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1.
PLoS One ; 15(1): e0227673, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31986163

RESUMO

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


Assuntos
Potenciais Evocados/fisiologia , Transtorno de Pânico/fisiopatologia , Transtorno de Pânico/terapia , Adulto , Estudos de Casos e Controles , Eletroencefalografia , Potenciais Evocados Visuais/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/complicações , Transtornos da Personalidade/complicações , Transtornos da Personalidade/fisiopatologia , Transtornos da Personalidade/psicologia , Estimulação Luminosa , Psicoterapia , Adulto Jovem
2.
Z Psychosom Med Psychother ; 65(2): 198, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31154929

RESUMO

Long-term effectiveness of psychodynamic inpatient therapy on depressive disorders - Catamnestic- Results of the STOP-D-Study Objectives: Depression is one of the most common disorders with a rate of recurrence between 60-75 %. The effectiveness of psychodynamic therapy is well-proven, but there is still a lack of studies proving the long-term effectiveness of inpatient treatment on depressive symptom load. Methods: After psychodynamic inpatient treatment in a psychodynamically oriented psychosomatic hospital unit, the reduction in general and depressive symptom load (e. g. BDI, HAMD, SCL-90-R) was evaluated by a six-month follow up design. The study was set up as naturalistic multicenter intervention study including a female follow-up sample (N = 291; age 25-45 years). Results: The symptom improvement reached by the inpatient treatment remained stable at the follow-up survey. Patients treated with antidepressant medication showed stronger depressive symptom load at discharge and follow-up survey compared to patients without antidepressant medication. Sociodemographic variables and a comorbid personality disorder were not associated with increased drop-out rates, but depressive symptom load and a premature ending of the treatment. Conclusions: The obtained results demonstrate the long-term effectiveness of inpatient psychodynamic psychotherapy. Further studies about the influence of post-hospital psychotherapy and medical treatment as well as patient satisfaction seem necessary.


Assuntos
Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Pacientes Internados/psicologia , Psicoterapia Psicodinâmica , Adulto , Depressão/complicações , Depressão/psicologia , Depressão/terapia , Transtorno Depressivo/complicações , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Fatores de Tempo , Resultado do Tratamento
3.
Personal Ment Health ; 13(3): 168-179, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31237109

RESUMO

A high prevalence of people present to 'Improving Access to Psychological Therapies' (IAPT) in England with common mental health disorders and co-morbid personality disorder. This group have suboptimal treatment outcomes in IAPT. Whilst new short-term treatment approaches are advocated, no solutions or guidance have been provided. This qualitative study explored IAPT health-care professional (N = 28) perspectives of working with people who present to IAPT with co-morbid personality disorder. Individual semi-structured interviews were digitally recorded, transcribed verbatim and analysed using a framework analysis approach. Results identified a lack of skills and confidence in working with this patient group, restrictive service constraints and a treatment gap between the interface of primary and secondary services. Insight into acceptable adaptions to practice are identified that have transferable utility to a wider international audience who can identify people outside of specialist mental health services with common mental health disorders and co-morbid personality disorder traits. © 2019 John Wiley & Sons, Ltd.


Assuntos
Acesso aos Serviços de Saúde , Serviços de Saúde Mental , Transtornos da Personalidade/complicações , Psicoterapia , Atitude do Pessoal de Saúde , Inglaterra , Humanos , Transtornos da Personalidade/psicologia , Transtornos da Personalidade/terapia , Pesquisa Qualitativa
4.
Soc Psychiatry Psychiatr Epidemiol ; 54(8): 897-904, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30929043

RESUMO

PURPOSE: People with personality disorders have significantly reduced life expectancy and increased rates of cardiovascular disease compared to members of the general population. Given that more people die annually of cardiovascular disease across the globe than from any other cause, it is important to identify the evidence for interventions aimed at improving cardiovascular health among people with personality disorders. METHODS: Systematic literature review. PsycINFO, MEDLINE and EMBASE were searched using NICE Healthcare Databases, as well as CENTRAL and trial registries. We sought to identify randomised controlled trials of interventions pertaining to adults with a primary diagnosis of personality disorder, where the primary outcome measure was cardiovascular health before and after the intervention. RESULTS: A total of 1740 records were identified and screened by two independent reviewers. No papers meeting the inclusion criteria were identified. CONCLUSIONS: This systematic review did not identify any randomised controlled trials testing interventions aimed at improving the cardiovascular health of people with personality disorders. Research in this area could have important public health implications, spanning the fields of psychiatry and general medicine.


Assuntos
Doenças Cardiovasculares/terapia , Transtornos da Personalidade/terapia , Adulto , Doenças Cardiovasculares/psicologia , Feminino , Humanos , Masculino , Transtornos da Personalidade/complicações , Transtornos da Personalidade/fisiopatologia
5.
Actas esp. psiquiatr ; 47(2): 61-69, mar.-abr. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181341

RESUMO

Objetivos. El hecho de que cada vez haya más personas que padezcan demencia hace que sea muy importante conocer los diferentes factores de riesgo para prevenir su aparición. El objetivo de este artículo es estudiar el trastorno de la personalidad como posible factor de riesgo para la aparición de un proceso demencial, y relacionar trastornos de la personalidad del Clúster B y demencia. Metodología. Se realizó una revisión sistemática y metaanálisis con literatura científica publicada hasta el año 2015. Resultados. Doce de los artículos que se encontraron cumplían con los criterios de selección y calidad especificados y estudian la relación entre un trastorno de personalidad y la aparición de una demencia. Aunque con los estudios hechos hasta el momento no se puede concluir que el primero sea un factor de riesgo para el segundo, sí que se ha podido observar, mediante técnicas de neuroimagen, que los pacientes con trastornos de personalidad del Clúster B desarrollan alteraciones en estructuras cerebrales (en la corteza prefrontal, temporal y/o parietal, además de una alteración en los niveles de N-acetil Aspartato y de sustancia gris) que también están implicadas en un proceso demencial. Conclusiones. En definitiva, los pacientes con historia clínica de trastorno límite o trastorno narcisista de la personalidad presentan más alteraciones en las estructuras cerebrales mencionadas, de tal manera que presentar este tipo de trastornos de la personalidad podría aumentar el riesgo de padecer demencia en un futuro


Objectives. The fact that more and more people suffer from dementia makes it very important to know the different risk factors to prevent their appearance. The objective of this article is to study personality disorder as a possible risk factor for the onset of an insane process, and to relate personality disorders of Cluster B and dementia. Methodology. A systematic review and meta-analysis was carried out with scientific literature published up to 2015. Results. Twelve of the articles that we found met the specified criteria of selection and quality and study the relationship between a personality disorder and the emergence of a dementia. Although with the studies made so far it can’t be concluded that the first one is a risk factor for the second one, it has been noted, thanks to neuroimaging techniques, that patients with Cluster B personality disorders develop alterations in brain structures (in the prefrontal, temporal and parietal cortex, as well as an alteration in the NAA levels and the grey matter levels) and which are also involved in a demented process. Conclusions. Definitely, the patients with medical record of the borderline or narcissistic personality disorder present more alterations in the brain structures mentioned, such that presenting these types of personality disorders could increase the risk of developing dementia in the future


Assuntos
Humanos , Demência/etiologia , Transtorno da Personalidade Borderline/diagnóstico por imagem , Narcisismo , Fatores de Risco , Cérebro/fisiopatologia , Transtornos da Personalidade/complicações , Transtorno da Personalidade Antissocial/fisiopatologia , Transtorno da Personalidade Histriônica/fisiopatologia
6.
J Couns Psychol ; 66(3): 351-361, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30702321

RESUMO

Across a breadth of psychotherapeutic approaches, feeling affect intensely and then talking about those feelings is a common means for increasing insight and other desired outcomes. While several naturalistic and laboratory studies have found that depression symptoms attenuate (i.e., weaken) the association between negative-affect intensity and negative-affect expression, depression's attenuating effect has not been examined in a psychotherapeutic context. The first aim of the present study was to examine if depression symptoms' attenuating effect on the association between negative-affect intensity and negative-affect expression extended into group psychotherapy. Our second aim was to examine group effects on patients' negative-affect expression. Participants (N = 239) were patients consecutively admitted into a psychodynamic group-psychotherapy day treatment program for people with personality disorders. Patients indicated their negative-affect intensity and negative-affect expression each week that they were in treatment. Depression symptoms were assessed at baseline. Results indicated that depression symptoms attenuated (i.e., moderated) the association between negative-affect intensity and negative-affect expression. Further, while the association between patient intensity and expression increased over the course of treatment, the moderating effect of depression on this association did not vary over treatment. Regarding group effects, group negative-affect intensity was associated with higher levels of patient negative-affect expression. Inversely, group affect expression was associated with lower levels of patient affect expression. Patient depression symptoms did not moderate the association between group negative-affect intensity and patient negative-affect expression. Our findings indicate that while group affect intensity and affect expression impacts patients' expression, depression's attenuating effect on negative-affect expression extends to patient effects but not group effects. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Depressão/complicações , Depressão/psicologia , Emoções , Transtornos da Personalidade/psicologia , Transtornos da Personalidade/terapia , Psicoterapia de Grupo , Adolescente , Adulto , Idoso , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Adulto Jovem
7.
BMC Psychiatry ; 19(1): 3, 2019 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-30606154

RESUMO

BACKGROUND: Early exposure to trauma is a known risk factor for personality disorder (PD), but evidence for late-onset personality pathology following trauma in adults is much less clear. We set out to investigate whether exposure to war trauma can lead to lasting personality pathology in adults and to compare the mental health and social functioning of people with late-onset personality problems with those with PD. METHODS: We recruited patients who scored positively on the International Personality Disorder Examination (IPDE) in southern Croatia 15 years after the Croatian war of independence and used a semi-structured interview to establish when the person's personality-related problems arose. All participants also completed Harvard Trauma Questionnaire, and measures of mental health and social functioning. RESULTS: Among 182 participants with probable personality disorder, 65 (35.7%) reported that these problems started after exposure to war-trauma as adults. The most prevalent personality problems among those with late-onset pathology were borderline, avoidant, schizotypal, schizoid and paranoid. Participants with late-onset personality pathology were more likely to have schizotypal (75.4% vs. 47.3%) and schizoid traits (73.8% vs. 41.1%) compared to those with PD. Participants with late-onset personality pathology were three times more likely to have complex personality pathology across all three DSM-IV clusters compared to those with PD (OR = 2.96, 95% CI 1.54 to 5.67) after adjusted for gender and marital status. The prevalence of depression and social dysfunction were as high among those with late-onset personality pathology as among those with personality disorder. CONCLUSION: Retrospective accounts of people with significant personality pathology indicate that some develop these problems following exposure to severe trauma in adulthood. Personality-related problems which start in adulthood may be as severe as those that have an earlier onset. These findings highlight the long term impact of war trauma on the mental health and have implications for the way that personality pathology is classified and treated.


Assuntos
Transtornos de Início Tardio/psicologia , Transtornos da Personalidade/psicologia , Ferimentos e Lesões/psicologia , Adulto , Conflitos Armados/psicologia , Croácia/epidemiologia , Depressão/complicações , Depressão/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Prevalência , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
8.
Eur Neuropsychopharmacol ; 29(1): 122-126, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30497838

RESUMO

Inhaled Loxapine (IL) has demonstrated efficacy in the treatment of agitation in schizophrenic and bipolar patients, although data in patients with Personality Disorder (PD) are scarce. To evaluate the effectiveness and safety of IL in the treatment of agitation in PD, data from 41 patients who presented at our unit with acute agitation and were treated with 9.1 mg of IL were collected retrospectively. The results showed that IL significantly decreased agitation within 10 minutes and its effect was greater at 20 minutes (Positive and Negative Syndrome Scale-excited component: from 22.78 ±â€¯4.39 at baseline to 11.14 ±â€¯4.17 at 20 minutes; p < 0.001; Agitation and Calmness Evaluation Scale: from 1.80 ±â€¯0.49 at baseline to 4.53 ±â€¯1.05 at 20 minutes; p < 0.01) without any severe adverse reactions registered. IL led to fast, safe and well-tolerated control of agitation in patients with PD.


Assuntos
Loxapina/uso terapêutico , Transtornos da Personalidade/tratamento farmacológico , Agitação Psicomotora/tratamento farmacológico , Administração por Inalação , Adolescente , Adulto , Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Bases de Dados Factuais , Feminino , Humanos , Loxapina/administração & dosagem , Loxapina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Agitação Psicomotora/complicações , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
9.
Behav Genet ; 49(1): 11-23, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30536213

RESUMO

A statistical mediation model was developed within a twin design to investigate the etiology of alcohol use disorder (AUD). Unlike conventional statistical mediation models, this biometric mediation model can detect unobserved confounding. Using a sample of 1410 pairs of Norwegian twins, we investigated specific hypotheses that DSM-IV personality-disorder (PD) traits mediate effects of childhood stressful life events (SLEs) on AUD, and that adulthood SLEs mediate effects of PDs on AUD. Models including borderline PD traits indicated unobserved confounding in phenotypic path coefficients, whereas models including antisocial and impulsive traits did not. More than half of the observed effects of childhood SLEs on adulthood AUD were mediated by adulthood antisocial and impulsive traits. Effects of PD traits on AUD 5‒10 years later were direct rather than mediated by adulthood SLEs. The results and the general approach contribute to triangulation of developmental origins for complex behavioral disorders.


Assuntos
Alcoolismo/etiologia , Transtornos da Personalidade/genética , Adulto , Experiências Adversas da Infância , Alcoolismo/genética , Biometria , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Doenças em Gêmeos , Feminino , Interação Gene-Ambiente , Humanos , Acontecimentos que Mudam a Vida , Masculino , Modelos Estatísticos , Noruega , Personalidade , Transtornos da Personalidade/complicações , Fenótipo , Fatores de Risco , Gêmeos/genética , Gêmeos/psicologia
10.
Acta Neurol Belg ; 119(2): 201-205, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30474829

RESUMO

To investigate the clinical manifestation, disease course, and prognosis of migraine patients with or without personality disorders. This cross-sectional study evaluated 61 patients with migraine diagnosed according to the criteria of the International Headache Society (IHS). Personality disorders were assessed with the Structured Clinical Interview for DSM-IV (SCID-II). Migraine severity was assessed with the Headache Impact Test-6 (HIT-6). We also used a structured clinical interview to diagnose comorbid mood disorders. Of the 61 patients, 20 (32.8%) had personality disorders. Personality disorders included obsessive-compulsive 14/61 (23.0%), avoidant 6/61 (9.8%), borderline 6/61 (9.8%), paranoid 6/61 (9.8%), schizoid 2/61 (3.3%), histrionic 1/61 (1.6%) and dependent 1/61 (1.6%) types. Compared to migraine patients without personality disorders, comorbidity with any personality disorders was associated with an increased frequency of chronic migraine (p < 0.001) and more severe headache as assessed by the HIT-6 (p < 0.001). Comorbidity with personality disorders was associated with more severe forms of migraine symptoms.


Assuntos
Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos de Enxaqueca/complicações , Transtornos da Personalidade/complicações , Adulto , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/fisiopatologia , Transtornos da Personalidade/fisiopatologia , Transtornos da Personalidade/terapia , Escalas de Graduação Psiquiátrica
11.
Encephale ; 45(2): 152-161, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-30314673

RESUMO

INTRODUCTION: Preventing students from dropping out of higher education, and particularly university, requires understanding the different factors that can lead to individuals failing to complete their studies. The role of personality in academic success or failure remains poorly understood. Block's personality profile model (Resilients, Overcontrollers, Undercontrollers) has been used to link personality traits to academic performance. The objective of this study is to apply this model to the risk factors of dropping out of higher education courses, including psychological vulnerability, level of autonomy, and the feeling of not being able to keep up. This involved validating Block's profiles in relation to the Big Five personality traits (Extraversion, Agreeableness, Conscientiousness, Neuroticism and Openness), and their links with the risk factors for dropping out. METHODS: This study is based on a quantitative survey of 196 students (mean age 21.32 years±3.11 years, with 63% females) taking higher education courses in France. Three measuring instruments were used: a French scale of Autonomy-situnomy, the French version of the Big Five Inventory (BFI-Fr) for personality traits, and the French version of the General Health Questionnaire (GHQ-28) for psychiatric morbidity. One item empirically evaluated the feeling of not being able to keep up. Data was processed using a k-average cluster analysis to establish the personality profiles, then by analysis of variance measures to evaluate the differences between them, and Bravais-Pearson correlation coefficient to identify links between risk factors and profiles. RESULTS: Conscientiousness (Control) was the trait most strongly associated with high autonomy and a low feeling of not being able to keep up. There was also a positive influence of Extraversion and Agreeableness on autonomy. On the other hand, Neuroticism scores were related to greater psychiatric morbidity, a greater feeling of not keeping up, and lower autonomy. The results for personality profiles confirm the stability of Block's profiles (Resilients, Overcontrollers and Undercontrollers) and their relevance in higher education contexts. Resilients and Overcontrollers had greater autonomy and a lower feeling of not keeping up, but Resilients had the lowest psychiatric morbidity. Undercontrollers were associated with the greatest risk factors: lowest autonomy, the highest psychiatric morbidity and the strongest feeling of not keeping up. Gender comparisons indicated that women were more affected by psychiatric morbidity, but had higher Conscientiousness and autonomy.


Assuntos
Apego ao Objeto , Transtornos da Personalidade , Personalidade/fisiologia , Resiliência Psicológica , Evasão Escolar/psicologia , Estudantes/psicologia , Adolescente , Adulto , Feminino , França/epidemiologia , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Morbidade , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade , Testes de Personalidade , Evasão Escolar/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Universidades/estatística & dados numéricos , Adulto Jovem
12.
J Nerv Ment Dis ; 206(12): 964-967, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30439781

RESUMO

Although the self-image distortions and sensitivities of pathological narcissism have been theorized to contribute to somatization, limited empirical research has been devoted to this issue. The present study was developed to test the hypothesis that pathological narcissism contributes to somatic symptoms through increased hypervigiliance to physical sensations. A community sample of 248 adults completed measures of pathological narcissism, somatosensory amplification, somatic symptoms, and depression. Mediation analysis was conducted, controlling for depression, using 99% bootstrapped confidence intervals to examine the indirect effect of pathological narcissism on somatic symptoms via somatosensory amplification. Although pathological narcissism was not directly related to somatic symptoms, a significant indirect effect was observed for pathological narcissism on somatic symptoms via somatosensory amplification. This finding suggests that pathological narcissism contributes to physical hypersensitivity, in turn influencing perceptions of somatic distress. The role of narcissistic dysfunction in somatization indicates the importance of further research and potential clinical consideration.


Assuntos
Transtornos da Personalidade/complicações , Transtornos Somatoformes/psicologia , Adulto , Depressão/complicações , Depressão/psicologia , Feminino , Humanos , Masculino , Transtornos da Personalidade/psicologia , Escalas de Graduação Psiquiátrica , Transtornos Somatoformes/etiologia , Inquéritos e Questionários
13.
Eur Addict Res ; 24(5): 226-233, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30278456

RESUMO

Substance use disorders (SUD) and personality disorders co-occur frequently. This relationship might be understood by studying schema modes (a key concept in Schema therapy), which explain the dysfunctions characterizing personality disorder patients. In the present study, we compared the schema modes and personality disorder symptoms between alcohol-dependent patients, cocaine-dependent patients and healthy controls. We found indications that specific schema modes are specific for SUD patients. However, no differences between specific subtypes of SUD patients (alcohol- vs. cocaine-dependent patients) could be found regarding schema modes. Further, it is suggested that borderline personality disorder symptoms are highly relevant for SUD patients. A first step is made in understanding the relationship between schema modes and SUD, which may contribute to the understanding of the problematic behaviour seen in patients with personality disorders and SUD (and may possibly contribute to the improvement of the treatment of this group of patients).


Assuntos
Alcoolismo/complicações , Alcoolismo/diagnóstico , Transtornos Relacionados ao Uso de Cocaína/complicações , Transtornos Relacionados ao Uso de Cocaína/diagnóstico , Cognição , Emoções , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Escalas de Graduação Psiquiátrica , Adulto Jovem
14.
Compr Psychiatry ; 87: 128-133, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30367986

RESUMO

BACKGROUND: Several conditions presenting with abdominal pain are associated with specific personality factors although it is unclear if this is true also in emergency clinic settings. OBJECTIVE: To study personality factors among patients with acute abdominal pain in an emergency ward. METHODS: Consecutive patients (N = 165) with abdominal symptoms at an emergency clinic were administrated the Temperament and Character Inventory (TCI). Three main groups were identified; specific abdominal diagnoses, (N = 77), non-specific abdominal pain, (N = 67) and organic dyspepsia (N = 21). TCI results were compared between clinical groups and a control group (N = 122). RESULTS: As compared to individuals with specific abdominal diagnoses and controls, those with organic dyspepsia were significantly more anxious (harm avoidance), (p = 0.003), and had lower ability to cooperate (cooperativeness) (p = 0.048 and p = 0.004 respectively). They were also significantly more unpretentious (self-transcendence) compared to individuals with specific abdominal diagnoses (p = 0.048), non-specific abdominal pain (p = 0.012) and controls (p = 0.004) and evidenced less mature character (sum of self-directedness and cooperativeness) compared to those with specific abdominal diagnoses and controls (p = 0.003). CONCLUSION: Individuals seeking care at an emergency clinic with organic dyspepsia showed a distinguishable pattern of personality features that distinguished them from the other comparison groups. Therefore an evaluation of personality factors may add a new dimension to the diagnostic investigation in the emergency care of abdominal pain and contribute to the optimization of the treatment of organic dyspepsia.


Assuntos
Abdome Agudo/psicologia , Ansiedade/etiologia , Caráter , Transtornos da Personalidade/diagnóstico , Temperamento , Abdome Agudo/diagnóstico , Adulto , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Inventário de Personalidade
15.
Curr Psychiatry Rep ; 20(12): 107, 2018 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-30306417

RESUMO

PURPOSE OF REVIEW: This review aims to give an overview on the current literature on sex differences in personality disorders and to highlight the potential of dimensional approaches. RECENT FINDINGS: Empirical findings on sex differences in personality disorders are inconsistent and appear to be highly dependent on study settings. Current studies have mainly focused on borderline and antisocial personality disorder and the question whether these are sex-specific representations of a common substrate. In general, sexes differ in the manifestation of personality disorders as well as in comorbidities. Criticism of the established categorical model led to an additional dimensional model of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Investigations on sex differences in personality disorders are sparse and mainly limited to antisocial and borderline personality disorder. The introduction of a dimensional model offers the chance to re-think the construct of "personality disorder" and thereby also opens the possibility for a better understanding of sex differences.


Assuntos
Transtornos da Personalidade/psicologia , Caracteres Sexuais , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico
16.
Artigo em Russo | MEDLINE | ID: mdl-30251971

RESUMO

AIM: To define clinical specifics of depression in patients with personality disorders (PD) in youth and work out differential/diagnostic criteria of these states. MATERIAL AND METHODS: One hundred and sixty patients (136 men, 24 women, mean age19.5±3.2 years) were studied. Later 42 patients from this group participated in the follow-up study. RESULTS: The following types of depression were described: 'with overvalued ideas', 'with neurotic disorders', 'with predominant addictions', 'with youth asthenic incapacity' and 'with attenuated psychotic symptoms'. These types clearly correlate with the type of PD. CONCLUSION: Personality abnormality plays a role in the pathogenesis of these states. This finding contributes to the more accurate diagnosis, prognostic and therapeutic solutions.


Assuntos
Depressão , Transtornos da Personalidade , Adolescente , Depressão/complicações , Feminino , Seguimentos , Humanos , Masculino , Transtornos da Personalidade/complicações , Transtornos Psicóticos , Adulto Jovem
17.
Rev. psiquiatr. salud ment. (Barc., Ed. impr.) ; 11(3): 151-155, jul.-sept. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-176744

RESUMO

Introducción: Se ha observado una alta comorbilidad entre el trastorno por déficit de atención e hiperactividad (TDAH) y categorías diagnósticas de trastornos de personalidad (tp). Los rasgos dimensionales del TDAH y de tp asociados están siendo investigados para descubrir si hay una diferenciación entre ambos trastornos o no. Metodología: Setenta y ocho pacientes ambulatorios que acuden al Centro de Salud Mental de Arganda (Madrid) fueron evaluados entre enero de 2013 y junio de 2015, en un estudio transversal. El diagnóstico de TDAH se realizó con las escalas CAARS, CAADID y WURS; el de los tp con el cuestionario del SCID-II-DSM-IV. Ningún paciente estaba tomando estimulantes ni atomoxetina previamente al estudio. Todos firmaron el consentimiento informado antes de participar en el estudio. Resultados: Se encontró una alta comorbilidad con los 3 clusters de personalidad, especialmente con el tipo hiperactivo y combinado. El tp depresivo se asoció con el inatento. Conclusiones: A pesar de utilizar un cuestionario para evaluar los tp, vemos alguna diferenciación entre tipos específicos de TDAH y tp. Es necesario llevar a cabo más investigación sobre los rasgos de personalidad dimensionales para mejorar el diagnóstico y las metas terapéuticas


Introduction: A high comorbidity has been observed among attention-deficit hyperactivity disorder (ADHD) and categorical personality disorders (PD). A study is conducted on the dimensional traits associated with ADHD and PD, in order to determine whether there are any differences. Methodology: A cross-sectional study was conducted on 78 outpatients attending a Mental Health Clinic in Arganda (Madrid) from January 2013 to June 2015. ADHD diagnosis was evaluated with the CAARS, the CAADID, and the WURS scales, and the PD with the SCID-II-DSM-IV questionnaire. None of the patients were receiving any stimulant or atomoxetine before the study, and all patients signed the informed consent before the study. Results: A high comorbidity was found with all PD clusters, especially with hyperactive and combined type ADHD. Depressive PD was associated with inattentive ADHD. Conclusions: In spite of using a questionnaire to evaluate PD, some differences can be observed between specific ADHD types and PD. More studies are needed to investigate dimensional personality traits in order to improve the diagnosis and therapeutics goals


Assuntos
Humanos , Masculino , Feminino , Adulto , Transtornos da Personalidade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Comorbidade , Estudos Transversais , Psicometria/instrumentação , Testes Psicológicos/estatística & dados numéricos
18.
Psychiatry Res ; 268: 229-237, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30064070

RESUMO

Childhood maltreatment history is a prevalent risk factor for substance use disorder and has lifelong adverse consequences on psychiatric wellbeing. The role of personality variations in determining childhood maltreatment-associated outcomes is poorly understood. This study sought to test neuroticism and agreeableness as mediator and moderator, respectively, of functional outcomes associated with having a history of childhood maltreatment and presence/absence of cocaine dependence. Ninety-four participants completed the Structured Clinical Interview for DSM-IV (SCID-IV), Childhood Trauma Questionnaire (CTQ), NEO-Five Factor Inventory (NEO-FFI), and the Addiction Severity Index (ASI). The distribution-of-the-product strategy tested if neuroticism mediated the relationship between CTQ and ASI scores. Agreeableness was tested as a moderator using bootstrapped multiple regression analyses with agreeableness*CTQ interaction terms as predictors of ASI scores. Analyses covaried for cocaine dependence to determine its influence. Neuroticism mediated the relationship between severity of childhood maltreatment history and family (ASI-Family) and psychiatric (ASI-Psychiatric) dysfunction in adulthood, independent of cocaine dependence. Agreeableness negatively moderated the effect of childhood maltreatment severity on family dysfunction. Exposure to emotional neglect and abuse selectively drove the mediation and moderation effects. Personality-directed interventions that reduce neuroticism or increase agreeableness may be promising approaches to uncouple childhood maltreatment history from lifelong social and psychiatric dysfunction.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Neuroticismo , Transtornos da Personalidade/psicologia , Personalidade/fisiologia , Adulto , Transtornos Relacionados ao Uso de Cocaína/complicações , Transtornos Relacionados ao Uso de Cocaína/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
19.
Trends Psychiatry Psychother ; 40(2): 93-103, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29995155

RESUMO

OBJECTIVE: To investigate the clinical functioning of the criticism avoidance dimension from the Dimensional Clinical Personality Inventory 2 (Inventário Dimensional Clínico da Personalidade 2 [IDCP-2]), establishing a clinically relevant cut-off for the typical traits of avoidant personality disorder (AvPD) for screening purposes. METHODS: We administered the IDCP-2 to a sample of 2,276 subjects aged 18 to 90 years (mean = 26.95, standard deviation = 9.71). Of the total sample, 1,650 were women (67%) and most were college students (72.7%). The sample was divided into psychiatric patients diagnosed with other personality disorders (PDs) (n = 53), patients diagnosed with AvPD without comorbidities (n = 10), patients with AvPD with comorbidities (n=42) and those without a known diagnosis of PD (nonpsychiatric patients; n=2,171). RESULTS: We checked for psychometric properties, assessed the adequacy of psychometric assumptions, and proceeded to focus analyses. The Wright item-person map showed the predominance of patients with AvPD in high levels of the scale. Analysis of variance (ANOVA) post hoc comparisons pointed to significant and expressive differences for almost all the comparisons; in the receiver operating characteristic (ROC) curve, we observed a sensitivity of 79% and a specificity of 87%. CONCLUSION: We found a suitable cut-off for the dimension, and results suggest that the dimension may help clinicians discriminate between patients with and without high levels in the symptoms of AvPD.


Assuntos
Transtornos da Personalidade/diagnóstico , Escalas de Graduação Psiquiátrica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Aprendizagem da Esquiva , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade , Psicometria , Curva ROC , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-29971194

RESUMO

Background: Increased depression, hearing loss, dementia, alcoholism, and mortality in essential tremor patients remain unexplained. We investigated whether conditions associated with tremor are linked to chronic stress. Methods: The FY2013 Veterans Affairs database was queried for 38 selected dual diagnosis combinations in 5,854,223 veterans aged 21-95 years. Results: Post-traumatic stress disorder, anxiety, and depression were the most common psychiatric diagnoses in tremor patients, with the odds ratio exceeding 2 in all 15-year cohorts. Depending on age, patients with essential tremor were more likely than those without to have obsessive-compulsive disorder, bipolar illness, schizophrenia, use tobacco and abuse alcohol, have hypertension, obesity, hyperlipidemia, diabetes, vitamin D deficiency, coronary and cerebrovascular diseases, congestive heart failure, stroke, asthma, hypothyroidism, irritable bowel syndrome, renal insufficiency, alcoholic liver disease, hearing loss, glaucoma, macular degeneration, migraine, epilepsy, idiopathic polyneuropathy, history of head trauma, and 'Alzheimer's dementia. In contrast, lung and colorectal cancer, amyotrophic lateral sclerosis, psychostimulant abuse, and rheumatoid arthritis were not more common. Discussion: Post-traumatic stress disorder, anxiety, and depression, strongly associated with essential tremor, are known risk factors for poor health habits, tobacco use and alcohol abuse; collectively these are risk factors for vascular disease, with further negative health consequences for multiple organ systems. As essential tremor is associated with all these conditions, we propose that chronic stress is not only responsible for the conditions associated with tremor but in some cases itself directly and indirectly induces essential tremor, so that tremor and poor health share a common cause.


Assuntos
Tremor Essencial/complicações , Tremor Essencial/epidemiologia , Veteranos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Transtornos do Humor/epidemiologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Fatores de Risco , Estresse Psicológico/complicações , Estresse Psicológico/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Veteranos/psicologia , Adulto Jovem
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