The growth and development of research on personality disorders: A bibliometric study.

This study objective was to investigate publication trends on personality disorders (PD) and to identify patterns of historical development. Publication rates were determined using the Results by Year Timeline feature of PubMed. Time series autoregressive integrated moving average models were used to analyse the publication rates for PDs in quinquennial periods beginning in 1980 and ending in 2019 and to predict the number of publications in the 2024-2029 period. More than 300 articles on antisocial and borderline PD are being published each year, and the models suggest an accelerating growth rate. Approximately 100 articles are being published on average every year on schizotypal PD, and the regression model indicates linear growth in the near future. The mean number of publications per year for obsessive-compulsive, narcissistic and avoidant PDs is in the range of 10-30 with the corresponding models indicating linear growth. Fewer than 10 articles are being published each year on dependent, paranoid, histrionic and schizoid PD, whereas dependent PD shows modest growth and paranoid PD rates tended to stability, histrionic and schizoid PD exhibit declining rates. Personality disorders are a group of conditions with diverse etiological, prognostic, therapeutic, legal, research, social and cultural implications that influence publication rates.

The Jornal Brasileiro de Psiquiatria: a bibliometric survey of the one hundred most cited articles in the last 15 years / Jornal Brasileiro de Psiquiatria: uma pesquisa bibliométrica sobre os 100 artigos mais citados nos últimos 15 anos

OBJECTIVE: Bibliometrics is a group of statistical and mathematical methods employed to measure and analyze the quantity and the quality of scientific articles, books, and other forms of publications. The objective of the present study was to conduct a bibliometric analysis of the Jornal Brasileiro de Psiquiatria (JBP) by listing its 100 most highly cited articles in the scientific literature and identifying their main characteristics in terms of authorship and research topics and design. METHODS: The 100 topcited references in the JBP were identified through a search with Google Scholar. The main author, last author, corresponding author, the total number of authors, gender of the authors, year of publication, research institution, geographic origin, language, and the research design and subject of each reference were recorded and analyzed. RESULTS: A marked increase in the number of citations in the last 15 years, a relatively balanced distribution of publications among the Brazilian states and research centers, absence of gender bias among authors, and a varied range of published topics suggest a good current editorial performance by the JBP. Relative lack of systematic reviews and longitudinal studies, dearth of articles published in the English language, and modest participation of foreign authors were points requiring improvement. CONCLUSION: The present study suggests that a survey of the 100 most cited articles in the JBP can provide a historical overview of the progress of this journal, as well as highlight the main obstacles, constraints, and challenges faced by its editors and authors.

OBJETIVO: Bibliometria é um grupo de métodos estatísticos e matemáticos empregados para medir e analisar a quantidade e a qualidade de artigos científicos, livros e outras formas de publicações. O objetivo do presente estudo foi realizar uma análise bibliométrica do Jornal Brasileiro de Psiquiatria (JBP), relacionando seus 100 artigos mais citados na literatura científica e identificando suas principais características em termos de autoria e questões de pesquisa e delineamento experimental. MÉTODOS: As 100 referências mais citadas no JBP foram identificadas por meio de uma busca no Google Scholar. Foram registradas e analisadas as seguintes informações: autor principal, último autor, autor correspondente, número total de autores, gênero dos autores, ano de publicação, instituição de pesquisa, origem geográfica e idioma de cada referência e seu tema de investigação e delineamento metodológico. RESULTADOS: O aumento acentuado no número de citações nos últimos 15 anos, a boa distribuição das publicações entre os estados e centros de pesquisa brasileiros, a ausência de viés de gênero entre os autores e a variada gama de tópicos publicados sugerem um bom desempenho editorial atual do JBP. A relativa falta de revisões sistemáticas e estudos longitudinais, os poucos artigos publicados em inglês e a pequena participação de autores estrangeiros são pontos que requerem melhorias. CONCLUSÃO: O presente estudo sugere que o levantamento dos 100 artigos mais citados no JBP pode fornecer um panorama histórico da evolução dessa revista, bem como destacar os principais obstáculos, restrições e desafios enfrentados por seus editores e autores.

Unnecessarily prolonged suffering: a case of missed diagnosis of post-traumatic stress disorder in a teaching hospital / Sofrimento desnecessariamente prolongado: um caso de diagnóstico perdido de transtorno de estresse pós-traumático em um hospital de ensino

ABSTRACT We described a case in which a heavily-traumatized patient had been under psychiatric treatment for seven years (five of them in a university mental health clinic) but was never diagnosed with PTSD and, therefore, did not receive the proper treatment for a very long period. After the correct diagnosis was made and personalized treatment instituted, the patient has shown marked improvement in functionality and wellbeing. The key element in this case, was the adequacy of psychiatric training. Our report suggests that psychiatrists are not being adequately trained to identify traumatic events and to diagnose atypical cases of PTSD. With that in mind, we emphasize that theoretical modules on trauma and trauma-related disorders and practical training in specialized PTSD clinics should be incorporated into the psychiatric residency training programs wherever they may be missing, particularly in countries most impacted by violence. Furthermore, continuing medical education on trauma and PTSD should be provided by medical associations and journals to keep physicians updated on recent progress in the field.

RESUMO Descrevemos o caso de um paciente gravemente traumatizado que estava em tratamento psiquiátrico há sete anos (cinco deles em uma clínica universitária de saúde mental), mas nunca foi diagnosticado com transtorno de estresse pós-traumático (TEPT) e, portanto, não recebeu o tratamento adequado por muito tempo. Após o diagnóstico correto e o tratamento personalizado instituído, o paciente mostrou melhora acentuada na funcionalidade e no bem-estar. O elemento-chave, neste caso, foi a adequação do treinamento psiquiátrico. Nosso relatório sugere que os psiquiatras não estão sendo treinados adequadamente para identificar eventos traumáticos e diagnosticar casos atípicos de TEPT. Com isso em mente, enfatizamos que os módulos teóricos sobre eventos traumáticos e transtornos relacionados ao trauma e treinamento prático em clínicas especializadas de TEPT devem ser incorporados aos programas de treinamento em residência psiquiátrica onde quer que ainda estejam ausentes, particularmente nos países mais afetados pela violência. Além disso, a educação médica continuada sobre trauma e TEPT deve ser fornecida por associações médicas e periódicos científicos para manter os médicos atualizados sobre os avanços recentes na área.

Can horror movies induce PTSD-like syndrome? / Podem filmes de terror induzir uma síndrome TEPT-símile? / Les films d'horreur peuvent-ils induire un syndrome semblable au SSPT? / ¿Pueden las películas de terror inducir a un trastorno similar al TEPT?

We reported a case of a 10-year-old girl who developed a PTSD-like syndrome after watching a horror movie. After 6 years, the now 16-year-old patient still fulfilled the DSM-IV criteria for PTSD, except for the trauma itself. We reviewed the scientific literature for case reports of PTSD-like syndrome induced by horror movies and found 13 cases. In only two was the presence of the DSM criteria confirmed. Watching horror movies may thus trigger PTSD-like syndromes in vulnerable viewers

O caso de uma menina de 10 anos de idade que desenvolveu síndrome do tipo transtorno de estresse pós-traumático (TEPT) após assistir a filme de terror é relatado. Após seis anos, a paciente ainda preenchia os critérios do DSM-IV para TEPT. Em revisão da literatura, identificamos 13 casos de síndrome TEPT-símile induzida por filmes de terror, mas o diagnóstico baseado em critérios DSM foi feito em dois casos apenas. Filmes de terror podem desencadear síndromes TEPT-símile em pessoas vulneráveis.

Presentamos el caso de una niña de 10 años que desarrolló un síndrome tipo trastorno de estrés postraumático (TEPT) después de ver una película de terror. Al cabo de seis años, la paciente aún cumplía con los criterios del DSM-IV para el TEPT. Durante la revisión de la literatura, identificamos 13 casos de síndromes similares al TEPT, inducidos por películas de terror, pero el diagnóstico basado en los criterios DSM fue hecho solo en dos casos. Películas de terror pueden desencadenar síndromes similares al TEPT en espectadores vulnerables.

Cet article décrit le cas d'une jeune fille de 10 ans qui a développé un syndrome qui ressemble à celui du stress post-traumatique (SSPT) après avoir regardé un film d'horreur. Six ans plus tard, la patiente présentait toujours les symptômes du SSPT correspondants aux critères du DSM-IV. La littérature scientifique a été examinée à la recherche de cas semblables et treize cas semblables ont été recensés. La présence des critères DSM-IV a été confirmée uniquement dans deux cas. Nous concluons que l'exposition à des films d'horreur peut déclencher un syndrome du type SSPT chez les personnes vulnérables.

Dieser Artikel beschreibt den Fall eines 10-jährigen Mädchens, das ein PTBS-ähnliches Syndrom entwickelte, nachdem sie einen Horrorfilm angeschaut hatte. Sechs Jahre später zeigte die nun 16 Jahre alte Patientin nach wie vor PTBS Symptome auf, die den Kriterien des DSM-IV entsprachen. Wir forschten in der wissenschaftlichen Literatur nach Fallberichten des PTBS-ähnlichen Syndroms, die durch Horrorfilme induziert wurden und fanden 13 Fälle. In nur zwei Fällen wurden die DSM-IV-Kriterien bestätigt. Wir kommen zum Schluss, dass bei anfälligen Personen, die sich Horrorfilmen aussetzen, es zu PTBS-ähnlichen Syndromen kommen kann.

Pre-traumatic vs post-traumatic OCD in PTSD patients: Are differences in comorbidity rates and functional health status related to childhood abuse?

OBJECTIVE: The goal of this study was to compare the clinical and functional status and the trauma-related characteristics of PTSD patients with comorbid OCD whose onset predated the index traumatic event (pre-traumatic OCD) with those of PTSD patient whose comorbid OCD only emerged after the exposure to the traumatic event (post-traumatic OCD). METHODS: Sixty-three individuals with PTSD and comorbid OCD were evaluated with the Structured Clinical Interview for DSM-IV AXIS I Disorders and completed the Posttraumatic Stress Disorder Checklist - Civilian Version, the Beck Depression Inventory, the Beck Anxiety Inventory, the Trauma History Questionnaire and the 36-Item Short-Form Health Survey. RESULTS: A history of childhood abuse was significantly more frequent among PTSD patients with pre-traumatic OCD (45.2%) than among their counterparts with post-traumatic OCD (16%). PTSD patients with pre-traumatic OCD had higher rates of psychiatric comorbidity in general and showed a lower functional health status in a physical domain (SF-36 Role Limitation due to Physical Health). In contrast, PTSD patients with post-traumatic OCD had a decreased functional health status in a psychological domain (SF-36 Emotional Well Being). The effect sizes were in the medium to large range. CONCLUSIONS: A history of child abuse may be an important, but often neglected, factor accounting for clinical, functional, and trauma-related differences between pre-traumatic and posttraumatic OCD in PTSD patients.

Early scars are forever: Childhood abuse in patients with adult-onset PTSD is associated with increased prevalence and severity of psychiatric comorbidity.

Childhood abuse and PTSD are independently associated with severe psychiatric comorbidity. We hypothesized that among patients with adult-onset PTSD, a history of child abuse was associated with increased prevalence and severity of comorbid mental disorders. Participants were 109 adult treatment-seeking patients, 23.9% of whom had a history of childhood sexual, physical or emotional abuse. The socio-demographic characteristics and comorbidity profile of PTSD patients with and without history of child abuse were compared using the two-tailed t-test and the chi-square test. PTSD patients with a history of child abuse had significantly higher average PCL-C hyperarousal [21.8 (SD = 3.6) vs 19.8 (SD = 3.5)] and BDI [35.7 (SD = 9.2) vs 29.1 (SD = 13.9)] scores, a significantly increased average number of lifetime [4.85 (SD = 1.43) vs 3.93 (SD = 1.33)] and current [4.46 (SD = 1.24) vs 3.75 (SD = 1.32)] comorbid disorders, and a greater prevalence of lifetime (73.1% vs 44.6%) and current (79.2% vs 46.7%) panic disorder/agoraphobia and of psychotic symptoms (73.1% vs 30.1%). All effect sizes were in the medium to large range. Adult-onset PTSD patients with a history of child abuse may represent a subgroup with a more severe form of the disorder that is associated with a more serious clinical course, treatment resistance and poorer outcome.

The impact of posttraumatic symptoms and comorbid mental disorders on the health-related quality of life in treatment-seeking PTSD patients.

BACKGROUND: There is a dearth of literature dealing with the impact of the severity of posttraumatic symptoms and of comorbid mental disorders on the health-related quality of life (HRQOL) of victims of civilian violence with a primary diagnosis of PTSD. OBJECTIVES: To investigate the influence of the severity of posttraumatic symptoms and of presence of comorbid mental disorders on the HRQOL of treatment-seeking outpatients with PTSD. METHODS: A sample of 65 PTSD patients was recruited in a specialized outpatient clinic. The volunteers had the diagnoses of PTSD and of comorbid mental disorders established with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). The severity of posttraumatic, depression and anxiety symptoms was measured with the PCL-C, BDI and BAI, respectively. HRQOL was assessed by means of the SF-36, a 36-item self-administered scale that measures eight domains of quality of life: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health. Multiple linear regression models were fitted to investigate the relationship between the severity of posttraumatic, mood, and anxiety symptoms; the presence of specific current comorbid disorders and of psychotic symptoms, and the number of current comorbid conditions for each of the eight domains of HRQOL, after adjusting for the effect of sociodemographic characteristics. RESULTS: The severity of PTSD symptoms predicted worse HRQOL in all eight domains of SF-36, even after controlling for the severity of depression and anxiety symptoms, the presence of panic disorder, OCD, specific and social phobia, psychotic symptoms, and the number of comorbid disorders. The strongest negative association between PTSD symptoms severity and HRQOL was found in the Social Functioning domain. Although the inclusion of the depressive symptoms in the models led to a reduction of the magnitude of the negative association between the severity of PTSD symptoms and the HRQOL domain scores, the former still accounted for most of the explained variance of the latter. CONCLUSIONS: We found that even in the presence of comorbid mental disorders, the severity of posttraumatic symptoms remained the strongest predictor for impaired HRQOL in PTSD outpatients. Our results suggest that improvement of HRQOL should be considered a therapeutic objective and an essential outcome measure in the treatment of PTSD.