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1.
JNMA J Nepal Med Assoc ; 59(234): 184-187, 2021 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-34506452

RESUMO

INTRODUCTION: Personality disorders is comprised of deeply ingrained and enduring behavioral patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations." Personality Disorders are frequently occurring among patients with substance use disorders. Co-occurrence of substance use disorders and personality disorder is associated with a greater functional impairment affecting treatment adherence. This study's objective was to find out the prevalence of personality disorders among substance use disorders from the Department of Psychiatry and Mental Health, of a tertiary care center of Nepal. METHODS: A descriptive cross-sectional study was done at the Department of Psychiatry and Mental Health of Shree Birendra Hospital, Chhauni, Kathmandu, Nepal. The ethical approval was approved by the Institutional Review Committee prior to the study. The International Personality Disorder Examination ICD-10 module interview schedule was used to determine personality disorders. There were 100 patients, 86 males and 14 females of age ranging between 18-59 years, from different education levels, socioeconomic statuses, and ethnicities. RESULTS: Of the total 100 patients, 63% of the patients with substance use disorders were found to have either single 24 (24%) or multiple 39 (39%) personality disorders. The most frequently identified disorders were Emotionally Unstable Borderline Type 34 (34%), Anxious Personality Disorder 27 (27%), Emotionally Unstable Impulsive Type 27 (27%). CONCLUSIONS: Present study indicates that personality disorders were highly comorbid with patients of substance use disorders with either single or multiple personality disorders. Personality disorders mostly found in substance use disorders are Emotional Unstable Borderline Type, Anxious Personality Disorder, and Emotional Unstable impulsive Type.


Assuntos
Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Nepal/epidemiologia , Transtornos da Personalidade/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Centros de Atenção Terciária , Adulto Jovem
2.
Zh Nevrol Psikhiatr Im S S Korsakova ; 121(5. Vyp. 2): 35-40, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34405655

RESUMO

OBJECTIVE: To determine clinical and psychopathological specifics of the first depressive episode (DE) in the context of formation of personality anomalies and their dynamics in adolescence. MATERIAL AND METHODS: Two hundred and thirty-seven patients (180 male, 57 female), aged 16 to 25 years, with the first DE and comorbid personality disorder (PD) were clinically observed and psychopathologically evaluated. Later 149 patients from this group participated in the follow-up study. RESULTS: The first DE with PD in adolescence is characterized by psychopathological variety due to PD type and age factor. Diagnosis of PD in adolescence is based on pathological traits, while affective impairment is a separate dimension. PD determines the clinical features of the first DE and all spectrum of affective disorders. The high conjugation of the first DE with autoagressive behavior confirms their suicidal risk. Autoagressive behavior is noted in 201 (84.8%) patients, of which 59 (29.4%) had non-suicide self-injury (NSSI) and 14 (70.6%) had suicidal activity. The follow-up study identified variants of further dynamics of PD with comorbid affective spectrum disorders after the first DE developed in youth that had prognostic value: unipolar major depression in schizoid PD (13 (37.1%) patients), cluster C PD (8 (26.7%)); bipolar affective disorders in borderline (42 (28.2%)) and narcissistic (16 (40.0%)) PD; recurrent depressive disorder in PD of cluster C (14 (46.7%)). CONCLUSIONS: The revealed clinical and psychopathological features will contribute to the creation of a unified model for predicting affective disorders and the formation of therapy standards.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Adolescente , Transtorno Bipolar/epidemiologia , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Transtornos do Humor , Transtornos da Personalidade/epidemiologia
3.
Tijdschr Psychiatr ; 63(6): 441-450, 2021.
Artigo em Holandês | MEDLINE | ID: mdl-34231863

RESUMO

BACKGROUND: Results from previous meta-analyses of the impact of comorbid personality disorders (PD's) on treatment outcomes for depressive disorder are contradictory and biased by methodological differences between included studies. AIM: To investigate the impact of comorbid PD on the outcome of depression treatments, using only studies with controlled treatments and structured measurement instruments (PROSPERO, CRD42019120200). METHOD: Studies were searched in PubMed, PsycINFO and Embase, and in reference lists of selected articles and previous meta-analyses. Treatment studies for depression with a subset of individuals with comorbid PD were included. Primary outcome was depression severity change during treatment. Effect sizes were estimated using random effect models, study-level variables were examined with meta-regression. Bias was assessed with the Risk of Bias tool. RESULTS: Six studies involving 942 individuals (447 with PD) were included. There was no significant difference in depression severity reduction between individuals with and without PD (g = 0.03, 95% CI -0.15-0.20, p = 0.27). Heterogeneity and risk of bias were low. The meta-regression did not yield significant results. CONCLUSION: Findings don't indicate an impact of comorbid PD on the outcome of acute phase treatment for depression. Depressed patients with and without comorbid PD should receive the same evidence-based depression treatments.


Assuntos
Depressão , Transtornos da Personalidade , Humanos , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/terapia , Resultado do Tratamento
4.
Compr Psychiatry ; 109: 152264, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34271258

RESUMO

BACKGROUND: Depressed suicide attempters are, according to some earlier studies, treated more often with antipsychotics than depressive non-suicide attempters. Cluster B personality disorders, especially borderline personality disorder, are associated with a high suicide risk, and antipsychotics are commonly used for the reduction of symptoms. However, no previous study has taken comorbid personality disorders into account when assessing the use of antipsychotics in patients with unipolar depression. Therefore, the aim of this study was to investigate the clinical selection of pharmacotherapy in unipolar depression with and without a previous suicide attempt, taking into account potential confounders such as cluster B personality disorders. METHODS: The study sample consisted of 247 patients with unipolar depression. The study was approved by the Regional Ethical Review Board in Lund, Sweden. Study participants were recruited from 4 different secondary psychiatric care clinics in Sweden and were diagnosed according to the DSM-IV-TR with the MINI and SCID II. Previous and ongoing psychiatric treatments were investigated in detail and medical records were assessed. RESULTS: Thirty percent of the patients had made previous suicide attempts. Depressed suicide attempters underwent both lifetime treatment with antipsychotics and an ongoing antipsychotic treatment significantly more often than non-attempters. Significances remained after a regression analysis, adjusting for cluster B personality disorders, symptom severity, age at the onset of depression, and lifetime psychotic symptoms. CONCLUSIONS: This is the first study to consider the effect of comorbidity with cluster B personality disorders when comparing treatment of depressive suicide and non-suicide attempters. Our findings suggest that suicide attempters are more frequently treated with antipsychotics compared to non-suicide attempters, regardless of cluster B personality disorder comorbidity. These findings are important for clinicians to consider and would also be relevant to future studies evaluating reduction of suicide risk with antipsychotics in patients with psychiatric comorbidity and a history of attempted suicide.


Assuntos
Antipsicóticos , Tentativa de Suicídio , Antipsicóticos/uso terapêutico , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/tratamento farmacológico , Transtornos da Personalidade/epidemiologia , Fatores de Risco
5.
Syst Rev ; 10(1): 182, 2021 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-34148544

RESUMO

BACKGROUND: Separately, mental and musculoskeletal disorders (MSDs) are prevalent across the life course and are leading contributors to disability worldwide. While people with personality disorder (PD) have been shown to have an increased risk of certain physical health comorbidities-associations with MSDs have not been thoroughly explored. The proposed scoping review aims to explore the existing clinical- and population-based literature on the comorbidity of PD and MSDs among adults ≥ 18 years and the burden associated with their comorbidity, identify knowledge gaps on this topic, and propose recommendations for future research. METHODS: This protocol describes the methodology to undertake the scoping review. It is guided by Arksey and O'Malley's framework and the extensions recommended by the Joanna Briggs Institute. A comprehensive search strategy will be used to identify relevant articles, which will be underpinned by Population, Concept, and Context (PCC) inclusion criteria. One author will perform the search and two authors will independently screen titles/abstracts followed by a full-text review for articles considered relevant. The supervising author will confirm the final selection of articles to be included. One author will extract relevant information from the articles using a predetermined charting form, while a second will perform validation of all information entered. DISCUSSION: Information will be synthesised to inform a discussion of what is known regarding associations between PD and MSDs, and the burden associated with their comorbidity in different contexts, with future research directions proposed. SYSTEMATIC REVIEW REGISTRATION: This protocol is registered in Open Science Framework Registries ( https://osf.io/mxbr2/ ).


Assuntos
Pessoas com Deficiência , Doenças Musculoesqueléticas , Adulto , Comorbidade , Atenção à Saúde , Humanos , Doenças Musculoesqueléticas/epidemiologia , Transtornos da Personalidade/epidemiologia , Literatura de Revisão como Assunto
6.
J Affect Disord ; 292: 276-283, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34134026

RESUMO

BACKGROUND: Response rates after and tolerability of electroconvulsive therapy (ECT) in depressive disorders with psychiatric comorbidity are uncertain. METHODS: Data on patients with a depressive episode and a first course of ECT were collected from the Swedish National Quality Register for ECT. Logistic regression analyses, adjusted for gender, age, and depressive episode severity, were used to compare patients with and without comorbidity. The clinical response assessment Clinical Global Impression - Improvement Scale was used in 4413 patients and the memory item from the Comprehensive Psychiatric Rating Scale was used for subjective memory impairment rating after ECT in 3497 patients. RESULTS: In patients with depressive disorder and comorbid personality disorder or anxiety disorder, 62.7% and 73.5%, respectively, responded after ECT compared with 84.9% in patients without comorbidity [adjusted odds ratio (aOR) 0.43, 95% confidence interval (CI) 0.34-0.55, and aOR 0.61, 95% CI 0.51-0.73, respectively]. The proportion of responding patients with comorbid alcohol use disorder was 77.1%, which was not significantly different from that in patients without comorbidity (aOR 0.75, 95% CI 0.57-1.01). The impact of comorbidity decreased with higher age and depressive episode severity. Subjective ratings of memory impairment did not differ between patients with and without comorbidity. LIMITATIONS: Observational non-validated clinical data. CONCLUSIONS: The response rate after ECT in depression may be lower with concurrent personality disorder and anxiety disorder; however, the majority still respond to ECT. This implies that psychiatric comorbidity should not exclude patients from ECT.


Assuntos
Transtorno Depressivo Maior , Eletroconvulsoterapia , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/terapia , Humanos , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/terapia , Escalas de Graduação Psiquiátrica , Suécia/epidemiologia , Resultado do Tratamento
7.
J Forensic Sci ; 66(5): 1788-1796, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33955549

RESUMO

We identified 43 cases of mutilation homicides in a nationwide population-based study in Sweden during the period of 1991-2017. 70% of cases were classified as defensive mutilations where the main motive was disposal of the body, while 30% were classified as offensive, that is, due to an expression of strong aggression, necro-/sexual sadism, or psychiatric illness. In comparison with a previous study covering mutilation homicides in Sweden between 1961 and 1990, we noted an increase in incidence. The percentage of cases involving mutilation had increased from 0.5% of all homicides in the 1960s to 2.4% in the 2010s. The most common cause of death was sharp force, but in 28% of the cases, the cause of death could not be determined. The clearance rate in cases of mutilation homicide was 67%, and in a large majority of the cases, the offender was known to the victim. With regards to gender women made up 44% of the victims, whilst men constituted 56% of the victims and a total of 95% of the offenders. Half of the offenders had a personality disorder, however, only 13% were sentenced to forensic psychiatric care.


Assuntos
Desmembramento de Cadáver , Homicídio/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Vítimas de Crime/estatística & dados numéricos , Criminosos/estatística & dados numéricos , Feminino , Homicídio/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Transtornos da Personalidade/epidemiologia , Estudos Retrospectivos , Distribuição por Sexo , Suécia/epidemiologia , Adulto Jovem
8.
Soc Psychiatry Psychiatr Epidemiol ; 56(10): 1809-1819, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33677644

RESUMO

PURPOSE: To investigate the mortality in both in- and outpatients with personality disorders (PD), and to explore the association between mortality and comorbid substance use disorder (SUD) or severe mental illness (SMI). METHODS: All residents admitted to Norwegian in- and outpatient specialist health care services during 2009-2015 with a PD diagnosis were included. Standardized mortality ratios (SMRs) with 95% confidence intervals (CI) were estimated in patients with PD only and in patients with PD and comorbid SMI or SUD. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% CIs in patients with PD and comorbid SMI or SUD compared to patients with PD only. RESULTS: Mortality was increased in both in- and outpatients with PD. The overall SMR was 3.8 (95% CI 3.6-4.0). The highest SMR was estimated for unnatural causes of death (11.0, 95% CI 10.0-12.0), but increased also for natural causes of death (2.2, 95% CI 2.0-2.5). Comorbidity was associated with higher SMRs, particularly due to poisoning and suicide. Patients with comorbid PD & SUD had almost four times higher all-cause mortality HR than patients with PD only; young women had the highest HR. CONCLUSION: The SMR was high in both in- and outpatients with PD, and particularly high in patients with comorbid PD & SUD. Young female patients with PD & SUD were at highest risk. The higher mortality in patients with PD cannot, however, fully be accounted for by comorbidity.


Assuntos
Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Suicídio , Causas de Morte , Comorbidade , Feminino , Humanos , Transtornos Mentais/epidemiologia , Transtornos da Personalidade/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
9.
Infant Ment Health J ; 42(4): 488-501, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33759190

RESUMO

BACKGROUND: Mentalization is defined as the human capacity to reflect upon one's own or others' behaviors in terms of underlying mental states and intentions. Several concepts of mentalizing exist, which differ in content, assessment, and clinical prediction. AIMS: The present study examines the relationship between the three main concepts of mentalizing, namely, reflective functioning (RF), parental reflective functioning (PRF), and Mind-Mindedness (MM), in mothers with postpartum depression. It was hypothesized that mentalizing concepts differ in their convergent and divergent variance, as well as their clinical validity regarding comorbid anxiety and personality disorders (PDs). METHOD: Fifty clinically referred mothers with postpartum depression and infants aged 3-10 months were examined by means of the Reflective Functioning Scale, Parental Reflective Functioning Questionnaire, and Mind-Mindedness Coding-System. RESULTS: No significant associations were found between RF and PRF, or between PRF and MM; higher RF was associated with more MM-nonattuned mind-related comments. Increased depression and anxiety were linked to lower PRF in terms of higher PRF-prementalizing. Lower RF, but not PRF, was associated with comorbid PDs. Specifically, obsessive-compulsive PD was associated to considerably fewer MM-nonattuned mind-related comments. CONCLUSION: Distinct concepts of mentalizing represent divergent competencies, differentially linked to maternal postpartum psychopathology.


Assuntos
Depressão Pós-Parto , Mentalização , Ansiedade/epidemiologia , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Lactente , Mães , Transtornos da Personalidade/epidemiologia
10.
Z Psychosom Med Psychother ; 67(2): 114-131, 2021 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-33653233

RESUMO

The relationship between trauma, consequences of trauma and personality structure: A mediation analysis Background: This study deals with the hitherto scarcely explored relationship between the extent of traumatization, psychopathological consequences and personality structure. It is examined whether the structural integrity of the personality has a mediating influence on the relationship between trauma and symptoms of post-traumatic stress disorder (PTSD) and mental pain after traumatization. Methods: The investigated community sample consisted of 381 adults (89 % female) who reported at least one lifetime traumatic experience. The path analysis technique was applied to estimate associations between the degree of traumatization, PTSD symptoms, mental pain and the integrity of personality structure. Results: The extent of experienced traumatization is significantly associated with increased impairment of personality structure (ß = .40; p < .001), severity of the mental pain (ß = .21; p < .001) and PTSD symptoms (ß = .14; p < .01). Deficits in the personality structure were associated with increased mental pain (ß = .67; p < .001) and PTSD symptoms (ß = .73; p < .001). The mediation analysis showed an indirect effect of traumatization on mental pain (ß = .27; p < .001) and PTSD symptoms (ß = .29; p < .001), which is partially mediated by personality structure level. A detailed analysis showed that this mediation relationship can be attributed in particular to deficits in the ability to observe oneself. Discussion: The results of this study emphasize the significance of personality structure in the development of psychological consequences of traumatization. Regarding therapeutic practice, especially the ability to observe oneself seems to offer an important starting point for the treatment of mental pain and PTSD symptoms.


Assuntos
Análise de Mediação , Transtornos de Estresse Pós-Traumáticos , Adulto , Feminino , Humanos , Masculino , Personalidade , Transtornos da Personalidade/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários
11.
Epilepsy Behav ; 118: 107918, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33735815

RESUMO

BACKGROUND: Psychogenic nonepileptic seizures (PNES) are major challenges for diagnosis and management. The heterogeneity of psychogenic seizures is attributed to diverse psychopathological comorbidities, and the causal relationship between PNES and underlying psychopathologies is still enigmatic. OBJECTIVE: Our objective was to study psychiatric comorbidities and personality constructs in patients with PNES and compare them to a control group of patients with epilepsy. METHOD: We randomly recruited 33 patients with PNES and 33 patients with epilepsy. All patients completed the Mini-International Neuropsychiatric Interview (MINI) to screen for psychiatric comorbidities, the Structured Clinical Interview for psychiatric disorders in Axis II (SCID II) to screen for personality disorders, and Goldberg's International Personality Item Pool (IPIP) Big Five personality questionnaire to study the psychological constructs of extroversion-introversion, agreeableness, conscientiousness, emotional stability-neuroticism, and intellect. RESULT: Mood and anxiety disorders were highly prevalent in patients with PNES (72.7% and 54.5%, respectively); however, the prevalence of only cluster B personality disorder was higher in patients with PNES (69.7%) compared to 33.3% among patients with epilepsy (p < 0.05). Screening for personality disorders using SCID II showed that the prevalence of borderline and depressive personality disorders was significantly higher in patients with PNES (p < 0.001). Patients with psychogenic seizures were more likely to be receiving polydrug therapy (75.8%) compared to patients with epileptic seizures (45.5%); this difference was statistically significant (p < 0.05). CONCLUSION: Psychiatric comorbidities are highly prevalent among patients with PNES.


Assuntos
Epilepsia , Convulsões , Comorbidade , Eletroencefalografia , Epilepsia/complicações , Epilepsia/epidemiologia , Humanos , Transtornos da Personalidade/complicações , Transtornos da Personalidade/epidemiologia , Psicopatologia , Convulsões/complicações , Convulsões/epidemiologia
12.
Addict Behav ; 118: 106887, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33714033

RESUMO

OBJECTIVE: This study explored the differential psychopathological profile between male perpetrators of intimate partner violence (IPV) with and without problematic alcohol use (PAU). METHOD: A sample of 981 men was recruited from a specialized IPV perpetrators treatment programme. All of them were assessed with the Symptom Checklist-90-Revised (SCL-90-R), the State-Trait Anger Expression Inventory-2 (STAXI-2), and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Comparisons between perpetrators with (n = 125) and without (n = 856) PAU on all the variables studied were carried out. RESULTS: Perpetrators with PAU were less frequently employed and had higher rates of previous psychiatric history and childhood family violence. Moreover, they presented with higher levels of cognitive biases about women and violence. On a psychopathological level, participants with PAU reported significantly higher scores on the SCL-90-R, on the STAXI-2, and on almost all the MCMI-III scales than did those without PAU. The multivariate logistic regression analyses showed that the main variables related to PAU were as follows: higher levels of previous psychiatric history, distorted thoughts about women, depression, drug dependence, and various personality disorders (bipolar, dysthymia, antisocial, avoidant, borderline, and schizotypal); and lower scores on internal control, anger reaction, paranoid ideation, and schizoid personality disorders. DISCUSSION: IPV perpetrators with PAU have a more severe psychopathological profile than those without PAU. Additionally, several variables along with PAU may have contributed to the development of IPV. Therefore, tailored interventions should be developed for those perpetrators with PAU.


Assuntos
Violência por Parceiro Íntimo , Ira , Transtorno da Personalidade Antissocial , Feminino , Humanos , Masculino , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade
13.
PLoS One ; 16(3): e0248403, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33755679

RESUMO

INTRODUCTION: Alcohol Use Disorders are frequently comorbid with personality disorders. However, the heterogeneity of the prevalence estimates is high, and most data come from high income countries. Our aim is to estimate the prevalence and association between alcohol use outcomes and the three DSM-5 clusters of personality disorders in a representative sample of the São Paulo Metropolitan Area. MATERIALS AND METHODS: A representative household sample of 2,942 adults was interviewed using the WHO Composite International Diagnostic Interview and the International Personality Disorder Examination Screening Questionnaire. Lifetime PD diagnoses were multiply imputed, and AUD diagnoses were obtained using DSM-5 criteria. We conducted cross-tabulations and logistic regression to estimate the associations between AUDs and PDs. RESULTS AND DISCUSSION: Our study did not find significant associations of PDs with heavy drinking patterns or mild AUD. Cluster B PD respondents tended to show the highest conditional prevalence estimates of most alcohol use patterns and AUD, including its severity subtypes. When alcohol outcomes were regressed on all PD Clusters simultaneously, with adjustment for sex and age, only cluster B was significantly associated with past-year alcohol use (OR 3.0), regular drinking (OR 3.2), and AUDs (OR 8.5), especially moderate and severe cases of alcohol use disorders (OR 9.7 and 16.6, respectively). These associations between Cluster B PDs and these alcohol outcomes were shown to be independent of other PD Clusters and individuals´ sex and age. CONCLUSION: The main finding of our study is that AUDs are highly comorbid with PDs. The presence of Cluster B PDs significantly increases the odds of alcohol consumption and disorders and of more severe forms of AUDs. Considering the local context of poor treatment provision, more specific prevention and intervention strategies should be directed to this population.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos da Personalidade/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem
14.
Am J Med Genet B Neuropsychiatr Genet ; 186(2): 77-89, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33590662

RESUMO

HeiDE is a longitudinal population-based study that started in the 1990s and, at baseline, assessed an array of health-related personality questionnaires in 5133 individuals. Five latent personality dimensions (The Heidelberg Five) were identified and interpreted as Emotional Lability (ELAB), Lack of Behavioral Control (LBCN), Type A Behavior (TYAB), Locus of Control over Disease (LOCC), and Psychoticism (PSYC). At follow-up, 3268 HeiDE participants (post-QC) were genotyped on single nucleotide polymorphism (SNP) arrays. To further characterize The Heidelberg Five, we analyzed genomic underpinnings, their relations to the genetic basis of the Big Five trait Neuroticism, and longitudinal associations with psychiatric symptoms at follow-up. SNP-based heritability was significant for ELAB (34%) and LBCN (29%). A genome-wide association study for each personality dimension was conducted; only the phenotype PSYC yielded a genome-wide significant finding (p < 5 × 10-8 , top SNP rs138223660). Gene-based analyses identified significant findings for ELAB, TYAB, and PSYC. Polygenic risk scores for Neuroticism were only associated with ELAB. Each of The Heidelberg Five was related to depressive symptoms at follow-up. ELAB, LBCN, and PSYC were also associated with lifetime anxiety symptoms. These results highlight the clinical importance of health-related personality traits and identify LBCN as a heritable "executive function" personality trait.


Assuntos
Transtornos de Ansiedade/epidemiologia , Marcadores Genéticos , Transtornos do Humor/epidemiologia , Neuroticismo , Transtornos da Personalidade/epidemiologia , Polimorfismo de Nucleotídeo Único , Psicopatologia , Adulto , Idoso , Transtornos de Ansiedade/genética , Transtornos de Ansiedade/patologia , Feminino , Estudo de Associação Genômica Ampla , Genótipo , Alemanha , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/genética , Transtornos do Humor/patologia , Transtornos da Personalidade/genética , Transtornos da Personalidade/patologia , Fenótipo , Fatores de Tempo
15.
J Affect Disord ; 282: 1125-1131, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33601687

RESUMO

BACKGROUND: Although depression and personality disorders (PDs) often co-occur, less is known about the impact of PDs on health-related quality of life (HRQOL) in patients with depression. This study explores the differences in HRQOL of depressed patients with and without PD. METHODS: Baseline data of 397 patients with depression from two randomised controlled trials were used for this analysis. HRQOL was measured with the EuroQol-5D (EQ-5D). Differences were examined between three groups: patients with 1) depression-only, 2) depression and comorbid PD and 3) PD and comorbid depression. The EQ-5D scores of the groups were compared with linear regression. RESULTS: HRQOL scores were lower in the depression-only group than the depression + PD group, even though depression severity was higher in patients with PD. HRQOL in the PD ± depression group did not differ from the other groups. In addition, no associations were found between the type or severity of PD and HRQOL. DISCUSSION: These findings could indicate that patients with PD are less affected by the impact of depression on HRQOL. In addition, the EQ-5D might not adequately capture the impact of PD on quality of life. Further research is needed to compare the EQ-5D with quality of life instruments that include more life domains. LIMITATIONS: Two study samples are combined, and therefore not designed to compare the three groups directly. Generalisation of the results should be done with caution. CONCLUSION: Depressed patients with PD report higher HRQOL than depression-only patients. Although higher HRQOL, patients with PD report more severe depressions than depressed-only patients.


Assuntos
Transtorno Depressivo , Qualidade de Vida , Estudos Transversais , Humanos , Pacientes Ambulatoriais , Transtornos da Personalidade/epidemiologia , Inquéritos e Questionários
16.
Int J Offender Ther Comp Criminol ; 65(8): 899-915, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33412968

RESUMO

Early childhood adversity can cause an imbalance in the autonomic function, which may in turn lead to the development of trauma-spectrum disorders and aggressive behavior later in life. In the present study, we investigated the complex associations between early adversity, heart rate variability (HRV), cluster B personality disorders, and self-reported aggressive behavior in a group of 50 male forensic inpatients (M age = 41.16; SD = 10.72). Structural Equation Modeling analysis revealed that patients with cluster B personality disorders were more likely to have adverse early childhood experiences and reduced sympathetic dominance in response to a threat than patients without cluster B personality disorders. In addition, HRV and cluster B personality disorders did not significantly mediate the association between early childhood adversity and self-reported aggressive behavior. These findings are important for clinical practice to facilitate specific treatment programs for those affected.


Assuntos
Experiências Adversas da Infância , Agressão , Adulto , Pré-Escolar , Frequência Cardíaca , Humanos , Pacientes Internados , Masculino , Transtornos da Personalidade/epidemiologia
17.
Res Dev Disabil ; 110: 103856, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33497856

RESUMO

During the COVID-19 pandemic, the Oasi Research Institute of Troina (Italy) became an important hotbed for infection; in fact, 109 patients with different levels of Intellectual Disability (ID) tested positive for COVID-19. The procedures and interventions put in place at the Oasi Research Institute due to the COVID-19 pandemic are exhaustively reported in this paper. The description of the clinical procedures as well as remote/in person psychological support services provided to people with ID and their families are here divided into three different sections: Phase I (or Acute phase), Phase II (or Activity planning), and Phase III (or Activity consolidation). In each section, the main psycho-pathological characteristics of patients, the reactions of family members and the multidisciplinary interventions put in place are also described.


Assuntos
COVID-19/epidemiologia , Deficiências do Desenvolvimento/reabilitação , Deficiência Intelectual/reabilitação , Sistemas de Apoio Psicossocial , Telemedicina , Academias e Institutos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/reabilitação , COVID-19/mortalidade , COVID-19/fisiopatologia , COVID-19/psicologia , Criança , Pré-Escolar , Comorbidade , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/psicologia , Hotspot de Doença , Surtos de Doenças , Epilepsia/epidemiologia , Feminino , Hospitais Especializados , Humanos , Hipotireoidismo/epidemiologia , Lactente , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/psicologia , Itália , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Transtornos do Humor/reabilitação , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Transtornos da Personalidade/reabilitação , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/reabilitação , Síndrome do Desconforto Respiratório/fisiopatologia , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto Jovem
18.
Medicina (Kaunas) ; 57(1)2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33401519

RESUMO

The diagnosis of psychosis is a challenge for the scientific community, both in terms of its definition and treatment. Some recent studies have investigated the relationship between personality and psychosis onset to prevent or intervene early. Sixty young adults were recruited during their first access in 2019 near the Community Mental Health Service of Niguarda Hospital, Milan, Italy. The assessment included the Social and Occupational Functioning Assessment Scale (SOFAS), the Global Assessment of Functioning (GAF) (clinician scales), the 16-item Version of the Prodromal Questionnaire (PQ-16), the Personality Inventory for DSM-5 (PID-5) (self-report), and a clinical session. Statistical analysis was performed by SPSS. The results show a negative correlation between the Detachment domain and the GAF scores. Correlational analysis also highlights that all PID-5 domains, except for Antagonism, have positive correlations with high scores in the PQ-16. The multivariate analysis of variance showed that patients diagnosed with versus without a psychotic disorder significantly differed on Detachment, Antagonism and Psychoticism PID-5 domains. The involvement of the personality construct in psychopathological development is displayed. In particular, higher levels of Detachment and Psychoticism can distinguish people who are more vulnerable to psychosis or who already have overt psychosis from those who do not have a psychotic predisposition. The study highlights the fundamental role of personality traits, emerging from PID-5, to distinguish young adults at risk of onset.


Assuntos
Transtornos da Personalidade , Personalidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Itália , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade , Adulto Jovem
19.
Am J Addict ; 30(1): 34-42, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32667738

RESUMO

BACKGROUND AND OBJECTIVES: Previous research has shown that alcohol craving is associated with psychiatric comorbidities. However, no population studies have examined the odds of psychiatric disorders in cravers and noncravers. The purpose of this study was to investigate current prevalence rates and odds ratios of psychiatric disorders among alcohol drinkers with and without alcohol craving in a population-based sample. We also compared four craving groups (cravers with and without alcohol use disorder [AUD], noncravers with and without AUD) for psychiatric comorbidities. METHODS: The study data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). A subset of the NESARC sample (N = 22 000) who reported alcohol use during the past 12 months was included. Prevalence rates of psychiatric disorders were compared among current drinkers with alcohol craving (N = 900) and without alcohol craving (N = 21 500). RESULTS: Cravers had higher prevalence rates of current psychiatric disorders than noncravers. Even after adjustment for other psychiatric disorders including AUD, cravers had significantly higher odds of any substance use disorder (adjusted odds ratio [AOR], 9.01), any mood disorder (AOR, 1.78), any anxiety disorder (AOR, 1.86), and any personality disorder (AOR, 1.92) than noncravers. Interestingly, cravers without AUD had even higher rates of any anxiety disorder and any personality disorder than noncravers with AUD. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Alcohol craving is associated with a higher prevalence of various psychiatric disorders. These findings suggest that alcohol craving may be related to transdiagnostic features that are present across various psychiatric disorders. (Am J Addict 2021;30:34-42).


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Fissura , Transtornos do Humor/epidemiologia , Transtornos da Personalidade/epidemiologia , Transtornos Psicóticos/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Razão de Chances , Transtornos da Personalidade/psicologia , Prevalência , Transtornos Psicóticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
20.
Aging Ment Health ; 25(5): 930-935, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32067472

RESUMO

Objectives: The Pathological Narcissism Inventory (PNI) is a measure of narcissism, with two domains of Vulnerability and Grandiosity, that has limited evidence of validity among older adults. Subsequently, the objective of the present study was to examine relationships between the PNI and measures of diverse pathological personality features.Method: Participants consisted of 125 community-dwelling older adults (M age = 71.8 years) who completed the PNI, the Personality Inventory for DSM-5 (PID-5), and the Coolidge Axis II Inventory (CATI).Results: Total Narcissism, Vulnerability, and Grandiosity were significantly correlated with every PD scale, with the exception of Grandiosity with Schizotypal PD. Regression analyses revealed that Narcissistic and Avoidant PDs had the strongest relationships with the PNI. Total Narcissism was also significantly correlated with all five PID-5 domains, with regression indicating Negative Affect and Antagonism as the strongest predictors.Conclusions: Findings generally support the convergent validity of the PNI for use among older adults and suggest that pathological narcissism may be related to general personality pathology in later life.


Assuntos
Narcisismo , Transtornos da Personalidade , Idoso , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Personalidade , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade
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