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1.
PLoS One ; 19(3): e0299766, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38478492

RESUMO

This study examined the longitudinal relationship between a range of personality related variables measured throughout adolescence, and social anxiety disorder (SAD) in young adulthood. In addition, we examined to what degree the phenotypic associations between personality and SAD could be attributed to shared genetic and environmental factors, respectively. A total of 3394 twins (56% females), consisting of seven national birth cohorts from Norway, participated in the study. Personality was measured with self-report questionnaires at three times throughout adolescence, and SAD was measured with a diagnostic interview in early adulthood (M = 19.1 years, SD = 1.2). Correlation and regression analyses were performed to examine phenotypic associations between personality and SAD. We then created four composite scores of personality, in which the personality variables from four different ages throughout adolescence were weighted relative to their importance for SAD. Finally, a series of Cholesky decomposition models were used to examine the underlying genetic and environmental influences on the phenotypic associations between composite scores of personality and SAD. The results showed that especially higher neuroticism, lower extraversion, higher levels of loneliness, and lower levels of resilience, self-efficacy and sense of coherence, were associated with SAD. The phenotypic correlations between composite scores of personality and SAD increased from 0.42 when personality was measured 6-7 years prior to the assessment of SAD, to 0.52 when personality was measured shortly before the assessment of SAD. These phenotypic associations were mainly due to genetic influences, indicating that personality in adolescence predicts SAD in early adulthood due to shared genetic influences rather than having direct 'causal' effects on SAD.


Assuntos
Fobia Social , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Masculino , Personalidade/genética , Transtornos da Personalidade/complicações , Gêmeos/genética , Estudos Longitudinais
2.
Acta Psychol (Amst) ; 244: 104165, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38335812

RESUMO

Posttraumatic Stress Disorder (PTSD) and its complex form (C-PTSD) are psychopathological conditions that are related to several personality traits. In particular, the current study aims to investigate the associations of impairment of personality functioning (IPF) and positive outlook for the future (POF) with PTSD and C-PTSD. A sample of 304 Brazilian adults responded to an online survey. IPF was measured according to the alternative model for personality disorders, POF was operationalized using optimism and hope scales, and PTSD and C-PTSD were measured using the ICD-11 model. Data analysis included correlation, structural equation models, multivariate analysis of variance, and multinomial logistic regression. The results showed that IPF and POF were moderately correlated with PTSD and C-PTSD in positive and negative directions, respectively. IPF and POF were more strongly associated with C-PTSD than PTSD. From the categorical approach to psychopathology, IPF and POF were shown to be associated only with C-PTSD. This is the first study that provides empirical data on the association of IPF and POF with both forms of PTSD. Understanding the associations between pathological and resilient personality domains and PTSD and C-PTSD symptoms can support the development of effective interventions.


Assuntos
Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Personalidade , Transtornos da Personalidade/complicações , Inquéritos e Questionários
3.
Autism Res ; 17(1): 138-147, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37983956

RESUMO

The relationship between Autism Spectrum Disorders (ASD) and Narcissistic Personality Disorder (NPD), considering the dimensions of narcissistic grandiosity and vulnerability, represents an important differential diagnosis and potential ground of comorbidity, since both conditions show high grades of pervasiveness, a life-long course, ego-syntonic traits, and difficulties in building up and sustaining interpersonal relationships Although the co-diagnosis rates, according to the categorical criteria in use, are limited (0%-6.4%), it is common to encounter diagnostic doubts in clinical practice. Here we investigated the dimensions of narcissistic vulnerability and grandiosity in a sample of 87 adults diagnosed with ASD without intellectual disabilities through the administration of the Pathological Narcissism Inventory-52 Items (PNI-52). The mean scores of our sample were compared with the normative distribution available in the literature, and we found that individuals with ASD scored significantly higher than neurotypical controls at the Total Score and at the Vulnerable Narcissism subscale, but not at the Grandiose Narcissism subscales. Demographic features did not influence these results. Vulnerable narcissism was significantly associated with the "Ritvo Autism and Asperger Diagnostic Scale - Revised" subscale Social Relatedness. These findings could potentially be indicative of a greater comorbidity rate between the two disorders with respect to the one reported to date, possibly because DSM-5 criteria are mainly focused on the grandiose dimension. Potential explanatory links between ASD phenomenology and vulnerable narcissism, such as the personality dimension of neuroticism, are discussed, together with the possible role of narcissistic vulnerability in mediating internalizing symptoms (e.g., anxiety, depression) in individuals with ASD.


Assuntos
Transtorno do Espectro Autista , Deficiência Intelectual , Adulto , Humanos , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/diagnóstico , Narcisismo , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/epidemiologia , Deficiência Intelectual/complicações , Deficiência Intelectual/epidemiologia , Emoções
4.
J Fr Ophtalmol ; 47(2): 103997, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37919151

RESUMO

OBJECTIVES: To assess dysfunctional personality beliefs associated with specific personality disorders (PD), as well as psychopathological symptoms and psychological distress levels in central serous chorioretinopathy (CSC) patients. MATERIAL AND METHODS: This cross-sectional study included acute and chronic CSC patients and age- and sex-matched healthy volunteers. Dysfunctional personality beliefs and psychopathological symptoms assessed with Personality Belief Questionnaire-Short Form and Symptom Check List-90 Revised (SCL-90-R), respectively, were compared between CSC patients and healthy volunteers and between acute and chronic CSC patients. MAIN RESULTS: Of the 55 CSC patients included in the study analysis, 21 (38.2%) had acute and 34 (61.8%) chronic CSC. Avoidant PD (13.92±3.79 vs. 12.03±3.98, P=0.012) and obsessive-compulsive PD (13.94±3.95 vs. 12.27±3.75, P=0.025) scores on the PBQ-SF were significantly higher in CSC patients than in healthy volunteers. The PBQ-SF scores were similar between acute and chronic CSC patients. CSC patients scored significantly higher on the general severity index (GSI) and all symptom dimensions except phobic anxiety and psychoticism on the SCL-90-R. In addition, scores for obsessive-compulsive, depression, interpersonal sensitivity, paranoid ideation, and GSI were significantly higher in acute than in chronic CSC patients. CONCLUSIONS: This first study investigating the relationship between CSC and dysfunctional personality beliefs indicates that CSC patients have higher levels of dysfunctional beliefs related to avoidant and obsessive-compulsive PD than healthy volunteers. These findings present a new aspect of the personality profile of CSC patients and point to a target for intervention, i.e., dysfunctional beliefs, through a cognitive-psychiatric approach.


Assuntos
Coriorretinopatia Serosa Central , Humanos , Coriorretinopatia Serosa Central/complicações , Coriorretinopatia Serosa Central/diagnóstico , Coriorretinopatia Serosa Central/psicologia , Estudos Transversais , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/epidemiologia , Personalidade , Inquéritos e Questionários
5.
Obes Rev ; 25(3): e13669, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38114201

RESUMO

Binge eating disorder (BED) is a complex mental health problem entailing high risk for obesity, overweight, and other psychiatric disorders. However, there is still unclear evidence of the prevalence of personality disorders (PDs) in BED patients. We conducted a systematic review and a Bayesian meta-analysis for studies examining the prevalence of any PD in adult BED patients. Data sources included PubMed, Cochrane library, EBSCO, PsycINFO, and Science Direct. A Bayesian meta-analysis was conducted to estimate effect sizes for the prevalence of any PD in BED patients. Twenty eligible articles were examined with a total of 2945 BED patients. Borderline personality disorder and "Cluster C" PD, particularly obsessive-compulsive and avoidant PD, were the most frequent PD found in BED patients. BED diagnosis was associated with 28% probability of a comorbid diagnosis of any PD (0.279, 95%CrI: [0.22, 0.34]), with high levels of between-study heterogeneity (τ = 0.61, 95% CrI [0.40, 0.90]). Sensitivity analysis suggested effect sizes ranging from 0.27 to 0.28. The high comorbidity of PDs in BED patients draws attention to the potential complexity of BED clinical presentations, including those that might also be comorbid with obesity. Clinical practice should address this complexity to improve care for BED and obesity patients.


Assuntos
Transtorno da Compulsão Alimentar , Adulto , Humanos , Transtorno da Compulsão Alimentar/complicações , Transtorno da Compulsão Alimentar/epidemiologia , Transtorno da Compulsão Alimentar/psicologia , Prevalência , Teorema de Bayes , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/psicologia , Comorbidade
6.
J Pers Disord ; 37(6): 678-690, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38038657

RESUMO

The present study examines the 8-year course of physical pain and its interference with functioning in patients with borderline personality disorder (BPD) and a comparison group of patients with other personality disorders (other-PD). Participants completed the Brief Pain Inventory (BPI) at five assessments, each separated by 2 years. Results showed that across all 13 domains assessed, participants with BPD reported significantly higher levels of acute physical pain and its functional interference than other-PD comparison subjects. The severity of physical pain and its interference with multiple domains of functioning were relatively stable over 8 years of assessment for both study groups. Within the BPD group, pain was significantly associated with older age, comorbid major depressive disorder (MDD), and history of a physically violent partner. Taken together, these results suggest that physical pain is a serious health issue for individuals with BPD that interferes with functioning across a wide spectrum of areas.


Assuntos
Transtorno da Personalidade Borderline , Transtorno Depressivo Maior , Humanos , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/epidemiologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/epidemiologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Comorbidade , Dor/epidemiologia
7.
Neurol Neurochir Pol ; 57(6): 457-464, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38037683

RESUMO

INTRODUCTION: Migraine is a common primary headache disorder, which affects mainly young females, usually those with some specific personality traits including neuroticism and obsessive-compulsive disorder. Among many factors that may trigger headache are to be found those associated with eating patterns and behaviours. Eating disorders are psychiatric disorders of abnormal eating or weight-control behaviours. According to the most up-to-date classification, six main types are identified, including anorexia nervosa, bulimia nervosa, and binge eating disorder. Similar to migraine, eating disorders are mainly diagnosed in young adults and, moreover, personality pattern, in at least some of the eating disorders, is also suggested to be consistent. MATERIAL AND METHODS: This systematic review aimed to summarise the available literature related to this topic. We performed an electronic article search through the Embase, PubMed, and Cochrane databases and included 16 articles into analysis in accordance with PRISMA 2020 guidelines. RESULTS: Most of the studies revealed the presence of a putative correlation between migraine and eating disorders, and these encourage further investigations. Moreover, apart from the clinical aspect, also the pathogenesis underlying both disorders is suggested to be similar. More frequent co-occurrence of other psychiatric disorders in migraineurs, such as depression and anxiety, was reported and should be considered in future research. Furthermore, adverse interactions between pharmacotherapy and symptoms of comorbid conditions underline the importance of this problem. CONCLUSIONS: A correlation between migraine and eating disorders appears highly probable. However, further investigations are required focusing on diverse aspects such as clinical, psychological, and pathogenic.


Assuntos
Anorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos , Transtornos de Enxaqueca , Feminino , Adulto Jovem , Humanos , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Anorexia Nervosa/complicações , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/complicações
8.
J Clin Psychopharmacol ; 43(6): 498-506, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37930201

RESUMO

PURPOSE/BACKGROUND: Quetiapine is a first-line augmenting agent for treatment-resistant depression (TRD) and is used off-label in insomnia. Quetiapine and its active metabolite norquetiapine act mostly on 5-HT2A, 5-HT2C, H1, and D2 as antagonists and on 5-HT1A as partial agonists. Patients with TRD often have comorbid personality disorder (PD), and evidence suggests an association between sleep disturbance and recovery among patients with PD. Here, we aimed to evaluate the effects of quetiapine on sleep in TRD patients with and without PD (PD+/PD-). METHODS/PROCEDURES: We reviewed health records of 38 patients with TRD (20 TRD/PD+) who had been treated with a pharmacotherapy regimen including quetiapine. Clinical outcomes were determined by comparing changes in sleep items of the Hamilton Depression Rating Scale at the beginning (T0) and after 3 months of an unchanged treatment (T3). FINDINGS/RESULTS: Patients with TRD/PD+ and TRD/PD- taking quetiapine showed significant improvement in sleep items from T0 to T3 (P < 0.001, ηp2 ≥ 0.19). There was a significant personality × time interaction for sleep-maintenance insomnia (P = 0.006, ηp2 = 0.23), with TRD/PD+ showing a greater improvement at T3 compared with TRD/PD- (P = 0.01). While exploring other sleep items, no personality × time interaction was found. In the TRD/PD- group, improvement in sleep items was associated with an overall improvement in depressive symptoms (r = 0.55, P = 0.02). IMPLICATIONS/CONCLUSIONS: Quetiapine induced greater improvements in sleep-maintenance insomnia among TRD/PD+ patients than TRD/PD-. These findings suggest quetiapine could have a therapeutic role for insomnia in PD underscoring a distinct underlying neurobiological mechanism of sleep disturbance in people living with PD.


Assuntos
Antipsicóticos , Transtorno Depressivo Resistente a Tratamento , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Humanos , Antipsicóticos/farmacologia , Antipsicóticos/uso terapêutico , Depressão/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/complicações , Transtornos da Personalidade/tratamento farmacológico , Transtornos da Personalidade/induzido quimicamente , Transtornos da Personalidade/complicações , Fumarato de Quetiapina/farmacologia , Fumarato de Quetiapina/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Distúrbios do Início e da Manutenção do Sono/induzido quimicamente , Qualidade do Sono , Transtornos do Sono-Vigília/tratamento farmacológico
9.
Ideggyogy Sz ; 76(9-10): 297-307, 2023 Sep 30.
Artigo em Húngaro | MEDLINE | ID: mdl-37782064

RESUMO

Epilepsy is one of the most common neurological disorders. Therapeutic success shows high variability between patients, at least 20-30% of the cases are drug-resistant. It can highly affect the social status, interpersonal relationships, mental health and the overall quality of life of those affected.
Although several studies can be found on the psychiatric diseases associated with epilepsy, only a few researches focus on the occurrence of personality disorders accompanying the latter. The aim of this review is to help clinicians to recognize the signs of personality disorders and to investigate their connection and interaction with epilepsy in the light of current experiences.
The researches reviewed in this study confirm that personality disorders and pathological personality traits are common in certain types of epilepsy and they affect many areas of patients’ lives. These studies draw attention to the importance of a multidisciplinary approach to this neurological disorder and to provide suggestions about the available help options. Considering the high frequency of epilepsy-related pathological personality traits that can have a great impact on the therapeutic cooperation and on the patients’ quality of life, it important that the neurologist recognizes early the signs of the patient’s psychological impairment. Thus they can get involved in organizing the support of both the patient and their environment by including psychiatrists, psychologists, social and self-help associations.
As interdisciplinary studies show, epilepsy is a complex disease and besides trying to treat the seizures, it is also important to manage the patient’s psychological and social situation. Cooperation, treatment response and quality of life altogether can be significantly improved if our focus is on guiding the patient through the possibilities of assistance by seeing the complexity and the difficulties of their situation.

.


Assuntos
Epilepsia , Transtornos Mentais , Humanos , Qualidade de Vida , Transtornos da Personalidade/complicações , Transtornos Mentais/diagnóstico , Epilepsia/diagnóstico , Convulsões/diagnóstico , Saúde Mental
10.
J Psychosom Res ; 175: 111513, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37832273

RESUMO

OBJECTIVE: Psychiatric comorbidities such as depression, anxiety, and personality disorders are common in patients with functional limb weakness/paresis (FND-par). The impact of these conditions on the prognosis of FND-par has not been systematically reviewed. The aim of this study was to identify a potential prognostic effect of comorbid depression, anxiety, and/or personality disorder on prognosis in patients with FND-par. METHODS: A systematic review was performed to identify studies that reported measures of baseline depression, anxiety, and/or personality disorder, and physical disability. An individual patient data meta-analysis was subsequently performed. RESULTS: Eight studies comprising 348 individuals were included (7 prospective cohorts; 1 case-control study). There was heterogeneity in sample size, follow-up duration, and treatment modality. Depression and anxiety were present in 51.4% and 53.0% of FND-par patients, respectively. In individuals whose FND-par improved, there was no significant difference between those with versus without depression (52.6% vs 47.4%, p = 0.69) or those with versus without anxiety (50.3% vs 49.7%, p = 0.38). Meta-analysis showed no clear impact of baseline depression or anxiety per se [pooled OR for depression 0.85 (95%CI 0.50-1.45; p = 0.40) and anxiety 0.84 (95%CI 0.51-1.38; p = 0.91)]; and of depression or anxiety severity [pooled OR for depression 1.23 (95%CI 0.63-2.39; p = 0.91) and anxiety 1.40 (95%CI 0.70-2.78; p = 0.58)] on FND-par outcome. Insufficient data were available to assess the impact of personality disorders. CONCLUSION: We found no evidence that depression or anxiety influenced outcome in FND-par. Large-scale, prospective studies in FND-par, and other FND subtypes, are needed to fully contextualize the impact of concurrent mental health concerns on outcomes.


Assuntos
Ansiedade , Depressão , Humanos , Estudos Prospectivos , Depressão/epidemiologia , Estudos de Casos e Controles , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Paresia
11.
Ups J Med Sci ; 1282023.
Artigo em Inglês | MEDLINE | ID: mdl-37533817

RESUMO

Background: Personality disorders (PDs) in adulthood are considered stable over time and are likely to have lasting psychosocial impact on the affected individual, including in areas like vocational functioning. The aim of this study was to study labor market marginalization (LMM) and receipt of social welfare benefits during 13 years from age 18 to 25 years in a sample of former psychiatric patients with and without PD. Methods: This study followed-up 186 former psychiatric patients who were thoroughly assessed in 2002-2004, including for PD, and compared them with controls. Participants were divided into three groups: former patients with PD, without PD, and a matched control group from the general population. Register data on employment, sick leave absence, disability pensioning, education, days of psychiatric care, income, and receipt of social welfare benefits in 2003-2016 were collected. Results: Former patients had more days of unemployment, sick leave absence, and disability pensioning and received more social welfare benefits than controls during the study period. Differences between patients with and without PD were smaller than expected, but significant as regards receipt of social welfare benefits. PD also had an effect on income at age 30 years. Conclusions: Early onset of psychiatric disorders impairs vocational functioning up to 13 years after diagnosis, and most in those with PD.


Assuntos
Emprego , Transtornos da Personalidade , Humanos , Adulto , Adolescente , Adulto Jovem , Seguimentos , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Emprego/psicologia , Licença Médica
12.
Personal Ment Health ; 17(4): 396-407, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37452642

RESUMO

The relationship between childhood trauma with major depressive disorder (MDD) and personality disorders is complex. We explored the differences in the subjective reporting of childhood trauma to determine whether there were differences between those with a diagnosis of personality disorder and those with MDD. Adult patients with depressive symptoms were recruited from three adult psychiatry inpatient wards. Sixty inpatients fulfilled the study criteria and were requested to complete the childhood trauma questionnaire (CTQ). At discharge, diagnosis was determined and was allocated mainly to two groups: those with MDD and those with personality disorder. Those with MDD, dysthymia and subsyndromal depressive symptoms were included in the Depression Broad Definition (DBD) group (secondary analysis). Significantly higher subjective reporting of childhood trauma was observed in the personality disorder group compared with MDD in three CTQ domains. Similarly, significantly higher reporting of childhood trauma was observed in all five CTQ domains in those with a personality disorder compared with the DBD group. In conclusion, the presence of personality disorder was associated with greater subjective reporting of childhood trauma compared with those with MDD, and further research is required to explore the differences in objective experience of childhood trauma between the diagnoses using objective measures.


Assuntos
Experiências Adversas da Infância , Maus-Tratos Infantis , Transtorno Depressivo Maior , Adulto , Humanos , Criança , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/complicações , Inquéritos e Questionários
13.
J Nerv Ment Dis ; 211(5): 402-406, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-37040142

RESUMO

ABSTRACT: Justice-involved veterans are more likely to experience myriad mental health sequelae. Nonetheless, examination of personality psychopathology among justice-involved veterans remains limited, with studies focused on males within correctional settings. We examined Department of Veterans Affairs (VA) electronic medical records for 1,534,108 (12.28% justice-involved) male and 127,230 (8.79% justice-involved) female veterans. Male and female veterans accessing VA justice-related services were both approximately three times more likely to have a personality disorder diagnosis relative to those with no history of using justice-related services. This effect persisted after accounting for VA use (both overall and mental health), age, race, and ethnicity. Augmenting and tailoring VA justice-related services to facilitate access to evidence-based psychotherapy for personality psychopathology may promote optimal recovery and rehabilitation among these veterans.


Assuntos
Direito Penal , Transtornos da Personalidade , Veteranos , Feminino , Humanos , Masculino , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Estados Unidos/epidemiologia , United States Department of Veterans Affairs/legislação & jurisprudência , United States Department of Veterans Affairs/organização & administração , United States Department of Veterans Affairs/estatística & dados numéricos , Veteranos/legislação & jurisprudência , Veteranos/psicologia , Veteranos/estatística & dados numéricos , Direito Penal/legislação & jurisprudência
14.
Neurol Sci ; 44(8): 2853-2861, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36941517

RESUMO

INTRODUCTION: Cluster headache (CH) is usually comorbid to mood spectrum disorders, but the psychopathological aspects are poorly explored. We aimed at identifying discrete profiles of personality traits and their association with clinical features. METHODS: Based on the personality scales of the Millon Clinical Multiaxial Inventory-III, principal component analysis (PCA) identified psychological patterns of functioning of 56 CH patients. PCA outcomes were used for hierarchical cluster analysis (HCA) for sub-groups classification. RESULTS: Eighty-seven percent of patients had personality dysfunctions. PCA found two bipolar patterns: (i) negativistic, sadic-aggressive, borderline, and compulsive traits were distinctive of the psychological dysregulation (PD) dimension, and (ii) narcissistic, histrionic, avoidant, and schizoid traits loaded under the social engagement (SE) component. PD was associated with disease duration and psychopathology. SE was related to educational level and young age. HCA found three groups of patients, and the one with high PD and low SE had the worst psychological profile. CONCLUSIONS: Personality disorders are common in CH. Our data-driven approach revealed distinct personality patterns which can appear differently among patients. The worst combination arguing against mental health is low SE and high PD. Linking this information with medical history may help clinicians to identify tailored-based therapeutic interventions for CH patients.


Assuntos
Cefaleia Histamínica , Humanos , Cefaleia Histamínica/complicações , Transtornos da Personalidade/complicações , Personalidade , Inventário Clínico Multiaxial de Millon , Comorbidade
15.
Clin Dermatol ; 41(1): 105-111, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36878445

RESUMO

Personality disorders are characterized by "ego-syntonic" maladaptive behaviors that impair functioning. This contribution outlines the relevant characteristics and approach to patients with personality disorders pertaining to the dermatology setting. For patients with Cluster A personality disorders (paranoid, schizoid, and schizotypal), it is crucial to avoid being overly contradictory of eccentric beliefs and to take a straightforward, unemotional approach. Cluster B includes antisocial, borderline, histrionic, and narcissistic personality disorders. Promoting safety and boundaries is paramount when interacting with patients with an antisocial personality disorder. Patients with borderline personality disorder have higher rates of various psychodermatologic conditions and benefit from an empathetic approach and frequent followup. Patients with borderline, histrionic, and narcissistic personality disorders all have higher rates of body dysmorphia, and the cosmetic dermatologist needs to avoid unnecessary cosmetic procedures. Patients with Cluster C personality disorders (avoidant, dependent, and obsessive-compulsive) often have significant anxiety associated with their illness and may benefit from extensive and clear explanations of their condition and management plan. Due to the challenges posed by these patients' personality disorders, they are often undertreated or receive poorer quality care. Although it is essential to acknowledge and address challenging behaviors, their dermatologic concerns should not be dismissed.


Assuntos
Transtorno da Personalidade Borderline , Dermatologia , Humanos , Transtornos da Personalidade/complicações , Transtornos da Personalidade/psicologia , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/terapia , Transtorno da Personalidade Borderline/psicologia , Ansiedade
16.
J Affect Disord ; 325: 127-134, 2023 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-36623562

RESUMO

OBJECTIVE: To evaluate the effects of ketamine treatment on depression and suicidal ideation in treatment resistant depression (TRD) and to determine whether they are influenced by other psychiatric and personality comorbidities. METHODS: A randomized double-blind parallel-arm controlled study on 36 patients with TRD. Patients were divided into two treatment groups: ketamine (K group) and placebo (P group). Patients in the K and P groups received one infusion of medicine per week for two weeks. All participants were assessed using the Structured Interview for the Five-Factor Personality Model (SIFFM), Hamilton Depression Rating Scale (HDRS), Suicide Probability Scale (SPS), and Symptom Checklist 90 (SCL 90). RESULTS: After treatment, there was a significant decrease in the total HDRS and SPS scores in the K group compared to the P group, but the magnitude of response was not influenced by the presence of other psychiatric symptoms. Regression model, only receive ketamine treatment was significant factor for improve suicide and depression scores. LIMITATIONS: lack of data on other outcomes that are important to patients (e.g., quality of life, cognition) and need for a larger sample size. CONCLUSIONS: Ketamine infusions in TRD reduce suicidal ideation and depression despite the presence other psychiatric and personality disorders.


Assuntos
Transtorno Depressivo Resistente a Tratamento , Ketamina , Humanos , Ketamina/uso terapêutico , Ideação Suicida , Depressão/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/psicologia , Qualidade de Vida , Antidepressivos/uso terapêutico , Transtornos da Personalidade/complicações , Transtornos da Personalidade/tratamento farmacológico , Método Duplo-Cego , Personalidade , Resultado do Tratamento
17.
Orphanet J Rare Dis ; 18(1): 9, 2023 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-36631837

RESUMO

Although neurological manifestations and changes in brain volumes have been described in Erdheim-Chester disease (ECD), it remains unknown whether ECD may be associated with psychiatric symptoms and cognitive dysfunctions. We assessed the presence of psychiatric disorders, changes in temperaments and characters, and neuropsychological performances in 32 ECD patients (mean age = 59) younger than 70, not treated with interferon alpha during the last 6 months, and without other serious illnesses. ECD patients exhibited high level of past depressive disorder (80%) and anxiety disorder, especially agoraphobia (29%). They revealed personality changes, especially with high agreeableness (t = 3.18, p < 0.005) and high conscientiousness (t = 3.81, p < 0.001). Neuropsychological assessments showed impairments in attention (GZ: t = 16.12, p < 0.0001, KL: t = 37.01, p < 0.0001) and episodic memory performances (STIR: t = - 3.01, p = 0.006, LTFR: t = - 2.87, p = 0.008, LTIR: t = - 3.63, p = 0.001). Executive functions, such as flexibility, inhibitory control, were unimpaired. Although it remains to be clarified whether these psychiatric symptoms and cognitive impairments may impact the daily functioning and the quality of life, the present study highlights the need to consider cognitive and emotional states in ECD management.


Assuntos
Doença de Erdheim-Chester , Transtornos Mentais , Humanos , Pessoa de Meia-Idade , Doença de Erdheim-Chester/psicologia , Doença de Erdheim-Chester/terapia , Interferon-alfa/uso terapêutico , Transtornos Mentais/complicações , Qualidade de Vida , Transtornos da Personalidade/complicações
18.
PLoS One ; 18(1): e0280215, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36608051

RESUMO

Cognitive control is associated with impulsive and harmful behaviours, such as substance abuse and suicidal behaviours, as well as major depressive disorder (MDD) and borderline personality disorder (BPD). The association between MDD and BPD is partially explained by shared pathological personality traits, which may be underpinned by aspects of cognitive control, such as response inhibition. The neural basis of response inhibition in MDD and BPD is not fully understood and could illuminate factors that differentiate between the disorders and that underlie individual differences in cross-cutting pathological traits. In this study, we sought to explore the neural correlates of response inhibition in MDD and BPD, as well as the pathological personality trait domains contained in the ICD-11 personality disorder model. We measured functional brain activity underlying response inhibition on a Go/No-Go task using functional magnetic resonance imaging in 55 female participants recruited into three groups: MDD without comorbid BPD (n = 16), MDD and comorbid BPD (n = 18), and controls with neither disorder (n = 21). Whereas response-inhibition-related activation was observed bilaterally in frontoparietal cognitive control regions across groups, there were no group differences in activation or significant associations between activation in regions-of-interest and pathological personality traits. The findings highlight potential shared neurobiological substrates across diagnoses and suggest that the associations between individual differences in neural activation and pathological personality traits may be small in magnitude. Sufficiently powered studies are needed to elucidate the associations between the functional neural correlates of response inhibition and pathological personality trait domains.


Assuntos
Transtorno da Personalidade Borderline , Transtorno Depressivo Maior , Humanos , Feminino , Transtorno Depressivo Maior/psicologia , Transtorno da Personalidade Borderline/psicologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Transtornos da Personalidade/complicações , Comportamento Impulsivo
19.
Appl Neuropsychol Adult ; 30(3): 368-378, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34251923

RESUMO

At least one in four patients with substance use disorder (SUD) meet criteria for personality disorder and overlapping neurocognitive deficits may reflect shared neurobiological mechanisms. We studied neurocognition in females attending residential SUD treatment by comparing SUD with (n = 20) or without (n = 30) comorbid personality disorder. Neuropsychological testing included working memory, inhibition, shifting, verbal fluency, design fluency, psychomotor speed, immediate and delayed verbal memory, processing speed, premorbid functioning, cognitive screening, and self-reported executive function. As expected, whole-sample deficits included working memory (d = -.91), self-reported executive function (d = -.87), processing speed (d = -.40), delayed verbal memory recall (d = -.39), premorbid functioning (d = -.51), and cognitive screening performance (d = -.61). Importantly, the comorbid personality disorder group showed greater self-reported executive dysfunction (d = -.67) and poorer shifting performance (d = -.65). However, they also evidenced better working memory (d = .84), immediate (d = .95) and delayed (d = .83) verbal memory, premorbid functioning (d = .90), and cognitive screening performance (d = .77). Overall executive dysfunction deficits were concordant with those observed in previous SUD studies. Surprisingly, comorbid personality disorder was associated with a pattern indicating poorer subjective (self-report) but better objective performance on a number of tasks, apart from shifting deficits that may relate to emotion dysregulation. Subjective emotional dysfunction may influence the cognitive deficits observed in the personality disorder group.


Assuntos
Cognição , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Função Executiva/fisiologia , Memória de Curto Prazo , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações
20.
J Am Coll Health ; 71(5): 1436-1444, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-34133265

RESUMO

Objective: Self-harm and personality psychopathology have been linked, with the most robust correlations existing between negative affectivity and self-harm. Psychological pain, an emotionally-based aversive feeling, has been linked to self-harm. Considering the connection between personality psychopathology and self-harm, psychological pain may enhance self-harm risk. Participants: Analyses were conducted on 525 undergraduate students in the Spring and Fall semesters of 2019. Methods/Results: Correlation analyses indicated that self-harm was moderately correlated with Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. Additionally, self-harm was correlated with psychological pain. When examining if psychological pain moderates the relation between personality psychopathology and self-harm, results were mixed. In the cases of Disinhibition and Psychoticism, psychological pain enhanced self-harm. There was no moderating effect on the relations with Negative Affectivity, Detachment, or Antagonism. Conclusions: These findings support the role of psychological pain in self-harm outcomes for those experiencing personality psychopathology; however, this varies depending on the maladaptive traits.


Assuntos
Comportamento Autodestrutivo , Estudantes , Humanos , Universidades , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Personalidade , Dor
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