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1.
Tijdschr Gerontol Geriatr ; 51(2)2020 Jun 04.
Artigo em Holandês | MEDLINE | ID: mdl-32951383

RESUMO

Problem behavior is frequently present in older people living in nursing homes or needing home care services. When Personality disorders or maladaptive traits are involved these older people need specific care. In addition, they and their carers might experience psychological suffering as their behavior is not always properly recognized as the result of their personality. The importance of multidisciplinary teamwork, the role of psychiatric consultation given by an elderly psychiatrist as well as the need for upgrading the knowhow within the care sector itself is discussed using 2 vignettes.


Assuntos
Serviços de Assistência Domiciliar , Transtornos da Personalidade/complicações , Comportamento Problema , Idoso , Idoso de 80 Anos ou mais , Cuidadores , Humanos , Casas de Saúde , Transtornos da Personalidade/psicologia
2.
Rev Med Suisse ; 16(708): 1796-1800, 2020 Sep 30.
Artigo em Francês | MEDLINE | ID: mdl-32997449

RESUMO

Behavioural disorders in adults with mental disabilities are very common and represent a diagnostic challenge. In fact, they often hide a somatic problem, which is more frequent in this population compared to the general population. These somatic symptoms may cause or enhance psychiatric symptoms. People with mental disabilities often have difficulties expressing their pain, which often manifests itself as mood changes. Consequently, it is important to be able to identify the pain as a priority and to treat it. The general practitioner should therefore check for the most common somatic complaints in people with mental disabilities, with the help of the acronym DODUGO (Dental, Otic, Digestive, UroGenital, Orthopaedic).


Assuntos
Deficiência Intelectual , Sintomas Inexplicáveis , Comportamento Problema , Adulto , Humanos , Deficiência Intelectual/complicações , Deficiência Intelectual/psicologia , Dor/complicações , Dor/diagnóstico , Dor/psicologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia
3.
BMC Psychiatry ; 20(1): 271, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32487119

RESUMO

BACKGROUND: This naturalistic study examined the outcomes of Short-Term Schema Cognitive Behavioural Therapy in groups with personality disorders, and with high and low severity of depressive symptoms. METHODS: Assessments were made at baseline, at mid-treatment (week 10), at treatment termination (week 20) and at three-month follow-up (week 32) of 225 patients with personality disorders and high severity of depressive symptoms (PD-Hi) and patients with low severity of depressive symptoms (PD-Lo). The assessments focused on symptom (Symptom Checklist-90) and schema severity (Young Schema Questionnaire) and coping styles (Utrecht Coping List). We also measured the rate of symptom remission. The data obtained were subjected to multilevel analysis. RESULTS: Psychiatric symptoms and maladaptive schemas improved in both patient groups. Effect sizes were moderate, and even small for the coping styles. Symptom remission was achieved in the minority of the total sample. Remission in psychiatric symptomatology was seen in more PD-Lo patients at treatment termination. However, the difference in levels of remission between the two patient groups was no longer apparent at follow-up. CONCLUSION: A short-term form of schema therapy in groups proved to be an effective approach for a broad group of patients with personality disorders. However, the majority of patients did not achieve symptom remission. TRIAL REGISTRATION: Not applicable.


Assuntos
Terapia Cognitivo-Comportamental , Depressão/complicações , Depressão/psicologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/terapia , Psicoterapia de Grupo , Adulto , Depressão/terapia , Feminino , Humanos , Masculino , Transtornos da Personalidade/psicologia , Resultado do Tratamento
4.
PLoS One ; 15(6): e0234047, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32502161

RESUMO

AIM: Personality Disorders (PD) often share clinical and phenomenological overlap with psychotic disorders, especially at onset. However, there is little research on comorbid PD among people experiencing first episode psychosis. We examined the prevalence of PD recording and its sociodemographic and clinical correlates in people accepted to Early Intervention in Psychosis (EIP) services. METHODS: Participants were aged 16-35, accepted into 6 EIP services for suspected psychosis, as part of the Social Epidemiology of Psychoses in East Anglia (SEPEA) study. PD was recorded by clinicians according to ICD-10. Multilevel logistic regression was performed. RESULTS: Of 798 participants, 76 people (9.5%) received a clinical diagnosis of PD, with emotionally unstable PD (75.0%, N = 57) the most common subtype. In multivariable analysis, risk factors for PD included female sex (odds ratio [OR]: 3.4; 95% CI: 2.0-5.7), absence of psychotic disorder after acceptance to EIP (OR: 3.0; 95% CI: 1.6-5.5), more severe hallucinations (OR: 1.6; 95% CI: 1.2-2.1), and lower parental SES (OR: 1.4; 95% CI: 1.1-1.8). Compared with the white British, black and minority ethnic groups were less likely to receive a PD diagnosis (OR: 0.3; 95% CI: 0.1-0.7). There was no association between PD and neighbourhood-level deprivation or population-density. CONCLUSIONS: Recording of a PD diagnosis was three times more common amongst participants later found not to meet threshold criteria for psychotic disorder, implying phenomenological overlap at referral which highlights difficulties encountered in accurate diagnostic assessment, treatment and onward referral. People with PD experienced more individual-level, but not neighbourhood-level social disadvantage in an already disadvantaged sample.


Assuntos
Intervenção Médica Precoce , Transtornos da Personalidade/diagnóstico , Adulto , Estudos de Coortes , Feminino , Alucinações/complicações , Alucinações/patologia , Humanos , Masculino , Razão de Chances , Transtornos da Personalidade/complicações , Transtornos da Personalidade/etnologia , Transtornos da Personalidade/terapia , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Adulto Jovem
5.
Artigo em Russo | MEDLINE | ID: mdl-32323942

RESUMO

OBJECTIVE: Amplitude and latency of evoked potential P300 are considered as major correlates of cognitive functions. At the same time the changes in the theta-band event-related oscillations that appears at the same time window as P300 wave are less studied. The purpose of this study was to provide the complex assessment and comparison of neurophysiological indices of cognitive processes in healthy people and patients with personality disorder, schizotypal disorder and schizophrenia with different levels of cognitive dysfunction. MATERIAL AND METHODS: The total number of participants was 124, including 44 healthy volunteers, 40 schizophrenic patients, 22 patients with personality disorder, 18 patients with schizotypal disorder. Patients were examined in standard two-stimulus oddball paradigm. The P300 amplitude and latency, and evoked theta-band power and coherence were identified for target and non-target stimuli. RESULTS AND CONCLUSION: The decrease in P300 amplitude, prolongation of P300 latency, and reduction in the evoked theta-band power and coherence were revealed in all groups of patients compared to healthy subjects. These changes were spatially generalized and the most pronounced in schizophrenic patients. In patients with personality and schizotypal disorders, the changes had a local character, and didn't differ significantly when the groups were compared. The results show the gradual cognitive decline as follows: healthy patients, patients with schizotypal disorder, patients with personality disorder, and patients with schizophrenia. Such cognitive decline might be in line with the reduction of critical and prognostic abilities.


Assuntos
Potencial Evocado P300 , Transtornos da Personalidade/fisiopatologia , Esquizofrenia/fisiopatologia , Ritmo Teta , Transtornos Cognitivos/complicações , Transtornos Cognitivos/fisiopatologia , Eletroencefalografia , Potenciais Evocados Auditivos , Humanos , Transtornos da Personalidade/complicações , Esquizofrenia/complicações , Transtorno da Personalidade Esquizotípica/complicações , Transtorno da Personalidade Esquizotípica/fisiopatologia
6.
Artigo em Russo | MEDLINE | ID: mdl-32105268

RESUMO

AIM: To assess the formation of positive personality phenomena in patients with mild cognitive impairment and asthenic syndrome during the treatment with recognan (citicoline). MATERIAL AND METHODS: Thirty-eight patients (17 men and 21 women), aged 18 to 45 years (mean age 27.8±12.1 years), with asthenic syndrome with mild cognitive impairment (ICD-10 F06.7) were examined. Patients were divided into two groups: 20 people in the main group and 18 people in the comparison group. The main group received recognan (orally, in solution, 100 mg in 1 ml) for 30 days, the daily dosage of the drug was 0.5 g (5 ml solution). The comparison group did not receive any medications. Adapted methods of positive personality psychology were used: the Fordyce Emotions Questionnaire, the Subjective Happiness Scale (SHS), the Adult Hope Scale (AHS), the Satisfaction with Life Scale (SWLS), M. Atkinson's Scale of Emotional Maturity, the projective technique 'Map of experiences'. The follow-up period was 30 days. All subjects were examined three times (at baseline, 15 and 30 days after treatment). RESULTS AND CONCLUSION: After a month of treatment with recognan, there was an improvement of positive personality traits and a significant decrease in negative experiences, indicating the positive impact of the drug on the formation of positive personality manifestations and compensation for emotional disorders in patients with mild cognitive impairment and asthenic syndrome.


Assuntos
Astenia/complicações , Astenia/tratamento farmacológico , Disfunção Cognitiva/complicações , Disfunção Cognitiva/tratamento farmacológico , Citidina Difosfato Colina/uso terapêutico , Transtornos da Personalidade/complicações , Transtornos da Personalidade/tratamento farmacológico , Personalidade/efeitos dos fármacos , Adolescente , Adulto , Astenia/psicologia , Disfunção Cognitiva/psicologia , Citidina Difosfato Colina/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/psicologia , Adulto Jovem
7.
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
8.
J Nerv Ment Dis ; 208(2): 161-164, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977828

RESUMO

Research is scarce regarding the mechanisms by which pathological narcissism--consisting of narcissistic grandiosity and vulnerability--is linked with depression. The present study examined whether impaired emotional processing would mediate relations between pathological narcissism domains and depressive symptoms in a sample of 99 psychiatric outpatients. A significant indirect effect was found for narcissistic vulnerability on depressive symptoms, through unprocessed emotion as a mediator. Findings suggest that narcissistic vulnerability contributes to persistent and intrusive negative feelings, which in turn contribute to depressive symptom severity.


Assuntos
Transtorno Depressivo Maior/psicologia , Emoções , Transtornos da Personalidade/psicologia , Adulto , Transtorno Depressivo Maior/etiologia , Feminino , Humanos , Masculino , Pacientes Ambulatoriais/psicologia , Transtornos da Personalidade/complicações , Inventário de Personalidade , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Inquéritos e Questionários
9.
J Abnorm Psychol ; 129(3): 256-265, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31599630

RESUMO

Age of first drink (AFD) has repeatedly been found to be associated with alcohol use disorder (AUD); however, some studies suggest this is a noncausal effect that may be due to childhood risk factors or familial influences. In contrast to indicators of any early alcohol use, such as AFD, indicators of a pattern of repeated drinking may be more likely to be causally associated with later problematic alcohol use. The current study examined AFD and age of onset of regular drinking (ARD; defined as drinking at least once a month for 6 or more months) as quasicausal predictors of lifetime AUD symptoms. Participants were 3,005 adult Australian twins who reported having been regular drinkers in their lifetime. Semistructured interviews were conducted to assess AFD, ARD, AUD, externalizing symptomatology, and other substance use. Personality traits were assessed via questionnaire. Unadjusted and adjusted multilevel discordant twin models were conducted using data from 1,041 complete twin pairs; adjusted models included socioeconomic status, personality, conduct disorder, and early initiation of regular smoking and marijuana use as covariates. Results from fully adjusted models controlling for familial confounds provided evidence for a causal influence of ARD on AUD symptoms, whereby twins with an earlier age of regular drinking than their cotwin had more lifetime AUD symptoms. However, AFD did not significantly predict AUD symptoms after adjusting for confounds. These results suggest that early regular drinking may serve as a causal risk factor for future problems, while early initiation of any alcohol use may indicate genetic liability. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/etiologia , Personalidade/fisiologia , Adolescente , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/genética , Alcoolismo/genética , Alcoolismo/psicologia , Austrália , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Feminino , Humanos , Masculino , Transtornos da Personalidade/complicações , Transtornos da Personalidade/psicologia , Fatores de Risco , Fatores Socioeconômicos , Gêmeos/genética , Gêmeos/psicologia , Adulto Jovem
10.
Psychiatry Res ; 287: 112481, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31377008

RESUMO

Chronically depressed individuals have a high suicide risk. However, it is an open question whether previously observed risk factors for suicide attempts also apply to chronic depression or whether there are specific risk factors related to chronic-recurrent illness. We drew from a large group of chronically depressed individuals seeking psychotherapy to investigate demographic and psychological factors related to previous suicide attempts. Participants took part in the SCID and filled out established questionnaires. Among 368 chronically depressed individuals (68.7% women; Mage = 40.95 years), 75 participants (19.4%) reported previous suicide attempts. Men were more likely to have used violent methods. We tested the links of having attempted suicide with different variables using logistic regression analyses. Our findings corroborate previously observed risk factors (e.g. sexual abuse, personality disorders) and suggest other risk factors which could be especially relevant in chronic depression (e.g. depression severity, interpersonal problems, self-injurious behavior, and overall years of depression). Other risk factors from previous studies were not related to suicidal behavior within our sample (e.g. anxiety disorders, PTSD). Thus, mental health professionals should be aware that risk factors for suicidal behavior might vary between diagnosis groups and that chronic illness might be a risk factor in itself.


Assuntos
Agressão , Depressão/epidemiologia , Depressão/psicologia , Relações Interpessoais , Transtornos da Personalidade/complicações , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Transtornos de Ansiedade/psicologia , Doença Crônica , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Índice de Gravidade de Doença , Tentativa de Suicídio/estatística & dados numéricos , Inquéritos e Questionários
11.
J Anxiety Disord ; 68: 102153, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31704634

RESUMO

Although effective treatments for obsessive compulsive disorder (OCD) are increasingly available, a considerable percentage of patients fails to respond or relapses. Predictors associated with improved outcome of OCD were identified. However, information on interpersonal determinants is lacking. This study investigated the contribution of attachment style and expressed emotion to the outcome of exposure and response prevention (ERP), while accounting for previously documented intrapersonal (i.e., symptom severity and personality pathology) predictors. Using logistic regression analyses and multi-level modeling, we examined predictors of treatment completion and outcome among 118 adult OCD patients who entered ERP. We assessed outcome at post treatment, and at four and 13 months from treatment completion. OCD baseline severity and fearful attachment style emerged as the main moderators of treatment outcome. Severe and fearfully attached patients were more likely to dropout prematurely. The improvement of fearful clients was attenuated throughout treatment and follow-up compared to non-fearful clients. However, their symptom worsening at the long-term was also mitigated. Severe OCD patients had a more rapid symptom reduction during treatment and at follow-up, compared to less severe clients. The findings suggest that both baseline OCD severity and fearful attachment style play a role in the long-term outcome of ERP.


Assuntos
Relações Interpessoais , Apego ao Objeto , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Medo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/psicologia , Pacientes Desistentes do Tratamento/psicologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/psicologia , Prognóstico , Resultado do Tratamento , Adulto Jovem
12.
Psychiatr Pol ; 53(4): 901-914, 2019 Aug 31.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-31760416

RESUMO

OBJECTIVES: To assess of the levels of neurotic personality dimensions in a group of patients with arterial hypertension compared to healthy individuals. To test the relationship between the overall neurotic personality score and satisfaction with life as well as tendency to notice and attach importance to the positive aspects of life, experience, and oneself in a clinical sample. METHODS: Neurotic Personality Questionnaire (KON-2006) by Aleksandrowicz, Klasa, Sobanski, and Stolarska (2007), Satisfaction With Life Scale (SWLS) by Diener et al., and the P Scale by Caprara (2009). RESULTS: Individuals with arterial hypertension (N =81) are distinguished by significantly higher levels of twenty (out of twenty-four) neurotic personality dimensions than controls without arterial hypertension (N =88). Overall neurotic personality score correlates negatively with life satisfaction and the evaluation of positive aspects of life. CONCLUSIONS: The present study adds to the knowledge on the psychosocial aspects of ill people's functioning and sets directions of work for multidisciplinary teams seeking to improve patients' quality of life.


Assuntos
Hipertensão/psicologia , Transtornos Neuróticos/psicologia , Transtornos da Personalidade/psicologia , Personalidade , Adulto , Feminino , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Transtornos Neuróticos/complicações , Transtornos da Personalidade/complicações , Inventário de Personalidade , Qualidade de Vida/psicologia , Autoimagem
13.
Oncology (Williston Park) ; 33(10)2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31661154

RESUMO

Personality disorders exist on a spectrum in the general population and therefore may coexist in patients who have cancer. Patients with these disorders exhibit character rigidity resulting from enduring patterns of inner experience and behavior and may experience some level of interpersonal conflict among medical staff caring for them. These conditions become exacerbated under stressful cancer-related situations and may lead to adverse consequences and outcomes. This review highlights the conceptual and diagnostic issues of personality disorders for practicing oncologists and provides recommendations for recognizing and managing cancer patients with difficult personality traits or personality disorders.


Assuntos
Neoplasias/complicações , Transtornos da Personalidade/complicações , Estresse Psicológico/complicações , Humanos , Relações Interpessoais , Neoplasias/psicologia , Transtornos da Personalidade/psicologia , Estresse Psicológico/psicologia
15.
J Trauma Stress ; 32(4): 625-632, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31356704

RESUMO

Low treatment engagement is a barrier to implementation of empirically supported treatments for posttraumatic stress disorder (PTSD) among veterans. Understanding personality traits that predict dropout may help focus attempts to improve engagement. The current study included 90 veterans who served in recent conflicts in Iraq and/or Afghanistan and participated in a trial of cognitive processing therapy for PTSD. Goals were to characterize (a) personality correlates of PTSD, (b) patterns of engagement (i.e., attendance and homework completion), and (c) personality correlates of reduced engagement. Higher levels of PTSD symptoms were associated with a range of characteristics, including affective lability, r = .44 p < .001; anxiety, r = .38, p < .001; identity problems, r = .57, p < .001; intimacy problems, r = .34, p = .001; low affiliation, r = .33, p = .002; oppositionality, r = .36, p = .001; restricted expression, r = .35, p = .001; and suspiciousness, r = .50, p < .001. Notably, veterans with worse PTSD symptoms endorsed more cognitive dysregulation, r = .40, p < .001; and less insecure attachment, r = .14, p = .190, than expected. Only 52.2% of veterans completed the 12-session course of treatment and 31.0% of participants completed fewer than six sessions. Personality traits did not predict attendance or homework completion. Disengagement continues to be a significant issue in trauma-focused treatment for veterans with PTSD. Understanding veteran-level factors, such as personality traits, may be useful considerations for future research seeking to understand and improve engagement.


Assuntos
Pacientes Desistentes do Tratamento/psicologia , Transtornos da Personalidade/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adulto , Campanha Afegã de 2001- , Terapia Cognitivo-Comportamental/estatística & dados numéricos , Feminino , Humanos , Guerra do Iraque 2003-2011 , Masculino , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/terapia , Estados Unidos
16.
Psychiatry Res ; 278: 151-161, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31200194

RESUMO

Antisocial personality disorder (ASPD) and psychopathy attempt to represent individuals demonstrating callousness and disregard for others. ASPD has been criticized for capturing a heterogeneous population whilst missing the essence of the diagnosis by neglecting interpersonal/affective deficits which measures of psychopathy include. This heterogeneity in operationalizations has led to diverse findings without clear understanding of what characterizes this broader population. This study sought to clarify the neuropsychological profiles of ASPD and psychopathy. The Cambridge Neuropsychological Test Assessment Battery was administered to 85 adult male offenders in a personality disorder secure service and to 20 healthy controls. Of patients with ASPD, 46% met criteria for psychopathy. Of those with psychopathy, 89% met criteria for ASPD. There were two sets of comparisons: ASPD versus other personality disorders versus controls and psychopathy versus other personality disorders versus controls. ASPD showed deficits across executive functions, visual short-term and working memory, and attention (compared with controls). Psychopathy showed deficits limited to attention, complex planning, inhibitory control, and response reversal. Response reversal and visual search deficits appeared specific to ASPD and psychopathy versus other personality disorders and may underpin antisocial traits. Additional deficits in inhibitory control and working memory appeared to distinguish ASPD from other personality disorders.


Assuntos
Transtorno da Personalidade Antissocial/fisiopatologia , Atenção/fisiologia , Disfunção Cognitiva/fisiopatologia , Criminosos , Função Executiva/fisiologia , Transtornos da Memória/fisiopatologia , Transtornos da Personalidade/fisiopatologia , Adulto , Transtorno da Personalidade Antissocial/complicações , Disfunção Cognitiva/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Transtornos da Personalidade/complicações
17.
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
18.
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
19.
J Psychosom Res ; 123: 109721, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31103210

RESUMO

OBJECTIVE: Pain and prescription opioid medication use are prevalent and a major source of psychological and physical health burden. This research examines whether Five Factor Model personality traits prospectively predict who will experience persistent pain and use prescription opioid medication over a 10-year follow-up. METHODS: Participants (N = 8491) were drawn from the Health and Retirement Study. At baseline, participants reported on their personality and whether they were in pain. Every two years, participants reported on their pain and, at the most recent assessment, their current use of prescription opioid medication. Logistic regression was used to test whether personality was associated with persistent pain over the up to 10-year follow-up and whether it predicted who would be taking prescription opioid medication. RESULTS: Neuroticism was associated with higher risk of persistent pain (OR = 1.44, 95% CI = 1.38-1.51) and opioid medication use (OR = 1.21, 95% CI = 1.14-1.29) over the follow-up. Extraversion was associated with lower risk of persistent pain (OR = 0.83, 95% CI = 0.80-0.87) and opioid medication use (OR = 0.92, 95% CI = 0.86-0.97). Similarly, Conscientiousness was associated with lower risk of persistent pain (OR = 0.83, 95% CI = 0.79-0.87) and opioid medication use (OR = 0.91, 95% CI = 0.86-0.97). CONCLUSIONS: The findings suggest that personality traits are one psychological characteristic that modulates the likelihood of persistent pain and opioid medication use.


Assuntos
Analgésicos Opioides/uso terapêutico , Neuroticismo/fisiologia , Dor/tratamento farmacológico , Dor/etiologia , Transtornos da Personalidade/complicações , Idoso , Analgésicos Opioides/farmacologia , Feminino , Humanos , Masculino , Dor/psicologia , Estudos Prospectivos
20.
J Psychiatr Res ; 114: 149-152, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31078785

RESUMO

Traumatic brain injury (TBI) is a significant public health issue associated with increased medical comorbidity and economic burden. The majority of studies of TBI among clinical populations are geographically limited and rely on small samples. As such, the current study seeks to examine the prevalence and psychosocial correlates of TBI in a nationally representative emergency department (ED) sample. Using the 2016 Nationwide Emergency Department Sample, logistic regression was employed to examine the relationship between TBI history, sociodemographic factors and mental health disorders. An estimated 179,986 adults age 18 and older were admitted to United States EDs in 2016 with a personal history of TBI. The majority of patients were male (69.71%), ages 50 years or older (50.92%) with Medicare (44.30%) or Medicaid (28.65%) insurance. Diagnoses of posttraumatic stress disorder (AOR = 3.99), affective disorders (AOR = 2.97), anxiety disorders (AOR = 1.68), personality and behavior disorders (AOR = 2.77), and schizophrenia (AOR = 2.80) were significantly associated with history of TBI. These results provide insight into the developmental pathogenesis of TBI and its comorbid psychiatric consequences.


Assuntos
Lesões Encefálicas Traumáticas/etiologia , Transtornos Mentais/complicações , Adolescente , Adulto , Transtornos de Ansiedade/complicações , Lesões Encefálicas Traumáticas/psicologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Transtornos da Personalidade/complicações , Fatores de Risco , Esquizofrenia/complicações , Transtornos de Estresse Pós-Traumáticos/complicações , Estados Unidos/epidemiologia , Adulto Jovem
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