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1.
Adv Exp Med Biol ; 1180: 179-191, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31784963

RESUMO

Diagnosis for MDD in modern psychiatry has developed for decades based on long traceable historic efforts on conceptualizing the illness. This article reviews the historical background of current diagnostic framework for MDD, diagnostic criteria and two newly added specifiers ("with anxious distress" and "with mixed features" specifiers) of MDD in the DSM-5, the most influential diagnostic instrument in the world, as well as problems and limitations of symptom-based diagnosis for sake of better understanding about the inter-relationship between diagnostic criteria and MDD.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos
2.
Adv Exp Med Biol ; 1192: 17-25, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705488

RESUMO

Because of the poor link between psychiatric diagnosis and neurobiological findings, it is difficult to classify mental disorders. The changes made to psychiatric diagnostic systems over the years can be understood in terms of "practical conservatism." The Diagnostic and Statistical Manual of Mental Disorders (DSM)-I and DSM-II were theoretically supported by the psychoanalytic and psychodynamic approach. Subsequently, psychiatric diagnoses of this kind were opposed by the anti-psychiatry movement, as well as by the findings of the Rosenhan experiment. Thus, the DSM-III revolution contained more empiricism, aligning psychiatry with biomedicine. Psychiatric diagnoses are classified and defined in terms of Kraepelinian dualism, using a categorical approach. The empirical trend was continued in the DSM-IV. To overcome the limitations of current psychiatric diagnostic systems and integrate fundamental genetic, neurobiological, behavioral, environmental, and experimental components into psychiatry, the Research Domain Criteria (RDoC) were established. To overcome the limitations of the categorical approach, psychiatrists have considered adopting a dimensional approach. However, their efforts were frustrated in the DSM-5 revision process. Thus, the DSM-5 is characterized by the rearrangement of psychiatric diagnoses, the partial adoption of a dimensional approach, the introduction of new diagnoses, and harmonization with the International Classification of Diseases.


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos Mentais/classificação , Transtornos Mentais/psicologia , Psiquiatria , Humanos , Classificação Internacional de Doenças , Neurobiologia
6.
Harefuah ; 158(9): 607-611, 2019 Sep.
Artigo em Hebraico | MEDLINE | ID: mdl-31507114

RESUMO

INTRODUCTION: Excoriation (Skin-Picking) disorder is a clinically recognized condition which was recently included in the Diagnostic and Statistical manual of the American Psychiatric Association (DSM) - fifth edition, as OCD (obsessive compulsive disorder) related disorder. The disorder's official status has been achieved due to its high frequency and unique clinical picture involving both mental and physical impairment. In this article, we would like to present a concise review of the literature together with an illustrative case. Epidemiological surveys show a prevalence of 3% to 5% for the general population, with heterogeneous gender and age distribution. In recent years the disorder has been categorized under the family of BFRB's (Body Focused Repetitive Behaviours). However, there are some elements associated with movement suppression and tic disorders, as well as disorders belonging to obsessive-compulsive spectrum. The treatment of this disorder may be pharmacological and/or psychological. There is some evidence for the benefit of some SSRI (Selective Serotonin Reuptake Inhibitors) agents as well as for N-Acetyl-Cysteine. Various psychological treatments have been investigated and some of them have proven to be effective. These include cognitive behavioural protocols, some of which have been developed specifically for this disorder.


Assuntos
Transtorno Obsessivo-Compulsivo , Comportamento Autodestrutivo , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Prevalência , Inibidores de Captação de Serotonina
7.
West Afr J Med ; 36(2): 183-188, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385606

RESUMO

OBJECTIVE: There is paucity of information on delirium in sub-Saharan Africa (SSA) particularly in the older persons (>60 years of age), leaving questions about the burden of the disease in an environment with lower health care standards. In this article, we set out to determine the frequency, precipitants and symptomatology of delirium in elderly patients admitted into medical wards in a teaching hospital in South-West Nigeria. METHODS: This was a descriptive study involving a pre-planned sample of one hundred and fifty patients aged 60 years and over, assessed for cognitive impairment and delirium using the previously validated IDEA cognitive screen, and the Confusion Assessment Method (CAM) respectively. Diagnosis of delirium was made using the CAM and DSM-IV criteria. RESULTS: Delirium was diagnosed in 32 patients giving a frequency of 21.3% (95%CI: 14.7-30.0%). Patients with delirium were significantly older (p<0.05). A quarter of the patients had dementia. Hypertension was a notable co-morbid condition. All the patients had altered sleep wake cycle, inattention, disorientation, and altered consciousness. Neurological diseases were the most common precipitant. There was a good agreement between the DSM-IV and CAM diagnoses. CONCLUSION: Delirium is common in hospitalised elderly patients particularly those with neurological diseases. Co-morbidities like hypertension, dementia, and depression should be looked for in delirious elderly patients.


Assuntos
Disfunção Cognitiva/diagnóstico , Confusão/diagnóstico , Delírio/diagnóstico , Demência/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/epidemiologia , Comorbidade , Confusão/psicologia , Delírio/epidemiologia , Delírio/psicologia , Demência/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Hipertensão/epidemiologia , Entrevista Psiquiátrica Padronizada/estatística & dados numéricos , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Testes Neuropsicológicos/estatística & dados numéricos , Nigéria/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Centros de Atenção Terciária
9.
Psychopathology ; 52(3): 184-190, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31401628

RESUMO

BACKGROUND: Different studies have shown that a patient's attachment correlates with the psychotherapy outcome. However, these findings are based on the traditional interview and paper and pencil attachment methods. Latency-based methods like the Implicit Association Test (IAT) have not yet been investigated in clinical attachment research, specifically in therapy outcome research. OBJECTIVES: It can be hypothesized that patients with positive schemas of their mother and their partner may show a better psychotherapeutic outcome than those with less positive schemas of their mother/partner. METHOD: A sample of 103 patients suffering from panic disorder with or without agoraphobia (age 36.73, SD = 10.80), including 56% of patients with affective or other anxiety disorders as comorbidities without a personality disorder, based on the Structured Clinical Interview for DSM-IV (SCID-I/II), were treated with a manualized cognitive-behavioral confrontation therapy. Two IATs (for mother and partner) were implemented before the therapy (t1). The symptom reduction was assessed by the Symptom Checklist-90 (SCL-90) and the Beck Depression Inventory (BDI) with symptoms at t1 and IAT at t1 as predictors of symptoms at t2. RESULTS: The results confirmed a moderate to high therapeutic effect of the confrontation therapy. Furthermore, the mother's IAT at t1 predicted the Global Severity Index (ß = 0.20) as well as the Anxiety subscale (ß = 0.18) at t2 above and beyond the t1 measurement of the criteria. CONCLUSIONS: Implicit attitudes of the mother predicted the symptom reduction and a better therapeutic outcome. Relationship aspects with less impact awareness predicted the therapeutic outcome, even though mostly cognitive-behavioral techniques were used.


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtorno de Pânico/psicologia , Psicoterapia/métodos , Adulto , Feminino , Humanos , Masculino , Resultado do Tratamento
10.
Rev Med Chil ; 147(4): 475-479, 2019 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-31344210

RESUMO

DSM-5 is a significant factor in promoting the "remedicalization" of psychiatry as the focus of psychiatric knowledge, developed by the evidence-based medicine movement, shifted from the clinically-based biopsychosocial model to a research-based medical model. DSM-5 purposes are 1]clinical: diagnosis, prevention, early identification, management, outcome, assessment of improvement; 2] clinical research: etiology, course, effective treatments, cost-effective treatments, reliability and validity and utility of diagnosis; 3] a worldwide common language of diagnostic criteria used by mental health professionals; and 4] to improve communication with users of services, caregivers, and society in general. In the absence of a "gold standard" there are two basic questions still without answers 1] what kind of entities are psychiatric disorders?; and 2] How to integrate the multiple explanatory perspectives of psychiatric illness?.


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos Mentais/diagnóstico , Humanos , Psiquiatria/normas
11.
Psychiatr Danub ; 31(2): 182-188, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31291222

RESUMO

BACKGROUND: Despite relatively consistent findings regarding the number of personality pathology domains, differences in domain structure remain. Recently the proposed ICD-11 domains were partially validated in a sample of patients with major depression producing five domains: Detached, Anankastic, Negative Emotional, Antisocial and Borderline. The aim of our study was to attempt to cross-validate these findings in a sample of patients primarily diagnosed with personality disorder (PD). SUBJECTS AND METHODS: All subjects were assessed by Structured Clinical Interview for the DSM-IV Axis II PD. Exploratory factor analysis (EFA) was applied on fifty seven DSM PD symptoms selected to represent the five proposed domains. RESULTS: SCID II data were collected from a total of 223 subjects. The EFA extracted five factors. The first factor labeled as borderline-internalizing constituted of borderline together with avoidant and dependent items, the second, labeled as disinhibited/ borderline externalizing, incorporated narcissistic and histrionic items. The other three separate factors in our study labeled as antisocial, anankastic and detached, were less robust. CONCLUSIONS: In our study five personality pathology domains were partly replicated. The most robust findings support the existence of the two factors, borderline-internalizing and disinhibited/borderline externalizing. However, the EFA was performed on a relatively low prevalence symptoms distribution, particularly for antisocial and schizoid factors.


Assuntos
Transtornos da Personalidade/psicologia , Personalidade , Adolescente , Adulto , Idoso , Transtorno Depressivo Maior/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Transtornos da Personalidade/diagnóstico , Adulto Jovem
12.
BMC Psychol ; 7(1): 46, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291999

RESUMO

BACKGROUND: A taxonomy of the objects of study, theory, assessment, and intervention is critical to the development of all clinical sciences. Clinical psychology has been conceptually and administratively dominated by the taxonomy of an adjacent discipline - psychiatry's Diagnostic and statistical manual of mental disorders (DSM). Many have called for a 'paradigm shift' away from a medical nosology of diseases toward clinical psychology's own taxonomy of clinical psychological problems (CPPs), without being able to specify what is to be listed and classified. MAIN TEXT: An examination of DSM's problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of CPPs in what clinical psychologists actually do, leads to the proposal that: The critical psychological-level phenomenon underlying CPPs is the occurrence of 'problem-maintaining circles' (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli. This concept provides an empirically-derived, theory-based, treatment-relevant, categorical, essentialist, parsimonious, and nonstigmatizing definition of CPPs. It distinguishes psychological problems in which PMCs have not (yet?) formed, and which may respond to 'counseling', clinical psychological problems in which active PMCs require clinical intervention, and psychopathological problems which are unlikely to be 'cured' by PMC-breaking alone. CONCLUSION: A subsequent classification and coding system of PMCs is proposed, and expected benefits to research, communication, and the quality of case formulation in clinical psychology are described, reliant upon a development effort of some meaningful fraction of that which has been devoted to the DSM.


Assuntos
Transtornos Mentais/classificação , Transtornos Mentais/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Classificação Internacional de Doenças , Transtornos Mentais/psicologia , Psiquiatria/normas
13.
J Forensic Sci ; 64(6): 1884-1888, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31287563

RESUMO

In clinical and most forensic evaluations, "diagnosis" connotes the expectation of a DSM-5 or ICD-10 formally labeled mental condition. When the task is to evaluate the security risk a person's psychological makeup presents to an institution, such a molar diagnosis can blind the clinician and elevate the risk to a security agency. When "diagnosis" connotes achieving an understanding of a person's behavior that has raised security concerns, then a different conceptualization of the diagnostic process is required. Unlike the clinical situation, the evaluation is not being performed to benefit the person but for the purpose of assessing risk to an agency. The differences this introduces involve every aspect of the evaluation and changes the type of diagnosis expected. Not appreciating these differences can cause the clinician to fail in the task of assessing psychological tendencies that affect national security.


Assuntos
Emprego , Transtornos Mentais/diagnóstico , Medidas de Segurança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Classificação Internacional de Doenças , Entrevista Psicológica , Transtornos Mentais/psicologia , Testes Psicológicos
14.
East Asian Arch Psychiatry ; 29(2): 41-47, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31237245

RESUMO

OBJECTIVE: To examine the prevalence and comorbidity of gastro-oesophageal reflux disease (GORD) with generalised anxiety disorder (GAD) and major depressive episodes (MDE) in a general population using DSM-IV, and to evaluate the associations between these conditions and healthcare utilisation. METHODS: A random population-based telephone survey was conducted to record frequency of GORD symptoms, symptoms of GAD and MDE based on DSM-IV, and healthcare utilisation. RESULTS: Of 2011 respondents, 4.2% had weekly GORD and 13.9% had monthly GORD, whereas 3.8% reported GAD and 12.4% reported MDE. Those with monthly GORD had higher risk of GAD (p = 0.01) and MDE (p < 0.001). GORD symptom frequency was independently correlated with MDE and GAD in a dose-response manner. The number of psychiatric diagnoses was independently correlated with GORD. GORD symptom frequency, GAD, and MDE were correlated with consultation frequency. GORD symptom frequency was corelated with high investigation expenditure. CONCLUSION: GORD had a strong dose-response relationship with GAD and MDE in a Hong Kong population. Excessive healthcare utilisation should alert clinicians to the risk of psychiatric comorbidity.


Assuntos
Transtornos de Ansiedade , Transtorno Depressivo Maior , Refluxo Gastroesofágico , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/fisiopatologia , Comorbidade , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/fisiopatologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/psicologia , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevalência , Medição de Risco
15.
Tijdschr Psychiatr ; 61(6): 384-391, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31243748

RESUMO

BACKGROUND: There is an average 10-year delay in diagnosing bipolar disorder, hampering the application of effective therapeutic interventions.
AIM: To investigate factors contributing to early recognition.
METHOD: We give a stage-oriented overview of the opportunities for early recognition.
RESULTS: Recognition in stage 0 (at-risk) and stage 1 (prodromal) is yet impossible. In stage 2 (syndromal) there are opportunities for better recognition in patients presenting with depression by conducting a thorough (collateral) psychiatric assessment, family history and by applying additional screening tools. CONCLUSIONS There are opportunities for better recognition of bipolar disorder in the syndromal stage.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/psicologia , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Escalas de Graduação Psiquiátrica
16.
BMC Med ; 17(1): 120, 2019 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-31234891

RESUMO

BACKGROUND: Rates of suicide are increasing in the US. Although psychiatric disorders are associated with suicide risk, there is a dearth of epidemiological research on the relationship between suicide attempts (SAs) and eating disorders (EDs). The study therefore aimed to examine prevalence and correlates of SAs in DSM-5 EDs-anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED)-in a nationally representative sample of US adults. In addition, prevalence and correlates of SAs were examined in the two subtypes of AN-restricting (AN-R) and binge/purge (AN-BP) types. METHODS: The study included 36,171 respondents in the Third National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III) who completed structured diagnostic interviews (AUDADIS-5) and answered questions regarding SA histories and psychosocial impairment associated with EDs. We evaluated lifetime prevalence of SA, psychosocial impairment, clinical profiles, and psychiatric comorbidity in adults with EDs with and without SA histories, and temporal relationships between age onset of SA and EDs. RESULTS: Prevalence estimates of suicide attempts were 24.9% (for AN), 15.7% (for AN-R), 44.1% (for AN-BP), 31.4% (for BN), and 22.9% (for BED). Relative to respondents without specific EDs, adjusted odds ratios (AORs) of SAs were significantly greater in all EDs: AN = 5.40 (95% confidence intervals [CIs] = 3.80-7.67), AN-R = 3.16 (95% CIs = 1.82-5.42), AN-BP = 12.09 (95% CIs = 6.29-23.24), BN = 6.33 (95% CIs = 3.39-11.81), and BED = 4.83 (95% CIs = 3.54-6.60). Among those with SA history, mean age at first SA and number of SAs were not significantly different across the specific EDs. SA was associated with significantly earlier ED onset in BN and BED, longer duration of AN but shorter duration of BN, greater psychosocial impairment in AN and BN, and with significantly increased risk for psychiatric disorder comorbidity across EDs. Onset of BED was significantly more likely to precede SA (71.2%) but onsets of AN (50.4%) and BN (47.6%) were not. CONCLUSIONS: US adults with lifetime DSM-5 EDs have significantly elevated risk of SA history. Even after adjusting for sociodemographic factors, those with lifetime EDs had a roughly 5-to-6-fold risk of SAs relative to those without specific EDs; the AN binge/purge type had an especially elevated risk of SAs. SA history was associated with distinctively different clinical profiles including greater risk for psychosocial impairment and psychiatric comorbidity. These findings highlight the importance of improving screening for EDs and for suicide histories.


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Tentativa de Suicídio/psicologia , Adulto , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Masculino , Estados Unidos , Adulto Jovem
17.
J Autism Dev Disord ; 49(9): 3732-3752, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31161304

RESUMO

Initial studies have presented the Music-based Scale for Autism Diagnostics (MUSAD) as a promising DSM-5-based observational tool to identify autism spectrum disorder (ASD) in adults with intellectual disability (ID). The current study is the first to address its clinical utility in a new sample of 124 adults with ID (60.5% diagnosed with ASD). The derived diagnostic algorithm differentiated well between individuals with and without ASD (sensitivity 79%, specificity 74%, area under the curve = 0.81). Inter-rater reliability, assessed by the scorings of four independent experts in 22 consensus cases, was excellent (ICC = 0.92). Substantial correlations with scores from other ASD-specific measures indicated convergent validity. The MUSAD yields accurate and reliable scores, supporting comprehensive ASD diagnostics in adults with ID.


Assuntos
Algoritmos , Transtorno do Espectro Autista/diagnóstico , Deficiência Intelectual/diagnóstico , Música/psicologia , Testes Psicológicos/estatística & dados numéricos , Adulto , Área Sob a Curva , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
18.
Nord J Psychiatry ; 73(4-5): 244-247, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31074670

RESUMO

Background: Body dysmorphic disorder (BDD) is preoccupation with perceived body defects leading to distress and impairment in social functioning. Most of adolescent BDD literature has been done on patients within the outpatient setting with prior versions of DSM with dearth of information about BDD and comorbid psychiatric conditions among adolescents within the inpatient setting. Aims: This pilot study evaluated the prevalence rate, clinical characteristics in adolescent BDD compared to non-BDD adolescents in a psychiatric in patient setting in addition to their comorbid issues like anxiety, OCD, ADHD and substance abuse. Methods: Forty-five consecutively admitted adolescent patients participated with 17 meeting the DSM 5 criteria for BDD while 28 did not. Patients were asked four questions designed around the DSM-5 criteria for BDD after which they were asked to complete questionnaires like BDDQ child and adolescent version, BDDM, Multiaxial Anxiety Scale for Children, Children's Depression Inventory, Y-BOCS and Vanderbilt ADHD rating scales. Results: Seventeen participants had BDD. Mean age of BDD patients was 13.1 while non-BDD was 12.4. Male patients with BDD were seven (41%) while female BDD patients were 10 (58.8%). Anxiety, depression, OCD and substance use disorders were common comorbid diagnoses. Majority of patients in the BDD group classified their BDD as a severe problem with more BDD, patient's considering suicide because of their BDD. Discussion: BDD is present in adolescents admitted in inpatient psychiatric hospital with more female patients endorsing BDD versus their male counterparts. Patients with BDD are more likely to endorse more comorbid psychiatric issues such as anxiety, OCD, ADHD and substance abuse.


Assuntos
Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Hospitais Psiquiátricos , Pacientes Internados/psicologia , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/psicologia , Adolescente , Transtornos Dismórficos Corporais/diagnóstico , Criança , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Hospitalização/tendências , Humanos , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Projetos Piloto , Prevalência , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários
19.
Psychol Addict Behav ; 33(4): 420-429, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31094546

RESUMO

The Diagnostic and Statistical Manual of Mental Disorders (DSM; 5th ed.) reassignment of gambling disorder as an addictive disorder alongside the substance-related addictive disorders encourages research into their shared etiologies. The aims of this study were to examine: (a) the associations of Big Five personality dimensions with alcohol, nicotine, cannabis, and gambling disorders, (b) the comorbidity between these disorders, (c) the extent to which common personality underpinnings explain comorbidity, (d) whether results differed for men and women, and (e) the magnitude of personality differences corresponding to the 4 disorders. Participants were 3,785 twins and siblings (1,365 men, 2,420 women; Mage = 32 years, range = 21-46 years) from the Australian Twin Registry who completed psychiatric interviews and Big Five personality inventories. The personality profile of high neuroticism, low agreeableness, and low conscientiousness was associated with all 4 addictive disorders. All but 1 of the pairwise associations between the disorders were significant. After accounting for Big Five traits, the associations were attenuated to varying degrees but remained significant. The results were generally similar for men and women. The results suggest that the Big Five traits of neuroticism, agreeableness, and conscientiousness are associated with the general propensity to develop an addictive disorder and may in part explain their co-occurrence; however, they may be more broadly associated with the propensity for any psychiatric disorder. The effect sizes of the personality associations suggest that the diagnosis of gambling disorder as operationalized by the DSM may be more severe than the other addictive disorders. Calibration of the diagnosis of gambling disorder to the other addictive disorders may be warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Comportamento Aditivo/psicologia , Jogo de Azar/psicologia , Personalidade , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Austrália/epidemiologia , Comportamento Aditivo/epidemiologia , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Jogo de Azar/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
20.
Rev Med Chil ; 147(2): 181-189, 2019 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-31095166

RESUMO

BACKGROUND: Depression is the most common psychiatric disorder in people with suicidal behavior. The knowledge of its risk factors should help to design preventive strategies. AIM: To describe suicidal behavior and risk factors for attempted suicide in people with major depressive disorders (MDD). MATERIAL AND METHODS: A 12-month follow-up study was conducted in 112 outpatients at three psychiatric care centers of Ñuble, Chile, with baseline and quarterly assessments. Demographic, psychosocial and clinical factors as potential risk factors of suicide attempts, were assessed. A clinical interview with DSM-IV diagnostic criteria checklist, Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. RESULTS: Sixty seven percent of participants had suicidal ideation and 43.8% had attempted suicide. Suicide risk was significantly higher in participants with a single major depressive episode (odds ratio [OR] = 3.98; 95% confidence intervals [CI] = 1,29-12,32 p = 0.02) and those with previous suicide attempts (OR = 13.15; 95% CI = 3,87-44.7 p < 0.01). Young age, not having a partner, being unemployed, having a severe major depressive episode, having psychotic symptoms, having a personality disorder and being devoid of medical illness increased the risk of suicide attempts, but they did not reach statistical significance. CONCLUSIONS: Significant risk factors should be specially considered when designing suicide preventive strategies in patients with MDD.


Assuntos
Transtorno Depressivo Maior/psicologia , Atenção Secundária à Saúde/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Chile , Transtorno Depressivo Maior/terapia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Determinação da Personalidade/estatística & dados numéricos , Transtornos Psicóticos/psicologia , Fatores de Risco , Fatores Socioeconômicos , Ideação Suicida , Tentativa de Suicídio/classificação , Adulto Jovem
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