Narcissism as a protective factor against the risk of self-harming behaviors without suicidal intention in Borderline Personality Disorder.

The spectrum of suicidal behavior is a core factor of the prognosis and care of Borderline Personality Disorder (BPD). The aim of this study is to identify possible BPD specific personality traits that could act as protective factors of nonsuicidal self-injuries (NSSI.

Antisocial traits and neuroticism as predictors of suicidal behaviour in borderline personality disorder: A retrospective study.

INTRODUCTION: The spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. METHODS: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ2 test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. RESULTS: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. CONCLUSIONS: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.

Rasgos antisociales y neuroticismo como predictores de conducta suicida en trastorno límite de la personalidad: un estudio retrospectivo

Introducción: El espectro de la conducta suicida (CS) es nuclear en la clínica y el tratamiento del trastorno límite de personalidad (TLP). Los rasgos patológicos del TLP intervienen como factores de riesgo de CS en confluencia con otras variables clínicas y sociodemográficas asociadas con el TLP. El objetivo del presente trabajo consiste en evaluar los rasgos de personalidad específicos del TLP que se relacionan con la CS. Métodos: Se realiza un estudio transversal, observacional y retrospectivo, de una muestra de 134 pacientes con diagnóstico de TLP según los criterios del DSM-5. Se utilizan los cuestionarios de Millon-II, Zuckerman-Kuhlman y Barrat para valorar distintos parámetros de la personalidad. Se realizan comparaciones por variables mediante las pruebas de la x2 y de la t de Student. La asociación entre variables se analiza mediante regresión logística multivariada. Resultados: Se objetivan diferencias estadísticamente significativas entre la CS y relacionadas y la dimensión neuroticismo-ansiedad en el test de Zuckerman-Kuhlman. Asimismo se relaciona de manera significativa con la subescala fóbica y antisocial del Millon-II. La impulsividad medida con las pruebas de Zuckerman-Kuhlman y Barrat no aparece relacionada con la CS. Conclusiones: Los resultados presentados plantean el papel de los rasgos fóbicos, antisociales y del neuroticismo como posibles rasgos de personalidad del TLP relacionados con la CS. Incluso se propone una importancia mayor que el de la impulsividad dentro de la relación del TLP con la CS. De cara al futuro, estudios longitudinales permitirían aumentar la evidencia científica de los hallazgos presentados. © 2021 Asociación Colombiana de Psiquiatría. Publicado por Elsevier Espafña, S.L.U. Todos los derechos reservados.

Introduction: The spectrum of suicidal behaviour (SB) is nuclear in the clinic andmanagement of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. Methods: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. Results: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. Conclusions: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings. © 2021 Asociacio´n Colombiana de Psiquiatria. Published by Elsevier España, S.L.U. All rights reserved.

Narcisismo como variable protectora frente al riesgo de conductas autolesivas sin intención suicida en Trastorno Límite de la Personalidad / Narcissism as a protective variable against the risk of self-injurious behaviour without suicidal intent in Borderline Personality Disorder

Introducción y objetivos: El espectro de la conducta suicida tiene un carácter nuclear en el pronóstico y manejo delTrastorno Límite de la Personalidad (TLP). El objetivo de esteestudio es identificar posibles rasgos de personalidad específicos del TLP que puedan actuar como protectores de lasautolesiones sin finalidad suicida (ASFS).Método. Se realiza un estudio transversal, observacionaly retrospectivo, de una muestra de 134 pacientes de entre 18y 56 años con TLP. La evaluación clínica se llevó a cabo conun cuestionario que valoraba la presencia o no de conductas suicidas (CS) y ASFS y distintas variables sociodemográficas. También se realizaron cuestionarios de personalidad:Inventario Clínico Multiaxial de Millon II, Cuestionario dePersonalidad de Zuckerman-Kuhlman y la entrevista ClínicaEstructurada para el eje II del DSM (SCID). La asociación entre variables se analizó a través de un modelo de regresiónlogística multivariado y binomial negativaResultados. Se encuentra una asociación estadísticamente significativa entre la CS con las ASFS y entre realizarmayor número de intentos de suicidio y la presencia de ASFS.Respectivamente, las ASFS se asocian de forma estadísticamente significativa con los intentos de suicidio. Por otrolado, se objetivan diferencias estadísticamente significativasen la asociación de ASFS con las variables en el SCID Trastorno Narcisista, apareciendo como variable con efecto protector. Los resultados presentados proporcionan una idea de larelación dinámica entre NSSI y SB en una población TLP concaracterísticas de gravedad. Conclusiones. El papel de los rasgos de personalidad narcisistas puede ser importante a la hora de identificar factoresprotectores para las NSSI y SB en TLP y podría ser objeto dedesarrollo de ulteriores proyectos de investigación. (AU)

Background and Objectives: The spectrum of suicidalbehavior is a core factor of the prognosis and care ofBorderline Personality Disorder (BPD). The aim of this study isto identify possible BPD specific personality traits that couldact as protective factors of nonsuicidal self-injuries (NSSI).Methods. We performed a cross-sectional, observationaland retrospective study of a sample of 134 BPD patients agedfrom 18 to 56. We assessed the presence or absence of suicidalbehavior and NSSI as well as different sociodemographicvariables. Millon, Zuckerman-Kuhlman and StructuredClinical Interview for DSM personality questionnaires werealso applied. The analysis of the association between variableswas carried out with a multivariate negative binomial logisticregression model.Results. A statistically significant associationbetween NSSI and suicidal behavior was found. Elseways,statistically significant differences were also found inthe association between NSSI and the SCID variables forNarcissistic Disorder, which appears as protective variables. These results provide an idea of the dynamic relationshipbetween NSSI and suicidal behavior in a BPD populationwith particularly severe characteristics.Conclusions. The role of narcissistic personality traitsappears to be important in identifying protective factors forNSSI and suicidal behavior in BPD patients and could be thesubject of further research projects. (AU)

Antisocial Traits and Neuroticism as Predictors of Suicidal Behaviour in Borderline Personality Disorder: a Retrospective Study. / Rasgos antisociales y neuroticismo como predictores de conducta suicida en trastorno límite de la personalidad: un estudio retrospectivo.

INTRODUCTION: The spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. METHODS: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ2 test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. RESULTS: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. CONCLUSIONS: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.

Bullying and childhood trauma events as predictive factors of suicidal behavior in borderline personality disorder: Preliminary findings.

Traumas in childhood could present a significant association with suicidal behavior in BPD. The aim of the report is to study the link between a traumatic childhood involving school bullying and the different forms and degrees of suicidal behavior in BPD. A cross-sectional study was carried out on a sample of 109 BPD patients. It is divided into two groups whether or not there is a history of suicidal behavior. The clinical variables are compared with Chi square and Student's T tests. Traumatic childhood history and bullying, in particular, showed a statistically significant association with the incidence of suicidal behaviors.

Tratamiento farmacológico del trastorno obsesivo-compulsivo en adultos: una guía de práctica clínica basada en el método ADAPTE / Pharmacological treatment of obsessive compulsive disorder in adults: a clinical practice guideline based on the ADAPTE methodology

A pesar de la existencia de tratamientos efectivos basados en la evidencia para el tratamiento del trastorno obsesivo-compulsivo (TOC), el abordaje de esta enfermedad sigue siendo subóptimo. Disponer de una guía terapéutica farmacológica del TOC puede ayudar a mejorar el manejo de la enfermedad en nuestro entorno y contribuir a reducir la carga de la enfermedad para el paciente. Con el patrocinio de la Sociedad Española de Psiquiatría un grupo de expertos ha desarrollado una guía para el tratamiento farmacológico del TOC a partir de algunas guías existentes siguiendo la metodología de la ADAPTE Collaboration. En este artículo se resume el proceso de elaboración de esta guía y las recomendaciones adoptadas por consenso por el grupo elaborador de las guías agrupadas en 5 áreas de interés: tratamiento agudo, duración del tratamiento, predictores de respuesta y síntomas especiales, respuesta parcial a falta de respuesta al tratamiento y poblaciones especiales

Despite the existence of effective evidence-based treatments for the management of obsessive-compulsive disorder (OCD), the therapeutic approach to this disease remains suboptimal. The availability of a therapeutic pharmacological guideline for OCD could help to improve the management of the disease in our setting and to reduce the burden of disease for the patient. With the sponsorship of the Spanish Society of Psychiatry, a group of experts has developed a guideline for the pharmacological treatment of OCD based on the recommendations of existing guidelines and following the methodology of the ADAPTE Collaboration. This article summarises the process of preparing this guideline and the recommendations adopted by consensus by a guideline panel grouped into five areas of interest: acute treatment, duration of treatment, predictors of response and special symptoms, partial response to lack of response to treatment, and special populations

La locura mixedematosa. El delirio que cura con levotiroxina / Myxoedema madness. The delusion that is cured with levothyroxine

Objetivo: El objetivo de este artículo es analizar, a través de un caso clínico, los trastornos psicóticos relacionados con el hipotiroidismo. Caso clínico: Se presenta el caso clínico de una mujer de 51años ingresada en el hospital por un trastorno psicótico agudo, con delirios paranoides y conducta alucinatoria. La evaluación revela un estado hipotiroideo severo y la paciente es tratada con terapia hormonal y antipsicóticos, consiguiéndose la remisión clínica completa. Resultados: La aparición de trastornos mentales, especialmente trastornos del estado de ánimo, durante las enfermedades de la tiroides se conoce desde hace un siglo, mientras que los trastornos psicóticos asociados con disfunción tiroidea rara vez se describen. Conclusiones: Este caso pone de relevancia el papel del equilibrio hormonal de la tiroides en el inicio de las manifestaciones psicóticas y enfatiza la necesidad de valorar la funcionalidad de esta glándula endocrina en el contexto del diagnóstico etiológico de la psicosis

Objective: The aim of this article is to analyse, using a clinical case, the psychotic disorders related to hypothyroidism. Case report: The case is presented of a 51-year-old woman who was admitted to the hospital with an acute psychotic disorder, as well as paranoid delusions and hallucinatory behaviour. The evaluation revealed a severe hypothyroid state, for which the patient was treated with hormone therapy and antipsychotics, resulting in full clinical remission. Results: The occurrence of mental disorders, especially mood disorders, during thyroid diseases have been known for a century, while psychotic disorders associated with thyroid diseases are rarely described. Conclusions: This case highlights the role of thyroid hormone balance in the onset of psychotic manifestations, and emphasises the need to assess the functionality of this endocrine gland in the context of the aetiological diagnosis of psychosis

Pharmacological treatment of obsessive compulsive disorder in adults: A clinical practice guideline based on the ADAPTE methodology. / Tratamiento farmacológico del trastorno obsesivo-compulsivo en adultos: una guía de práctica clínica basada en el método ADAPTE.

Despite the existence of effective evidence-based treatments for the management of obsessive-compulsive disorder (OCD), the therapeutic approach to this disease remains suboptimal. The availability of a therapeutic pharmacological guideline for OCD could help to improve the management of the disease in our setting and to reduce the burden of disease for the patient. With the sponsorship of the Spanish Society of Psychiatry, a group of experts has developed a guideline for the pharmacological treatment of OCD based on the recommendations of existing guidelines and following the methodology of the ADAPTE Collaboration. This article summarises the process of preparing this guideline and the recommendations adopted by consensus by a guideline panel grouped into five areas of interest: acute treatment, duration of treatment, predictors of response and special symptoms, partial response to lack of response to treatment, and special populations.

Tinnitus como síntoma de psicosis de inicio reciente. A propósito de un caso / Tinnitus as a symptom of early onset psychosis. A case report

Objetivo: En el presente artículo se pretende señalar, mediante la exposición de un caso clínico, la importancia de la detección de síntomas psicóticos atenuados en los pacientes de alto riesgo de psicosis para realizar una intervención precoz que mejore su pronóstico. Caso clínico: Se describe el caso de una paciente de 17 años de edad que presentaba en el momento del ingreso tinnitus de 3 meses de evolución con repercusión importante a nivel afectivo y conductual. Tras descartarse una causa orgánica de los acúfenos ingresó en psiquiatría. Recibió tratamiento con dosis bajas de antipsicótico atípico con mejoría clínica notoria. Resultados: El tinnitus es un síntoma heterogéneo en cuanto a su presentación clínica y etiología. Su interés para la psiquiatría radica en la elevada comorbilidad con psicopatología y en la variedad de trastornos con los que ha sido asociado. Entre estos, resulta especialmente compleja su relación con cuadros psicóticos, dada la superposición sintomática entre el tinnitus y los síntomas psicóticos atenuados. En el caso expuesto, una exploración cuidadosa de la paciente reveló características atípicas en el tinnitus, lo que junto a los síntomas y el declive funcional asociados llevó a su evaluación dentro del paradigma de los estados de alto riesgo de psicosis. Conclusiones: El caso presentado resalta el hecho de que algunos síntomas inespecíficos como el tinnitus pueden ser un indicio de psicosis de inicio reciente. Reconocer estos síntomas es fundamental para identificar aquellos casos que puedan beneficiarse de una intervención precoz

Objectives: In this article, and using a clinical case report, it is intended to point out the importance of the detection of attenuated psychotic symptoms in patients at high risk of psychosis in order to carry out an early intervention that may improve their prognosis. Case report: The case is presented of a 17-year- old woman who suffered tinnitus for the last three months, with important affective and behavioural repercussions. After ruling out an organic cause of the tinnitus, she was admitted to psychiatry, where she received treatment with a low dose of an atypical antipsychotic drug, resulting in a significant clinical improvement. Results: Tinnitus is a heterogeneous symptom in terms of its clinical presentation and aetiology. Its interest for psychiatry lies in the high comorbidity with psychiatric illness and in the variety of disorders with which it has been associated. Among these, its relationship with psychotic disorders is particularly complex, given the symptomatic overlap between tinnitus and attenuated psychotic symptoms. In the present case, a careful examination of the patient revealed atypical features in tinnitus, which along with the associated symptoms and functional decline led to its evaluation within the paradigm of high risk states of psychosis. Conclusions: This case report highlights the fact that some non-specific symptoms, such as tinnitus, may be a sign of recent onset psychosis. Recognising these symptoms is essential in order to identify those cases that may benefit from early intervention

Síndrome de Charles Bonnet: la alucinación visual en el anciano / No disponible

El síndrome de Charles Bonnet se caracteriza por la presencia de alucinaciones visuales complejas, elaboradas y persistentes, que el paciente reconoce como irreales, en ausencia de otros síntomas psiquiátricos. Se entrevistaron a un total de 18 pacientes derivados del Servicio de Oftal - mología con posible diagnóstico de síndrome de Charles Bonnet, con el fin de descartar patología psiquiátrica. Se realizó un análisis descriptivo de la muestra. La edad media fue de 78,99 años (desviación típica de 9,12), con un 83,33% de mujeres y un 16,67 % de varones. En la mayor parte de los pacientes (72 %) no había ansiedad secundaria, así como tampoco patología somática cardiológica (78 %) ni neurológica (78 %). Todos presentaban patología oftalmológica, siendo la más frecuente la degeneración macular (50 %). Las alucinaciones más frecuentes fueron sobre objetos y figuras (67 %), manifestándose de manera continua hasta en un 28 % de los pacientes. El 17 % de los pacientes presentaba patología psiquiátrica, pero ninguna justificaba la presencia de alucinaciones visuales. El síndrome de Charles Bonnet es una enfermedad infradiagnosticada y de difícil manejo, ya que exige diversas valoraciones por distintos especialistas(AU)

The Charles Bonnet syndrome is characterized by the presence of complex visual hallucinations, elaborate and persistent, which the patient recognizes as unreal, in the absence of other psychiatric symptoms. We interviewed a total of eighteen patients from the ophthalmology service with the possible diagnosis of Charles Bonnet syndrome in order to rule out psychiatric disorders. We performed a descriptive analysis of the sample. The mean age was 78.99 years (standard deviation of 9.12) with 83.33% female and 16.67 % male. Most patients (72 %) had no secondary anxiety nor cardiological pathology (78 %) or neurological pathology (78 %). All of them had ophthalmologic pathology, being the most frequent macular degeneration (50%). The most frequent hallucinations were about objects and figures (67 %), manifested continuously up to 28 % of patients. 17 % of the patients had psychiatric disorders, but none justified the presence of visual hallucinations. The Charles Bonnet syndrome is an underdiagnosed disease and difficult to manage, as it requires various evaluations by different specialists(AU)