach System (BAS) scales. The findings revealed poor fit and poorly defined factors at the item-level alongside adequate fit and well-defined factors at the scale-level. The higher-order factors in the latter model were supported for external validity in terms of demonstrating the expected theoretical and empirical correlations with the scales of the BIS/BAS scales. Result related implications for professional application, as well as potential revisions of the MPQ-BF are illustrated.


Assuntos
Emoções/fisiologia , Transtornos da Personalidade/genética , Personalidade/genética , Psicometria , Adulto , Agressão/fisiologia , Comportamento/fisiologia , Feminino , Humanos , Comportamento Impulsivo/fisiologia , Inibição Psicológica , Análise de Classes Latentes , Masculino , Personalidade/fisiologia , Transtornos da Personalidade/patologia , Transtornos da Personalidade/fisiopatologia , Inventário de Personalidade/normas , Testes de Personalidade , Inquéritos e Questionários
9.
Am J Psychother ; 73(2): 63-66, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32093484

RESUMO

OBJECTIVE: Psychiatry residents learn psychodynamic psychotherapy for generalizable skills and as a transdiagnostic, long-term treatment indicated for patients with chronic mood, anxiety, or personality disorders. It is unknown how these indications align with actual patients of trainees. The aim of this descriptive study was to define characteristics of outpatients receiving psychodynamic psychotherapy from psychiatry residents. METHODS: Case reports (N=204) from 184 psychiatry residents were analyzed for patients' diagnoses and past treatments. RESULTS: Eighty-six percent of patients had prior psychiatric medication or treatment, 31% had three or more past courses of psychotherapy, and 48% had two or more diagnoses, including depression (62%), anxiety (46%), and personality disorders or traits (27%). CONCLUSIONS: Patients receiving psychodynamic psychotherapy from psychiatry residents had multiple psychiatric illnesses and a history of prior treatments that had not achieved or sustained recovery, suggesting complex and chronic illness. Consistent with community-based findings, these patient characteristics correspond with psychodynamic psychotherapy treatment indications.


Assuntos
Internato e Residência , Psiquiatria , Psicoterapia Psicodinâmica , Humanos , Aprendizagem , Pacientes Ambulatoriais , Transtornos da Personalidade , Psiquiatria/educação , Psicoterapia
10.
Artigo em Russo | MEDLINE | ID: mdl-32105268

RESUMO

AIM: To assess the formation of positive personality phenomena in patients with mild cognitive impairment and asthenic syndrome during the treatment with recognan (citicoline). MATERIAL AND METHODS: Thirty-eight patients (17 men and 21 women), aged 18 to 45 years (mean age 27.8±12.1 years), with asthenic syndrome with mild cognitive impairment (ICD-10 F06.7) were examined. Patients were divided into two groups: 20 people in the main group and 18 people in the comparison group. The main group received recognan (orally, in solution, 100 mg in 1 ml) for 30 days, the daily dosage of the drug was 0.5 g (5 ml solution). The comparison group did not receive any medications. Adapted methods of positive personality psychology were used: the Fordyce Emotions Questionnaire, the Subjective Happiness Scale (SHS), the Adult Hope Scale (AHS), the Satisfaction with Life Scale (SWLS), M. Atkinson's Scale of Emotional Maturity, the projective technique 'Map of experiences'. The follow-up period was 30 days. All subjects were examined three times (at baseline, 15 and 30 days after treatment). RESULTS AND CONCLUSION: After a month of treatment with recognan, there was an improvement of positive personality traits and a significant decrease in negative experiences, indicating the positive impact of the drug on the formation of positive personality manifestations and compensation for emotional disorders in patients with mild cognitive impairment and asthenic syndrome.


Assuntos
Astenia/complicações , Astenia/tratamento farmacológico , Disfunção Cognitiva/complicações , Disfunção Cognitiva/tratamento farmacológico , Citidina Difosfato Colina/uso terapêutico , Transtornos da Personalidade/complicações , Transtornos da Personalidade/tratamento farmacológico , Personalidade/efeitos dos fármacos , Adolescente , Adulto , Astenia/psicologia , Disfunção Cognitiva/psicologia , Citidina Difosfato Colina/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/psicologia , Adulto Jovem
13.
Epidemiol Psychiatr Sci ; 29: e84, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31915099

RESUMO

AIMS: Although immune-mediated inflammatory diseases (IMID) are associated with multiple mental health conditions, there is a paucity of literature assessing personality disorders (PDs) in these populations. We aimed to estimate and compare the incidence of any PD in IMID and matched cohorts over time, and identify sociodemographic characteristics associated with the incidence of PD. METHODS: We used population-based administrative data from Manitoba, Canada to identify persons with incident inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA) using validated case definitions. Unaffected controls were matched 5:1 on sex, age and region of residence. PDs were identified using hospitalisation or physician claims. We used unadjusted and covariate-adjusted negative binomial regression to compare the incidence of PDs between the IMID and matched cohorts. RESULTS: We identified 19 572 incident cases of IMID (IBD n = 6,119, MS n = 3,514, RA n = 10 206) and 97 727 matches overall. After covariate adjustment, the IMID cohort had an increased incidence of PDs (incidence rate ratio [IRR] 1.72; 95%CI: 1.47-2.01) as compared to the matched cohort, which remained consistent over time. The incidence of PDs was similarly elevated in IBD (IRR 2.19; 95%CI: 1.69-2.84), MS (IRR 1.79; 95%CI: 1.29-2.50) and RA (IRR 1.61; 95%CI: 1.29-1.99). Lower socioeconomic status and urban residence were associated with an increased incidence of PDs, whereas mid to older adulthood (age 45-64) was associated with overall decreased incidence. In a restricted sample with 5 years of data before and after IMID diagnosis, the incidence of PDs was also elevated before IMID diagnosis among all IMID groups relative to matched controls. CONCLUSIONS: IMID are associated with an increased incidence of PDs both before and after an IMID diagnosis. These results support the relevance of shared risk factors in the co-occurrence of PDs and IMID conditions.


Assuntos
Artrite Reumatoide/epidemiologia , Doenças do Sistema Imunitário/complicações , Inflamação/complicações , Doenças Inflamatórias Intestinais/epidemiologia , Esclerose Múltipla/epidemiologia , Transtornos da Personalidade/epidemiologia , Adolescente , Adulto , Canadá/epidemiologia , Estudos de Coortes , Comorbidade/tendências , Feminino , Humanos , Doenças do Sistema Imunitário/epidemiologia , Incidência , Inflamação/epidemiologia , Masculino , Manitoba/epidemiologia , Pessoa de Meia-Idade , Transtornos da Personalidade/psicologia , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
14.
PLoS One ; 15(1): e0227364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31895938

RESUMO

OBJECTIVES: Depression is a common illness with substantial economic consequences for society and a great burden for affected individuals. About 30% of patients with depression do not respond to repeated treatments. Psychiatric comorbidity is known to affect duration, recurrence and treatment outcome of depression. However, there is a lack of knowledge on the extent to which psychiatric comorbidity is identified in the clinical setting for depressed patients in secondary psychiatric care. Therefore, the aim of this study was to compare the agreement between traditional diagnostic assessment (TDA) and a structured and comprehensive diagnostic procedure (SCDP) for identification of personality and anxiety disorder comorbidity in depressed patients in secondary psychiatric care. METHODS: 274 patients aged 18-77 were referred from four secondary psychiatric care clinics in Sweden during 2012-2017. ICD-10 diagnoses according to TDA (mostly unstructured by psychiatric specialist and residents in psychiatry), were retrieved from medical records and compared to diagnoses resulting from the SCDP in the study. This included the Mini International Neuropsychiatric Interview, the Structured Interview for DSM Axis II Personality Disorders and semi-structured questions on psychosocial circumstances, life-events, psychiatric symptoms, psychiatric treatments, substance use, and suicidal and self-harm behaviour. The assessment was carried out by psychiatric specialists or by residents in psychiatry with at least three years of psychiatric training. RESULTS: SCDP identified personality disorder comorbidity in 43% of the patients compared to 11% in TDA (p<0,0001). Anxiety disorder comorbidity was identified in 58% with SCDP compared to 12% with TDA (p<0,0001). CONCLUSIONS: Important psychiatric comorbidity seems to be unrecognized in depressive patients when using TDA, which is routine in secondary psychiatric care. Comorbidities are better identified using the proposed model involving structured and semi-structured interviews together with clinical evaluations by clinical experts.


Assuntos
Transtornos de Ansiedade , Transtorno Depressivo , Entrevista Psicológica/métodos , Transtornos da Personalidade , Atenção Secundária à Saúde/métodos , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Comorbidade , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/epidemiologia , Escalas de Graduação Psiquiátrica , Psiquiatria , Psicoterapia , Suécia , Adulto Jovem
15.
J Nerv Ment Dis ; 208(2): 161-164, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977828

RESUMO

Research is scarce regarding the mechanisms by which pathological narcissism--consisting of narcissistic grandiosity and vulnerability--is linked with depression. The present study examined whether impaired emotional processing would mediate relations between pathological narcissism domains and depressive symptoms in a sample of 99 psychiatric outpatients. A significant indirect effect was found for narcissistic vulnerability on depressive symptoms, through unprocessed emotion as a mediator. Findings suggest that narcissistic vulnerability contributes to persistent and intrusive negative feelings, which in turn contribute to depressive symptom severity.


Assuntos
Transtorno Depressivo Maior/psicologia , Emoções , Transtornos da Personalidade/psicologia , Adulto , Transtorno Depressivo Maior/etiologia , Feminino , Humanos , Masculino , Pacientes Ambulatoriais/psicologia , Transtornos da Personalidade/complicações , Inventário de Personalidade , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Inquéritos e Questionários
16.
PLoS One ; 15(1): e0227673, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31986163

RESUMO

Despite the scientific consensus on the efficacy of psychotherapy for the treatment of psychological disorders, the evidence of treatment-related changes towards normalization of abnormal brain functions in patients is mixed. In the present experiment, we investigated whether treatment can affect early information processing, by testing abnormal event-related potentials (ERPs) evoked by internal and external signals in panic disorder. Sixteen patients with panic disorder and comorbid personality disorder and sixteen control participants performed a response-choice task and a passive viewing task in two testing sessions, separated by around 14 months. During this period, patients received psychological treatment. In agreement with previous studies of performance monitoring, the abnormal amplitude of the Ne/ERN-an index of error processing based on internal signals-did not change between the first and second testing session. However, treatment-related changes were evident for the abnormal vertex positive potential (VPP) evoked by external signals in the response-choice task and the passive viewing task. In patients, the VPP was smaller in the second session compared to the first session, whereas no significant changes occurred in controls. This result supplies evidence of treatment-related changes towards normalization in the early information processing of external visual stimuli in panic disorder.


Assuntos
Potenciais Evocados/fisiologia , Transtorno de Pânico/fisiopatologia , Transtorno de Pânico/terapia , Adulto , Estudos de Casos e Controles , Eletroencefalografia , Potenciais Evocados Visuais/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/complicações , Transtornos da Personalidade/complicações , Transtornos da Personalidade/fisiopatologia , Transtornos da Personalidade/psicologia , Estimulação Luminosa , Psicoterapia , Adulto Jovem
17.
Health Psychol ; 39(3): 245-254, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31944798

RESUMO

OBJECTIVE: Bariatric surgery is an effective treatment for obesity, which has been increasing worldwide. However, bariatric surgery causes dramatic physical changes that can cause significant stress. Prior research has found that psychological variables such as personality traits and levels of psychopathology can influence success after bariatric surgery (in terms of body mass index [BMI] reduction and weight loss). However, most prior studies have been limited by small sample sizes, inconsistent follow up, and categorical assessment of psychopathology. METHOD: The present study examines the predictive utility of the Personality Assessment Inventory (PAI) scales for three bariatric surgery outcomes (BMI reduction, weight loss, and percent excess weight loss [%EWL]) across 10 follow-up points 5 years after surgery. It also examines the largest sample of bariatric surgery-completing patients (N = 2,267) on the PAI to date. Latent growth modeling was used to examine change in the outcome variables. RESULTS: Results indicate that personality and psychopathology variables predicted less BMI reduction, weight loss, and %EWL 5 years after surgery and also affected the trajectories of change in the outcome variables across time. The PAI scales predicted more variance in the 5-year BMI outcomes than did age and gender. The most robust effects were for scales assessing phobias, traumatic stress, identity problems, and negative relationships. CONCLUSION: The PAI may be useful to clinical health psychologists who conduct recommended psychological evaluations with potential bariatric surgery candidates. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Cirurgia Bariátrica/métodos , Índice de Massa Corporal , Obesidade Mórbida/cirurgia , Transtornos da Personalidade/psicologia , Psicopatologia/métodos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/psicologia , Resultado do Tratamento
18.
Arch Sex Behav ; 49(2): 607-622, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31989410

RESUMO

A diverse U.S. sample comprising 1437 men and 1474 women was assessed on sexual orientation, masculinity-femininity of occupational preferences (MF-Occ), self-ascribed masculinity-femininity (Self-MF), Big Five personality traits, sex drive, and sociosexuality (positive attitudes toward uncommitted sex). Discriminant analyses explored which traits best distinguished self-identified heterosexual, bisexual, and homosexual individuals within each sex. These analyses correctly classified the sexual orientation of 55% of men and 60% of women, which was substantially better than a chance rate (33%) of assigning participants to one of three groups. For men, MF-Occ and Self-MF distinguished heterosexual, bisexual, and gay men, with heterosexual men most gender typical, gay men most gender atypical, and bisexual men intermediate. Independently, higher sex drive, sociosexuality, and neuroticism and lower conscientiousness distinguished bisexual men from other groups. For women, gender-related interests and Self-MF distinguished lesbians from other groups, with lesbians most gender atypical. Independently, higher sociosexuality, sex drive, and Self-MF distinguished non-heterosexual from heterosexual women. These findings suggest that variations in self-reported sexual orientation may be conceptualized in terms of two broad underlying individual difference dimensions, which differ somewhat for men and women: one linked to gender typicality versus gender atypicality and the other linked to sex drive, sociosexuality, and various personality traits.


Assuntos
Bissexualidade/psicologia , Heterossexualidade/psicologia , Homossexualidade Feminina/psicologia , Homossexualidade Masculina/psicologia , Transtornos da Personalidade/psicologia , Comportamento Sexual/psicologia , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
19.
Lancet Psychiatry ; 7(2): 135-147, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31974072

RESUMO

BACKGROUND: Psychiatric disorders are established risk factors for self-harm. However, variation in the risk of self-harm by specific psychiatric disorder and stratified by gender and age is rarely examined in population-representative samples. This study aimed to investigate the risk of self-harm following diagnosis of different psychiatric disorders in an Asian population, through a review of inpatient records retrieved from the Hong Kong Clinical Data Analysis and Reporting System (CDARS). METHODS: For this nested case-control study, the inpatient data of people admitted for any reason to Hong Kong public hospitals, between Jan 1, 2000, and Dec 31, 2010, were extracted from CDARS. Cases were people aged 10 years or older who had been admitted to inpatient care with a first-listed record of psychiatric disorder during the study period. The seven psychiatric disorders of interest were: depression, alcohol misuse or dependence, personality disorders, bipolar disorders, anxiety disorders, schizophrenia, and substance misuse or dependence. Two control patients were matched per case from a subsample of all individuals with the same gender, age, and admission time (ie, same calendar year and month), who did not have any record of the psychiatric disorders of interest. Any patients with a history of self-harm diagnosis before, or at the same time as, the first diagnosis of psychiatric disorder (cases) or admission (controls), were excluded. For each diagnostic category, a Cox proportional hazard regression model was fitted to estimate the adjusted hazard ratio (HR; plus 95% CIs) of associated self-harm, adjusting for gender, age, control-matched admission time, 20 districts of residence, physical comorbidities established as risk factors for self-harm (diabetes, asthma, migraine, epilepsy, HIV, and cancer), and presence of the six other psychiatric disorders. We repeated this analysis in subgroups stratified by gender (male and female) and by age (adolescent, 10-24 years; young adult, 25-44 years; middle-aged, 45-64 years; and older people, ≥65 years). FINDINGS: Between 2000 and 2010, we followed up a cohort of 86 353 people with a first-recorded diagnosis of a psychiatric disorder of interest, and 134 857 matched controls. The highest risk of self-harm was observed in patients with substance misuse or dependence (adjusted HR vs matched controls, 9·6 [95% CI 8·4-11·0]), followed by those with personality disorders (3·7 [2·8-4·9]) and alcohol misuse or dependence (3·2 [2·9-3·7]). When stratified by gender and age, the highest risk of self-harm behaviour was found in the substance misuse or dependence group for both genders (for female patients: adjusted HR vs matched controls, 7·7 [6·0-9·8]; and for male patients, 10·5 [8·9-12·4]), and for all age groups (adolescent: 9·6 [7·2-12·7]; young adults: 10·2 [8·4-12·3]; middle-aged: 11·2 [8·0-15·6], and older people: 3·2 [1·7-6·1]). INTERPRETATION: First-recorded diagnoses of psychiatric disorders were significantly associated with an elevated risk of subsequent self-harm. The associations varied considerably by diagnostic categories across gender and age subgroups. Our findings highlight the need to develop more efficient and targeted preventive measures in psychiatric care management, with specific attention to demographic characteristics linked to increased risk within the same diagnostic category. FUNDING: None.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Bipolar/epidemiologia , Transtorno Depressivo/epidemiologia , Transtornos da Personalidade/epidemiologia , Esquizofrenia/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Estudos de Casos e Controles , Criança , Feminino , Seguimentos , Hong Kong/epidemiologia , Hospitais Públicos/estatística & dados numéricos , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Sistemas Computadorizados de Registros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Risco , Fatores Sexuais , Adulto Jovem
20.
Braz J Psychiatry ; 42(1): 14-21, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31116261

RESUMO

OBJECTIVE: This study aimed to determine if personality disorder (PD) predicted functional outcomes in patients with major depressive disorder (MDD). METHODS: Data (n=71) from a double-blind, randomized, placebo-controlled 12-week trial assessing the efficacy of 200 mg/day adjunctive minocycline for MDD were examined. PD was measured using the Standardized Assessment of Personality Abbreviated Scale. Outcome measures included Clinical Global Impression - Improvement (CGI-I), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Social and Occupational Functioning Scale (SOFAS), and Range of Impaired Functioning (RIFT). Analysis of covariance was used to examine the impact of PD (dichotomized factor [≥ 3] or continuous measure) on the outcome measures-treatment group correlation. RESULTS: PD was identified in 69% of the sample. After adjusting for age, sex, and baseline scores for each of the outcome measures, there was no significant difference between participants with and without PD on week 12 scores for any of the outcome measures (all p > 0.14). CONCLUSION: In this secondary analysis of a primary efficacy study, PD was a common comorbidity among those with MDD, but was not a significant predictor of functional outcomes. This study adds to the limited literature on PD in randomized controlled trials for MDD. CLINICAL TRIAL REGISTRATION: ACTRN12612000283875.


Assuntos
Antidepressivos/administração & dosagem , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/psicologia , Minociclina/administração & dosagem , Transtornos da Personalidade/psicologia , Adulto , Idoso , Comorbidade , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Testes de Personalidade , Efeito Placebo , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Autorrelato , Resultado do Tratamento
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