WorldWideScience

Sample records for co-morbid personality disorder

  1. Co-morbid disorders in Tourette syndrome

    DEFF Research Database (Denmark)

    Debes, Nanette Marinette Monique

    2013-01-01

    in persons with TS. Both in clinical cohorts and in population-based cohorts the prevalence of co-morbidities is high. The presence of co-morbid ADHD and/or OCD has an impact on psychosocial, educational, and neuropsychological consequences of TS and it is associated with higher rates of other co......-morbid disorders, like rage, anxiety, and conduct disorders. The symptoms of a co-morbid disorder might appear prior to the time that tics reach clinical attention. The TS phenotype probably changes during the course of the disease. The exact aetiology of the co-occurrence of co-morbid disorders and TS...

  2. Co-morbidity of adult attention-deficit/hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center.

    Science.gov (United States)

    Jacob, Christian P; Romanos, Jasmin; Dempfle, Astrid; Heine, Monika; Windemuth-Kieselbach, Christine; Kruse, Anja; Reif, Andreas; Walitza, Susanne; Romanos, Marcel; Strobel, Alexander; Brocke, Burkhard; Schäfer, Helmut; Schmidtke, Armin; Böning, Jobst; Lesch, Klaus-Peter

    2007-09-01

    The prevalence and consequences of co-morbid axis-I and axis-II disorders as well as personality traits were examined in a large cohort of adult attention-deficit/hyperactivity disorder (AADHD) at a tertiary referral center. In- and outpatients referred for diagnostic assessment of AADHD were screened. 372 affected probands were examined by means of the Structured Clinical Interview of DSM-IV axis-I/II disorders, the Revised NEO Personality Inventory (NEO-PI-R), and the Tridimensional Personality Questionnaire (TPQ). Lifetime co-morbidity with mood disorders was 57.3%, with anxiety disorders 27.2%, and with substance use disorders 45.0%. The histrionic personality disorder (35.2%) was the most frequent personality disorder. AADHD patients exhibited significantly altered scores on most of the NEO-PI-R and TPQ personality dimensions. The extent of substance abuse and dependence, as well as the presence of antisocial personality disorder alone or the cumulative number of other specific personality disorders was associated with lower psychosocial status (pdisorders was remarkably prevalent. In AADHD co-morbid mood, anxiety, and personality disorders as well as substance abuse/dependence is likely to be predictive of poor outcome.

  3. Adult antisocial syndrome co-morbid with borderline personality disorder is associated with severe conduct disorder, substance dependence and violent antisociality.

    Science.gov (United States)

    Freestone, Mark; Howard, Rick; Coid, Jeremy W; Ullrich, Simone

    2013-01-01

    This study tested the hypothesis that syndromal adult antisocial behaviour (AABS) co-morbid with borderline personality disorder (BPD) is a syndrome that emerges from severe conduct disorder (CD) in childhood and adolescence and is strongly associated, in adulthood, with both violence and substance dependence. In a sample of 8 580 community-resident adults screened for the presence of personality disorders, the following predictions arising from this hypothesis were tested: first, that those with AABS co-morbid with BPD would, in comparison with those showing AABS or BPD only, show a high level of antisocial outcomes, including violence; second, that adjusting for co-morbid alcohol dependence would attenuate group differences in many of the antisocial outcomes, and violence in particular; and third, that the AABS/BPD group would show both a high prevalence and a high severity of CD, and that adjusting for co-morbid CD would attenuate any association found between AABS/BPD co-morbidity and violence. Results confirmed these predictions, suggesting that AABS/BPD co-morbidity mediates the relationship between childhood CD and a predisposition to adult violence. The triad of AABS/BPD co-morbidity, alcohol dependence and severe CD is likely associated with the risk of criminal recidivism in offenders with personality disorder following release into the community. Copyright © 2012 John Wiley & Sons, Ltd.

  4. Obsessive–compulsive disorder: subclassification based on co-morbidity

    Science.gov (United States)

    Nestadt, G.; Di, C. Z.; Riddle, M. A.; Grados, M. A.; Greenberg, B. D.; Fyer, A. J.; McCracken, J. T.; Rauch, S. L.; Murphy, D. L.; Rasmussen, S. A.; Cullen, B.; Pinto, A.; Knowles, J. A.; Piacentini, J.; Pauls, D. L.; Bienvenu, O. J.; Wang, Y.; Liang, K. Y.; Samuels, J. F.; Roche, K. Bandeen

    2011-01-01

    Background Obsessive–compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes. Method Seven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated. Results Two and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive–compulsive personality disorder (OCPD) features, high scores on the ‘taboo’ factor of OCD symptoms, and low conscientiousness. Conclusions OCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors. PMID:19046474

  5. The anxiety disorders and suicidal ideation: accounting for co-morbidity via underlying personality traits.

    Science.gov (United States)

    Naragon-Gainey, K; Watson, D

    2011-07-01

    The anxiety disorders are robust correlates/predictors of suicidal ideation, but it is unclear whether (a) the anxiety disorders are specifically associated with suicidal ideation or (b) the association is due to co-morbidity with depression and other disorders. One means of modeling co-morbidity is through the personality traits neuroticism/negative emotionality (N/NE) and extraversion/positive emotionality (E/PE), which account for substantial shared variance among the internalizing disorders. The current study examines the association between the internalizing disorders and suicidal ideation, after controlling for co-morbidity via N/NE and E/PE. The sample consisted of 327 psychiatric out-patients. Multiple self-report and interview measures were collected for internalizing disorders [depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), social anxiety, panic and specific phobia] and suicidal ideation, as well as self-report measures for N/NE and E/PE. A model was hypothesized in which each disorder and suicidal ideation was regressed on N/NE, and depression and social anxiety were regressed on E/PE. Structural equation modeling (SEM) was used to examine the unique association of suicidality with each disorder, beyond shared variance with N/NE and E/PE. The hypothesized model was an acceptable fit to the data. Although zero-order analyses indicated that suicidal ideation was moderately to strongly correlated with all of the disorders, only depression and PTSD remained significantly associated with suicidal ideation in the SEM analyses. In a latent variable model that accounts for measurement error and a broad source of co-morbidity, only depression and PTSD were uniquely associated with suicidal ideation; panic, GAD, social anxiety and specific phobia were not.

  6. Psychological treatment of depression and anxiety in patients with co-morbid personality disorder: A scoping study of trial evidence.

    Science.gov (United States)

    French, L R M; Turner, K M; Dawson, S; Moran, P

    2017-05-01

    It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Conscious knowledge influences decision making differently in substance use disorder adults with or without co-morbid antisocial personality disorder

    DEFF Research Database (Denmark)

    Mellentin, Angelina; Skot, Lotte; Teasdale, Thomas William

    2013-01-01

    Decision-making impairment, as measured by the Iowa Gambling Task (IGT), is a consistent finding among individuals with substance use disorder (SUD). We studied how this impairment is influenced by co-morbid antisocial personality disorder (ASPD) and conscious knowledge of the task. Three groups...

  8. Social anxiety disorder and alcohol use disorder co-morbidity in the National Epidemiologic Survey on Alcohol and Related Conditions.

    Science.gov (United States)

    Schneier, F R; Foose, T E; Hasin, D S; Heimberg, R G; Liu, S-M; Grant, B F; Blanco, C

    2010-06-01

    To assess the prevalence and clinical impact of co-morbid social anxiety disorder (SAD) and alcohol use disorders (AUD, i.e. alcohol abuse and alcohol dependence) in a nationally representative sample of adults in the United States. Data came from a large representative sample of the US population. Face-to-face interviews of 43093 adults residing in households were conducted during 2001-2002. Diagnoses of mood, anxiety, alcohol and drug use disorders and personality disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV version. Lifetime prevalence of co-morbid AUD and SAD in the general population was 2.4%. SAD was associated with significantly increased rates of alcohol dependence [odds ratio (OR) 2.8] and alcohol abuse (OR 1.2). Among respondents with alcohol dependence, SAD was associated with significantly more mood, anxiety, psychotic and personality disorders. Among respondents with SAD, alcohol dependence and abuse were most strongly associated with more substance use disorders, pathological gambling and antisocial personality disorders. SAD occurred before alcohol dependence in 79.7% of co-morbid cases, but co-morbidity status did not influence age of onset for either disorder. Co-morbid SAD was associated with increased severity of alcohol dependence and abuse. Respondents with co-morbid SAD and alcohol dependence or abuse reported low rates of treatment-seeking. Co-morbid lifetime AUD and SAD is a prevalent dual diagnosis, associated with substantial rates of additional co-morbidity, but remaining largely untreated. Future research should clarify the etiology of this co-morbid presentation to better identify effective means of intervention.

  9. Posttraumatic stress disorder (ptsd and co-morbidity

    Directory of Open Access Journals (Sweden)

    Ifeta Ličanin

    2002-02-01

    Full Text Available Posttraumatic Stress Disorder (PTSD very often occurs accompanied with other psychiatric disorders such as: Alcohol and Drug abuse, Personality Disorder, General Anxiety Disorder, Obsessive Compulsive Disorder, Schizophrenia etc. Sometimes it might be a problem for clinicians to differ PTSD symptoms from symptoms of coexisting psychic disorders. The aim of this study was to present the most common PTSD coexisting psycho-disorders. This research was conducted during the period from April 1998 to October 1999. Participants were divided in two groups each containing 30 examinees. The first group consisted of 30 participants with symptoms of PTSD only while the second group included participants who suffered from both PTSD and other psychic disorders (co-morbidity. Both groups were quite similar regarding participants gender and age. The scientific tools used in the research were: Standard Psychiatric Interview, Harvard Trauma Questionnaire (HTQ, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Drug and Alcohol Abuse Checklist. Our research results are indicating that PTSDsymptoms are most common in middle-aged persons, regardless of their gender and age. We have found following coexisting psychic disorders: personality disorder 46.6% (from which 13.3% is permanent personality disorder after the traumatic experience; depression 29.9% (depression without psychotic symptoms 23.3% and depression with coexisting psychotic symptoms 6.6%; drug abuse 13.3; alcohol abuse 6.7% and dissociative (conversion disorder 3.3%. The results of our work are suggesting that co-morbid psychic symptoms have significant regressive influence on PTSD course and prognosis.

  10. Re-offending in forensic patients released from secure care: the role of antisocial/borderline personality disorder co-morbidity, substance dependence and severe childhood conduct disorder.

    Science.gov (United States)

    Howard, Rick; McCarthy, Lucy; Huband, Nick; Duggan, Conor

    2013-07-01

    Research suggests that a particular externalising phenotype, manifested in a developmental trajectory from severe childhood conduct disorder through early-onset substance abuse to adult antisocial/borderline personality disorder co-morbidity, may increase risk of antisocial behaviour in general and criminal recidivism in particular. This study aims to test the hypothesis that antisocial/borderline co-morbidity together with the triad of substance dependence, severe conduct disorder and borderline pathology would result in an increased risk of criminal recidivism. Fifty-three men who had been assessed and treated in a secure hospital unit were followed up after they had returned to the community. They were assessed for severity of the following: (i) antisocial personality disorder; (ii) borderline personality disorder; (iii) drug/alcohol dependence; and (iv) high Psychopathy Checklist Revised scores (factors 1 and 2). Patients with antisocial/borderline co-morbidity took significantly less time to re-offend compared with those without such co-morbidity. Both Psychopathy Checklist Revised factor 2 and the tripartite risk measure significantly predicted time to re-offence; the former largely accounted for the predictive accuracy of the latter. Risk of criminal recidivism can be adequately assessed without recourse to the pejorative term 'psychopath'. It is sufficient to assess the presence of the three elements of our risk measure: borderline and antisocial personality disorders in the context of drug/alcohol dependence and severe childhood conduct disorder. Practical implications of the study are as follows. (i) Sound assessment of personality, inclusive of a detailed history of childhood conduct disorder as well as adolescent and adult substance misuse, yields good enough information about risk of recidivism without recourse to the pejorative concept of 'psychopathy'. (ii) Given the high risk of alcohol-related violence in individuals with antisocial/borderline co-morbidity

  11. PSYCHIATRIC CO - MORBIDITY IN PERSONS WITH HANSEN’S DISEASE

    Directory of Open Access Journals (Sweden)

    Anita

    2015-05-01

    Full Text Available OBJECTIVE: To estimate prevalence of psychiatric co - morbidity and its effect on quality of life in persons with Hansen’s disease. METHOD: The study was conducted on around 80 persons above 18 year age with Hansen’s disease in out - patient department dermatology and i n leprosy home. Participants were diagnosed cases of Hansen’s disease, selected randomly and were evaluated with socio demographic questionnaire, Duke’s general health questionnaire, DSM - 5 self rated level 1 cross cutting symptom measure – adult and WHO - QO L - BREF. The period of data collection was from October 2014 to March 2015. RESULTS: The assessment showed that prevalence of at least one psychiatric co morbidity was 83.75% (67/80 patients and of these 67 patients 18(26.86% have one diagnosis, 26(38.80% have two diagnoses and 23(34.32% have 3 or more psychiatric diagnoses. Among all depression was most prevalent (28.35% mental disorder; followed by anxiety disorder (23.88%. Quality of life was significantly impaired in almost all persons with Hansen’ s disease. CONCLUSION: Persons with Hansen’s disease have significantly high prevalence of mental disorders which have much impact on their quality of life which were under diagnosed and thus remained untreated

  12. Conscious knowledge influences decision-making differently in substance abusers with and without co-morbid antisocial personality disorder.

    Science.gov (United States)

    Mellentin, Angelina I; Skøt, Lotte; Teasdale, Thomas W; Habekost, Thomas

    2013-08-01

    Decision-making impairment, as measured by the Iowa Gambling Task (IGT), is a consistent finding among individuals with substance use disorder (SUD). We studied how this impairment is influenced by co-morbid antisocial personality disorder (ASPD) and conscious knowledge of the task. Three groups were investigated: SUD individuals without co-morbid ASPD (n = 30), SUD individuals with co-morbid ASPD (n = 16), and healthy controls (n = 17). Both SUD and SUD+ASPD participants had poor overall IGT performance. A block-by-block analysis revealed that SUD participants exhibited slow but steady improvement across the IGT, whereas SUD+ASPD participants exhibited initial normal improvement, but dropped off during the last 40 trials. Conscious knowledge of the task was significantly correlated to performance for controls and SUD participants, but not for SUD+ASPD participants. Our findings suggest that decision-making proceeds differently in SUD and SUD+ASPD individuals due to differences in acquisition and application of conscious knowledge. © 2013 The Scandinavian Psychological Associations.

  13. Co-morbid anxiety disorders in bipolar disorder and major depression: familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder.

    Science.gov (United States)

    Goes, F S; McCusker, M G; Bienvenu, O J; Mackinnon, D F; Mondimore, F M; Schweizer, B; Depaulo, J R; Potash, J B

    2012-07-01

    Co-morbidity of mood and anxiety disorders is common and often associated with greater illness severity. This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees. The sample comprised 566 BP families with 1416 affected subjects and 675 MDD families with 1726 affected subjects. Clinical characteristics and familiality of panic disorder, social phobia, specific phobia and obsessive-compulsive disorder (OCD) were examined in BP and MDD pedigrees with multivariate modeling using generalized estimating equations. Co-morbidity between mood and anxiety disorders was associated with several markers of clinical severity, including earlier age of onset, greater number of depressive episodes and higher prevalence of attempted suicide, when compared with mood disorder without co-morbid anxiety. Familial aggregation was found with co-morbid panic and OCD in both BP and MDD pedigrees. Specific phobia showed familial aggregation in both MDD and BP families, although the findings in BP were just short of statistical significance after adjusting for other anxiety co-morbidities. We found no evidence for familiality of social phobia. Our findings suggest that co-morbidity of MDD and BP with specific anxiety disorders (OCD, panic disorder and specific phobia) is at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity.

  14. Co-morbid disorders and sexual risk behavior in Nigerian adolescents with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Bakare Muideen O

    2009-06-01

    Full Text Available Abstract Background Adolescent onset bipolar disorder often presents with co-morbid disorders of which psychoactive substance use disorders are notable. Mania symptoms and co-morbid psychoactive substance use disorders prone adolescents with bipolar disorder to impulsivity, impaired judgment, and risk taking behavior which often includes sexual risk behavior. There are dearth of information on pattern of co-morbid disorders and sexual risk behavior in adolescent onset bipolar disorder in Nigeria. This study assessed the prevalence and pattern of co-morbid disorders and determined associated factors of sexual risk behavior among adolescents with bipolar disorder. Methods Socio-demographic information was obtained from the adolescents using socio-demographic questionnaire. Clinical interview, physical examination and laboratory investigations were employed to establish co-morbid disorders in these adolescents during the outpatient follow up visits over a one year period. Results A total of forty six (46 adolescents with bipolar disorder were followed up over a one year period. Twenty two (47.8% of the adolescents had co-morbid disorders with cannabis use disorders, alcohol use disorders, conduct disorder with or without other psychoactive substance use accounting for 23.9%, 8.7%, 13.0% respectively and HIV infection, though a chance finding accounting for 2.2%. Twenty one (45.7% of the adolescents had positive history of sexual risk behavior, which was significantly associated with presence of co-morbid disorders (p = 0.003, level of religion activities in the adolescents (p = 0.000, and marital status of the parents (p = 0.021. Conclusion When planning interventions for children and adolescents with bipolar disorder, special attention may need to be focused on group of adolescents with co-morbid disorders and propensity towards impulsivity and sexual risk behavior. This may help in improving long term outcome in this group of adolescents.

  15. Co-morbidity in Attention-Deficit Hyperactivity Disorder: A Clinical Study from India.

    Science.gov (United States)

    Jacob, P; Srinath, S; Girimaji, S; Seshadri, S; Sagar, J V

    2016-12-01

    To assess the prevalence of neurodevelopmental and psychiatric co-morbidities in children and adolescents diagnosed with attention-deficit hyperactivity disorder at a tertiary care child and adolescent psychiatry centre. A total of 63 children and adolescents who were diagnosed with attention-deficit hyperactivity disorder and fulfilled the inclusion criteria were comprehensively assessed for neurodevelopmental and psychiatric co-morbidities. The tools used included the Mini-International Neuropsychiatric Interview for Children and Adolescents, Attention Deficit Hyperactivity Disorder Rating Scale IV (ADHD-RS), Children's Global Assessment Scale, Clinical Global Impression Scale, Vineland Social Maturity Scale, and Childhood Autism Rating Scale. All except 1 subject had neurodevelopmental and / or psychiatric disorder co-morbid with attention-deficit hyperactivity disorder; 66.7% had both neurodevelopmental and psychiatric disorders. Specific learning disability was the most common co-existing neurodevelopmental disorder and oppositional defiant disorder was the most common psychiatric co-morbidity. The mean baseline ADHD-RS scores were significantly higher in the group with psychiatric co-morbidities, especially in the group with oppositional defiant disorder. Co-morbidity is present at a very high frequency in clinic-referred children diagnosed with attention-deficit hyperactivity disorder. Psychiatric co-morbidity, specifically oppositional defiant disorder, has an impact on the severity of attention-deficit hyperactivity disorder. Co-morbidity needs to be explicitly looked for during evaluation and managed appropriately.

  16. [Personality disorders and psychiatric morbidity in adolescent anorexia nervosa. Results of a prospective 10 year catamnesis].

    Science.gov (United States)

    Müller, B; Herpertz, S; Heussen, N; Neudörfl, A; Wewetzer, C; Remschmidt, H; Herpertz-Dahlmann, B

    2000-05-01

    The aim of the current prospective study was to examine at regular intervals the course of the eating disorder symptoms and the psychiatric (co-) morbidity including personality disorders among juvenile patients who fulfilled the DSM-III-R criteria for anorexia nervosa. Ten years after release from hospital all 39 patients (100%), as well as a control group parallelized for age, gender and occupational status were personally followed-up. Symptoms of eating disorders were documented by means of the Standardized Interview for Anorexia and Bulimia nervosa (SIAB, Fichter et al., 1991), the Composite International Diagnostic Interview (WHO, 1990) was applied to diagnose psychiatric (co-) morbidity, and the Structured Clinical Interview (SKID-II, Spitzer et al., 1993) to assess personality disorders. Compared to the control group, at the time of follow-up a significantly greater number of patients were suffering from a psychiatric disorder, primarily an anxiety disorder, an affective disorder or from drug, respectively alcohol abuse. Personality disorders, chiefly anxious-avoidant types on the DSM-III-R were diagnosed among almost one-fourth of the patients. Our findings indicate that anorexia nervosa is not a developmental disorder limited to puberty but a disorder associated both cross-sectionally as well as longitudinally with other psychiatric disorders.

  17. Antisocial personality disorder and anxiety disorder: a diagnostic variant?

    Science.gov (United States)

    Coid, Jeremy; Ullrich, Simone

    2010-06-01

    Antisocial personality disorder (ASPD) with co-morbid anxiety disorder may be a variant of ASPD with different etiology and treatment requirements. We investigated diagnostic co-morbidity, ASPD criteria, and anxiety/affective symptoms of ASPD/anxiety disorder. Weighted analyses were carried out using survey data from a representative British household sample. ASPD/anxiety disorder demonstrated differing patterns of antisocial criteria, co-morbidity with clinical syndromes, psychotic symptoms, and other personality disorders compared to ASPD alone. ASPD criteria demonstrated specific associations with CIS-R scores of anxiety and affective symptoms. Findings suggest ASPD/anxiety disorder is a variant of ASPD, determined by symptoms of anxiety. Although co-morbid anxiety and affective symptoms are the same as in anxiety disorder alone, associations with psychotic symptoms require further investigation. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Response to "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study"

    NARCIS (Netherlands)

    de Jongh, A.; ten Broeke, E.

    2014-01-01

    Last November, the European Journal of Psychotraumatology published an interesting paper entitled "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study". This article

  19. The role of co-morbid personality pathology in predicting self-reported aggression in patients with schizophrenia

    DEFF Research Database (Denmark)

    Bo, Sune; Abu-Akel, Ahmad; Kongerslev, Mickey

    2013-01-01

    BACKGROUND: Personality pathology affects behavioral patterns in patients with schizophrenia notwithstanding psychotic symptomatology. An investigation of the role of co-morbid personality pathology in the occurrence of aggression in schizophrenia is explored using both categorical and dimensional...... approaches to personality pathology. METHODS: In a cross-sectional study we evaluate, in 97 patients diagnosed with schizophrenia, the effect of personality pathology on the occurrence of aggression in schizophrenia using both a categorical approach, as described in DSM-IV-TR Axis II, and a dimensional...... approach, as operationalized in the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). We also employ mediation analyses to explore the extent to which dimensions within the DAPP mediate the relationship between co-morbid personality disorders and aggression. RESULTS...

  20. Psychiatric co-morbidity in chronic pain disorder

    International Nuclear Information System (INIS)

    Yaqoob, N.; Sharif, A.; Shoaib, A.

    2013-01-01

    Objective: To determine the psychiatric co-morbidity in patients with chronic pain disorder in hospital setting. Design: Cross sectional descriptive study. Place and duration of study: This study was conducted at Combined Military Hospital (CMH) Okara from June 2011 to May 2012. Patients and Methods: A purposive sample of 400 patients (males=117; females=283) gathered from pain clinic and other outpatient departments of the hospital and were interviewed in detail and Present State Examination was carried out. Demographic variables were scored using descriptive statistics and results were analyzed using correlation methods. Results: It was revealed that psychiatric illness in overall sample prevailed among 266 participants (67%). Among which 164 participants (62%) were diagnosed with depression, 67 patients (25.2%) of chronic pain were diagnosed with anxiety disorders, 28 patients (11%) with adjustment disorder and 1.5% and 1.1% diagnosed with drug dependence and somatization disorder, respectively. Conclusion: Psychiatric co-morbidity especially the incidence of depression, anxiety and adjustment disorders were high amongst patients suffering from chronic pain disorder. (author)

  1. Impact of deleting 5 DSM-IV personality disorders on prevalence, comorbidity, and the association between personality disorder pathology and psychosocial morbidity.

    Science.gov (United States)

    Zimmerman, Mark; Chelminski, Iwona; Young, Diane; Dalrymple, Kristy; Martinez, Jennifer

    2012-02-01

    A high rate of comorbidity among the personality disorders has been consistently identified as a problem. To address the problem of excessive comorbidity, the DSM-5 Personality and Personality Disorders Work Group recommended reducing the number of specific personality disorder diagnoses from 10 to 5 by eliminating paranoid, schizoid, histrionic, narcissistic, and dependent personality disorders. No study has examined the impact of this change. The present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project examined the impact of eliminating these 5 personality disorders on the prevalence of personality disorders in a large sample of psychiatric outpatients presenting for treatment, comorbidity among the personality disorders, and association with psychosocial morbidity. From September 1997 to June 2008, 2,150 psychiatric patients presenting to the Rhode Island Hospital outpatient practice were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders and measures of psychosocial morbidity. More than one-quarter of the patients were diagnosed with one of the 10 DSM-IV personality disorders (28.6%, n = 614). When 5 personality disorders were excluded from consideration, then 25.8% (n = 555) were diagnosed with at least 1 of the 5 personality disorders proposed for retention in DSM-5, and the comorbidity rate dropped from 29.8% to 21.3%. Compared to patients without a personality disorder, the patients with either a retained or an excluded personality disorder had greater psychosocial morbidity. There was little difference in psychosocial morbidity between patients with a retained and an excluded personality disorder. The Personality and Personality Disorders Work Group's desired goal of reducing comorbidity would be achieved by deleting 5 personality disorders, although comorbidity would not be eliminated. The reduction of comorbidity could come with a cost of false-negative diagnoses

  2. Discriminability of Personality Profiles in Isolated and Co-Morbid Marijuana and Nicotine Users

    OpenAIRE

    Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L.; Filbey, Francesca M

    2016-01-01

    Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co-morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively fo...

  3. Discriminability of personality profiles in isolated and Co-morbid marijuana and nicotine users.

    Science.gov (United States)

    Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L; Filbey, Francesca M

    2016-04-30

    Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively for both. This study evaluated personality traits that distinguish isolated and co-morbid use of marijuana and nicotine. To that end, we collected the NEO Five Factor Inventory in participants who used marijuana-only (n=59), nicotine-only (n=27), both marijuana and nicotine (n=28), and in non-using controls (n=28). We used factor analyses to identify personality profiles, which are linear combinations of the five NEO Factors. We then conducted Receiver Operating Characteristics (ROC) curve analysis to test accuracy of the personality factors in discriminating isolated and co-morbid marijuana and nicotine users from each other. ROC curve analysis distinguished the four groups based on their NEO personality patterns. Results showed that NEO Factor 2 (openness, extraversion, agreeableness) discriminated marijuana and marijuana+nicotine users from controls and nicotine-only users with high predictability. Additional ANOVA results showed that the openness dimension discriminated marijuana users from nicotine users. These findings suggest that personality dimensions distinguish marijuana users from nicotine users and should be considered in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  4. Psychosocial morbidity associated with bipolar disorder and borderline personality disorder in psychiatric out-patients: comparative study.

    Science.gov (United States)

    Zimmerman, Mark; Ellison, William; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy

    2015-10-01

    The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders. To compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder. Patients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder. The patients with borderline personality disorder less frequently were college graduates, were diagnosed with more comorbid disorders, more frequently had a history of substance use disorder, reported more suicidal ideation at the time of the evaluation, more frequently had attempted suicide, reported poorer social functioning and were rated lower on the Global Assessment of Functioning. There was no difference between the two patient groups in history of admission to psychiatric hospital or time missed from work during the past 5 years. The level of psychosocial morbidity associated with borderline personality disorder was as great as (or greater than) that experienced by patients with bipolar disorder. From a public health perspective, efforts to improve the detection and treatment of borderline personality disorder might be as important as efforts to improve the recognition and treatment of bipolar disorder. © The Royal College of Psychiatrists 2015.

  5. Co-morbidity of personality disorder in schizophrenia among psychiatric outpatients in China: data from epidemiologic survey in a clinical population.

    Science.gov (United States)

    Wei, YanYan; Zhang, TianHong; Chow, Annabelle; Tang, YingYing; Xu, LiHua; Dai, YunFei; Liu, XiaoHua; Su, Tong; Pan, Xiao; Cui, Yi; Li, ZiQiang; Jiang, KaiDa; Xiao, ZePing; Tang, YunXiang; Wang, JiJun

    2016-07-08

    The reported rates of personality disorder (PD) in subjects with schizophrenia (SZ) are quite varied across different countries, and less is known about the heterogeneity of PD among subjects with SZ. We examined the co-morbidity of PD among patients who are in the stable phase of SZ. 850 subjects were randomly sampled from patients diagnosed with SZ in psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. Co-morbidity of PDs was assessed through preliminary screening and patients were administered several modules of the SCID-II. Evidence of heterogeneity was evaluated by comparing patients diagnosed with SZ with those who presented with either affective disorder or neurosis (ADN). 204 outpatients (24.0 %) in the stable phase of SZ met criteria for at least one type of DSM-IV PD. There was a higher prevalence of Cluster-A (odd and eccentric PD) and C (anxious and panic PD) PDs in SZ (around 12.0 %). The most prevalent PD was the paranoid subtype (7.65 %). Subjects with SZ were significantly more likely to have schizotypal PD (4.4 % vs. 2.1 %, p = 0.003) and paranoid PD (7.6 % vs. 5.4 %, p = 0.034), but much less likely to have borderline, obsessive-compulsive, depressive, narcissistic and histrionic PD. These findings suggest that DSM-IV PD is common in patients with SZ than in the general population. Patterns of co-morbidity with PDs in SZ are different from ADN.

  6. Kleptomania and Co-morbid addictive disorders.

    Science.gov (United States)

    Kim, Hyoun S; Christianini, Aparecida Rangon; Bertoni, Daniela; de Oliveira, Maria do Carmo Medeiros; Hodgins, David C; Tavares, Hermano

    2017-04-01

    We examined the association between kleptomania and addictive disorders, including behavioral addictions. Fifty-three individuals with a diagnosis of kleptomania completed measures of kleptomania severity, semi-structured clinical interviews to assess co-morbid diagnosis of addictive disorders, and the Shorter PROMIS Questionnaire (SPQ) assessing an array of addictive behaviors. 20.75% of the sample met criteria for an addictive disorder; four for a substance use disorder and four for a behavioral addiction. Kleptomania severity was significantly associated with compulsive work and shopping measured by the SPQ. The results suggest the need to assess a wide array of addictive behaviors in individuals with kleptomania. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. Dreams and Nightmares in Personality Disorders.

    Science.gov (United States)

    Schredl, Michael

    2016-02-01

    Although the relationship between dreaming and psychopathology has been studied quite extensively, research on dreaming in patients with personality disorders has been very scarce. In patients with borderline personality disorder, negatively toned dreams and heightened nightmare frequency have been found-characteristics not determined by co-morbid depression or posttraumatic stress disorder. The review includes suggestions for future studies as the existing results clearly indicate that this line of research is most interesting. Lastly, clinical recommendations especially regarding the treatment of the often found co-morbid nightmare disorder will be given.

  8. Gender Differences in Compulsive Buying Disorder: Assessment of Demographic and Psychiatric Co-Morbidities.

    Science.gov (United States)

    Nicoli de Mattos, Cristiana; Kim, Hyoun S; Requião, Marinalva G; Marasaldi, Renata F; Filomensky, Tatiana Z; Hodgins, David C; Tavares, Hermano

    2016-01-01

    Compulsive buying is a common disorder found worldwide. Although recent research has shed light into the prevalence, etiology and clinical correlates of compulsive buying disorder, less is known about gender differences. To address this empirical gap, we assessed potential gender differences in demographic and psychiatric co-morbidities in a sample of 171 compulsive buyers (20 men and 151 women) voluntarily seeking treatment in São Paulo, Brazil. A structured clinical interview confirmed the diagnosis of compulsive buying. Of the 171 participants, 95.9% (n = 164) met criteria for at least one co-morbid psychiatric disorder. The results found that male and female compulsive buyers did not differ in problem severity as assessed by the Compulsive Buying Scale. However, several significant demographic and psychiatric differences were found in a multivariate binary logistic regression. Specifically, male compulsive buyers were more likely to report being non-heterosexual, and reported fewer years of formal education. In regards to psychiatric co-morbidities, male compulsive buyers were more likely to be diagnosed with sexual addiction, and intermittent explosive disorder. Conversely, men had lower scores on the shopping subscale of the Shorter PROMIS Questionnaire. The results suggest that male compulsive buyers are more likely to present with co-morbid psychiatric disorders. Treatment planning for compulsive buying disorder would do well to take gender into account to address for potential psychiatric co-morbidities.

  9. Treatment outcome of schizophrenia co-morbid with obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    Khan, M.N.S.; Arshad, N.; Naeem Ullah

    2004-01-01

    Objective: To evaluate the pharmacological treatment outcome of schizophrenia, co-morbid with obsessive-compulsive disorder by comparing the effects of typical neuroleptic, atypical neuroleptic and a combination of typical with anti-obsessional drugs on positive and negative symptoms of schizophrenia and obsessional symptoms. Subjects and Methods: The sample consisted of 39 patients suffering from schizophrenia co-morbid with obsessive- compulsive disorder. They were divided in three groups according to the pharmacological treatment given by the treating psychiatrists. Sample was assessed at the start of treatment and twelve weeks later. Results: Patients receiving typical neuroleptics and anti-obsessional drugs showed better outcome (p < .05) both in psychotic (pre-intervention mean scores of positive scale of PANSS 26.90 as compared to postinterventional mean scores 19.00) and obsessional symptoms (pre-intervention mean scores on Padua Inventory 165.00 compared to 84.00 postinterventional mean scores) than those receiving typical and atypical neuroleptics alone. Conclusion: Treatment outcome of schizophrenia co-morbid with obsessive-compulsive disorder shows better results if anti-obsessional drugs are added to the neuroleptics. (author)

  10. Psychological co-morbidity in children with specific learning disorders

    Directory of Open Access Journals (Sweden)

    Manoj K Sahoo

    2015-01-01

    Full Text Available Children under 19 years of age constitute over 40% of India′s population and information about their mental health needs is a national imperative. Children with specific learning disorders (SLDs exhibit academic difficulties disproportionate to their intellectual capacities. Prevalence of SLD ranges from 2% to 10%. Dyslexia (developmental reading disorder is the most common type, affecting 80% of all SLD. About 30% of learning disabled children have behavioral and emotional problems, which range from attention deficit hyperactivity disorder (most common to depression, anxiety, suicide etc., to substance abuse (least common. Co-occurrence of such problems with SLD further adds to the academic difficulty. In such instances, diagnosis is difficult and tricky; improvement in academics demands comprehensive holistic treatment approach. SLD remains a large public health problem because of under-recognition, inadequate treatment and therefore merits greater effort to understand the co-morbidities, especially in the Indian population. As the literature is scarce regarding co-morbid conditions in learning disability in Indian scenario, the present study has tried to focus on Indian population. The educational concessions (recent most given to such children by Central Board of Secondary Education, New Delhi are referred to. The issues to be addressed by the family physicians are: Low level of awareness among families and teachers, improper dissemination of accurate information about psychological problems, available help seeking avenues, need to develop service delivery models in rural and urban areas and focus on the integration of mental health and primary care keeping such co-morbidity in mind.

  11. Psychological Co-morbidity in Children with Specific Learning Disorders.

    Science.gov (United States)

    Sahoo, Manoj K; Biswas, Haritha; Padhy, Susanta Kumar

    2015-01-01

    Children under 19 years of age constitute over 40% of India's population and information about their mental health needs is a national imperative. Children with specific learning disorders (SLDs) exhibit academic difficulties disproportionate to their intellectual capacities. Prevalence of SLD ranges from 2% to 10%. Dyslexia (developmental reading disorder) is the most common type, affecting 80% of all SLD. About 30% of learning disabled children have behavioral and emotional problems, which range from attention deficit hyperactivity disorder (most common) to depression, anxiety, suicide etc., to substance abuse (least common). Co-occurrence of such problems with SLD further adds to the academic difficulty. In such instances, diagnosis is difficult and tricky; improvement in academics demands comprehensive holistic treatment approach. SLD remains a large public health problem because of under-recognition, inadequate treatment and therefore merits greater effort to understand the co-morbidities, especially in the Indian population. As the literature is scarce regarding co-morbid conditions in learning disability in Indian scenario, the present study has tried to focus on Indian population. The educational concessions (recent most) given to such children by Central Board of Secondary Education, New Delhi are referred to. The issues to be addressed by the family physicians are: Low level of awareness among families and teachers, improper dissemination of accurate information about psychological problems, available help seeking avenues, need to develop service delivery models in rural and urban areas and focus on the integration of mental health and primary care keeping such co-morbidity in mind.

  12. Evaluation of changes in prescription medication use after a residential treatment programme for borderline personality disorder.

    Science.gov (United States)

    Broadbear, Jillian H; Nesci, Julian; Thomas, Rosemary; Thompson, Katherine; Beatson, Josephine; Rao, Sathya

    2016-12-01

    Residential patients diagnosed with borderline personality disorder were evaluated to determine whether borderline personality disorder-focused psychotherapy reduced prescribing, personality disorder and co-morbid symptom severity. Psychotropic prescriptions were measured at admission, discharge and 1 year later in 74 female participants with one or more personality disorder diagnosis and co-morbid mood disorders. Changes in pharmacotherapy were examined in the context of improvements in borderline personality disorder and/or co-morbid disorder symptom severity. Residential treatment included individual and group psychotherapy for borderline personality disorder. The Structured Clinical Interview for DSM-IV was used to confirm the borderline personality disorder diagnosis and associated co-morbid conditions. The Beck Depression Inventory was completed at each time point. A significant reduction in the incidence and severity of self-rated depression as well as clinician assessed personality disorder, including borderline personality disorder, was accompanied by a reduction in prescription of psychoactive medications. Three to six months of intensive borderline personality disorder-specific psychotherapy showed lasting benefit with regard to symptom severity of personality disorders (borderline personality disorder in particular) as well as depressive symptoms. This improvement corresponded with a reduction in prescriptions for psychoactive medications, which is consistent with current thinking regarding treatment for borderline personality disorder. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  13. Major depressive disorder as a co-morbid diagnosis in ...

    African Journals Online (AJOL)

    The purpose of this article is to focus on the importance of depressive symptoms in patients suffering from schizophrenia, and the dilemma posed by hierarchical classification methods, which exclude co-morbid diagnoses such as Major Depressive Disorder in patients with schizophrenia. The question arises that if Major ...

  14. Prevalence and co-morbidity among anxiety disorders in a national cohort of psychiatrically referred children and adolescents

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Hoeyer, Mette; Dyrborg, Jørgen

    2010-01-01

    The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from a data...... as routine to increase the precision in recognizing and reporting on childhood anxiety disorders.......The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from...... a database containing 83% of all youth referred from 2004 to 2007 (N=13,241). A prevalence of 5.7% of anxiety disorder was found in the sample. Homotypic co-morbidity was found in only 2.8%, whereas heterotypic co-morbidity was found in 42.9% of the cohort. A total of 73.6% had a principal anxiety disorder...

  15. Disordered gambling and co-morbidity of psychiatric disorders among college students: an examination of problem drinking, anxiety and depression.

    Science.gov (United States)

    Martin, Ryan J; Usdan, Stuart; Cremeens, Jennifer; Vail-Smith, Karen

    2014-06-01

    We assessed the occurrence of co-morbid psychiatric disorders (i.e., problem drinking, anxiety, and depression) among college students who met the threshold for disordered gambling. The participants included a large sample of undergraduate students (n = 1,430) who were enrolled in an introductory health course at a large, southeastern university in Spring 2011 and completed an online assessment that included scales to assess disordered gambling, problem drinking, anxiety, and depression. We calculated screening scores, computed prevalence rates for each disorder, and calculated Pearson correlations and Chi square tests to examine correlations and co-morbid relationships between the four disorders. Analyses indicated that all disorders were significantly associated (p students who experience disordered gambling (and other psychiatric disorders) are at increased risk of experiencing co-occurring disorders, it might be useful for college health professionals to concurrently screen and intervene for co-occurring disorders.

  16. Risk of preterm delivery and hypertensive disorders of pregnancy in relation to maternal co-morbid mood and migraine disorders during pregnancy.

    Science.gov (United States)

    Cripe, Swee May; Frederick, Ihunnaya O; Qiu, Chunfang; Williams, Michelle A

    2011-03-01

    We evaluated the risks of preterm delivery and hypertensive disorders of pregnancy among pregnant women with mood and migraine disorders, using a cohort study of 3432 pregnant women. Maternal pre-pregnancy or early pregnancy (migraine diagnoses were ascertained from interview and medical record review. We fitted generalised linear models to derive risk ratios (RR) and 95% confidence intervals (CI) of preterm delivery and hypertensive disorders of pregnancy for women with isolated mood, isolated migraine and co-morbid mood-migraine disorders, respectively. Reported RR were adjusted for maternal age, race/ethnicity, marital status, parity, smoking status, chronic hypertension or pre-existing diabetes mellitus, and pre-pregnancy body mass index. Women without mood or migraine disorders were defined as the reference group. The risks for preterm delivery and hypertensive disorders of pregnancy were more consistently elevated among women with co-morbid mood-migraine disorders than among women with isolated mood or migraine disorder. Women with co-morbid disorders were almost twice as likely to deliver preterm (adjusted RR=1.87, 95% CI 1.05, 3.34) compared with the reference group. There was no clear evidence of increased risks of preterm delivery and its subtypes with isolated migraine disorder. Women with mood disorder had elevated risks of pre-eclampsia (adjusted RR=3.57, 95% CI 1.83, 6.99). Our results suggest an association between isolated migraine disorder and pregnancy-induced hypertension (adjusted RR=1.42, 95% CI 1.00, 2.01). This is the first study examining perinatal outcomes in women with co-morbid mood-migraine disorders. Pregnant women with a history of migraine may benefit from screening for depression during prenatal care and vigilant monitoring, especially for women with co-morbid mood and migraine disorders. © 2011 Blackwell Publishing Ltd.

  17. Co-morbidities, social impact and quality of life in Tourette syndrome

    Directory of Open Access Journals (Sweden)

    Valsamma eEapen

    2016-06-01

    Full Text Available Tourette Syndrome (TS is more than having motor and vocal tics, and this review will examine the varied co-morbidities as well as the social impact and Quality of Life (QoL in individuals with TS. The relationship between any individual and his/her environment is complex and this is further exaggerated in the case of a person with TS. For example, tics may play a significant role in shaping the person’s experiences, perceptions and interactions with the environment. Further, associated clinical features, co-morbidities and co-existing psychopathologies may compound or alter this relationship. The common co-morbidities in this regard include Attention Deficit Hyperactivity Disorder (ADHD and disruptive behaviours, Obsessive Compulsive Disorder (OCD and Autism Spectrum Disorder (ASD, and co-existent problems include anxiety, depression and low self esteem, which can all lead to poorer psychosocial functioning and QoL. Thus, the symptoms of TS and the associated co-morbid conditions may interact to result in a vicious cycle or a downward spiralling of negative experiences and poor QoL. The stigma and social maladjustment in TS and the social exclusion, bullying and discrimination is considered to be caused in large part by misperceptions of the disorder by teachers, peers, and the wider community. Improved community and professional awareness about TS and related co-morbidities & other psychopathologies as well as the provision of multidisciplinary services to meet the complex needs of this clinical population are critical. Future research to inform the risk and resilience factors for successful long term outcomes is also warranted.

  18. The Impact of Obsessive Compulsive Personality Disorder on Cognitive Behaviour Therapy for Obsessive Compulsive Disorder.

    Science.gov (United States)

    Gordon, Olivia M; Salkovskis, Paul M; Bream, Victoria

    2016-07-01

    It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders. The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD. 92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders. At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD. The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.

  19. [Time for cluster C personality disorders: state of the art].

    Science.gov (United States)

    Hutsebaut, J; Willemsen, E M C; Van, H L

    Compared to cluster B personality disorders, the assessment and treatment of people with obsessive-compulsive, dependent, and avoidant personality disorders (cluster C) is given little attention in the field of research and clinical practice. Presenting the current state of affairs in regard to cluster C personality disorders. A systematic literature search was conducted using the main data bases. Cluster C personality disorders are present in approximately 3-9% of the general population. In about half of the cases of mood, anxiety, and eating disorders, there is co-morbid cluster C pathology. This has a major influence on the progression of symptoms, treatment effectiveness and potential relapse. There are barely any well conducted randomized studies on the treatment of cluster-C in existence. Open cohort studies, however, show strong, lasting treatment effects. Given the frequent occurrence of cluster C personality disorders, the burden of disease, associated societal costs and the prognostic implications in case of a co-morbid cluster C personality disorder, early detection and treatment of these disorders is warranted.

  20. Co-occurrence of dissociative identity disorder and borderline personality disorder.

    Science.gov (United States)

    Ross, Colin A; Ferrell, Lynn; Schroeder, Elizabeth

    2014-01-01

    The literature indicates that, among individuals with borderline personality disorder, pathological dissociation correlates with a wide range of impairments and difficulties in psychological function. It also predicts a poorer response to dialectical behavior therapy for borderline personality disorder. We hypothesized that (a) dissociative identity disorder commonly co-occurs with borderline personality disorder and vice versa, and (b) individuals who meet criteria for both disorders have more comorbidity and trauma than individuals who meet criteria for only 1 disorder. We interviewed a sample of inpatients in a hospital trauma program using 3 measures of dissociation. The most symptomatic group was those participants who met criteria for both borderline personality disorder and dissociative identity disorder on the Dissociative Disorders Interview Schedule, followed by those who met criteria for dissociative identity disorder only, then those with borderline personality disorder only, and finally those with neither disorder. Greater attention should be paid to the relationship between borderline personality disorder and dissociative identity disorder.

  1. Treatment of borderline personality disorder and co-occurring anxiety disorders

    Science.gov (United States)

    Valenstein, Helen R.

    2013-01-01

    Anxiety disorders are highly prevalent among individuals with borderline personality disorder, with comorbidity rates of up to 90%. Anxiety disorders have been found to reduce the likelihood of achieving remission from borderline personality disorder over time and to increase the risk of suicide and self-injury in this population. Evidence-based treatments for borderline personality disorder have not sufficiently focused on targeting anxiety disorders, and their effects on these disorders are either limited or unknown. Conversely, evidence-based treatments for anxiety disorders typically exclude suicidal, self-injuring, and seriously comorbid patients, thereby limiting their generalizability to individuals with borderline personality disorder. To address these limitations, recent research has begun to emerge focused on developing and evaluating treatments for individuals with co-occurring borderline personality disorder and anxiety disorders, specifically posttraumatic stress disorder (PTSD), with promising initial results. However, there is a need for additional research in this area, particularly studies evaluating the treatment of anxiety disorders among high-risk and complex borderline personality disorder patients. PMID:23710329

  2. Postpartum depression and infant-mother attachment security at one year: The impact of co-morbid maternal personality disorders.

    Science.gov (United States)

    Smith-Nielsen, Johanne; Tharner, Anne; Steele, Howard; Cordes, Katharina; Mehlhase, Heike; Vaever, Mette Skovgaard

    2016-08-01

    Previous studies on effects of postpartum depression (PPD) on infant-mother attachment have been divergent. This may be due to not taking into account the effects of stable difficulties not specific for depression, such as maternal personality disorder (PD). Mothers (N=80) were recruited for a longitudinal study either during pregnancy (comparison group) or eight weeks postpartum (clinical group). Infants of mothers with depressive symptoms only or in combination with a PD diagnosis were compared with infants of mothers with no psychopathology. Depression and PD were assessed using self-report and clinical interviews. Infant-mother attachment was assessed when infants were 13 months using Strange Situation Procedure (SSP). Attachment (in)security was calculated as a continuous score based on the four interactive behavioral scales of the SSP, and the conventional scale for attachment disorganization was used. PPD was associated with attachment insecurity only if the mother also had a PD diagnosis. Infants of PPD mothers without co-morbid PD did not differ from infants of mothers with no psychopathology. These results suggest that co-existing PD may be crucial in understanding how PPD impacts on parenting and infant social-emotional development. Stable underlying factors may magnify or buffer effects of PPD on parenting and child outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. A metastructural model of mental disorders and pathological personality traits.

    Science.gov (United States)

    Wright, A G C; Simms, L J

    2015-08-01

    Psychiatric co-morbidity is extensive in both psychiatric settings and the general population. Such co-morbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions - internalizing, externalizing and psychoticism - can account for much of the observed covariation among common mental disorders. However, the location of personality disorders within this emerging metastructure has only recently been studied, and no studies have yet examined where pathological personality traits fit within such a broad metastructural framework. We conducted joint structural analyses of common mental disorders, personality disorders and pathological personality traits in a sample of 628 current or recent psychiatric out-patients. Bridging across the psychopathology and personality trait literatures, the results provide evidence for a robust five-factor metastructure of psychopathology, including broad domains of symptoms and features related to internalizing, disinhibition, psychoticism, antagonism and detachment. These results reveal evidence for a psychopathology metastructure that (a) parsimoniously accounts for much of the observed covariation among common mental disorders, personality disorders and related personality traits, and (b) provides an empirical basis for the organization and classification of mental disorder.

  4. PSYCHIATRIC MORBIDITY AND PERSONALITY PROFILE IN DIVORCE SEEKING COUPLES

    Science.gov (United States)

    Batra, Lalit; Gautam, Shiv

    1995-01-01

    To what extent psychiatric morbidity and personality factors contribute to marital disharmony and decision to divorce is still an unanswered question in Indian setting. This study was undertaken with aims to find out (1) the prevalence of psychiatric morbidity in persons seeking divorce; (2) the prevalence of psychiatric morbidity in persons who had good marital adjustment; (3) the nature of psychiatric morbidity observed in these subjects, and (4) the personality profile of these subjects. Fifty randomly selected divorce seeking couples (n=100) from the matrimonial court of Jaipur City and thirty couples with good marital adjustment (n=60) selected from the community were studied. Probable psychiatric cases identified by administering GHQ (Hindi version) were diagnosed according to ICD-10 and personality profile of all cases was studied by using 16 PF. High psychiatric morbidity (50%) was found among divorce seeking couples in comparison to control group (13%). There was a high prevalence of neurone disorders (22%) and mood disorders (16%) in experimental group. Schizophrenia and related disorders (10%) and substance abuse disorder (2%) were seen only in the experimental group. Specific personality factors related to divorce seeking individuals and persons with stable marriage have been identified. The implications of this study are highlighted. PMID:21743746

  5. Co-Morbidities in psoriatic versus non-psoriatic patients

    Directory of Open Access Journals (Sweden)

    Rana Omar Al Houssien

    2018-01-01

    Conclusion: Patients with psoriasis were found to have an increased risk of developing major co-morbid disorders including diabetes, liver and renal function profile abnormalities. This indicates the importance of checking if this group of patients have co-morbid disorders.

  6. [Clinical features and risk factors of co-morbid tic disorder in children with attention deficit hyperactivity disorder].

    Science.gov (United States)

    Zhou, Ke-Ying; Xiao, Zhi-Hui; Chen, Yan-Zhao; Zhang, Zhao-Xia; Liu, Zhi-Ping; Yang, Chun-He; Gao, Mei-Hao

    2014-09-01

    To study the clinical features and risk factors of co-morbid tic disorder (TD) in children with attention deficit hyperactivity disorder (ADHD). A total of 312 children with ADHD were involved in this study. Subtypes of co-morbid TD, incidences of TD in different subtypes of ADHD (ADHD-I, ADHD-HI and ADHD-C) were observed. Thirteen potential factors influencing the comorbidity rate of TD in ADHD were evaluated by univariate analysis and multiple logistic regression analysis. Forty-two of 312 children with ADHD suffered from co-morbid TD (13.5%). Comorbidity rate of TD in children with ADHD-C (24.1%) was significantly higher than in those with ADHD-HI (10.9%) and ADHD-I (8.8%) (P<0.05). There were 21 cases (50.0%) of transient TD, 12 cases (28.6%) of chronic TD, and 9 cases (21.4%) of Tourette syndrome. The univariate analysis revealed 6 factors associated with comorbidity: addiction to mobile phone or computer games, poor eating habits, infection, improper family education, poor relationship between parents and poor relationship with schoolmates. Multiple logistic analysis revealed two independent risk factors for comorbidity: improper family education (OR=7.000, P<0.05) and infection (OR=2.564, P<0.05). The incidence of co-morbid TD in children with ADHD is influenced by many factors, and early interventions should be performed based on the main risk factors.

  7. [Bipolar disorders as co-morbidity in childhood and adolescence--underdiagnosed or overinterpreted? Therapy of a 14-year-old boy with hyperkinetic conduct disorder and hypomania].

    Science.gov (United States)

    Rothermel, Boris; Poustka, Luise; Banaschewski, Tobias; Becker, Katja

    2010-03-01

    Considerable debate exists regarding differing prevalence rates of co-morbid bipolar disorder in children and adolescents with ADHD in Germany as compared to the US. Described in this case report are the assessment of and treatment procedure for a 14-year old boy with hyperkinetic conduct disorder and co-morbid hypomanic episode, as well as different possible interpretations of symptoms. Further studies of children and adolescents with ADHD and coexisting impulsive-aggressive behaviour are needed. Important in practice is a precise differentiation of symptoms with regard to co-morbid bipolar disorder.

  8. Tourette syndrome, co-morbidities and quality of life.

    Science.gov (United States)

    Eapen, Valsamma; Snedden, Corina; Črnčec, Rudi; Pick, Anna; Sachdev, Perminder

    2016-01-01

    Tourette syndrome is often associated with attention deficit hyperactivity disorder, obsessive compulsive disorder and other co-morbidities, the presence of which can reduce health-related quality of life. The relationship between the number and type of co-morbidities and tic severity upon health-related quality of life has been insufficiently examined in Tourette syndrome populations and not at all in the Australian context. We hypothesised that an increased number of co-morbid diagnoses would be inversely related to health-related quality of life and that the presence of attention deficit hyperactivity disorder and obsessive compulsive disorder in particular would negatively impact health-related quality of life. In all, 83 people with a previously established diagnosis of Tourette syndrome, who responded to a letter of invitation sent to the Tourette Syndrome Association of Australia past-member database, formed the study sample. Participants completed the Gilles de la Tourette Syndrome-Quality of Life Scale and a short form of the National Hospital Interview Schedule to assess tics and related behaviours. Participants with pure-Tourette syndrome had significantly better health-related quality of life than those with Tourette syndrome and three or more co-morbid diagnoses. Few differences were observed between the pure-Tourette syndrome and Tourette syndrome and one or two co-morbid diagnoses groups. Analysis of the impact of individual co-morbid disorders and Tourette syndrome symptoms on health-related quality of life indicated that attention deficit hyperactivity disorder exerted a significant negative effect, as did the presence of complex tics, especially coprolalia and copropraxia. When these variables were examined in multiple regression analysis, number of co-morbidities and the presence of coprophenomena emerged as significant predictors of health-related quality of life. While tics are the defining feature of Tourette syndrome, it appears to be the

  9. Treatment seeking adults with autism or ADHD and co-morbid Substance Use Disorder: Prevalence, risk factors and functional disability

    NARCIS (Netherlands)

    Sizoo, Bram; van den Brink, Wim; Koeter, Maarten; Gorissen van Eenige, Marielle; van Wijngaarden-Cremers, Patricia; van der Gaag, Rutger Jan

    2010-01-01

    Background: Little is known about Autism Spectrum Disorder (ASD) in adults, especially not about ASD with co-morbid Substance Use Disorder (SUD). We wanted to examine how adults with ASD compare to adults with ADHD on prevalence and risk factors for co-morbid SUD, and on disability levels associated

  10. HIV-associated neurocognitive disorder: rate of referral for neurorehabilitation and psychiatric co-morbidity.

    LENUS (Irish Health Repository)

    Herlihy, D

    2012-04-01

    Despite advances in antiretroviral therapy, HIV-infected patients continue to present with HIV-associated neurocognitive disorder (HAND) which may be associated with significant psychiatric co-morbidity. We audited our patients with HAND referred for psychiatric assessment against the National Service Framework guidelines that they should receive neurorehabilitation. We found that despite these patients posing a risk to themselves and others due to poor insight and medication adherence, high rates of psychiatric co-morbidity and severely challenging behaviour, few were referred for neurorehabilitation. We recommend that clear referral pathways for psychiatric intervention and neurorehabilitation are established in HIV treatment centres.

  11. A study of chemokines, chemokine receptors and interleukin-6 in patients with panic disorder, personality disorders and their co-morbidity.

    Science.gov (United States)

    Ogłodek, Ewa A; Szota, Anna M; Just, Marek J; Szromek, Adam R; Araszkiewicz, Aleksander

    2016-08-01

    Stress may induce inflammatory changes in the immune system and activate pro-inflammatory cytokines and their receptors by activating the hypothalamic-pituitary-adrenal axis. 460 hospitalized patients with panic disorders (PD) and/or personality disorders (P) were studied. The study group comprised subjects with PD, avoidant personality disorder (APD), borderline personality disorder (BPD), obsessive-compulsive personality disorder (OCPD), and concomitant (PD+APD; PD+BPD; PD+OCPD). Each study group consisted of 60 subjects (30 females and 30 males). The control group included 20 females and 20 males without any history of mental disorder. ELISA was used to assess the levels of chemokines: CCL-5/RANTES (regulated on activation, normal T-cell expressed and secreted), CXCL-12/SDF-1 (stromal derived factor), their receptors CXCR-5 (C-C chemokine receptor type-5), CXCR-4 (chemokine C-X-C motif receptor-4), and IL-6. Statistically significant differences in the levels of CCL-5 and CCR-5 were revealed between all study groups. The greatest differences were found between the groups with PD+OCPD and PD+APD. Moreover, concomitance of PD with P significantly increased the level of chemokines and their receptors in all study groups versus the subjects with P alone. The results of the study show differences between the groups. To be specific, inflammatory markers were more elevated in the study groups than the controls. Therefore, chemokines and chemokine receptors may be used as inflammatory markers in patients with PD co-existent with P to indicate disease severity. PD was found to be a factor in maintaining inflammatory activity in the immune system in patients with P. Copyright © 2016 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  12. Relationship of Personality Disorders to the Course of Major Depressive Disorder in a Nationally Representative Sample

    Science.gov (United States)

    Skodol, Andrew E.; Grilo, Carlos M.; Keyes, Katherine; Geier, Timothy; Grant, Bridget F.; Hasin, Deborah S.

    2011-01-01

    Objective The purpose of this study was to examine the effects of specific personality disorder co-morbidity on the course of major depressive disorder in a nationally-representative sample. Method Data were drawn from 1,996 participants in a national survey. Participants who met criteria for major depressive disorder at baseline in face-to-face interviews (2001–2002) were re-interviewed three years later (2004–2005) to determine persistence and recurrence. Predictors included all DSM-IV personality disorders. Control variables included demographic characteristics, other Axis I disorders, family and treatment histories, and previously established predictors of the course of major depressive disorder. Results 15.1% of participants had persistent major depressive disorder and 7.3% of those who remitted had a recurrence. Univariate analyses indicated that avoidant, borderline, histrionic, paranoid, schizoid, and schizotypal personality disorders all elevated the risk for persistence. With Axis I co-morbidity controlled, all but histrionic personality disorder remained significant. With all other personality disorders controlled, borderline and schizotypal remained significant predictors. In final, multivariate analyses that controlled for age at onset of major depressive disorder, number of previous episodes, duration of current episode, family history, and treatment, borderline personality disorder remained a robust predictor of major depressive disorder persistence. Neither personality disorders nor other clinical variables predicted recurrence. Conclusions In this nationally-representative sample of adults with major depressive disorder, borderline personality disorder robustly predicted persistence, a finding that converges with recent clinical studies. Personality psychopathology, particularly borderline personality disorder, should be assessed in all patients with major depressive disorder, considered in prognosis, and addressed in treatment. PMID:21245088

  13. A genome-wide linkage study of bipolar disorder and co-morbid migraine

    DEFF Research Database (Denmark)

    Oedegaard, K. J.; Greenwood, T. A.; Lunde, Asger

    2010-01-01

    Migraine and Bipolar Disorder (BPAD) are clinically heterogeneous disorders of the brain with a significant, but complex, genetic component. Epidemiological and clinical studies have demonstrated a high degree of co-morbidity between migraine and BPAD. Several genomewide linkage studies in BPAD...... that using migraine comorbidity to look at subsets of BPAD families in a genetic linkage analysis would prove useful in identifying genetic susceptibility regions in both of these disorders. We used BPAD with comorbid migraine as an alternative phenotype definition in a re-analysis of the NIMH Bipolar...... osome 4 (not co-segregating with BPAD) in a sample of BPAD families with comorbid migraine, and suggest a susceptibility locus on chromosome 20, harboring a gene for the migraine/BPAD phenotype. Together these data suggest that some genes may predispose to both bipolar disorder and migraine....

  14. The impact of comorbid depression on recovery from personality disorders and improvements in psychosocial functioning: Results from a randomized controlled trial

    NARCIS (Netherlands)

    Renner, F.; Bamelis, L.L.M.; Huibers, M.J.H.; Speckens, A.; Arntz, A.

    2014-01-01

    Depressive disorders often co-occur with personality disorders. The extent to which depressive disorders influence treatment outcome in personality disorders remains unclear. The aim of this study was to determine the impact of co-morbid depression on recovery from personality disorders and

  15. Co-occurrence of personality disorders in persons with kleptomania: a preliminary investigation.

    Science.gov (United States)

    Grant, Jon E

    2004-01-01

    This study was conducted to examine the co-occurrence of personality disorders in a group of persons with kleptomania. Twenty-eight subjects with DSM-IV kleptomania were administered the Structured Clinical Interview for DSM-III-R Personality Disorders and a semistructured interview to assess demographics and clinical characteristics. Twelve subjects with kleptomania (42.9%) met criteria for at least one personality disorder. The most common were: paranoid (n = 5; 17.9%), schizoid (n = 3; 10.7%), and borderline (n = 3; 10.7%). Subjects with kleptomania combined with personality disorders had an earlier age of onset of stealing behavior (13.4 +/- 5.6 years compared with 27.4 +/- 14.2 years in those who had kleptomania only; t = 3.225; df = 26; p = .006). Severity of kleptomania symptoms did not differ among the Axis II comorbidities. Persons with kleptomania appear to have a high prevalence of personality disorders. Further studies are needed to understand the relationship of kleptomania to personality.

  16. Child attention deficit hyperactive disorder co morbidities on family stress: effect of medication.

    Science.gov (United States)

    Silva, Desiree; Houghton, Stephen; Hagemann, Erika; Jacoby, Peter; Jongeling, Brad; Bower, Carol

    2015-04-01

    We examined the degree of parental and child mental health in a community sample of children diagnosed with Attention Deficit Hyperactive Disorder and the effect on family stress prior to and during treatment using a community retrospective questionnaire study. In total 358 questionnaires were returned for analysis where 92 % of children had at least one co-morbid condition and mental health conditions in parents was common. Overall, the Family Strain Index was significantly reduced after commencement of medication (p disorders or autism spectrum disorder.

  17. Gender Differences in Compulsive Buying Disorder: Assessment of Demographic and Psychiatric Co-Morbidities

    OpenAIRE

    Nicoli de Mattos, Cristiana; Kim, Hyoun S.; Requi?o, Marinalva G.; Marasaldi, Renata F.; Filomensky, Tatiana Z.; Hodgins, David C.; Tavares, Hermano

    2016-01-01

    Compulsive buying is a common disorder found worldwide. Although recent research has shed light into the prevalence, etiology and clinical correlates of compulsive buying disorder, less is known about gender differences. To address this empirical gap, we assessed potential gender differences in demographic and psychiatric co-morbidities in a sample of 171 compulsive buyers (20 men and 151 women) voluntarily seeking treatment in São Paulo, Brazil. A structured clinical interview confirmed the ...

  18. STUDY ON PSYCHIATRIC CO - MORBIDITY IN PSORIASIS

    Directory of Open Access Journals (Sweden)

    Shrikant B.

    2015-06-01

    Full Text Available BACKGROUND: Psoriasis is relatively common , chronic inflammatory and hyper - proliferative skin disease that affects 1.4% to 2.0% of the population. Presence of itching , chronic recurrent course of disease and incomplete cure may contribute to great deal of psychiatric co - morbidity in these patients. the most persuasive indications of a link between stress and psoriasis comes from patients themselves , with studies illustrating that the majority of patients believe that stress or psychological distress is a factor in the manifestations of their condition . Depression and anxiety are the most common disorders that are associated with psoriasis , but the proportion of patient also having other psychiatric co - morbid diseases which include social phobia , generalize anxiety disorder , panic disorder , psychotic diso rder , etc. Moreover , symptoms of psoriasis , especially pruritus , are related to depression. OBJECTIVES : To evaluate different psychiatric illnesses their prevalence and severity in psoriasis patients. METHODOLOGY : This was cross - sectional observational stu dy comprised of 70 consecutive patients of psoriasis attending the out - patient department of Dermatology. All the patients were subjected to detailed examinations including the elicitation of dermatological and psychiatric profile after getting written con sent for study . Data was collected using self - developed , pre tested , semi structured Pro format by interview method. RESULTS : The profile of psychiatric diagnoses obtained in the present study depressive disorder 31.4% {18.57% depression , 12.85% Depression with anxiety symptoms} , anxiety disorder 25.7% (7.14% GAD , 8.17% panic disorder , 5.71% social phobia , 4.28 specific phobia. Severity of major depressive disorder was determined with HAM - D score 53.8% had mild depression , 30.7% moderate depression and 15. 5% severe depression. Similarly when HAM - A scale was used to determined severity of generalized

  19. Challenging behavior and co-morbid psychopathology in adults with intellectual disability and autism spectrum disorders.

    Science.gov (United States)

    McCarthy, Jane; Hemmings, Colin; Kravariti, Eugenia; Dworzynski, Katharina; Holt, Geraldine; Bouras, Nick; Tsakanikos, Elias

    2010-01-01

    We investigated the relationship between challenging behavior and co-morbid psychopathology in adults with intellectual disability (ID) and autism spectrum disorders (ASDs) (N=124) as compared to adults with ID only (N=562). All participants were first time referrals to specialist mental health services and were living in community settings. Clinical diagnoses were based on ICD-10 criteria and presence of challenging behavior was assessed with the Disability Assessment Schedule (DAS-B). The analyses showed that ASD diagnosis was significantly associated with male gender, younger age and lower level of ID. Challenging behavior was about four times more likely in adults with ASD as compared to non-ASD adults. In those with challenging behavior, there were significant differences in co-morbid psychopathology between ASD and non-ASD adults. However, after controlling for level of ID, gender and age, there was no association between co-morbid psychopathology and presence of challenging behavior. Overall, the results suggest that presence of challenging behavior is independent from co-morbid psychopathology in adults with ID and ASD. Copyright 2009 Elsevier Ltd. All rights reserved.

  20. Temperamental dimensions of the TEMPS-A in females with co-morbid bipolar disorder and bulimia.

    Science.gov (United States)

    Rybakowski, Janusz K; Kaminska, Katarzyna; Charytonik, Jolanta; Akiskal, Kareen K; Akiskal, Hagop S

    2014-08-01

    We investigated the effect of co-morbid bipolar disorder and bulimia on temperamental dimensions measured by TEMPS-A, relative to "pure" bulimia and "pure" bipolar disorder, in female patients. The study was performed on 47 patients with bipolar disorder (BD) with a mean age of 36±10 years, 96 patients with bulimia or bulimic type of anorexia, mean age 26±9 years and 50 control healthy females (HC), mean age 29±6 years. Among bulimic patients, a group of 68 subjects with co-morbid bulimia with bipolarity (BD+B) was identified, based on positive score of the Mood Disorder Questionnaire (MDQ). The TEMPS-A questionnaire, 110 questions version, has been used, evaluating five temperament domains: depressive, cyclothymic, hyperthymic, irritable and anxious. Parametric analysis was performed for 4 groups (BD, "pure" bulimia (PB), BD+B and HC), with 28 subjects randomly chosen from each group, using analysis of variance and cluster analysis. All clinical groups significantly differed from control group by having higher scores of depressive, cyclothymic, irritable and anxious temperaments and lower of hyperthymic one. Among patients, significantly higher scores of cyclothymic and irritable temperaments were found in BD+B compared to both PB and BD. These differences were also reflected in cluster analysis, where two clusters were identified. Bipolarity in bulimic patients assessed only by the MDQ. These results show that co-morbid bulimia and bipolar disorder is characterized by extreme dimensions of both cyclothymic and irritable temperaments, significantly higher than each single diagnosis. Possible clinical implications of such fact are discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Prevalence of Attention Deficit Hyperactivity Disorder among School Children and Associated Co-morbidities - A Hospital Based Descriptive Study.

    Science.gov (United States)

    Rimal, H; Pokharel, A

    Attention Deficit Hyperactivity Disorder is the most common neuro- developmental disorders of childhood characterized by the core symptoms including inattentiveness and distractibility and frequently involve impairments in executive functioning, increased impulsivity, and restlessness. Objective To find out the prevalence of Attention Deficit Hyperactivity Disorder among school aged children Presented to Pediatric clinic and also to investigate associated comorbidities. Method This study was conducted at Nobel Medical College Teaching Hospital, Biratnagar during April 2014 - March 2015. Attention Deficit Hyperactivity Disorder was diagnosed by the developmental Pediatrician after taking relevant history and the clinical assessment using Attention Deficit Hyperactivity Disorder rating scale with diagnostic criteria consistent with Diagnostic Statistical Manual - IV classification. Spence anxiety scale child and parent rated version and Strength and Difficulty Questionnaire were also used. Result Result showed the yearly prevalence of Attention Deficit Hyperactivity Disorder being 41(11.7%) with male: female ratio of 4:1. The study reported that Attention Deficit Hyperactivity Disorder combined type was the commonest type that was 26(63%) cases followed by Inattentive type 9(22%) cases and 6(15%) were hyperactive type. The mean age for Attention Deficit Hyperactivity Disorder was 7 years and 5 months. The most common co-morbidities were sleep problem 12(29.3%), Learning difficulty 10(24.4%), Anxiety disorder 10(24.4), Oppositional Defiant Disorder 9(22%), Autism Spectrum Disorder 5(12%), speech delay 6(14.6%), and 4(10%) had associated tics. There was abnormal SDQ prevalence of 29.3% across the area of emotional distress. The mean abnormal SDQ score in total difficulty area 8 (20.7%), socializing with peer 9(22%), behavioral difficulty 11(26.8%), hyperactivity/inattention 23(56.1%) and impact of difficulties in young person's life being 5(12.2%). Conclusion There is

  2. Co-occurring mental illness, substance use disorders, and antisocial personality disorder among clients of forensic mental health services.

    Science.gov (United States)

    Ogloff, James R P; Talevski, Diana; Lemphers, Anthea; Wood, Melisa; Simmons, Melanie

    2015-03-01

    Despite the number of studies investigating co-occurring disorders, and more recently, co-occurring disorders and criminal offending, few studies have considered samples from forensic mental health services. The present study was conducted to investigate the relationship between mental illness, substance use disorders, antisocial personality disorder, and offending. The prevalence of co-occurring disorders was investigated in 130 male offenders who had contact with the statewide forensic mental health service in Victoria, Australia. Offense histories and severity of offending were compared among participants diagnosed with a single mental illness (or no mental illness), co-occurring mental illness and substance use, and co-occurring disorders plus antisocial personality disorder. The majority of participants had co-occurring mental and substance use disorders; a significant minority met the criteria for antisocial personality disorder. Participants with co-occurring mental illness and substance use disorders, and those who had an additional diagnosis of antisocial personality disorder, were responsible for more serious and frequent offending than those with mental illness alone. Forensic mental health services must take into account the effect that co-occurring disorders have on clients' functioning and offending. Those who work with people with psychiatric disabilities and co-occurring substance use disorders must ensure that the substance disorders are addressed to help ensure recovery from the mental illness and to reduce the likelihood of offending. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  3. Interaction between ALDH2*1*1 and DRD2/ANKK1 TaqI A1A1 genes may be associated with antisocial personality disorder not co-morbid with alcoholism.

    Science.gov (United States)

    Lu, Ru-Band; Lee, Jia-Fu; Huang, San-Yuan; Lee, Sheng-Yu; Chang, Yun-Hsuan; Kuo, Po-Hsiu; Chen, Shiou-Lan; Chen, Shih-Heng; Chu, Chun-Hsien; Lin, Wei-Wen; Wu, Pei-Lin; Ko, Huei-Chen

    2012-09-01

    Previous studies on acetaldehyde dehydrogenase 2 (ALDH2) focused on drinking behavior or alcoholism because the ALDH2*2 allele protects against the risk of developing alcoholism. The mechanism provides that the ALDH2 gene's protective effect is also involved in dopamine metabolism. The interaction of the ALDH2 gene with neurotransmitters, such as dopamine, is suggested to be related to alcoholism. Because alcoholism is often co-morbid with antisocial personality disorder (ASPD), previous association studies on antisocial alcoholism cannot differentiate whether those genes relate to ASPD with alcoholism or ASPD only. This study examined the influence of the interaction effect of the ALDH2*1*1, *1*2 or *2*2 polymorphisms with the dopamine 2 receptor (DRD2) Taq I polymorphism on ASPD. Our 541 Han Chinese male participants were classified into three groups: antisocial alcoholism (ASPD co-morbid with alcohol dependence, antisocial ALC; n = 133), ASPD without alcoholism (ASPD not co-morbid with alcohol dependence, antisocial non-ALC; n = 164) and community controls (healthy volunteers from the community; n = 244). Compared with healthy controls, individuals with the DRD2 A1/A1 and the ALDH2*1/*1 genotypes were at a 5.39 times greater risk for antisocial non-ALC than were those with other genotypes. Our results suggest that the DRD2/ANKK1 and ALDH2 genes interacted in the antisocial non-ALC group; a connection neglected in previous studies caused by not separating antisocial ALC from ASPD. Our study made this distinction and showed that these two genes may be associated ASPD without co-morbid alcoholism. © 2010 The Authors, Addiction Biology © 2010 Society for the Study of Addiction.

  4. Co-morbidity and factor analysis on attention deficit hyperactivity disorder and autism spectrum disorder DSM-IV-derived items

    Directory of Open Access Journals (Sweden)

    Ahmad Ghanizadeh

    2012-01-01

    Full Text Available Background: There is a gap in the literature regarding the extent of possible co-occurrence of attention deficit hyperactivity disorder (ADHD and pervasive developmental disorders (PDD. This study aimed to investigate co-occurring of ADHD in children with PDD. Methods: A clinical sample of 68 children with PDD was assessed according to DSM-IV criteria to make ADHD and/ or PDD diagnoses. All the different types of PDD were included. DSM-IV derived criteria for ADHD and PDD were analyzed. An exploratory factor analysis was conducted. Results: the rate of autism, Asperger syndrome, Rett′s disorder, childhood disintegrative disorder and PDD-NOS (not otherwise specified was 55.4%, 16.9%, 3.1%, 3.1%, 21.5%, respectively. 53.8% of the sample was with ADHD co-morbidity. The rate of ADHD subtypes was 37.1%, 22.9%, and 40.0% for inattentive type, hyperactivity/impulsivity type and combined type, respectively. Conclusion: ADHD and its symptoms highly co-occur with PDD. Meanwhile, the result of factor analysis supports the independence of ADHD and PDD diagnostic criteria.

  5. Type of presentation of dissociative disorder and frequency of co-morbid depressive disorder.

    Science.gov (United States)

    Alvi, Tabassum; Minhas, Fareed Aslam

    2009-02-01

    To determine the frequency distribution of various types of dissociative disorders, along with existing co-morbid depression and its level of severity in patients with dissociative disorder. Observational, cross-sectional study. The Institute of Psychiatry, Rawalpindi General Hospital from October 2004 to March 2005. Fifty consecutive patients were included in the study through non-probable purposive sampling technique. Encounter form included socio-demographic profile and brief psychiatric history. ICD 10 diagnostic criteria for research were administered for determining the presentation of dissociative disorder. Present state examination was applied to make diagnosis of depressive disorder in the studied patients. Descriptive statistics for frequency analysis of sociodemographic variables, type of presentation of dissociative disorder and the frequency of depressive disorder in patients of dissociative disorder. The mean age was 23.6+/-8.67 years with female preponderance (n=40, 80% patients). Most of them were single, unemployed and belonged to urban population. Main stress was primary support group issue. Mixed category of dissociative disorder was highest (n=18, 38%) followed by unspecified and motor symptoms (n=13, 26%) in each group. Depression was present in 42 (84%) patients. Moderate depression was most frequent (n=19, 38%). Mixed dissociative symptoms were found in 38%, while 26% had motor and unspecified category of dissociative symptoms respectively. Depressive disorder was present in 42 (84%) cases of dissociative disorder with 38% having moderate depression.

  6. Developing a successful treatment for co-morbid insomnia and sleep apnoea.

    Science.gov (United States)

    Sweetman, Alexander M; Lack, Leon C; Catcheside, Peter G; Antic, Nick A; Chai-Coetzer, Ching Li; Smith, Simon S; Douglas, James A; McEvoy, R Doug

    2017-06-01

    Insomnia and sleep apnoea are the two most common sleep disorders, found in 6% and 23-50% of the general population respectively. These disorders also frequently co-occur, with 39-58% of sleep apnoea patients reporting symptoms indicative of co-morbid insomnia. When these disorders co-occur, clinicians are faced with difficult treatment decisions, patients experience the additive detrimental impacts of both disorders, and the effectiveness of discrete treatments for each disorder may be impaired. A common finding is that co-morbid insomnia and sleep apnoea (COMISA) is more difficult to treat than either disorder presenting alone. Co-morbid insomnia reduces the initial acceptance of, and later adherence to, continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea. This has resulted in recent recommendations that treatment approaches should initially target COMISA patients' insomnia to remove this barrier to CPAP treatment, and improve patient outcomes. However, no randomised controlled trial outcomes investigating this treatment approach currently exist. The current article aims to review and integrate recent research examining the prevalence, characteristics, and theoretical mechanistic relationships between co-occurring insomnia and OSA, and discuss previous treatment attempts. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. PERSONALITY TRAITS AND BORDERLINE PERSONALITY DISORDER

    Directory of Open Access Journals (Sweden)

    Senija TAHIROVIC

    2016-12-01

    Full Text Available The people with Borderline Personality Disorder (BPD show pathological personality traits in three of the five domains (APA 2013. In addition to diagnostic criteria for BPD, described by Diagnostic and Statistical Manual of Mental Disorders (DSM-5, the dimensional model of personality disorder, based on five-factor model of personality, seems to gain interest as it promisses to eliminate problems associated with poor-fit, co-morbidity and unclear diagnosis. The purpose of this study is to identify the personality traits by people who are already diagnosed with BPD using the DSM-5 categorical criteria. Based on the theoretical concepts and existing research findings as well as increased interest in the dimensional personality theory, we assume that people diagnosed with BPD will show high levels of pathology on three trait domains: negative affectivity, disinhibition and antagonism. This study was conducted in Germany in psychiatric clinic. Fifteen participants represented a convenience sample, of patients already diagnosed with BPD. For this study Personality Inventory for DSM-5 (PID-5 was used. The findings supported the assumptions that people with BPD show some degree of anxiousness, emotional lability, hostility, impulsivity, risk taking and separation anxiety. The study also found that traits such as distractibility, withdrawal and submissiveness were also present in this participant group. Even though, study was conducted with small number of participants it has provided contribution to the already existing knowledge and understanding in regards to common personality treats for people diagnosed with BPD.

  8. The impact of self-efficacy, alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: a moderated mediation analysis.

    Science.gov (United States)

    Chung, Man Cheung; Allen, Rachel D; Dennis, Ian

    2013-12-30

    This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas. © 2013 Elsevier

  9. Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD: A large, nationally representative survey in the Australian population

    Directory of Open Access Journals (Sweden)

    O'Neil Adrienne

    2012-01-01

    Full Text Available Abstract Background Co-morbid major depressive disorder (MDD and cardiovascular disease (CVD is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD. Methods This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841 to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of "healthy" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item. Results Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6. Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9 and CVD only (adj OR:0.8, 95% CI: 0.6-0.9 also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3 compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6. Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning. Conclusions Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid

  10. Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD): A large, nationally representative survey in the Australian population

    Science.gov (United States)

    2012-01-01

    Background Co-morbid major depressive disorder (MDD) and cardiovascular disease (CVD) is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD. Methods This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841) to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of "healthy" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item. Results Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6). Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9) and CVD only (adj OR:0.8, 95% CI: 0.6-0.9) also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3) compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6). Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning. Conclusions Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid MDD and CVD is

  11. Review of the evidence for the management of co-morbid Tic disorders in children and adolescents with attention deficit hyperactivity disorder.

    Science.gov (United States)

    Ogundele, Michael O; Ayyash, Hani F

    2018-02-08

    Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders (TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis (meta-analysis) was deemed appropriate. Meta-analysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors (Atomoxetine) and stimulants (Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette's syndrome (TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs.

  12. Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study.

    Science.gov (United States)

    Toft, Tomas; Fink, Per; Oernboel, Eva; Christensen, Kaj; Frostholm, Lisbeth; Olesen, Frede

    2005-08-01

    Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and socio-demographics are sketchy. A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18-65 years, consulting 28 family practices during March-April 2000 in Aarhus County, Denmark were screened, in the waiting room, for mental and somatic symptoms with SCL-8 and SCL-Somatization questionnaires, for illness worry with Whitely-7 and for alcohol dependency with CAGE. In a stratified random sample of 701 patients, physician interviewers established ICD-10 diagnoses using the SCAN interview. Prevalence was calculated using weighted logistic regression, thus correcting for sample skewness. Half of the patients fulfilled criteria for an ICD-10 mental disorders and a third of these for more than one group of disorders. Women had higher prevalence of somatization disorder and overall mental disorders than men. Men had higher prevalence of alcohol abuse and hypochondriasis than women. Psychiatric morbidity tended to increase with age. Prevalence of somatoform disorders was 35.9% (95% CI 30.4-41.9), anxiety disorders 164% (95% CI 12.7-20.9), mood disorders 13.5% (95% CI 11.1-16.3), organic mental disorders 3.1% (95% CI 1.6-5.7) and alcohol abuse 2.2% (95% CI 1.5-3.1). Co-morbidities between these groups were highest for anxiety disorders, where 89% also had another mental diagnosis, and lowest for somatoform disorders with 39%. ICD-10 mental disorders are very prevalent in primary care and there is a high co-occurrence between most disorders. Somatoform disorders, however, more often than not exist without other mental disorders.

  13. Genetic and environmental influences on the co-morbidity between depression, panic disorder, agoraphobia, and social phobia: a twin study.

    Science.gov (United States)

    Mosing, Miriam A; Gordon, Scott D; Medland, Sarah E; Statham, Dixie J; Nelson, Elliot C; Heath, Andrew C; Martin, Nicholas G; Wray, Naomi R

    2009-01-01

    Major depression (MD) and anxiety disorders such as panic disorder (PD), agoraphobia (AG), and social phobia (SP) are heritable and highly co-morbid. However, the relative importance of genetic and environmental etiology of the covariation between these disorders, particularly the relationship between PD and AG, is less clear. This study measured MD, PD, and AG in a population sample of 5,440 twin pairs and 1,245 single twins, about 45% of whom were also scored for SP. Prevalences, within individual co-morbidity and twin odds ratios for co-morbidity, are reported. A behavioral genetic analysis of the four disorders using the classical twin design was conducted. Odds ratios for MD, PD, AG, and SP in twins of individuals diagnosed with one of the four disorders were increased. Heritability estimates under a threshold-liability model for MD, PD, AG, and SP respectively were .33 (CI: 0.30-0.42), .38 (CI: 0.24-0.55), .48 (CI: 0.37-0.65), and .39 (CI: 0.16-0.65), with no evidence for any variance explained by the common environment shared by twins. We find that a common genetic factor explains a moderate proportion of variance in these four disorders. The genetic correlation between PD and AG was .83. MD, PD, AG, and SP strongly co-aggregate within families and common genetic factors explain a moderate proportion of variance in these four disorders. The high genetic correlation between PD and AG and the increased odds ratio for PD and AG in siblings of those with AG without PD suggests a common genetic etiology for PD and AG.

  14. Substance abusers' personality disorders and staff members' emotional reactions

    Directory of Open Access Journals (Sweden)

    Hesse Morten

    2008-04-01

    Full Text Available Abstract Background Previous research has indicated that aggressive behaviour and DSM-IV cluster B personality disorders (PD may be associated with professionals' emotional reactions to clients, and that cluster C PD may be associated with positive emotional reactions. Methods Staff members recruited from workshops completed a self-report inventory of emotional reactions to patients, the Feeling Word Checklist-58, and substance abusers completed a self-report of DSM-IV personality disorder, the DSM-IV and ICD-10 Personality Disorder Questionnaire. Correlational analysis and multiple regression analysis was used to assess the associations between personality disorders and emotional reations. Results Cluster B disorder features were associated with feeling distance to patients, and cluster C disorder features were associated with feeling helpful towards patients. Cluster A disorders had no significant impact on emotional reactions. Conclusion The findings confirm clinical experiences that personality disorder features in patients with substance abuse have an impact on staff members reactions to them. These reactions should be considered in supervision of staff, and in treatment models for patients with co-morbid personality disorders and substance abuse.

  15. Personality disorder

    DEFF Research Database (Denmark)

    Tyrer, Peter; Mulder, Roger; Crawford, Mike

    2010-01-01

    and to society, and interferes, usually negatively, with progress in the treatment of other mental disorders. We now have evidence that personality disorder, as currently classified, affects around 6% of the world population, and the differences between countries show no consistent variation. We are also getting......Personality disorder is now being accepted as an important condition in mainstream psychiatry across the world. Although it often remains unrecognized in ordinary practice, research studies have shown it is common, creates considerable morbidity, is associated with high costs to services...... increasing evidence that some treatments, mainly psychological, are of value in this group of disorders. What is now needed is a new classification that is of greater value to clinicians, and the WPA Section on Personality Disorders is currently undertaking this task....

  16. Co-morbidities of Interstitial Cystitis

    Directory of Open Access Journals (Sweden)

    Gisela eChelimsky

    2012-08-01

    Full Text Available Introduction: This study aimed to estimate the proportion of patients with Interstitial Cystitis/Painful Bladder Syndrome (IC/BPS with systemic dysfunction associated co-morbidities such as irritable bowel syndrome (IBS and fibromyalgia (FM. Material and Methods: Two groups of subjects with IC/BPS were included: 1 Physician diagnosed patients with IC/BPS and 2 Subjects meeting NIDDK IC/PBS criteria based on a questionnaire (ODYSA. These groups were compared to healthy controls matched for age and socio-economic status. NIDDK criteria required: pain with bladder filling that improves with emptying, urinary urgency due to discomfort or pain, polyuria > 11 times/24 hrs, and nocturia > 2 times/night. The ODYSA instrument evaluates symptoms pertaining to a range of disorders including chronic fatigue, orthostatic intolerance, syncope, IBS, dyspepsia, cyclic vomiting syndrome, headaches and migraines, sleep, Raynaud’s syndrome and chronic aches and pains. Results: IC/BPS was diagnosed in 26 subjects (mean age 47 +/- 16 yrs, 92% females, 58 had symptoms of IC/BPS by NIDDK criteria, (mean age 40 +/- 17 yrs, 79% females and 48 were healthy controls (mean age 31+/- 14 yrs, mean age 77%. Co-morbid complaints in the IC/BPS groups included gastrointestinal symptoms suggestive of IBS and dyspepsia, sleep abnormalities with delayed onset of sleep, feeling poorly refreshed in the morning, waking up before needed, snoring, severe chronic fatigue and chronic generalized pain, migraines and syncope. Discussion: Patients with IC/BPS had co-morbid central and autonomic nervous system disorders. Our findings mirror those of others in regard to IBS, symptoms suggestive of FM, chronic pain and migraine. High rates of syncope and functional dyspepsia found in the IC/BPS groups merit further study to determine if IC/BPS is part of a diffuse disorder of central, autonomic and sensory processing affecting multiple organs outside the bladder.

  17. Comparing the constructs of antisocial personality disorder and psychopathy in a sample of incarcerated women.

    Science.gov (United States)

    Warren, Janet I; South, Susan C

    2006-01-01

    Our study examines the relationship between Antisocial Personality Disorder (APD) and psychopathy among a sample of 137 female offenders. Drawing from a historical review of the evolution of these two concepts, we explore their differential relationship to patterns of criminal behavior, psychological adjustment, co-morbidity with other personality disorders, victimization, and institutional adjustment. Findings suggest that the two disorders share a common foundation of social norm violations and deception; however, APD is associated with impulsive, aggressive, and irresponsible behavior, higher rates of childhood abuse, and greater co-morbidity with Cluster A PDs, while psychopathy is better characterized by higher rates of property crimes, previous incarceration, and the manifestation of remorselessness. Results contribute to a further understanding of the etiology and phenomenology of these two disorders and suggest different types of treatment and intervention. Copyright (c) 2006 John Wiley & Sons, Ltd.

  18. Gender Differences in Co-Morbid Psychopathology and Clinical Management in Adults with Autism Spectrum Disorders

    Science.gov (United States)

    Tsakanikos, Elias; Underwood, Lisa; Kravariti, Eugenia; Bouras, Nick; McCarthy, Jane

    2011-01-01

    The present study examined rates of co-morbid psychopathology and clinical management/care pathways in adult females (N = 50) and males (N = 100) with autism spectrum disorders (ASD) and intellectual disability (ID) living in community settings. We also compared a sub-sample (N = 60) with ASD to an age-, gender- and ID-matched control group (N =…

  19. Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands.

    Science.gov (United States)

    Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

    2010-02-01

    This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified in 115 pharmacies and a questionnaire was sent to their stimulant prescribing physician. Of 773 questionnaires sent out, 556 were returned and were suitable for analysis (72%). The results are based on 510 questionnaires concerning stimulant-treated children for whom a diagnosis of ADHD was reported. Of the 510 children diagnosed with ADHD, 31% had also received one or more other psychiatric diagnoses, mainly pervasive developmental disorder or oppositional defiant disorder/conduct disorder. We found an association between the presence of co-morbidity and the use of psychosocial interventions for the child (P parents (P receive any form of additional interventions, while psychosocial interventions varied from 8 to 18% in children with ADHD and psychiatric co-morbidity. The presence of diagnostic co-morbidity was also associated with the use of psychotropic co-medication (overall, P = 0.012) and antipsychotics (P received more psychosocial interventions and psychotropic co-medication than children with ADHD-only. The type of psychosocial interventions and psychotropic co-medication received by the children and their parents, depended on the specific co-morbid psychiatric disorder being present.

  20. Using the mood disorder questionnaire and bipolar spectrum diagnostic scale to detect bipolar disorder and borderline personality disorder among eating disorder patients

    Science.gov (United States)

    2013-01-01

    Background Screening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. This study examined the accuracy of these scales for detecting bipolar disorder among patients referred for eating disorders and explored the possibility of simultaneous assessment of co-morbid borderline personality disorder. Methods Participants were 78 consecutive female patients who were referred for evaluation of an eating disorder. All participants completed the mood and eating disorder sections of the SCID-I/P and the borderline personality disorder section of the SCID-II, in addition to the MDQ and BSDS. Predictive validity of the MDQ and BSDS was evaluated by Receiver Operating Characteristic analysis of the Area Under the Curve (AUC). Results Fifteen (19%) and twelve (15%) patients fulfilled criteria for bipolar II disorder and borderline personality disorder, respectively. The AUCs for bipolar II disorder were 0.78 (MDQ) and 0.78 (BDSD), and the AUCs for borderline personality disorder were 0.75 (MDQ) and 0.79 (BSDS). Conclusions Among patients being evaluated for eating disorders, the MDQ and BSDS show promise as screening questionnaires for both bipolar disorder and borderline personality disorder. PMID:23443034

  1. Posttraumatic stress disorder following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity: the impact of alexithymia and coping.

    Science.gov (United States)

    Chung, Man Cheung; Rudd, Hannah; Wall, Natalie

    2012-05-30

    This study investigated the prevalence of post-asthma attack posttraumatic stress disorder (PTSD) and the severity of psychiatric co-morbidity among a group of college students and whether alexithymia and coping strategies would relate to health outcomes. This is a cross-sectional study in which 156 college students who had previously experienced asthma attack were recruited. They completed a demographic page, Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28, Toronto Alexithymia Scale and the COPE. They were also matched with 141 students without asthma. The results showed that 3% met the criteria for full-PTSD, 44% for partial and 53% for no-PTSD. There were no significant differences between the asthma and control groups in severity of psychiatric co-morbid symptoms. Path analyses showed that asthma severity was significantly correlated with PTSD and psychiatric co-morbidity. It was also correlated with alexithymia which was in turn associated with psychiatric co-morbidity but not PTSD. Coping strategies were not correlated with health outcomes. To conclude, people can develop PTSD symptoms and degrees of psychiatric co-morbid symptoms after suffering asthma attack. The severity of these symptoms relates to people's perceptions of asthma severity and alexithymia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Developmental Coordination Disorder in children with specific language impairment : Co-morbidity and impact on quality of life

    NARCIS (Netherlands)

    Flapper, Boudien C.T.; Schoemaker, Marina M.

    Co-morbidity of Developmental Coordination Disorder (DCD) in children with specific language impairment (SLI) and the impact of DCD on quality-of-life (QOL) was investigated in 65 5-8 year old children with SLI (43 boys, age 6.8 +/- 0.8; 22 girls, age 6.6 +/- 0.8). The prevalence of DCD was assessed

  3. Developmental Coordination Disorder, an umbrella term for motor impairments in children: nature and co-morbid disorders

    Directory of Open Access Journals (Sweden)

    Laurence eVaivre-Douret

    2016-04-01

    Full Text Available Background:Developmental Coordination Disorder (DCD defines a heterogeneous class of children exhibiting marked impairment in motor coordination as a general group of deficits in fine and gross motricity (subtype mixed group common to all research studies, and with a variety of other motor disorders that have been little investigated. No consensus about symptoms and aetiology has been established. Methods: Data from 58 children aged 6 to 13 years with DCD were collected on DSM-IV criteria, similar to DSM- 5 criteria. They had no other medical condition and inclusion criteria were strict (born full-term, no medication, no occupational /physical therapy. Multivariate statistical methods were used to evidence relevant interactions between discriminant features in a general DCD subtype group and to highlight specific co-morbidities. The study examined age-calibrated standardized scores from completed assessments of psychological, neuropsychological and neuropsychomotor functions, and more specifically the presence of minor neurological dysfunctions (MND including neurological soft signs (NSS, without evidence of focal neurological brain involvement. These were not considered in most previous studies. Results: Findings show the salient DCD markers for the mixed subtype (imitation of gestures, digital perception, digital praxia, manual dexterity, upper and lower limb coordination, versus surprising co-morbidities, with 33% of MND with mild spasticity from phasic stretch reflex (PSR, not associated with the above impairments but rather with sitting tone (p= .004 and dysdiadochokinesia (p= .011. PSR was not specific to a DCD subtype but was related to increased impairment of coordination between upper and lower limbs and manual dexterity. Our results highlight the major contribution of an extensive neuro-developmental assessment (mental and physical. Discussion: The present study provides important new evidence in favour of a complete physical

  4. Evaluation of the relationship between cognitive functioning in patients with borderline personality disorder and their general functioning.

    Science.gov (United States)

    Mosiołek, Anna; Gierus, Jacek; Koweszko, Tytus; Szulc, Agata

    2018-02-28

    The purpose of the study was to examine the relation between cognitive functioning in people with borderline personality disorder and their overall functioning level, as well as psychopathology intensification specific for this type of disorders. 64 patients aged 18-55 (M = 30.09) with borderline personality disorder (emotionally unstable personality - borderline type in the ICD-10) were examined. The study used: demographic-descriptive questionnaire, SCID II, Borderline Symptom Checlist-23, and Global Assessment of Functioning (GAF). For cognitive assessment, The Rey Auditory Verbal Learning Test, The Rey-Osterrieth Complex Figure test, TMTA, TMTB, verbal fluency test, Stroop test and Frontal Assessment Battery (FAB) were used. The average GAF score in the sample was M =43.65. Significant differences between the comorbidity group and non-comorbidity group were observed with respect to the GAF scores (Mann-Whitney U = 300.500, p = 0.008) as well as a number of significant (p borderline personality disorder. The obtained data seem to suggest that the cognitive functions affect the overall functioning only in patients with psychiatric co-morbidity. In people without psychiatric co-morbidity there is a relationship of cognitive functions only with certain aspects of psychopathology specific to BPD.

  5. Co-morbidity in psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone

    2017-01-01

    for the clinic to be able to recognize such co-morbidities. Areas covered: This is a review of studies investigating and discussing co-morbidities of psoriasis and screening. Literature was retrieved by searching on the PubMed database using individual and combined search terms related to relevant co...

  6. Gender differences in prevalence and correlates of antisocial personality disorder among heroin dependent users in compulsory isolation treatment in China.

    Science.gov (United States)

    Yang, Mei; Mamy, Jules; Zhou, Liang; Liao, Yan-Hui; Wang, Qiang; Seewoobudul, Vasish; Xiao, Shui-Yuan; Hao, Wei

    2014-03-01

    Little is known about gender difference in correlates of antisocial personality disorder (ASPD) among drug users. To detect gender difference in correlates of ASPD in a Chinese heroin dependent sample. Structured interviews were conducted among 882 heroin dependent users in two compulsory isolation settings in Changsha, China. Descriptive statistics were employed to report sample characteristics by gender. Bivariate relationships were examined between co-occurring ASPD and variables measuring demographic, drug use, and psychiatric co-morbidities. Multivariate logistic regressions with stepwise forward method were conducted to determine independent predictors for co-occurring ASPD. All analyses examining correlates of co-occurring ASPD were conducted for the total, the male and the female participants respectively to detect both the common and the unique correlates of ASPD by gender. Of the total participants, 41.4% (54.2% of males and 15.4% of females) met the DSM-IV criteria of ASPD. For male participants, lower educational level, unemployment, unmarried, younger age at first heroin use, previous history of compulsory treatment, larger amounts of heroin used per day and poly-drug abuse during past month before admission, as well as psychiatric co-morbidities of lifetime major depressive disorder and borderline personality disorder were independent predictors for co-occurring ASPD; while for female participants, only three variables: younger age at first heroin use, paranoid personality disorder and borderline personality disorder were independent predictors for co-occurring ASPD. Gender differences in prevalence and correlates of ASPD among heroin dependent users were detected. The findings highlight a need for gender-specific interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. [Internet addiction as a co-morbid disorder among patients of german addiction rehabilitation facilities: an exploratory investigation of clinical prevalence].

    Science.gov (United States)

    Müller, Kai W; Koch, Andreas; Beutel, Manfred E; Dickenhorst, Ulrike; Medenwaldt, Jens; Wölfling, Klaus

    2012-08-01

    Excessive internet use is being discussed as a non-substance-related addiction disorder. Estimations of its prevalence show that 1% of the German general population is affected by internet addiction. However, it is still unclear, whether internet addiction as a co-morbid disorder is also common among patients of the general health care system, especially in patients being treated in inpatient addiction rehabilitation centers. It seems plausible that these patients have a heightened proneness to co-morbid internet addiction. In order to address this issue, a government-funded cooperation project was conducted. Within six months every new patient admitted to one of 15 rehabilitation facilities was screened for internet addiction. 4.2% of the patients fulfilled criteria for internet addiction. Male patients of younger age with main diagnosis of cannabis dependence or pathological gambling were found to be at higher risk. Internet addiction is more common among patients of the rehabilitation system than in the general population. Especially young, male patients in treatment for cannabis dependence or pathological gambling are at risk for co-morbid internet addiction. It is recommended that regular screening for internet addiction should be implemented in facilities with patients at risk in order to offer indicative treatment. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Pharmacological and clinical dilemmas of prescribing in co-morbid adult attention-deficit/hyperactivity disorder and addiction

    Science.gov (United States)

    Pérez de los Cobos, José; Siñol, Núria; Pérez, Víctor; Trujols, Joan

    2014-01-01

    The present article reviews whether available efficacy and safety data support the pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD) in patients with concurrent substance use disorders (SUD). Arguments for and against treating adult ADHD with active SUD are discussed. Findings from 19 large open studies and controlled clinical trials show that the use of atomoxetine or extended-release methylphenidate formulations, together with psychological therapy, yield promising though inconclusive results about short term efficacy of these drugs in the treatment of adult ADHD in patients with SUD and no other severe mental disorders. However, the efficacy of these drugs is scant or lacking for treating concurrent SUD. No serious safety issues have been associated with these drugs in patients with co-morbid SUD-ADHD, given their low risk of abuse and favourable side effect and drug–drug interaction profile. The decision to treat adult ADHD in the context of active SUD depends on various factors, some directly related to SUD-ADHD co-morbidity (e.g. degree of diagnostic uncertainty for ADHD) and other factors related to the clinical expertise of the medical staff and availability of adequate resources (e.g. the means to monitor compliance with pharmacological treatment). Our recommendation is that clinical decisions be individualized and based on a careful analysis of the advantages and disadvantages of pharmacological treatment for ADHD on a case-by-case basis in the context of active SUD. PMID:23216449

  9. Use of integrated dual disorder treatment via assertive community treatment versus clinical case management for persons with co-occurring disorders and antisocial personality disorder.

    Science.gov (United States)

    Frisman, Linda K; Mueser, Kim T; Covell, Nancy H; Lin, Hsiu-Ju; Crocker, Anne; Drake, Robert E; Essock, Susan M

    2009-11-01

    We conducted secondary analyses of data from a randomized trial testing the effectiveness of Assertive Community Treatment (ACT) in delivery of integrated dual disorder treatment (IDDT) to explore the impact of IDDT delivered through ACT teams compared with standard clinical case management for dually-disordered persons with and without antisocial personality disorder (ASPD). This analysis included 36 individuals with ASPD and 88 individuals without ASPD. Participants with ASPD assigned to ACT showed a significantly greater reduction in alcohol use and were less likely to go to jail than those in standard clinical case management, whereas participants without ASPD did not differ between the 2 case management approaches. There were no significant differences for other substance use or criminal justice outcomes. This study provides preliminary evidence that persons with co-occurring serious mental illness, substance use disorders, and ASPD may benefit from delivery of IDDT through ACT teams.

  10. Social skills: differences among adults with intellectual disabilities, co-morbid autism spectrum disorders and epilepsy.

    Science.gov (United States)

    Smith, Kimberly R M; Matson, Johnny L

    2010-01-01

    Assessing social skills is one of the most complex and challenging areas to study because behavioral repertoires vary depending on an individual's culture and context. However, researchers have conclusively demonstrated that individuals with intellectual disabilities (ID) have impaired social skills as well as those with co-morbid autism spectrum disorders (ASD) and epilepsy. However, it is unknown how these groups differ. Assessment of social skills was made with the Matson Evaluation of Social Skills for Individuals with Severe Retardation. One hundred participants with ID were matched and compared across four equal groups comprising 25 participants with ID, 25 participants with epilepsy, 25 participants with ASD, and 25 participants with combined ASD and epilepsy. When controlling for age, gender, race, level of ID, and hearing and visual impairments, significant differences were found among the four groups on the MESSIER, Wilks's Λ=.58, F(18, 257)=3.05, psocial skills than the ID only or groups containing only a single co-morbid factor with ID (ASD or epilepsy only). Implications of these findings are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Metacognitive interpersonal therapy for co-occurrent avoidant personality disorder and substance abuse.

    Science.gov (United States)

    Dimaggio, Giancarlo; D'Urzo, Maddalena; Pasinetti, Manuela; Salvatore, Giampaolo; Lysaker, Paul H; Catania, Dario; Popolo, Raffaele

    2015-02-01

    Many patients with substance abuse problems present with co-occurrent cluster C personality disorders. Focusing on both disorders disrupts the maintenance mechanisms and the vicious cycle between the 2 conditions; however, treatment teams often neglect this issue. In this work, we describe the features of metacognitive interpersonal therapy as applied to a man with avoidant and depressive personality disorders and heroin, cocaine, and alcohol abuse. Psychotherapy proceeded through the following steps: (a) conducting drug therapy to deal with symptoms of abstinence from heroin; (b) forming a therapeutic bond to overcome the patient's severe emotional withdrawal; (c) fostering basic metacognitive capacities such as awareness of emotions and their triggers; (d) sharing formulations of maladaptive interpersonal schemas and descriptions of the associated states of mind; (e) conveying an understanding of the link between interpersonal events (recent ones and traumatic memories) and substance abuse; (f) facilitating the acquisition of critical distance from maladaptive schemas; and (g) promoting the use of adaptive coping skills instead of resorting to substance abuse. Implications for generalizing these procedures to the treatment of other patients with co-occurrent personality disorders and substance abuse are described. © 2014 Wiley Periodicals, Inc.

  12. [Comorbidity in patients with narcissistic personality disorder in comparison to patients with borderline personality disorder].

    Science.gov (United States)

    Ritter, Kathrin; Roepke, Stefan; Merkl, Angela; Heuser, Isabella; Fydrich, Thomas; Lammers, Claas-Hinrich

    2010-01-01

    Patients with a narcissistic personality disorder (NPD) do not often consult a psychotherapist or psychiatrist because of their NPD, but rather, because of co-occurring psychiatric disorders, or higher general symptom stress. Until now there is no actual data about rates of co-occurrence disorders and general symptom stress. Which axis I and axis II disorders occur typically in NPD in comparison to patients with a borderline personality disorder (BPD)? How are general symptom stress and depressive symptoms related? Prevalence of co-occurring disorders (Structured Clinical Interview for DSM-IV for Axis I and Axis II) and general symptom stress (SCL-90-R) and depression (BDI) were investigated in 62 patients with a NPD, 62 patients with a BPD and 59 patients with a double diagnosis NPD/BPD. Affective disorders (64.5%) and substance use disorders (35.5%) were the most comorbid psychiatric disorders in patients with NPD. Substance use disorders (pdisorder (PTSD) (pdisorders (ppersonality disorder (pdisorders and antisocial personality disorder. Patients with NPD showed lowest rates of co-occurring disorders and lowest scores in general symptom stress and depression than the other two groups. In general, patients with NPD showed similar co-occurring disorders as patients with BPD, or with the co-diagnosis NPD and BPD, but they showed lower scores for general symptom stress and depression. (c) Georg Thieme Verlag KG Stuttgart New York.

  13. Exploring the interrelationship between alexithymia, defense style, emotional suppression, homicide-related posttraumatic stress disorder and psychiatric co-morbidity.

    Science.gov (United States)

    Chung, Man Cheung; Di, Xiaohu; Wan, King Hung

    2016-09-30

    This study investigated the interrelationship between alexithymia, defense style, emotional suppression, posttraumatic stress disorder (PTSD) following homicide and psychiatric co-morbidity. One hundred and fifty male homicide perpetrators and 156 male perpetrators of non-violent crime completed the Posttraumatic Stress Diagnostic Scale (except for non-violent perpetrators), the General Health Questionnaire-28, the Defense Styles Questionnaire, the Courtauld Emotional Control Scale and the Toronto Alexithymia Scale-20. The results showed that 44% of homicide perpetrators met the criteria for PTSD. No significant differences were found between groups in alexithymia, defense style and psychiatric co-morbidity. Homicide perpetrators suppressed depression significantly more than the non-violent group. PLS analyses showed that alexithymia was significantly correlated with defense style. Defense styles were significantly correlated with emotional suppression which, in turn, was associated with homicide-related PTSD and psychiatric co-morbidity. To conclude, perpetrators can experience PTSD reactions following the act of homicide. The severity of these reactions and other psychological problems were related to difficulty getting in touch with distressing emotions, the defenses they used to protect themselves psychologically and the way they suppressed their emotion. Copyright © 2016. Published by Elsevier Ireland Ltd.

  14. The impact of trauma exposure characteristics on post-traumatic stress disorder and psychiatric co-morbidity among Syrian refugees.

    Science.gov (United States)

    Cheung Chung, Man; AlQarni, Nowf; AlMazrouei, Mariam; Al Muhairi, Shamsa; Shakra, Mudar; Mitchell, Britt; Al Mazrouei, Sara; Al Hashimi, Shurooq

    2018-01-01

    This study investigated the impact of trauma exposure characteristics on post-traumatic stress disorder (PTSD) and psychiatric co-morbidity among Syrian refugees. One thousand one hundred and ninety-seven refugees residing in Turkey and Sweden participated in the research. They completed the Harvard Trauma Questionnaire and the General Health Questionnaire-28. Forty-three percent of refugees met the cutoff for PTSD. After adjusting for location of residence, witnessing horror and exposure to life threat and assault were significantly correlated with PTSD and psychiatric co-morbidity respectively. Death of, or life threat to family members or friends were significantly correlated with both distress outcomes. Refugees residing in Turkey had significantly higher levels of PTSD, psychiatric co-morbidity and trauma characteristics than those living in Sweden. To conclude, Syrian refugees who witnessed horror, life threat or had family or friends die, tended to have elevated psychological distress. Levels of distress among resettled refugees can vary depending on country of resettlement. We recommend systematic mental health screening and implementation of psychotherapeutic interventions to address issues pertaining to subjective experience of resettlement and trauma exposure for Syrian refugees. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Clinical differences between cocaine-dependent patients with and without antisocial personality disorder.

    Science.gov (United States)

    Comín, Marina; Redondo, Santiago; Daigre, Constanza; Grau-López, Lara; Casas, Miguel; Roncero, Carlos

    2016-12-30

    The aim of this study is to compare the features of two groups of cocaine dependent patients in treatment, one of them with co-morbid diagnosis of antisocial personality disorder and the other not. Cross-sectional design, with 143 cocaine-dependent patients attending a drug unit, distributed in two groups: patients with and without Antisocial Personality Disorder. As results, we found that the 15.38% of the sample were diagnosed with an Antisocial Personality Disorder. In relation to socio-demographic variables, Antisocial Personality Disorder patients have less probability of being working or studying (9.1% vs. 47.9%). After multivariate analysis it was found that significantly Antisocial Personality Disorder patients have more opiates dependence (OR: 0.219; 95% IC 0.072-0.660), sedative dependence (OR: 0.203; 95% IC 0.062-0.644) and in more cases show Borderline Personality Disorder (OR: 0.239; 95% IC 0.077-0.746). This study highlights significant differences between cocaine addicts with or without an Antisocial Personality Disorder. All these differences are good indicators of the complexity of the patients with this personality disorder. Better knowledge of their profile will help us to improve the design of specific treatment programs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Co-morbidity and cannabis use in a mental health trust in South East England.

    Science.gov (United States)

    Trathen, Bruce; O'gara, Colin; Sarkhel, Arghya; Sessay, Mohammed; Rao, Harish; Luty, Jason

    2007-10-01

    The prevalence of co-morbidity (severe mental illness and substance) may be less in rural and semi-rural areas than inner cities. The aims were therefore to measure the prevalence of co-morbidity among patients of attending a mental health service in a semi-rural area South East England. Cross-sectional prevalence survey of 1,808 patients with detailed assessments from a representative sample of 373 patients identified as having a combination of severe mental illness and substance misuse. Interviews with key workers were performed using validated methods from the COSMIC study. The response rates equalled or exceeded 90% for the various parts of the study. One-tenth of patients attending the Community Mental Health Teams (CMHTs) reported problematic use of illicit drugs and 17% reported alcohol problems in the past year. 22% of Community Drug and Alcohol Service (CDAS) clients reported a severe mental illness and 46% reported some other form of psychiatric disorder. Of patients with a combined diagnosis of mental illness and substance misuse, cannabis use was 4-fold more common amongst patients attending the CMHT than CDAS (33% vs. 8%) while use of amphetamine was five-fold higher in the CMHT group (10% vs. 2%). Patients with concurrent psychiatric and substance misuse problems represent a similar proportion of the aggregate caseload of both treatment services with observed prevalence amongst the CDAS and CMHT patients with a diagnosis for anxiety disorder (18% vs. 26%), minor depression (42% vs. 32%), personality disorders (32% vs. 36%), histories of self-harm (52% vs. 46%) and violence (33% vs. 30%) respectively. Co-morbidity is common in clients amongst CMHT and CDAS clients although use of cannabis was significantly more common in CMHT clients than in CDAS clients.

  17. Co-morbidities of vertiginous diseases

    OpenAIRE

    Warninghoff, Jan C; Bayer, Otmar; Ferrari, Uta; Straube, Andreas

    2009-01-01

    Abstract Background Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD), vestibular migraine and phobic vertigo (PPV)) have also different spectrums of co-morbidities. Methods All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes ...

  18. Homicidal behaviour among people with avoidant, dependent and obsessive-compulsive (cluster C) personality disorder.

    Science.gov (United States)

    Laajasalo, Taina; Ylipekka, Mikko; Häkkänen-Nyholm, Helinä

    2013-02-01

    Despite a growing forensic psychiatry literature, no previous study has examined in detail homicidal behaviour among offenders with cluster C personality disorders - the avoidant, dependent or obsessional personality disorders. This study aims to compare homicide offenders with cluster C personality disorders with those with other personality disorders on criminal history, offender-victim relationship and post-offence reaction variables. The sample was drawn from all Finnish homicide cases of 1996-2004 for whom a forensic psychiatric evaluation had been conducted. Data were extracted from forensic psychiatric and crime reports. In a nationwide sample of 593 homicide offenders, 21 had at least one cluster C personality disorder. These offenders had significantly shorter criminal histories than the others. Offender-victim relationship did not differ between the groups, but confession to the crime and feelings of remorse were more common among people with cluster C disorders. In addition, compared with other personality disorder clusters, co-morbid depression was more common. Cluster C personality disorders are rare, but not nonexistent, among homicide offenders. Observed differences in their backgrounds and post-offence behaviours indicate that they may have special needs. Copyright © 2012 John Wiley & Sons, Ltd.

  19. [Eating Disorder Treatment in Iceland - Treatment adherence, psychiatric co-morbidities and factors influencing drop-out].

    Science.gov (United States)

    Gunnarsdottir, Gudrun Mist; Palsson, Sigurdur Pall; Thorsteinsdottir, Gudlaug

    2015-05-01

    Treatment adherence in patients with eating disorders (ED) in Iceland is unknown. The aim of the study was to investigate treatment drop-out and explore factors that influence premature termination of treatment in a specialized ED treatment unit, at the University Hospital of Iceland, during the period of September 1, 2008 - May 1, 2012. The study is retrospective and naturalistic. Hospital records of referred patients were examined. Those meeting the ICD 10 criteria of anorexia nervosa (AN) (F50.0, F50.1), bulimia nervosa (BN) (F50.2, F50.3) and eating disorder not otherwise specified (EDNOS) (F50.9) were included. The total sample was 260 and 182 patients met inclusion criteria. No-shows were 7%. Drop-out was defined as premature termination of treatment without formal discharge. The sample consisted of 176 women and 6 men, mean age 26.3 years. BN was diagnosed in 52.7% of patients, EDNOS in 36.8% AN in 10.4%. 74.7% had one or more co-morbid psychiatric diagnosis. Anxiety- and/or depression were diagnosed in 72.5%, Attention hyperactivity deficiency disorder in 15.4% and personality disorders in 8.2%. Lifetime prevalence of substance use disorders (SUDs) was 30.8%. Drop-out from treatment occurred in 54.4% of cases (with approximately 1/3 returning to treatment), 27.5% finished treatment and 18.1% were still in treatment at the end of the follow up period. Treatment adherence was significantly higher in patients who had a university degree, in those who had themselves taken the initiative to seek ED treatment and in those with higher anxiety scores at assessment. AN patients did better than other ED patients while patients with SUDs showed a tendency for higher drop-out (p=0.079). The drop-out rates were similar to what has been reported from other western countries. Follow-up time was longer and AN patient did better than expected. Higher education, initiative in seeking treatment and higher anxiety scores on questionnaires were protective.

  20. The Collaborative Longitudinal Personality Disorders Study: baseline Axis I/II and II/II diagnostic co-occurrence.

    Science.gov (United States)

    McGlashan, T H; Grilo, C M; Skodol, A E; Gunderson, J G; Shea, M T; Morey, L C; Zanarini, M C; Stout, R L

    2000-10-01

    To describe baseline diagnostic co-occurrence in the Collaborative Longitudinal Personality Disorders Study. Six hundred and sixty-eight patients were reliably assessed with diagnostic interviews for DSM-IV Axis I and II disorders to create five groups: Schizotypal (STPD), Borderline (BPD), Avoidant (AVPD), Obsessive-Compulsive (OCPD) and Major Depressive Disorder (MDD) without personality disorder (PD). Mean number of Axis I lifetime diagnoses was 3.4; STPD and BPD groups had more diagnoses than AVPD, OCPD, and MDD groups. Significant Axis I co-occurrences emerged for Social Phobia/ AVPD, PTSD/BPD and Substance Use/BPD. Mean number of co-occurring PDs was 1.4; STPD had more than BPD group which had more than AVPD and OCPD groups. Significant PD co-occurrence emerged for: STPD/ Paranoid and Schizoid PDs, BPD with Antisocial and Dependent PDs, and lower frequency for OCPD/Antisocial PD. Diagnostic co-occurrences generally followed base rates, while significant departures resemble those of controlled literature.

  1. Co-morbidities of vertiginous diseases.

    Science.gov (United States)

    Warninghoff, Jan C; Bayer, Otmar; Ferrari, Uta; Straube, Andreas

    2009-07-07

    Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD), vestibular migraine and phobic vertigo (PPV)) have also different spectrums of co-morbidities. All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index), migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

  2. Co-morbidities of vertiginous diseases

    Directory of Open Access Journals (Sweden)

    Ferrari Uta

    2009-07-01

    Full Text Available Abstract Background Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD, vestibular migraine and phobic vertigo (PPV have also different spectrums of co-morbidities. Methods All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index, migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. Results We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. Conclusion In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

  3. Chronic pain patients with possible co-morbid post-traumatic stress disorder admitted to multidisciplinary pain rehabilitation

    DEFF Research Database (Denmark)

    Andersen, Tonny Elmose; Andersen, Lou-Ann Christensen; Andersen, Per Grünwald

    2014-01-01

    BACKGROUND: Although post-traumatic stress disorder (PTSD) is a common co-morbidity in chronic pain, little is known about the association between PTSD and pain in the context of chronic pain rehabilitation. OBJECTIVE: The aim of the present study was two-fold: (1) to investigate the association......: A consecutively referred cohort of 194 patients completed a baseline questionnaire at admission covering post-traumatic stress, pain symptoms, physical and mental functioning, as well as self-reported sleep quality and cognitive difficulties. Medication use was calculated from their medical records. A total of 95...

  4. Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review.

    Science.gov (United States)

    Garbarino, Sergio; Lanteri, Paola; Durando, Paolo; Magnavita, Nicola; Sannita, Walter G

    2016-08-18

    Sleep disorders are frequent (18%-23%) and constitute a major risk factor for psychiatric, cardiovascular, metabolic or hormonal co-morbidity and mortality. Low social status or income, unemployment, life events such as divorce, negative lifestyle habits, and professional requirements (e.g., shift work) are often associated with sleep problems. Sleep disorders affect the quality of life and impair both professional and non-professional activities. Excessive daytime drowsiness resulting from sleep disorders impairs efficiency and safety at work or on the road, and increases the risk of accidents. Poor sleep (either professional or voluntary) has detrimental effects comparable to those of major sleep disorders, but is often neglected. The high incidence and direct/indirect healthcare and welfare costs of sleep disorders and poor sleep currently constitute a major medical problem. Investigation, monitoring and strategies are needed in order to prevent/reduce the effects of these disorders.

  5. Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review

    Directory of Open Access Journals (Sweden)

    Sergio Garbarino

    2016-08-01

    Full Text Available Sleep disorders are frequent (18%–23% and constitute a major risk factor for psychiatric, cardiovascular, metabolic or hormonal co-morbidity and mortality. Low social status or income, unemployment, life events such as divorce, negative lifestyle habits, and professional requirements (e.g., shift work are often associated with sleep problems. Sleep disorders affect the quality of life and impair both professional and non-professional activities. Excessive daytime drowsiness resulting from sleep disorders impairs efficiency and safety at work or on the road, and increases the risk of accidents. Poor sleep (either professional or voluntary has detrimental effects comparable to those of major sleep disorders, but is often neglected. The high incidence and direct/indirect healthcare and welfare costs of sleep disorders and poor sleep currently constitute a major medical problem. Investigation, monitoring and strategies are needed in order to prevent/reduce the effects of these disorders.

  6. Distinguishing bipolar II depression from major depressive disorder with comorbid borderline personality disorder: demographic, clinical, and family history differences.

    Science.gov (United States)

    Zimmerman, Mark; Martinez, Jennifer H; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy

    2013-09-01

    Because of the potential treatment implications, it is clinically important to distinguish between bipolar II depression and major depressive disorder with comorbid borderline personality disorder. The high frequency of diagnostic co-occurrence and resemblance of phenomenological features has led some authors to suggest that borderline personality disorder is part of the bipolar spectrum. Few studies have directly compared patients with bipolar disorder and borderline personality disorder. In the present study from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we compared these 2 groups of patients on demographic, clinical, and family history variables. From December 1995 to May 2012, 3,600 psychiatric patients presenting to the outpatient practice at Rhode Island Hospital (Providence, Rhode Island) were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders. The focus of the present study is the 206 patients with DSM-IV major depressive disorder and borderline personality disorder (MDD-BPD) and 62 patients with DSM-IV bipolar II depression without borderline personality disorder. The patients with MDD-BPD were significantly more often diagnosed with posttraumatic stress disorder (P depression had a significantly higher morbid risk for bipolar disorder in their first-degree relatives than the MDD-BPD patients (P depression and major depressive disorder with comorbid borderline personality disorder differed on a number of clinical and family history variables, thereby supporting the validity of this distinction. © Copyright 2013 Physicians Postgraduate Press, Inc.

  7. Personality disorder: a new global perspective

    Science.gov (United States)

    TYRER, PETER; MULDER, ROGER; CRAWFORD, MIKE; NEWTON-HOWES, GILES; SIMONSEN, ERIK; NDETEI, DAVID; KOLDOBSKY, NESTOR; FOSSATI, ANDREA; MBATIA, JOSEPH; BARRETT, BARBARA

    2010-01-01

    Personality disorder is now being accepted as an important condition in mainstream psychiatry across the world. Although it often remains unrecognized in ordinary practice, research studies have shown it is common, creates considerable morbidity, is associated with high costs to services and to society, and interferes, usually negatively, with progress in the treatment of other mental disorders. We now have evidence that personality disorder, as currently classified, affects around 6% of the world population, and the differences between countries show no consistent variation. We are also getting increasing evidence that some treatments, mainly psychological, are of value in this group of disorders. What is now needed is a new classification that is of greater value to clinicians, and the WPA Section on Personality Disorders is currently undertaking this task. PMID:20148162

  8. Personality disorder: a new global perspective

    DEFF Research Database (Denmark)

    Tyrer, Peter; Mulder, Roger; Crawford, Mike

    2010-01-01

    Personality disorder is now being accepted as an important condition in mainstream psychiatry acreoss the world. Although it often remains unrecognized in ordinary practice, research studies have shown it is common, creates considerable morbidity, is associated with high costs to services...... and to society, and interferes, usually negatively, with progress in the treatment of other mental disorders. We now have evidence that personality disorder, as currently classified, affects around 6% of the world population, and the differences between countries show no consistent variation. We are also getting...... incerasing evidence that some teratments, manilyl psychological, are of value in this group of disorders. What is now needed is a new classification that is of greater value to clinicians, and the WPA Section on Personality Disorders is currently undertaking this task....

  9. Personality profiles in patients with eating disorders

    OpenAIRE

    Tomotake, Masahito; Ohmori, Tetsuro

    2002-01-01

    The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger’s personality theory suggested that high Harm Avoidance might be relevant ...

  10. The Relationship between Obsessive Compulsive Personality and Obsessive Compulsive Disorder Treatment Outcomes: Predictive Utility and Clinically Significant Change.

    Science.gov (United States)

    Sadri, Shalane K; McEvoy, Peter M; Egan, Sarah J; Kane, Robert T; Rees, Clare S; Anderson, Rebecca A

    2017-09-01

    The evidence regarding whether co-morbid obsessive compulsive personality disorder (OCPD) is associated with treatment outcomes in obsessive compulsive disorder (OCD) is mixed, with some research indicating that OCPD is associated with poorer response, and some showing that it is associated with improved response. We sought to explore the role of OCPD diagnosis and the personality domain of conscientiousness on treatment outcomes for exposure and response prevention for OCD. The impact of co-morbid OCPD and conscientiousness on treatment outcomes was examined in a clinical sample of 46 participants with OCD. OCPD diagnosis and scores on conscientiousness were not associated with poorer post-treatment OCD severity, as indexed by Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, although the relative sample size of OCPD was small and thus generalizability is limited. This study found no evidence that OCPD or conscientiousness were associated with treatment outcomes for OCD. Further research with larger clinical samples is required.

  11. Lower Frequency of co-Morbid Medical Disorders Related to Poor Impulse Control in Parkinson's than Alzheimer's Disease.

    Science.gov (United States)

    Saito, Erin K; Diaz, Natalie; Morrow, Julia; Chung, Julia; McMurtray, Aaron

    2016-01-01

    Parkinson's disease is associated with progressive degeneration of mesolimbic dopaminergic neurons that are involved in reward-based behavior learning, including rewarding effects of food consumption and drugs of abuse. The importance of this pathway in development of addictive behaviors led us to hypothesize that medical disorders related to poor impulse control may occur less frequently among patients with Parkinson's disease than those with other progressive neurodegenerative disorders such as Alzheimer's disease. Retrospective cross-sectional study of all patients treated for Parkinson's disease and Alzheimer's disease in a community based clinic during a two-year period. Associations were summarized using odds ratios (OR) and 95% confidence intervals (95% CI) estimated from logistic regression models, adjusted for differences in gender distribution between the groups. A total of 106 patients with Parkinson's disease and 72 patients with Alzheimer's disease were included. Patients with Parkinson's disease were less likely to have either past substance use (adjusted OR = 0.035, 95% CI = 0.009 - 0.130) or presence of co-morbid medical conditions related to poor dietary choices (adjusted OR = 0.157, 95% CI = 0.062 - 0.397). Co-morbid medical conditions related to poor impulse control occur less frequently among those with Parkinson's disease than those with Alzheimer's disease. These findings are consistent with dysfunction of dopamine dependent pathways involved in addiction during the presymptomatic phase of Parkinson's disease and support a biological basis for addiction.

  12. Affective disorders among patients with borderline personality disorder.

    Science.gov (United States)

    Sjåstad, Hege Nordem; Gråwe, Rolf W; Egeland, Jens

    2012-01-01

    The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar spectrum. This association may reflect

  13. Affective disorders among patients with borderline personality disorder.

    Directory of Open Access Journals (Sweden)

    Hege Nordem Sjåstad

    Full Text Available BACKGROUND: The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. METHODS: In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773, we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043 had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636. Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. RESULTS: More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. CONCLUSIONS: The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than

  14. Affective Disorders among Patients with Borderline Personality Disorder

    Science.gov (United States)

    Sjåstad, Hege Nordem; Gråwe, Rolf W.; Egeland, Jens

    2012-01-01

    Background The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. Methods In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. Results More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. Conclusions The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar

  15. Three cases of dissociative identity disorder and co-occurring borderline personality disorder treated with dynamic deconstructive psychotherapy.

    Science.gov (United States)

    Chlebowski, Susan M; Gregory, Robert J

    2012-01-01

    Dissociative Identity Disorder (DID) is an under-researched entity and there are no clinical trials employing manual-based therapies and validated outcome measures. There is evidence that borderline personality disorder (BPD) commonly co-occurs with DID and can worsen its course. The authors report three cases of DID with co-occurring BPD that we successfully treated with a manual-based treatment, Dynamic Deconstructive Psychotherapy (DDP). Each of the three clients achieved a 34% to 79% reduction in their Dissociative Experiences Scale scores within 12 months of initiating therapy. Dynamic Deconstructive Psychotherapy was developed for treatment refractory BPD and differs in some respects from expert consensus treatment of DID. It may be a promising modality for DID complicated by co-occurring BPD.

  16. Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands

    NARCIS (Netherlands)

    Faber, Adrianne; Kalverdijk, Luuk J.; de Jong-van den Berg, Lolkje T. W.; Hugtenburg, Jacqueline G.; Minderaa, Ruud B.; Tobi, Hilde

    This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified

  17. Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands

    NARCIS (Netherlands)

    Faber, A.; Kalverdijk, L.J.; de Jong-van den Berg, L.T.W.; Hugtenburg, J.G.; Minderaa, R.B.; Tobi, H.

    2010-01-01

    This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified

  18. The Impact of Stressful Life Events on Alcohol Relapse: Findings from the Collaborative Longitudinal Personality Disorders Study.

    Science.gov (United States)

    Reyes, Christina Delos; Pagano, Maria Elizabeth; Ronis, Robert J

    2009-04-01

    Alcohol relapse is impacted by a variety of environmental, interpersonal, and intrapersonal factors. We examined the interaction between stressful life events, personality disorder subtype, and alcohol relapse among individuals enrolled in the Collaborative Longitudinal Personality Disorders Study (CLPS). Negative life events predicted relapse in all subjects. In individuals with a history of an alcohol use disorder prior to study entry, positive life events also predicted alcohol relapse. Individuals with Antisocial Personality Disorder (ASPD) were found to be twice as likely to relapse in response to life stressors compared to individuals with Obsessive-Compulsive Personality Disorder (OCPD), who were half as likely to relapse in response to life stressors. Further analysis revealed that individuals with OCPD and no history of an alcohol use disorder were almost 10 times more likely to relapse in the face of a stressful romantic problem, while those with ASPD and a history of an alcohol use disorder were six times more likely to relapse in response to a stressful financial event. These findings have implications for both the assessment and the treatment of individuals who present with co-morbid personality and alcohol use disorders.

  19. Dimensional representations of DSM-IV cluster B personality disorders in a population-based sample of Norwegian twins: a multivariate study.

    Science.gov (United States)

    Torgersen, S; Czajkowski, N; Jacobson, K; Reichborn-Kjennerud, T; Røysamb, E; Neale, M C; Kendler, K S

    2008-11-01

    The personality disorders (PDs) in the 'dramatic' cluster B [antisocial (ASPD), histrionic (HPD), narcissistic (NPD) and borderline (BPD)] demonstrate co-morbidity. However, the degree to which genetic and/or environmental factors influence their co-occurrence is not known and, with the exception of ASPD, the relative impact of genetic and environmental risk factors on liability to the cluster B PDs has not been conclusively established. PD traits were assessed in 1386 Norwegian twin pairs between the age of 19 and 35 years using the Structured Interview for DSM-IV Personality Disorders (SIDP-IV). Using the statistical package Mx, multivariate twin models were fitted to dimensional representations of the PDs. The best-fitting model, which did not include sex or shared family environment effects, included common genetic and environmental factors influencing all four dramatic PD traits, and factors influencing only ASPD and BPD. Heritability was estimated at 38% for ASPD traits, 31% for HPD traits, 24% for NPD traits and 35% for BPD traits. BPD traits had the lowest and ASPD traits the highest disorder-specific genetic variance. The frequently observed co-morbidity between cluster B PDs results from both common genetic and environmental influences. Etiologically, cluster B has a 'substructure' in which ASPD and BPD are more closely related to each other than to the other cluster B disorders.

  20. Co-morbidities in severe asthma

    DEFF Research Database (Denmark)

    Porsbjerg, Celeste; Menzies-Gow, Andrew

    2017-01-01

    Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma...... to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical...... impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD...

  1. Dimensions of personality structure among patients with substance use disorders and co-occurring personality disorders: a comparison with psychiatric outpatients and healthy controls.

    Science.gov (United States)

    Di Pierro, Rossella; Preti, Emanuele; Vurro, Nicoletta; Madeddu, Fabio

    2014-08-01

    Although dual diagnosis has been a topic of great scientific interest for a long time, few studies have investigated the personality traits that characterize patients suffering from substance use disorders and co-occurring personality disorders through a dimensional approach. The present study aimed to evaluate structural personality profiles among dual-diagnosis inpatients to identify specific personality impairments associated with dual diagnosis. The present study involved 97 participants divided into three groups: 37 dual-diagnosis inpatients, 30 psychiatric outpatients and 30 nonclinical controls. Dimensions of personality functioning were assessed and differences between groups were tested using Kernberg's dimensional model of personality. Results showed that dual diagnosis was associated with the presence of difficulties in three main dimensions of personality functioning. Dual-diagnosis inpatients reported a poorly integrated identity with difficulties in the capacity to invest, poorly integrated moral values, and high levels of self-direct and other-direct aggression. The present study highlighted that a dimensional approach to the study of dual diagnosis may clarify the personality functioning of patients suffering from this pathological condition. The use of the dimensional approach could help to advance research on dual diagnosis, and it could have important implications on clinical treatment programs for dual-diagnosis inpatients. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Assessment and importance of personality disorders in medical patients: an update.

    Science.gov (United States)

    Dhossche, D M; Shevitz, S A

    1999-06-01

    Personality disorders in medical patients have received less attention than depression, anxiety, or somatization. We conducted a selective literature search to assess the role of personality disorders in medical patients. Review of recent studies suggests a high prevalence and morbidity of personality disorders in medical populations. Important correlates in selected groups are depression, somatization, noncompliance, sexual risk taking, and substance abuse. Difficulties in physician-patient relationships are also frequently reported. Psychiatric interventions are considered beneficial, though no single treatment of choice is available. We recommend that physicians consider the possibility of personality disorders in medical patients to choose appropriate treatments for selected symptoms. Training in interviewing skills may enhance recognition of personality disorders and management of associated psychiatric conditions.

  3. Treatment of alcohol dependence in patients with co-morbid major depressive disorder – predictors for the outcomes with memantine and escitalopram medication

    Directory of Open Access Journals (Sweden)

    Lönnqvist Jouko

    2008-10-01

    Full Text Available Abstract Background Alcohol dependence comorbid with major depressive disorder poses a major challenge in the clinical setting. The results in the treatment with selective serotonin re-uptake inhibitors have been conflicting. Thus, we compared in alcohol-dependent patients with co-morbid major depressive disorder the selective serotonin re-uptake inhibitor escitalopram to a compound that acts on different transporter system and may reduce craving, the glutamate receptor antagonist memantine. Methods Eighty alcohol-dependent patients comorbid with major depressive disorder in municipal alcohol clinics were randomized 1:1 to receive memantine 20 mg or escitalopram 20 mg in a double-blind manner. During the 26-week study period patients continued their routine treatment at the clinics. Abstinence was not required but encouraged. The patients attended visits weekly during the first month, and then at 3 and at 6 months. Outcome measures were Alcohol Use Disorders Identification Test (AUDIT, Obsessive Compulsive Drinking Scale (OCDS and Drinking Diary. Results The completion rate was high in both groups, especially among the patients who had been abstinent at the beginning of the study. However, among those patients who were not abstinent at baseline, 47% in both groups discontinued the study. Numbers of abstinent days were high in both groups throughout the study. Alcohol consumption measured by the AUDIT QF (quantity-frequency score was significantly reduced in both groups, as was the craving for alcohol measured by the OCDS. Early age at first alcohol intoxication predicted poor treatment outcomes in patients treated with escitalopram, and the same was seen with the early onset of the first depressive episode. The same predictive effects were not found in patients treated with memantine. Conclusion Our results indicate that both memantine and escitalopram are useful adjunct medications for the treatment of alcohol dependence co-morbid with major

  4. Multimodal examination of emotion regulation difficulties as a function of co-occurring avoidant personality disorder among women with borderline personality disorder.

    Science.gov (United States)

    Gratz, Kim L; Tull, Matthew T; Matusiewicz, Alexis M; Breetz, Alisa A; Lejuez, C W

    2013-10-01

    Despite a robust association between borderline personality disorder (BPD) and emotion dysregulation, evidence of within-BPD group differences in emotion regulation (ER) difficulties highlights the need to examine factors that increase the risk for ER difficulties within BPD. One factor that warrants consideration is co-occurring avoidant personality disorder (AVPD), the presence of which is associated with worse outcomes in and outside of BPD and theorized to interfere with adaptive ER. Thus, this study examined if co-occurring AVPD among women with BPD is associated with heightened ER difficulties (assessed across self-report, behavioral, and physiological domains). Participants included 39 women with BPD (13 with co-occurring AVPD) and 18 women without BPD. Although results revealed no significant differences in overall self-reported ER difficulties (or the specific dimensions involving emotional clarity and the control of behaviors when distressed) between BPD participants with and without AVPD (with both groups reporting greater ER difficulties than non-BPD participants), other ER difficulties were found to be heightened among BPD participants with AVPD. Specifically, BPD participants with (vs. without) AVPD reported greater difficulties accessing effective ER strategies, evidenced less willingness to experience distress on a laboratory stressor, and exhibited a greater decrease in high frequency heart rate variability in response to this stressor (indicative of poor ER capacity). Findings add to the literature on ER difficulties in BPD, suggesting that co-occurring AVPD within BPD may be associated with a lower capacity for regulating distress and greater difficulties accessing effective ER strategies, potentially leading to greater efforts to avoid emotional distress. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  5. Personality assessment and feedback (PAF): strategies and preliminary findings

    DEFF Research Database (Denmark)

    Hesse, Morten; Fridell, Mats; Pedersen, Mads Kjær

    2008-01-01

    Background: Co-morbid personality disorders are common in substance dependent patients, and personality disorders are associated with worse clinical outcomes, worse retention and compliance, and alliance problems. The whole range of personality disorders is present in substance dependent patients......, and antisocial personality disorder is particularly common. However, clinical strategies must vary strongly across disorders. Objectives: To test the clinical effectiveness of a full personality disorder assessment and individual feedback to patient and caseworker, against screening for axis I disorders alone...... anxiety or depression, drug and alcohol dependence, attention deficit hyperactivity disorder, and current level of functioning. The axis II disorder includes a semi-structured interview for personality disorders. Outcomes include global functioning (Work and Social Adjustment Scale), substance use...

  6. Childhood trauma among individuals with co-morbid substance use and post traumatic stress disorder

    Science.gov (United States)

    Farrugia, Philippa L; Mills, Katherine L; Barrett, Emma; Back, Sudie E; Teesson, Maree; Baker, Amanda; Sannibale, Claudia; Hopwood, Sally; Rosenfeld, Julia; Merz, Sabine; Brady, Kathleen T

    2011-01-01

    Background Little is known about the impact of childhood trauma (CT) on the clinical profile of individuals with co-occurring substance use disorder (SUD) and post traumatic stress disorder (PTSD). Aims To compare the clinical characteristics of individuals with SUD+PTSD who have a history of CT with SUD+PTSD individuals who have experienced trauma during adulthood only. Method Data were collected on 103 individuals as part of a randomised controlled trial examining the efficacy of an integrated psychosocial treatment for SUD+PTSD. Participants were recruited from substance use treatment services, community referrals and advertising. Data were collected on demographic characteristics, substance use and treatment histories, lifetime trauma exposure, and current physical and mental health functioning. Results The vast majority (77%) of the sample had experienced at least one trauma before the age of 16, with 55% of those endorsing childhood sexual abuse. As expected individuals with a CT history, as compared to without, evidenced significantly longer duration of PTSD. Those with a CT history also had more extensive lifetime trauma exposure, an earlier age of first intoxication, and reported more severe substance use (e.g., a greater number of drug classes used in their lifetime, higher severity of dependence scores and greater number of drug treatment episodes). Conclusion Individuals with co-morbid SUD+PTSD who have experienced CT present with a more severe and chronic clinical profile in relation to a number of trauma and substance use characteristics, when compared to individuals with adulthood only trauma histories. It is therefore important for SUD+PTSD treatment planning that CT be carefully assessed. PMID:21984884

  7. The structure of common and uncommon mental disorders.

    Science.gov (United States)

    Forbush, K T; Watson, D

    2013-01-01

    Co-morbidity patterns in epidemiological studies of mental illness consistently demonstrate that a latent internalizing factor accounts for co-morbidity patterns among unipolar mood and anxiety disorders, whereas a latent externalizing factor underlies the covariation of substance-use disorders and antisocial behaviors. However, this structure needs to be extended to include a broader range of disorders. Exploratory and confirmatory factor analyses were used to examine the structure of co-morbidity using data from the Collaborative Psychiatric Epidemiological Surveys (n = 16 233). In the best-fitting model, eating and bipolar disorders formed subfactors within internalizing, impulse control disorders were indicators of externalizing, and factor-analytically derived personality disorder scales split between internalizing and externalizing. This was the first large-scale nationally representative study that has included uncommon mental disorders with sufficient power to examine their fit within a structural model of psychopathology. The results of this study have important implications for conceptualizing myriad mental disorders.

  8. Profile of Co-morbidities in the Obese

    Directory of Open Access Journals (Sweden)

    Salati SA

    2015-07-01

    Full Text Available Objective: To study the profile of co-morbidities in obese patients reporting for bariatric surgical procedures. Methods: A retrospective study was conducted at the Bariatric Surgery Unit of Department of Surgery of the College of Medicine, Qassim University, Saudi Arabia. The records of all the obese patients (with Body Mass Index greater than 30, evaluated in the department over the period of two years from Jan 2012 to Dec 2014, were studied and co-morbidities were sought in all subjects. Results: Of the 172 subjects, 76.2% (n=131 were female and 23.8% (n=41 male. The age ranged from 17–49 years (Mean 29.9 years; Mode 28 years. The weight ranged from 82 kg–146kg and BMI ranged from 33–54 (mean BMI 44.7 kg/m. Out of the total of 172 patients, 96 (56 % including 72 females and 24 males had one or more co-morbidities. Conclusion: A wide range of co-morbidities occur in obese patients that have the potential to decrease the quality of life and the life span.

  9. Aggression in war veterans suffering from posttraumatic stress disorder with co-morbid alcoholism.

    Science.gov (United States)

    Babić, Dragan; Martinac, Marko; Bjelanović, Vedran; Babić, Romana; Sutović, Alija; Sinanović, Osman

    2010-03-01

    For thousands of years it has been known that aggression as a symptom appears in numerous psychiatric disorders and diseases. During the last decade the appearance of the aggressive behavior related to the posttraumatic stress disorder (PTSD) has been frequently investigated, often associated with war trauma. The goal of this study is to analyze the impact of alcoholism on a way war veterans suffering from chronic PTSD express and control aggression. The sample included 240 war veterans with chronic PTSD. The subjects were divided in two groups. PTSD group (n=147) and controlled group composed of those suffering from alcoholism in addition to PTSD (n=93). In this study, the following psychological instruments were used: The Harvard trauma questionnaire for PTSD diagnosis (HTQ); the questionnaire for self-evaluation of aggression (STAXI); The Profile Index Emotion (PIE); questionnaire for auto-diagnosis of alcoholism (CAGE). The obtained results indicate that subjects who have PTSD with co-morbid alcoholism are more deprived, aggressive (p alcoholism (PIE). The aggression is statistically more expressed in subjects with PTSD who have also been diagnosed with alcoholism on all subscales in comparison to subjects with PTDS who have not been diagnosed with alcoholism: the current state of aggression, the general state of aggression, aggression towards an unfair treatment, aggression directed inwards and outwards (p alcoholism show a higher degree of aggression in comparison to subjects with PTDS who are not diagnosed with alcoholism.

  10. Co-morbidity in a cystic fibrosis population attending a regional clinic.

    LENUS (Irish Health Repository)

    Healy, F

    2010-11-01

    Pulmonary disease remains the major cause of morbidity in patients with cystic fibrosis (CF). However, of 115 patients attending a regional CF clinic we noted 16 cases (14%) with co-morbid conditions. Of this group, 4 of 115 patients (3.5%) had renal problems including both structural and functional defects and 4 (3.5%) had neurological disorders, 3 of which were types of epilepsy. Notably, 3 of 115 patients (2.6%) had different forms of neoplasia, all of which required significant surgical and\\/or chemotherapeutic intervention. There is now increasing evidence of the association between digestive tract malignancy and CF, which further complicates management of these already complex cases.

  11. Personality profiles in patients with eating disorders.

    Science.gov (United States)

    Tomotake, Masahito; Ohmori, Tetsuro

    2002-08-01

    The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger's personality theory suggested that high Harm Avoidance might be relevant to the pathology of anorexia nervosa and high Novelty Seeking and Harm Avoidance to bulimia nervosa. Moreover, high Self-Directedness was suggested to be associated with favorable outcome in bulimia nervosa. The assessment of personality in a cross-sectional study, however, might be influenced by the various states of the illness. Therefore, a sophisticated longitudinal study will be required to advance this area of research.

  12. Is borderline personality disorder only a mental health problem?

    Science.gov (United States)

    Cailhol, Lionel; Francois, Margot; Thalamas, Claire; Garrido, Cécile; Birmes, Philippe; Pourcel, Laure; Lapeyre-Mestre, Maryse; Paris, Joel

    2016-11-01

    Patients with borderline personality disorder (BPD) have been shown to have increased rates of the use of medical services. The objective of this multicentre study was to compare the utilization of physical health services by patients with severe BPD (n = 36) with that of two control groups: one with other personality disorders (PDs) (n = 38) and one with matched subjects randomly selected from the general population (n = 165). Information was drawn from an insurance database collected over a 5-year period. The results showed that the BPD group had a higher mean number of medication prescriptions (377.3 vs. 97.4, p groups with BPD and other PDs. The annual health-care cost for each BPD patient is estimated to be 12 761 euros, of which 17.6% is due to somatic care. In the BPD group, co-morbidity for narcissistic PD (NPD) contributed to the overall use of medications and hospitalization use. Combined with other data, this exploratory study shows that BPD is a medical burden and not just a psychiatric one. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Association of psychiatric co-morbidity and efficacy of treatment in chronic daily headache in Indian population

    Directory of Open Access Journals (Sweden)

    Ajai Kumar Singh

    2013-01-01

    Full Text Available Objective: To study the prevalence of psychiatric co-morbidity in patients of chronic daily headache (CDH and compare the efficacy of treatment between various type of headache associated with psychiatric co-morbidity. Materials and Methods: Prospective case control cohort study, 92 consecutive patients of CDH meeting eligibility criteria. The diagnosis of various subtypes of CDH was made according to the IHS criteria. Age, sex, educational, marital and socioeconomic status, matched controls were also selected. Patients were evaluated with the Mini International Neuropsychiatric Interview (MINI scale at the time of enrolment and at 3 months. Results: CDH accounted for 28% of all headache patients. The mean age of presentation was 30.2 ± 10.3 years, male: Female ratio of 28:64 and mean duration of 4.56 ± 0.56 years. Chronic migraine (CM accounted for 59 patients, chronic tension type headache (CTTH 22 patients, new daily persistent headache (NDPH 3 patients and miscellaneous 8 patients. Psychiatric co-morbidity was present in 53.3% patients with CDH, and was more common in CM (62.7% as compared to CTTH (36.4%. Single psychiatric co-morbidity was seen in 26 patients, while 23 patients had multiple co-morbidity. Major depressive episode, anxiety disorder, agoraphobia and dysthymia were significant psychiatric co-morbidities. Patients with CM were treated with topiramate or divalproex sodium ER and CTTH were treated with amitriptyline. 55 patients came for follow up at 3 months, improvement in headache was seen in 29 patients. Conclusion: Psychiatric co-morbidity was present in more than 50% patients with CDH and its presence along with a duration of ≥2 years was associated with a poor response to treatment.

  14. A review of autism spectrum disorders children co-morbid attention deficit hyperactivity disorder%孤独症谱系障碍共患注意力缺陷多动障碍的研究进展

    Institute of Scientific and Technical Information of China (English)

    李堃

    2016-01-01

    研究发现,很多孤独症谱系障碍(autism spectrum disorders,ASD)儿童伴有不同程度的注意力缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)的症状.与单纯ASD儿童相比,共患病儿童的ASD症状更明显,认知功能也受损更严重,其生活也会受到影响.该文对目前共患ADHD的ASD儿童临床表现以及执行功能的相关研究做出综述.%In recent several decades, studies have reported the representation of attention deficit/hyperactivity disorder(ADHD) symptoms could co-morbid in children with autism spectrum disorders(ASD).Compared with the ASD-only group, children with both ADHD and ASD often have a more obvious representation of autism symptom as well as more impaired cognitive functions which could deeply impact on their daily life.There is a brief review of observation and executive functions in ASD children co-morbid ADHD-symptoms.

  15. Sleep EEG findings in ICD-10 borderline personality disorder in Egypt.

    Science.gov (United States)

    Asaad, Tarek; Okasha, Tarek; Okasha, Ahmed

    2002-09-01

    Previous work has demonstrated that patients with borderline personality disorder show some similarities to patients with major depression, especially regarding their sleep profile. This study aimed at investigating such a hypothesis in an Egyptian sample, considering the possible influence of cultural differences. All night polysomnographic assessments were made for 20 ICD-10 diagnosed borderline patients (without co-morbid depression), in addition to 20 patients with major depression and 20 healthy matched controls. The two patient groups differed significantly from controls in their sleep profile, especially regarding sleep continuity measures, decreased SWS and REM sleep abnormalities. High similarity was found in EEG sleep profile of the two patient groups, though the changes were more robust in patients with depression. The small number of subjects precluded finer analyses of sleep microstructure by depressive symptoms. The great similarity in EEG sleep profile between borderline personality disorder patients and patients with major depression suggests a common biological origin for both conditions, with the difference being 'quantitative' rather than 'qualitative'. Our data are all the more compelling in that the presumed personality disturbance in the Egyptian culture manifests neurophysiologically as in the Western world.

  16. Voxel-based morphometry in women with borderline personality disorder with and without comorbid posttraumatic stress disorder.

    Directory of Open Access Journals (Sweden)

    Inga Niedtfeld

    Full Text Available Patients with Borderline Personality Disorder (BPD showed reduced volume of amygdala and hippocampus, but similar findings are evident in Posttraumatic Stress Disorder (PTSD. Applying voxel-based morphometry (VBM in a larger cohort of patients with BPD, we sought to extend earlier findings of volume abnormalities in limbic regions and to evaluate the influence of co-occurring PTSD in BPD patients. We used voxel-based morphometry to study gray matter volume (GMV in 60 healthy controls (HC and 60 patients with BPD. Subgroup analyses on 53 patients concerning the role of co-occurring PTSD were conducted. Additionally, regression analyses were calculated to assess the relation between borderline symptom severity as well as dissociative experiences and GMV. Differences in local GMV between patients with BPD and HC were observed in the amygdale and hippocampus as well as in the fusiform and cingulate gyrus. Co-occurring PTSD was accompanied by increased GMV in the superior temporal gyrus and dorsolateral prefrontal cortex. Independent of co-occurring PTSD, severity of BPD symptoms predicted smaller GMV in the amygdala and dorsal ACC. Dissociation was positively related to GMV in the middle temporal gyrus. We could replicate earlier findings of diminished limbic GMV in patients with BPD and additionally show that patients with co-morbid PTSD feature increased GMV in prefrontal regions associated with cognitive control.

  17. Brief Report: Children with ADHD without Co-Morbid Autism Do Not Have Impaired Motor Proficiency on the Movement Assessment Battery for Children

    Science.gov (United States)

    Papadopoulos, Nicole; Rinehart, Nicole; Bradshaw, John L.; McGinley, Jennifer L.

    2013-01-01

    Motor proficiency was investigated in a sample of children with Attention Deficit Hyperactivity Disorder-Combined type (ADHD-CT) without autism. Accounting for the influence of co-morbid autistic symptoms in ADHD motor studies is vital given that motor impairment has been linked to social-communication symptoms in children who have co-morbid ADHD…

  18. Relationship between obsessive-compulsive personality disorder and obsessive-compulsive disorder.

    Science.gov (United States)

    Diaferia, G; Bianchi, I; Bianchi, M L; Cavedini, P; Erzegovesi, S; Bellodi, L

    1997-01-01

    This study investigated the presence of obsessive-compulsive personality disorder (OCPD) in a group of 277 patients (88 with obsessive-compulsive disorder [OCD], 58 with major depressive disorder [MDD], and 131 with panic disorder [Panic]) to test the specificity of the relationship between OCPD and OCD. OCPD is statistically significantly more frequent in patients with OCD than in those with Panic and MDD. The distribution of single criteria of OCPD in the three groups does not differ significantly. Discriminant analysis selects a list of items that provide a correct classification rate of 66% based on OCPD criteria selected by canonical function. OCD patients with and without OCPD do not differ in sex, age of onset, duration of illness, positive family history for Tics disorder/Tourette syndrome (TS), or morbidity risk for OCD.

  19. The effect of co-morbid depression and anxiety on the course and outcome of alcohol outpatient treatment

    DEFF Research Database (Denmark)

    Mellentin, Angelina Isabella; Nielsen, Bent; Stenager, Elsebeth

    2015-01-01

    Background: Studies examining the effect of alcohol treatment among patients with alcohol use disorders (AUD) and co-morbid depression and/or anxiety are few and show inconsistent, but mainly negative drinking outcomes. Aims: To describe the prevalence of anxiety and depression among Danish....... No difference was found between patients with and without co-morbidity. Conclusion: In contrast to the majority of prior studies, this study provides evidence that depression and anxiety do not have an effect on alcohol treatment. However, because of the naturalistic setting, a number of limitations should...

  20. Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Mayer, J.S.; Hees, K.; Medda, J.; Grimm, O.; Asherson, P.; Bellina, M.; Colla, M.; Ibanez, P.; Koch, E.; Martinez-Nicolas, A.; Muntaner-Mas, A.; Rommel, A.; Rommelse, N.N.J.; Ruiter, S.W. de; Ebner-Priemer, U.W.; Kieser, M.; Ortega, F.B.; Thome, J.; Buitelaar, J.K.; Kuntsi, J.; Ramos-Quiroga, J.A.; Reif, A.; Freitag, C.M.

    2018-01-01

    BACKGROUND: The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently

  1. Subtyping borderline personality disorder by suicidal behavior.

    Science.gov (United States)

    Soloff, Paul H; Chiappetta, Laurel

    2012-06-01

    Course and outcome of Borderline Personality Disorder (BPD) are favorable for the vast majority of patients; however, up to 10% die by suicide. This discrepancy begs the question of whether there is a high lethality subtype in BPD, defined by recurrent suicidal behavior and increasing attempt lethality over time. In a prospective, longitudinal study, we sought predictors of high lethality among repeat attempters, and defined clinical subtypes by applying trajectory analysis to consecutive lethality scores. Criteria-defined subjects with BPD were assessed using standardized instruments and followed longitudinally. Suicidal behavior was assessed on the Columbia Suicide History, Lethality Rating Scale, and Suicide Intent Scale. Variables discriminating single and repeat attempters were entered into logistic regression models to define predictors of high and low lethality attempts. Trajectory analysis using three attempt and five attempt models identified discrete patterns of Lethality Rating Scale scores. A high lethality trajectory was associated with inpatient recruitment, and poor psychosocial function, a low lethality trajectory with greater Negativism, Substance Use Disorders, Histrionic and/or Narcissistic PD co-morbidity. Illness severity, older age, and poor psychosocial function are characteristics of a poor prognosis subtype related to suicidal behavior.

  2. Causal pathways between substance use disorders and personality pathology

    NARCIS (Netherlands)

    Verheul, R.; van den Brink, W.

    2005-01-01

    A high co-occurrence between personality and substance use disorders suggests causal relationships between these conditions. Most empirical evidence strongly supports causal pathways in which (pathological) personality traits contribute to the development of a substance use disorder (i.e., primary

  3. ‘Everything’s from the inside out with PCOS’: Exploring women’s experiences of living with polycystic ovary syndrome and co-morbidities through Skype™ interviews

    Directory of Open Access Journals (Sweden)

    Sophie Williams

    2015-08-01

    Full Text Available Polycystic ovary syndrome is an endocrine disorder affecting 1 in 10 women. Women with polycystic ovary syndrome can experience co-morbidities, including depressive symptoms. This research explores the experience of living with polycystic ovary syndrome and co-morbidities. Totally, 10 participants with polycystic ovary syndrome took part in Skype™ interviews and analysed using thematic analysis. Four themes emerged from the data: change (to life plans and changing nature of condition; support (healthcare professionals, education and relationships; co-morbidities (living with other conditions and depression, self-harm and suicidal ideation and identity (feminine identity and us and them. The findings highlight the need for screening of women with polycystic ovary syndrome for depressive disorders.

  4. Effects of serotonin-2A receptor binding and gender on personality traits and suicidal behavior in borderline personality disorder.

    Science.gov (United States)

    Soloff, Paul H; Chiappetta, Laurel; Mason, Neale Scott; Becker, Carl; Price, Julie C

    2014-06-30

    Impulsivity and aggressiveness are personality traits associated with a vulnerability to suicidal behavior. Behavioral expression of these traits differs by gender and has been related to central serotonergic function. We assessed the relationships between serotonin-2A receptor function, gender, and personality traits in borderline personality disorder (BPD), a disorder characterized by impulsive-aggression and recurrent suicidal behavior. Participants, who included 33 BPD patients and 27 healthy controls (HC), were assessed for Axis I and II disorders with the Structured Clinical Interview for DSM-IV and the International Personality Disorders Examination, and with the Diagnostic Interview for Borderline Patients-Revised for BPD. Depressed mood, impulsivity, aggression, and temperament were assessed with standardized measures. Positron emission tomography with [(18)F]altanserin as ligand and arterial blood sampling was used to determine the binding potentials (BPND) of serotonin-2A receptors in 11 regions of interest. Data were analyzed using Logan graphical analysis, controlling for age and non-specific binding. Among BPD subjects, aggression, Cluster B co-morbidity, antisocial PD, and childhood abuse were each related to altanserin binding. BPND values predicted impulsivity and aggression in BPD females (but not BPD males), and in HC males (but not HC females.) Altanserin binding was greater in BPD females than males in every contrast, but it did not discriminate suicide attempters from non-attempters. Region-specific differences in serotonin-2A receptor binding related to diagnosis and gender predicted clinical expression of aggression and impulsivity. Vulnerability to suicidal behavior in BPD may be related to serotonin-2A binding through expression of personality risk factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Narcissistic disorder and the failure of symbolisation: a Relational Affective Hypothesis.

    Science.gov (United States)

    Mizen, C S

    2014-09-01

    The psychoanalytic concept of narcissistic disorder is broader than that of Narcissistic Personality Disorder (DSM-5 [1]), underlying a range of Personality Disorders (PD) and their co-morbidities. Existing Mentalisation, Psychoanalytic and Cognitive models, fail to account fully for the emerging evidence of biological, developmental, relational and defensive contributions to narcissistic disorder, nor do they account for the common and variant features of co-morbidities namely Anorexia Nervosa, Somatisation, Substance Misuse and Autistic Spectrum Disorder. Alexithymia and concrete modes of relating are common findings in narcissistic disorder and these co-morbid conditions. Current models do not provide a comprehensive account, on the basis of neuro-scientific and developmental evidence, of how affective feelings come to be represented in words and the association between narcissistic disorders and failures of symbolisation. In this paper I propose an empirically based Relational Affective Hypothesis that narcissistic disorder and its comorbidities represent failures at specific points on a representational function pathway through which subcortical affect and visceral feeling in a relational context become the basis for abstraction and language. The elucidation of this pathway allows investigation of the contribution of biological, social and psychogenic factors in narcissistic disorders. It also brings a new understanding of the neurological underpinning of psychodynamic defences in narcissistic disorders. Research and novel treatment implications are briefly considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Associations in the Course of Personality Disorders and Axis I Disorders Over Time

    Science.gov (United States)

    Shea, M. Tracie; Yen, Shirley; Pagano, Maria E.; Morey, Leslie C.; McGlashan, Thomas H.; Grilo, Carlos M.; Sanislow, Charles A.; Stout, Robert L.; Skodol, Andrew E.; Gunderson, John G.; Bender, Donna S.; Zanarini, Mary C.

    2012-01-01

    In this study, the authors examined time-varying associations between schizotypal (STPD), borderline (BPD), avoidant (AVPD), or obsessive–compulsive (OCPD) personality disorders and co-occurring Axis I disorders in 544 adult participants from the Collaborative Longitudinal Personality Disorders Study. The authors tested predictions of specific longitudinal associations derived from a model of crosscutting psychobiological dimensions (L. J. Siever & K. L. Davis, 1991) with participants with the relevant Axis I disorders. The authors assessed participants at baseline and at 6-, 12-, and 24-month follow-up evaluations. BPD showed significant longitudinal associations with major depressive disorder and posttraumatic stress disorder. AVPD was significantly associated with anxiety disorders (specifically social phobia and obsessive–compulsive disorder). Two of the four personality disorders under examination (STPD and OCPD) showed little or no association with Axis I disorders. PMID:15535783

  7. Compulsive masturbation in a patient with delusional disorder

    OpenAIRE

    Sagar Karia; Avinash De Sousa; Nilesh Shah; Sushma Sonavane

    2015-01-01

    Compulsive masturbation is a type of paraphilia related disorder in which a person engages in masturbatory behavior to such an extent that it causes socio-occupational dysfunction. The psychiatric co-morbidities associated with it include mood and anxiety disorders, substance use disorders, etc. Here, we report a case of a patient with the delusional disorder having compulsive masturbation.

  8. Obesity and psychotic disorders: uncovering common mechanisms through metabolomics

    Directory of Open Access Journals (Sweden)

    Matej Orešič

    2012-09-01

    Full Text Available Primary obesity and psychotic disorders are similar with respect to the associated changes in energy balance and co-morbidities, including metabolic syndrome. Such similarities do not necessarily demonstrate causal links, but instead suggest that specific causes of and metabolic disturbances associated with obesity play a pathogenic role in the development of co-morbid disorders, potentially even before obesity develops. Metabolomics – the systematic study of metabolites, which are small molecules generated by the process of metabolism – has been important in elucidating the pathways underlying obesity-associated co-morbidities. This review covers how recent metabolomic studies have advanced biomarker discovery and the elucidation of mechanisms underlying obesity and its co-morbidities, with a specific focus on metabolic syndrome and psychotic disorders. The importance of identifying metabolic markers of disease-associated intermediate phenotypes – traits modulated but not encoded by the DNA sequence – is emphasized. Such markers would be applicable as diagnostic tools in a personalized healthcare setting and might also open up novel therapeutic avenues.

  9. Understanding Obsessive-Compulsive Personality Disorder

    OpenAIRE

    Steven C. Hertler

    2013-01-01

    With the ultimate goal of better understanding Obsessive-Compulsive Personality Disorder (OCPD), the present work is a review and critique of Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) diagnostic criteria at the end of their 18 years of use. Problems of specificity (polythetic criteria and failure to employ a hallmark feature) make OCPD an indistinct diagnostic category that consequently co...

  10. Post-Traumatic Stress Disorder and severe maternal morbidity: is there an association?

    Science.gov (United States)

    Angelini, Carina R; Pacagnella, Rodolfo C; Parpinelli, Mary A; Silveira, Carla; Andreucci, Carla B; Ferreira, Elton C; Santos, Juliana P; Zanardi, Dulce M; Souza, Renato T; Cecatti, Jose G

    2018-01-01

    To evaluate the occurrence of Post-Traumatic Stress Disorder among women experiencing a severe maternal morbidity event and associated factors in comparison with those without maternal morbidity. In a retrospective cohort study, 803 women with or without severe maternal morbidity were evaluated at 6 months to 5 years postpartum for the presence of Post-Traumatic Stress Disorder. Interviews were conducted by telephone and electronic data was stored. Data analysis was carried out by using χ2, Fisher's Exact test, and logistic regression analysis. There was no significant change in the prevalence of Post-Traumatic Stress Disorder related to a previous severe maternal morbidity experience. There were also no differences in diagnostic criteria for severe maternal morbidity (hypertensive syndromes, hemorrhage, surgical intervention or intensive care unit admission required, among other management criteria). Low parity (2.5-fold risk) and increasing age were factors associated with Post-Traumatic Stress Disorder. A severe maternal morbidity episode is not associated with Post-Traumatic Stress Disorder symptoms within five years of the severe maternal morbidity event and birth. However, a more advanced maternal age and primiparity increased the risk of Post-Traumatic Stress Disorder. This does not imply that women who had experienced a severe maternal morbidity event did not suffer or need differentiated care.

  11. The co-occurrence of autistic traits and borderline personality disorder traits is associated to increased suicidal ideation in nonclinical young adults.

    Science.gov (United States)

    Chabrol, Henri; Raynal, Patrick

    2018-04-01

    The co-occurrence of Autism Spectrum Disorder (ASD) and Borderline Personality Disorder (BPD) is not rare and has been linked to increased suicidality. Despite this significant comorbidity between ASD and BPD, no study had examined the co-occurrence of autistic traits and borderline personality disorder traits in the general population. The aim of the present study was to examine the co-occurrence of autistic and borderline traits in a non-clinical sample of young adults and its influence on the levels of suicidal ideation and depressive symptomatology. Participants were 474 college students who completed self-report questionnaires. Data were analysed using correlation and cluster analyses. Borderline personality traits and autistic traits were weakly correlated. However, cluster analysis yielded four groups: a low traits group, a borderline traits group, an autistic traits group, and a group characterized by high levels of both traits. Cluster analysis revealed that autistic and borderline traits can co-occur in a significant proportion of young adults. The high autistic and borderline traits group constituted 17% of the total sample and had higher level of suicidal ideation than the borderline traits group, despite similar levels of depressive symptoms. This result suggests that the higher suicidality observed in patients with comorbid ASD and BPD may extent to non-clinical individuals with high levels of co-occurrent autistic and borderline traits. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Social cognition in borderline personality disorder

    Directory of Open Access Journals (Sweden)

    Stefan eRoepke

    2013-01-01

    Full Text Available Many typical symptoms of borderline personality disorder (BPD occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent, the research focusing on accuracy in inferring mental states (i.e., cognitive empathy is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010. A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions, the deficits in attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention.

  13. Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients.

    Science.gov (United States)

    Kuipers, Greet S; van Loenhout, Zara; van der Ark, L Andries; Bekker, Marrie H J

    2016-01-01

    To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires. Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables. Eating disorder patients' low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.

  14. Psychotropic medication management in persons with co-occurring psychiatric and substance use disorders.

    Science.gov (United States)

    Sowers, W; Golden, S

    1999-01-01

    Persons presenting with concurrent psychiatric and substance problems present unique challenges for diagnosis and for effective and rational treatment planning. This is especially true for psychiatrists attempting to prescribe pharmacologic interventions which will promote recovery from both disorders and improve function. In order to be effective in this endeavor it is important to have a clear understanding of the dynamics of addiction as well as the particular issues and struggles related to mental illness which will affect an individual's attitude toward and use of medication. This article discusses some of the common problems related to diagnostic decision making and initiation of medication in persons with co-occurring disorders. An algorithm for guiding these decisions is presented. Common misconceptions held by these individuals regarding medication, as distinguished from "drugs," are considered. Unique psychodynamic issues that may lead these persons to actively seek medication as a solution to their problems, or which may, conversely, lead them to an outright rejection of medication as a part of their recovery, are discussed. Countertransferential issues influencing the physician's approach to prescribing for this population are also considered. The article concludes with recommendations for pharmacologic approaches to address specific psychiatric syndromes which may present in this population.

  15. [Tuberculosis and diabetes co-morbidity: an unresolved problem].

    Science.gov (United States)

    Ugarte-Gil, César; Moore, David A J

    2014-01-01

    Co-morbidity between tuberculosis and diabetes has been described since the early 20th century. In developed countries, where there has been a decrease of infectious diseases with an increase of non-communicable diseases, as well as those countries who still have a high prevalence of infectious diseases but an increase of non-communicable diseases, it is observed that the prevalence of co-morbidity between tuberculosis and diabetes is increasing, making clinical management and control at the public health level a new challenge for health systems. This review aims to show the current available evidence that can inform research lines being developed to understand the problem. In countries like Peru, where there is an epidemiological transition, further research could allow us to understand and describe in a better way the characteristics and impact of this co-morbidity.

  16. Personality disorders in substance abusers: Validation of the DIP-Q through principal components factor analysis and canonical correlation analysis

    Directory of Open Access Journals (Sweden)

    Hesse Morten

    2005-05-01

    Full Text Available Abstract Background Personality disorders are common in substance abusers. Self-report questionnaires that can aid in the assessment of personality disorders are commonly used in assessment, but are rarely validated. Methods The Danish DIP-Q as a measure of co-morbid personality disorders in substance abusers was validated through principal components factor analysis and canonical correlation analysis. A 4 components structure was constructed based on 238 protocols, representing antagonism, neuroticism, introversion and conscientiousness. The structure was compared with (a a 4-factor solution from the DIP-Q in a sample of Swedish drug and alcohol abusers (N = 133, and (b a consensus 4-components solution based on a meta-analysis of published correlation matrices of dimensional personality disorder scales. Results It was found that the 4-factor model of personality was congruent across the Danish and Swedish samples, and showed good congruence with the consensus model. A canonical correlation analysis was conducted on a subset of the Danish sample with staff ratings of pathology. Three factors that correlated highly between the two variable sets were found. These variables were highly similar to the three first factors from the principal components analysis, antagonism, neuroticism and introversion. Conclusion The findings support the validity of the DIP-Q as a measure of DSM-IV personality disorders in substance abusers.

  17. Exploring the relationship between posttraumatic stress disorder and deliberate self-harm: the moderating roles of borderline and avoidant personality disorders.

    Science.gov (United States)

    Gratz, Kim L; Tull, Matthew T

    2012-08-30

    Despite increasing evidence for an association between posttraumatic stress disorder (PTSD) and deliberate self-harm (DSH), few studies have examined the factors that moderate this association or the impact of co-occurring personality disorders among individuals with PTSD on DSH frequency. Given the high rates of co-occurrence between PTSD and two personality disorders of particular relevance to DSH, borderline personality disorder (BPD) and avoidant personality disorder (AVPD), this study examined the moderating role of these personality disorders in the association between PTSD and DSH frequency among a sample of substance use disorder patients (N=61). Patients completed structured clinical interviews assessing PTSD, BPD, and AVPD and a questionnaire assessing DSH. Results revealed more frequent DSH among patients with (vs. without) PTSD and provided evidence for the moderating role of AVPD in this association. Specifically, results revealed heightened levels of DSH only among PTSD patients with co-occurring AVPD. Findings are consistent with past research demonstrating that the presence of co-occurring AVPD among patients with other Axis I and II disorders is associated with worse outcomes, and highlight the importance of continuing to examine the moderating role of AVPD in the association between PTSD and a variety of health-risk behaviors. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Compulsive masturbation in a patient with delusional disorder

    Directory of Open Access Journals (Sweden)

    Sagar Karia

    2015-01-01

    Full Text Available Compulsive masturbation is a type of paraphilia related disorder in which a person engages in masturbatory behavior to such an extent that it causes socio-occupational dysfunction. The psychiatric co-morbidities associated with it include mood and anxiety disorders, substance use disorders, etc. Here, we report a case of a patient with the delusional disorder having compulsive masturbation.

  19. A study of phenomenology, psychiatric co-morbidities, social and adaptive functioning in children and adolescents with OCD.

    Science.gov (United States)

    Agarwal, Vivek; Yaduvanshi, Rakesh; Arya, Amit; Gupta, Pawan Kumar; Sitholey, Prabhat

    2016-08-01

    To study the phenomenology, social, adaptive and global functioning of children and adolescents with OCD. Studies have shown varying prevalence of paediatric OCD ranging from 1% to 4%. Childhood-onset OCD have some important differences in sex distribution, presentation, co-morbidities and insight. 25 subjects (6 to ≤18 years) with a DSM-IV-TR diagnosis of OCD were included in this study. Subjects were evaluated using K-SADS-PL, Children's Y-BOCS, HoNOSCA, C-GAS and VABS-II. The mean age of the sample was 14.9±2.2 years. Obsession of contamination was commonest (68%) followed by aggressive obsession (60%); commonest compulsions were washing and cleaning (72%) followed by checking (56%). Most distressing obsessions were obsession of doubt about their decision (28%), having horrible thoughts about their family being hurt (20%) and thought that something terrible is going to happen and it will be their fault (16%). Most subjects rate spending far too much time in washing hands (60%) as most distressing compulsion, followed by rewriting and checking compulsions (both 12%). 76% subjects have co-morbid psychiatric diagnosis. Anxiety disorders (24%), depression (16%), and dissociative disorder (16%) were common co-morbidities. Mean C-GAS score of the sample was 53.2±9.9. 44% of subjects had below average adaptive functioning. The study shows that, most frequent obsessions and compulsions may be different from most distressing ones and this finding might have clinical implication. Most of the children and adolescent with OCD have co-morbidities. Children also had problems in adaptive functioning. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults.

    Science.gov (United States)

    Wuthrich, V M; Rapee, R M; Kangas, M; Perini, S

    2016-03-01

    Co-morbid anxiety and depression in older adults is associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments in older adults. However, there is a paucity of research focused on testing the efficacy of the co-morbid treatment of anxiety and depression in older adults using psychological interventions. Accordingly, the primary objective of the current study was to test the effects of a group cognitive behavior therapy (CBT) program in treating co-morbid anxiety and depression in a sample of older age adults. A total of 133 community-dwelling participants aged ⩾60 years (mean age = 67.35, s.d. = 5.44, male = 59) with both an anxiety disorder and unipolar mood disorder, as assessed on the Anxiety Disorder Interview Schedule (ADIS), were randomly allocated to an 11-week CBT group or discussion group. Participants with Mini-Mental State Examination scores <26 were excluded. Participants were assessed pre-treatment, post-treatment and at 6 months follow-up on the ADIS, a brief measure of well-being, Geriatric Anxiety Inventory and Geriatric Depression Scale. Both conditions resulted in significant improvements over time on all diagnostic, symptom and wellbeing measures. Significant group × time interaction effects emerged at post-treatment only for diagnostic severity of the primary disorder, mean severity of all anxiety disorders, mood disorders, and all disorders, and recovery rates on primary disorder. Group CBT produced faster and sustained improvements in anxiety and depression on diagnostic severity and recovery rates compared to an active control in older adults.

  1. The epidemiology of vertigo, dizziness and unsteadiness and its links to co-morbidities.

    Directory of Open Access Journals (Sweden)

    Alexandre eBisdorff

    2013-03-01

    Full Text Available Vertigo, dizziness and unsteadiness (VDU are common symptoms traditionally considered to result from different kinds of vestibular and non-vestibular dysfunctions. The epidemiology of each symptom and how they relate to each other and to migraine, agoraphobia, motion sickness susceptibility (MSS, vaso-vagal episodes (VVE and anxiety-depression (AD was the object of this population-based study in north-eastern France. A self-administered questionnaire was returned by 2987 adults (age span 18-86 years, 1471 women. The 1-year prevalence for vertigo was 48.3%, for unsteadiness 39.1% and for dizziness 35.6%. The three symptoms were correlated with each other, occurred mostly (69.4% in various combinations rather than in isolation, less than once per month, and 90% of episodes lasted ≤ 2 minutes. The three symptoms were similar in terms of female predominance, temporary profile of the episodes and their link to falls and nausea. Symptom episodes of >1 hour increase the risk of falls. VDU are much more common than the known prevalence of vestibular disorders. The number of drugs taken increase VDU even when controlling for age. Each VDU symptom was correlated with each co-morbidity in Chi2 tests. The data suggest that the three symptoms are more likely to represent a spectrum resulting from a range of similar — rather than from different, unrelated — mechanisms or disorders. Logistic regressions controlling for each vestibular symptom showed that vertigo correlated with each co-morbidity but dizziness and unsteadiness did not, suggesting that vertigo is certainly not a more specific symptom than the other two. A logistic regression using a composite score of VDU, controlling for each co-morbidity showed a correlation of VDU to migraine and VVE but not to MSS and not to agoraphobia in men, only in women.

  2. A systematic review of personality disorder, race and ethnicity: prevalence, aetiology and treatment

    Directory of Open Access Journals (Sweden)

    Lee Tennyson

    2010-05-01

    Full Text Available Abstract Background Although psychoses and ethnicity are well researched, the importance of culture, race and ethnicity has been overlooked in Personality Disorders (PD research. This study aimed to review the published literature on ethnic variations of prevalence, aetiology and treatment of PD. Method A systematic review of studies of PD and race, culture and ethnicity including a narrative synthesis of observational data and meta-analyses of prevalence data with tests for heterogeneity. Results There were few studies with original data on personality disorder and ethnicity. Studies varied in their classification of ethnic group, and few studies defined a specific type of personality disorder. Overall, meta-analyses revealed significant differences in prevalence between black and white groups (OR 0.476, CIs 0.248 - 0.915, p = 0.026 but no differences between Asian or Hispanic groups compared with white groups. Meta-regression analyses found that heterogeneity was explained by some study characteristics: a lower prevalence of PD was reported among black compared with white patients in UK studies, studies using case-note diagnoses rather than structured diagnostic interviews, studies of borderline PD compared with the other PD, studies in secure and inpatient compared with community settings, and among subjects with co-morbid disorders compared to the rest. The evidence base on aetiology and treatment was small. Conclusion There is some evidence of ethnic variations in prevalence of personality disorder but methodological characteristics are likely to account for some of the variation. The findings may indicate neglect of PD diagnosis among ethnic groups, or a true lower prevalence amongst black patients. Further studies are required using more precise cultural and ethnic groups.

  3. A systematic review of personality disorder, race and ethnicity: prevalence, aetiology and treatment.

    Science.gov (United States)

    McGilloway, Angela; Hall, Ruth E; Lee, Tennyson; Bhui, Kamaldeep S

    2010-05-11

    Although psychoses and ethnicity are well researched, the importance of culture, race and ethnicity has been overlooked in Personality Disorders (PD) research. This study aimed to review the published literature on ethnic variations of prevalence, aetiology and treatment of PD. A systematic review of studies of PD and race, culture and ethnicity including a narrative synthesis of observational data and meta-analyses of prevalence data with tests for heterogeneity. There were few studies with original data on personality disorder and ethnicity. Studies varied in their classification of ethnic group, and few studies defined a specific type of personality disorder. Overall, meta-analyses revealed significant differences in prevalence between black and white groups (OR 0.476, CIs 0.248 - 0.915, p = 0.026) but no differences between Asian or Hispanic groups compared with white groups. Meta-regression analyses found that heterogeneity was explained by some study characteristics: a lower prevalence of PD was reported among black compared with white patients in UK studies, studies using case-note diagnoses rather than structured diagnostic interviews, studies of borderline PD compared with the other PD, studies in secure and inpatient compared with community settings, and among subjects with co-morbid disorders compared to the rest. The evidence base on aetiology and treatment was small. There is some evidence of ethnic variations in prevalence of personality disorder but methodological characteristics are likely to account for some of the variation. The findings may indicate neglect of PD diagnosis among ethnic groups, or a true lower prevalence amongst black patients. Further studies are required using more precise cultural and ethnic groups.

  4. Is research on borderline personality disorder underfunded by the National Institute of Health?

    Science.gov (United States)

    Zimmerman, Mark; Gazarian, Doug

    2014-12-30

    The relationship between bipolar disorder and borderline personality disorder has generated intense interest. Similar to patients with bipolar disorder, patients with borderline personality disorder are frequently hospitalized, are chronically unemployed, abuse substances, attempt and commit suicide. However, one significant difference between the two disorders is that patients with borderline personality disorder are often viewed negatively by mental health professionals. In the present paper we examined whether this negative bias against borderline personality disorder might be reflected in the level of research funding on the disorder. We searched the National Institute of Health (NIH) Research Portfolio Online Portfolio Reporting Tool (RePORT) for the past 25 years and compared the number of grants funded and the total amount of funding for borderline personality disorder and bipolar disorder. The yearly mean number of grants receiving funding was significantly higher for bipolar disorder than for borderline personality disorder. Results were the same when focusing on newly funded grants. For every year since 1990 more grants were funded for bipolar disorder than borderline personality disorder. Summed across all 25 years, the level of funding for bipolar disorder was more than 10 times greater than the level of funding for borderline personality disorder ($622 million vs. $55 million). These findings suggest that the level of NIH research funding for borderline personality disorder is not commensurate with the level of psychosocial morbidity, mortality, and health expenditures associated with the disorder.

  5. Personality disorders and normal personality dimensions in obsessive-compulsive disorder.

    Science.gov (United States)

    Samuels, J; Nestadt, G; Bienvenu, O J; Costa, P T; Riddle, M A; Liang, K Y; Hoehn-Saric, R; Grados, M A; Cullen, B A

    2000-11-01

    Little is known about personality disorders and normal personality dimensions in relatives of patients with obsessive-compulsive disorder (OCD). To determine whether specific personality characteristics are part of a familial spectrum of OCD. Clinicians evaluated personality disorders in 72 OCD case and 72 control probands and 198 case and 207 control first-degree relatives. The selfcompleted Revised NEO Personality Inventory was used for assessment of normal personality dimensions. The prevalence of personality disorders and scores on normal personality dimensions were compared between case and control probands and between case and control relatives. Case probands and case relatives had a high prevalence of obsessive-compulsive personality disorder (OCPD) and high neuroticism scores. Neuroticism was associated with OCPD in case but not control relatives. Neuroticism and OCPD may share a common familial aetiology with OCD.

  6. Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness.

    Science.gov (United States)

    Kacel, Elizabeth L; Ennis, Nicole; Pereira, Deidre B

    2017-01-01

    Narcissistic Personality Disorder (NPD) is characterized by a persistent pattern of grandiosity, fantasies of unlimited power or importance, and the need for admiration or special treatment. Individuals with NPD may experience significant psychological distress related to interpersonal conflict and functional impairment. Research suggests core features of the disorder are associated with poor prognosis in therapy, including slow progress to behavioral change, premature patient-initiated termination, and negative therapeutic alliance. The current manuscript will explore challenges of working with NPD within the context of life-limiting illness for two psychotherapy patients seen in a behavioral health clinic at a large academic health science center. The ways in which their personality disorder affected their illness-experience shared significant overlap characterized by resistance to psychotherapeutic change, inconsistent adherence to medical recommendations, and volatile relationships with providers. In this manuscript we will (1) explore the ways in which aspects of narcissistic personality disorder impacted the patients' physical health, emotional well-being, and healthcare utilization; (2) describe psychotherapeutic methods that may be useful for optimizing psychosocial, behavioral, and physical well-being in individuals with co-morbid NPD and life-limiting disease; and (3) review conceptualizations of NPD from the DSM-5 alternative model for assessing personality function via trait domains.

  7. Comorbid personality disorders and violent behavior in psychotic patients.

    Science.gov (United States)

    Volavka, Jan

    2014-03-01

    Schizophrenia without any comorbidity confers a modest, but statistically significant elevation of the risk for violence. That risk is considerably increased by comorbid antisocial personality disorder or psychopathy as well as by comorbid substance use disorders. These comorbidities are frequent. Conduct disorder and conduct disorder symptoms elevate the risk for aggressive behavior in patients with schizophrenia. Violence among adults with schizophrenia may follow at least two distinct pathways-one associated with premorbid conditions, including antisocial conduct, and another associated with the acute psychopathology of schizophrenia. Aggressive behavior in bipolar disorder occurs mainly during manic episodes, but it remains elevated in euthymic patients in comparison with controls. The risk of violent behavior is increased by comorbidity with borderline personality disorder, antisocial personality disorder, and substance use disorders. These comorbidities are frequent. Borderline personality disorder and bipolar disorder are related in their phenomenology and response to medication. These two disorders share a tendency to impulsiveness, and impulsive behavior, including impulsive aggression, is particularly expressed when they co-occur.

  8. Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study

    Directory of Open Access Journals (Sweden)

    Ethy Dorrepaal

    2013-11-01

    Full Text Available Background: In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD and personality disorders (PDs are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. Objective: In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. Method: In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive (N=14 with the non-adaptive patients (N=24 as revealed by a cluster analysis. Results: We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles “withdrawn” and “aggressive,” were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Conclusion: Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.

  9. Co-morbidities of COPD in primary care: frequency, relation to COPD, and treatment consequences.

    Science.gov (United States)

    van der Molen, Thys

    2010-12-01

    In the Western world, chronic obstructive pulmonary disease (COPD) is predominantly caused by long-term smoking, which results in pulmonary inflammation that is often associated with systemic inflammation. A number of co-morbid conditions, such as cardiovascular disease, muscle wasting, type 2 diabetes and asthma, may coexist with COPD; these and other co-morbidities not directly related to COPD are major causes of excess morbidity and mortality. This review sets out to explore the most frequent co-morbidities in COPD and their implications for treatment. Review of the literature on co-morbidities of COPD. Co-morbidities are frequent, but often remain undiagnosed in the COPD patient. In order to provide the best possible care for people with COPD, the physician should be aware of all potential co-morbidities that may arise, and the critical role that effective management of these co-morbidities can play in improving patient outcomes. Increased awareness of the potential co-morbidities of COPD, although potentially adding to the general practitioner's work burden, may provide insights into this difficult disease state and possibly improve each individual's prospects for effective management.

  10. The influence of risperidone on attentional functions in children and adolescents with attention-deficit/hyperactivity disorder and co-morbid disruptive behavior disorder.

    Science.gov (United States)

    Günther, Thomas; Herpertz-Dahlmann, Beate; Jolles, Jellemer; Konrad, Kerstin

    2006-12-01

    This study aims to examine the influence of risperidone on various attentional functions, including intensity and selectivity aspects of attention plus inhibitory control in children with attention deficit/hyperactivity disorder (ADHD) with co-morbid Disruptive Behavior Disorders (DBD) and normal IQ. Children with ADHD and DBD, aged 8-15 years, were treated with risperidone (mean daily dose: 1.5 mg; n = 23) and examined with three attentional paradigms before and after a 4-week treatment period. Age- and IQ-matched normal controls (n = 23) were also tested without medication on the same two occasions. No influence of the medication could be detected for any neuropsychological variable, neither as a positive enhancement nor as adverse side effects. However, clinical symptoms of ADHD and DBD assessed on the IOWA Conners Scale significantly improved after the 4-week treatment period. Divergent behavioral and cognitive effects of risperidone on ADHD symptoms were observed, with a significant reduction in behavioral symptoms, whereas no positive treatment effects were found on laboratory tasks of impulsivity. Thus, the cognitive effects of risperidone seem to differ from the cognitive effects of stimulant treatments in children with ADHD + DBD. However, no negative impact of risperidone was observed on attentional functions either, i.e., there was no slowing of cognitive speed.

  11. Personality Disorders

    Science.gov (United States)

    ... Disorders in Adults Data Sources Share Personality Disorders Definitions Personality disorders represent “an enduring pattern of inner ... MSC 9663 Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS ...

  12. Organization of co-occurring Axis II features in borderline personality disorder.

    Science.gov (United States)

    Critchfield, Kenneth L; Clarkin, John F; Levy, Kenneth N; Kernberg, Otto F

    2008-06-01

    Considerable heterogeneity exists in the comorbid Axis II features that frequently accompany borderline personality disorder (BPD). These features have potential to be meaningfully organized, relate to specific BPD presentation, and have implications for treatment process and outcome. The present study explored patterns of Axis II comorbidity in order to identify subtypes of BPD. A well-defined sample of 90 patients diagnosed with BPD was recruited as part of an RCT study. Participants were administered the International Personality Disorder Examination (Loranger, 1999) to diagnose BPD and assess comorbid Axis II features. Other measures were also administered to assess aspects of current work and relationship functioning, symptomatology, and self-concept. Q-factoring was used to develop subtypes based on commonly occurring Axis II profiles, identifying three: Cluster A (elevated paranoid and schizotypal features), Cluster B (elevated narcissistic and histrionic features), and Cluster C (elevated avoidant and obsessive-compulsive features). An additional factor analysis revealed two dimensions underlying the comorbid features identifiable as: extraversion versus introversion and antagonism versus constraint. Validity of these two maps of comorbidity was explored in terms of the BPD criteria themselves, as well as on work and relationship functioning, identity diffusion, views of self and others, positive and negative affect, behavioural dyscontrol, and symptomatic distress. Clinically meaningful subtypes can be identified for BPD based on co-occurring Axis II features. Further research is needed to replicate and further establish base-rates of these subtypes as well as their differential implications for treatment.

  13. Co-morbid substance use behaviors among youth: any impact of school environment?

    Science.gov (United States)

    Costello, Mary Jean E; Leatherdale, Scott T; Ahmed, Rashid; Church, Dana L; Cunningham, John A

    2012-03-01

    Substance use is common among youth; however, our understanding of co-morbid tobacco, alcohol and marijuana use remains limited. The school-environment may play an important role in the likelihood a student engages in high risk substance use behaviors, including co-morbid use. This study aims to: (i) describe the prevalence of co-morbid substance use behaviors among youth; (ii) identify and compare the characteristics of youth who currently use a single substance, any two substances, and all three substances; (iii) examine if the likelihood of co-morbid use varies by school and; (iv) examine what factors are associated with co-morbid use. This study used nationally representative data collected from students in grades 9 to 12 (n = 41,886) as part of the 2006-2007 Canadian Youth Smoking Survey (YSS). Demographic and behavioral data were collected including, current cigarette, alcohol and marijuana use. Results. 6.5% (n = 107,000) reported current use of all three substances and 20.3% (n = 333,000) of any two substances. Multi-level analysis revealed significant between school variability in the odds a student used all three substances and any two substances; accounting for 16.9% and 13.5% of the variability, respectively. Co-morbid use was associated with sex, grade, amount of available spending money and perceived academic performance. Co-morbid substance use is high among youth; however, not all schools share the same prevalence. Knowing the school characteristics that place particular schools at risk for student substance use is important for tailoring drug and alcohol education programs. Interventions that target the prevention of co-morbid substance use are required.

  14. Comorbid personality disorders in subjects with panic disorder: which personality disorders increase clinical severity?

    OpenAIRE

    Mustafa Ozkan; Abdurrahman Altindag

    2003-01-01

    Personality disorders are common in subjects with panic disorder. Personality disorders have shown to affect the course of panic disorder. The purpose of this study was to examine which personality disorders effect clinical severity in subjects with panic disorder. This study included 122 adults (71 female, 41 male), who met DSM-IV criteria for panic disorder (with or without agoraphobia). Clinical assessment was conducted by using the Structured Clinical Interview for DSM-IV Axis I Disorders...

  15. The Relationship between Concurrent Substance Use Disorders and Eating Disorders with Personality Disorders

    Directory of Open Access Journals (Sweden)

    Christine Courbasson

    2009-07-01

    Full Text Available Objective: The current pilot study investigated whether patients with concurrent substance use disorders and eating disorders (SUD and ED who experienced a reduction in SUD and ED symptoms following treatment for SUD and ED also experienced a reduction in personality disorder (PD symptoms. Method: Twenty patients with SUD and ED and PD were assessed pre and post treatment using clinical interviews, self-report questionnaires, and a therapist questionnaire on DSM-IV-TR symptoms for PD. Results: Symptoms for the personality disorders were reduced following treatment. This reduction was correlated with a decrease in the number of symptoms of ED at post treatment. Discussion: Chronic concurrent SUD and ED may make it difficult to separate PD symptoms from co-occurring disorders. Many features attributed to PDs may be reduced when problematic substance use and disordered eating are addressed, a fact that may increase clinician and patients’optimism about therapeutic change.

  16. Comorbid personality disorders in subjects with panic disorder: which personality disorders increase clinical severity?

    Directory of Open Access Journals (Sweden)

    Mustafa Ozkan

    2003-03-01

    Full Text Available Personality disorders are common in subjects with panic disorder. Personality disorders have shown to affect the course of panic disorder. The purpose of this study was to examine which personality disorders effect clinical severity in subjects with panic disorder. This study included 122 adults (71 female, 41 male, who met DSM-IV criteria for panic disorder (with or without agoraphobia. Clinical assessment was conducted by using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I, the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II and the Panic and Agoraphobia Scale (PAS, Global Assessment Functioning Scale (GAF, Beck Depression Inventory (BDI, and State-Trait Anxiety Inventory (STAI. Patients who had a history of sexual abuse were assessed with Sexual Abuse Severity Scale. Logistic regressions were used to identify predictors of suicide attempts, suicidal ideation, agoraphobia, different panic attack symptoms, sexual abuse, and early onset of disorders. The rates of comorbid Axis I and Axis II psychiatric disorders were 80.3% and 33.9%, consecutively, in patients with panic disorder. Panic disorder patients with comorbid personality disorders had more severe anxiety, depression and agoraphobia symptoms, and had earlier ages of onset, and lower levels of functioning. The rates of suicidal ideation and suicide attempts were 34.8% and 9.8%, consecutively, in subjects with panic disorder. The rate of patients with panic disorder had a history of childhood sexual abuse was 12.5%. The predictor of sexual abuse was more than one comorbid Axis II diagnosis. The predictors of suicide attempt were comorbid paranoid and borderline personality disorders, and the predictor of suicidal ideation was major depressive disorder in subjects with panic disorder. In conclusion, this study documents that comorbid personality disorders increase the clinical severity of panic disorder. Patients with more than one

  17. Differentiating normal and disordered personality using the General Assessment of Personality Disorder (GAPD).

    Science.gov (United States)

    Hentschel, Annett G; John Livesley, W

    2013-05-01

    Criteria to differentiate personality disorder from extremes of normal personality variations are important given growing interest in dimensional classification because an extreme level of a personality dimension does not necessarily indicate disorder. The DSM-5 proposed classification of personality disorder offers a definition of general personality disorder based on chronic interpersonal and self/identity pathology. The ability of this approach to differentiate personality disorder from other mental disorders was evaluated using a self-report questionnaire, the General Assessment of Personality Disorder (GAPD). This measure was administered to a sample of psychiatric patients (N = 149) from different clinical sub-sites. Patients were divided into personality disordered and non-personality disordered groups on the basis of the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). The results showed a hit rate of 82% correct identified patients and a good accuracy of the predicted model. There was a substantial agreement between SCID-II interview and GAPD personality disorder diagnoses. The GAPD appears to predict personality disorder in general, which provides support of the DSM-5 general diagnostic criteria of personality disorder. Copyright © 2012 John Wiley & Sons, Ltd.

  18. Comorbidity of mood and substance use disorders in patients with binge-eating disorder: Associations with personality disorder and eating disorder pathology.

    Science.gov (United States)

    Becker, Daniel F; Grilo, Carlos M

    2015-08-01

    Binge-eating disorder (BED) is associated with elevated rates of mood and substance use disorders, but the significance of such comorbidity is ambiguous. We compared personality disorder and eating disorder psychopathology in four subgroups of BED patients: those with mood disorders, those with substance use disorders, those with both, and those with neither. Subjects were 347 patients who met DSM-IV research criteria for BED. Semistructured interviews evaluated lifetime DSM-IV axis I disorders, DSM-IV personality disorder features, and eating disorder psychopathology. Among these patients, 129 had co-occurring mood disorder, 34 had substance use disorder, 60 had both, and 124 had neither. Groups differed on personality disorder features, with those having mood disorder and both mood and substance use disorders showing the highest frequencies. Although groups did not differ in body mass index or binge eating frequency, they did differ on eating disorder psychopathology-with the groups having mood disorder and both comorbidities demonstrating higher eating, weight, and shape concerns. No differences were observed between groups with respect to ages of onset for specific eating behaviors, but some differences were observed for ages of disorder onset. Mood and substance use disorders co-occur frequently among patients with BED. Compared with a previous work, the additional comparison group (those with both mood and substance use disorders) and the control group (those with neither) afforded better discrimination regarding the significance of these comorbidities. Our findings suggest approaches to subtyping BED based on psychiatric comorbidity, and may also have implications for treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Assessment of Personality Dimensions in Children and Adolescents with Bipolar Disorder Using the Junior Temperament and Character Inventory

    Science.gov (United States)

    Fonseca, Manoela; Caetano, Sheila C.; Hatch, John P.; Hunter, Kristina; Nicoletti, Mark; Pliszka, Steven R.; Cloninger, C. Robert; Soares, Jair C.

    2009-01-01

    Abstract Objective We compared temperament and character traits in children and adolescents with bipolar disorder (BP) and healthy control (HC) subjects. Method Sixty nine subjects (38 BP and 31 HC), 8–17 years old, were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia–Present and Lifetime. Temperament and character traits were measured with parent and child versions of the Junior Temperament and Character Inventory. Results BP subjects scored higher on novelty seeking, harm avoidance, and fantasy subscales, and lower on reward dependence, persistence, self-directedness, and cooperativeness compared to HC (all p adolescents. Higher parent-rated novelty seeking, lower self-directedness, and lower cooperativeness were associated with co-morbid attention-deficit/hyperactivity disorder (ADHD). Lower parent-rated reward dependence was associated with co-morbid conduct disorder, and higher child-rated persistence was associated with co-morbid anxiety. Conclusions These findings support previous reports of differences in temperament in BP children and adolescents and may assist in a greater understating of BP children and adolescents beyond mood symptomatology. PMID:19232019

  20. Sensory symptom profiles and co-morbidities in painful radiculopathy.

    Directory of Open Access Journals (Sweden)

    Friederike Mahn

    Full Text Available Painful radiculopathies (RAD and classical neuropathic pain syndromes (painful diabetic polyneuropathy, postherpetic neuralgia show differences how the patients express their sensory perceptions. Furthermore, several clinical trials with neuropathic pain medications failed in painful radiculopathy. Epidemiological and clinical data of 2094 patients with painful radiculopathy were collected within a cross sectional survey (painDETECT to describe demographic data and co-morbidities and to detect characteristic sensory abnormalities in patients with RAD and compare them with other neuropathic pain syndromes. Common co-morbidities in neuropathic pain (depression, sleep disturbance, anxiety do not differ considerably between the three conditions. Compared to other neuropathic pain syndromes touch-evoked allodynia and thermal hyperalgesia are relatively uncommon in RAD. One distinct sensory symptom pattern (sensory profile, i.e., severe painful attacks and pressure induced pain in combination with mild spontaneous pain, mild mechanical allodynia and thermal hyperalgesia, was found to be characteristic for RAD. Despite similarities in sensory symptoms there are two important differences between RAD and other neuropathic pain disorders: (1 The paucity of mechanical allodynia and thermal hyperalgesia might be explained by the fact that the site of the nerve lesion in RAD is often located proximal to the dorsal root ganglion. (2 The distinct sensory profile found in RAD might be explained by compression-induced ectopic discharges from a dorsal root and not necessarily by nerve damage. These differences in pathogenesis might explain why medications effective in DPN and PHN failed to demonstrate efficacy in RAD.

  1. Narcissistic personality disorder: a clinical perspective.

    Science.gov (United States)

    Ronningstam, Elsa

    2011-03-01

    Narcissistic traits and narcissistic personality disorder (NPD) present specific diagnostic challenges. While they are often readily and straightforwardly identified, their presentation in some patients and the reasons for which such patients seek treatment may conceal significant narcissistic pathology. Recently, several empirical studies have confirmed that the phenotypic range of people with NPD includes individuals with insecure, shy, and hypersensitive traits with prominent internalized narcissistic features and functioning. Other studies have confirmed that internal emotional distress, interpersonal vulnerability, fear, pain, anxiety, a sense of inadequacy, and depressivity can also co-occur with narcissistic personality functioning. This paper focuses on integrating these findings into the diagnostic evaluation and initial negotiation of treatment for NPD. In patients with narcissistic traits or NPD, it is important to give attention to the two sides of character functioning, which include both self-serving and self-enhancing manifestations as well as hypersensitivity, fluctuations in self-esteem, and internal pain and fragility. This article highlights some of these seemingly incompatible clinical presentations of narcissistic traits and NPD, especially as they co-occur with depressivity and perfectionism, and it discusses implications for building a treatment alliance with a patient with such a predominant disorder of character functioning. The article also discusses the importance of retaining the NPD diagnosis as a separate type of personality disorder, with this range of features, in the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS-5).

  2. Personality disorders in persons with gender identity disorder.

    Science.gov (United States)

    Duišin, Dragana; Batinić, Borjanka; Barišić, Jasmina; Djordjevic, Miroslav L; Vujović, Svetlana; Bizic, Marta

    2014-01-01

    Investigations in the field of gender identity disorder (GID) have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality and personality disorders (PDs). The aim of the study was to assess the presence of PDs in persons with GID as compared to cisgendered (a cisgender person is a person who is content to remain the gender they were assigned at birth) heterosexuals, as well as to biological sex. The study sample consisted of 30 persons with GID and 30 cisgendered heterosexuals from the general population. The assessment of PDs was conducted by application of the self-administered Structured Clinical Interview for DSM-IV Axis II PDs (SCID-II). Persons with GID compared to cisgender heterosexuals have higher presence of PDs, particularly Paranoid PD, avoidant PDs, and comorbid PDs. In addition, MtF (transwomen are people assigned male at birth who identify as women) persons are characterized by a more severe psychopathological profile. Assessment of PDs in persons with GID is of great importance as it comprises a key part of personalized treatment plan tailoring, as well as a prognostic factor for sex-reassignment surgery (SRS) outcome.

  3. Relationship between personality and disability in patients with major depressive disorder.

    Science.gov (United States)

    Güleç, Medine Yazici; Hocaoğlu, Ciçek

    2011-01-01

    The co-morbidity of major depressive disorder (MDD ) with personality disorders (PDs) in patients with long-standing work disability at a psychiatry clinic was investigated. The purpose of our study was to evaluate personality for contributing to disability in patients with MDD and to investigate the relationship with these two psychometric characters in patients with MDD. Seventy-two patients with a MDD and 72 healthy controls were assessed by means of both clinician and self-rating scales for depression, anxiety, disability, and the SCID-II personality inventory. There was no difference between the personality parameters of the groups regarding schizotypal and antisocial PDs. Avoidant personality was found to be less common in the patient group (p=0.030). Dependent (p less than 0.001), obsessive (p=0.003), passive-aggressive (p=0.025), self-defeating (p less than 0.001), paranoid (p less than 0.001), schizoid (p=0.012), histrionic (p=0.001), narcissistic (p less than 0.001), and borderline (p less than 0.001) PDs in patients were more common than in controls. On the disability sub-scales, physical role limitation, vitality, social functioning, emotional role limitation, and mental health were significantly lower in patient group than normal control group. While Cluster A was not related to any disability subscale, Cluster B had a positive correlation with vitality and mental health, whereas Cluster C and Cluster NOS had a negative correlation with emotional role limitation. Only the emotional role limitation predicts the presence of depression, whereas only self-defeating, obsessive, paranoid, and passive aggressive personality predict the emotional role limitation. Patients with MDD have personality and disability problems. PDs in depression contribute to disability. Our results demonstrated that the emotional role limitation is the unique sub-scale that predicts the MDD group.

  4. Comorbidity bipolar disorder and personality disorders.

    Science.gov (United States)

    Latalova, Klara; Prasko, Jan; Kamaradova, Dana; Sedlackova, Jana; Ociskova, Marie

    2013-01-01

    Outcome in bipolar patients can be affected by comorbidity of other psychiatric disorders. Comorbid personality disorders are frequent and may complicate the course of bipolar illness. We have much information about treating patients with uncomplicated bipolar disorder (BD) but much less knowledge about possibilities for patients with the comorbidity of BD and personality disorder. We conducted a series of literature searches using, as key words or as items in indexed fields, bipolar disorder and personality disorder or personality traits. Articles were obtained by searching MEDLINE from 1970 to 2012. In addition, we used other papers cited in articles from these searches, or cited in articles used in our own work. Tests of personality traits indicated that euthymic bipolar patients have higher scores on harm avoidance, reward dependence, and novelty seeking than controls. Elevation of novelty seeking in bipolar patients is associated with substance abuse comorbidity. Comorbidity with personality disorders in BD patients is associated with a more difficult course of illness (such as longer episodes, shorter time euthymic, and earlier age at onset) and an increase in comorbid substance abuse, suicidality and aggression. These problems are particularly pronounced in comorbidity with borderline personality disorder. Comorbidity with antisocial personality disorder elicits a similar spectrum of difficulties; some of the antisocial behavior exhibited by patients with this comorbidity is mediated by increased impulsivity.

  5. Personality Disorders

    Science.gov (United States)

    Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors ... serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and ...

  6. Integrated psychological treatment for substance use and co-morbid anxiety or depression vs. treatment for substance use alone

    DEFF Research Database (Denmark)

    Hesse, Morten

    2009-01-01

    Background There is a growing consensus in favour of integrated treatment of substance use disorders and co-morbid conditions, such as depression or anxiety. However, up till now no systematic reviews have been published. Methods Based on a systematic search of MedLine and PsychInfo, 10 trials of...

  7. Co-occurrence of avoidant personality disorder and child sexual abuse predicts poor outcome in long-standing eating disorder.

    Science.gov (United States)

    Vrabel, Karianne R; Hoffart, Asle; Rø, Oyvind; Martinsen, Egil W; Rosenvinge, Jan H

    2010-08-01

    Few consistent predictive factors for eating disorder have been identified across studies. In the current 5-year prospective study, the objective was to examine whether (a) personality disorder and child sexual abuse predict the course of severity of eating disorder symptoms after inpatient treatment and (b) how the predictors interact. A total of 74 patients with long-standing eating disorder and mean age of 30 years were assessed at the beginning and end of inpatient therapy and at 1-, 2-, and 5-year follow-up. A mixed model was used to examine the predictors. Avoidant personality disorder and child sexual abuse interacted in predicting high levels of eating disorder over a long-term course. These results suggest that eating disorder, avoidant personality disorder, and sequelae after child sexual abuse are potential targets for treatment that need further investigation. Copyright 2010 APA, all rights reserved

  8. Personality Disorders in Persons with Gender Identity Disorder

    Directory of Open Access Journals (Sweden)

    Dragana Duišin

    2014-01-01

    Full Text Available Background. Investigations in the field of gender identity disorder (GID have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality and personality disorders (PDs. Aims. The aim of the study was to assess the presence of PDs in persons with GID as compared to cisgendered (a cisgender person is a person who is content to remain the gender they were assigned at birth heterosexuals, as well as to biological sex. Methods. The study sample consisted of 30 persons with GID and 30 cisgendered heterosexuals from the general population. The assessment of PDs was conducted by application of the self-administered Structured Clinical Interview for DSM-IV Axis II PDs (SCID-II. Results. Persons with GID compared to cisgender heterosexuals have higher presence of PDs, particularly Paranoid PD, avoidant PDs, and comorbid PDs. In addition, MtF (transwomen are people assigned male at birth who identify as women persons are characterized by a more severe psychopathological profile. Conclusions. Assessment of PDs in persons with GID is of great importance as it comprises a key part of personalized treatment plan tailoring, as well as a prognostic factor for sex-reassignment surgery (SRS outcome.

  9. PSYCHOLOGICAL MORBIDITY IN PATIENTS WITH TINNITUS : A HOSPITAL BASED CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Arti

    2015-08-01

    Full Text Available INTRODUCTION: Tinnitus is not a disease but a symptom of hearing sound when no external sound is present. Studies have shown that some people, the sound causes anxiety or interferes with concentration, incr eased awareness of depression and personality disorders. To this purpose we evaluated the prevalence of psychiatric morbidity in chronic tinnitus using MINI interview. METHODS: A sample of 53 male and female patients with tinnitus between the age of 13 and 50 years participated in the study. Patients with ear infections , disease of th e heart or blood vessels , Meniere's disease , brain tumors , exposure to certain medications, a previous head injury and earwax were excluded. The subjects so chosen, were explained the nature of the study. Da ta was collected from outpatient ENT Clinics regarding demographic and clinical profiles from these patients. Each subject was then administered Mini International Neuropsychaitric Interview (M.I.N.I RESULTS: More numbers of females were there than males and majority were in between 30 - 39 years. Both married and unmarried people were equally affected. Middle class and upper lower classes were most affected. The prevalence of psychiatric co morbidity in these tinnitus patients follows in descending order: M ajor depressive disorder>>Social Phobia > Suicide > Panic - disorder > Obsessive – compulsive – disorder > Agarophobia = Dysthymic - disorder=Generalized - anxiety. CONCLUSION : We observed that the prevalence of psychiatric morbidity in chronic tinnitus patients were as follows in descending order Major - depressive - disorder >> Social - Phobia > Suicide > Pani c - disorder > Obsessive - compulsive – disorder > Agarophobia = Dysthymic disorder=Generalized - anxiety . Treatment of this psychiatric morbidity with medications and psychotherapy may likely reduce the severity of tinnitus in many of these patients.

  10. Salivary Cortisol and Binge Eating Disorder in Obese Women After Surgery for Morbid Obesity

    OpenAIRE

    Larsen, Junilla K.; van Ramshorst, Bert; van Doornen, Lorenz J. P.; Geenen, Rinie

    2009-01-01

    Background Binge eating episodes characterized by loss of control are hypothesized to be accompanied by changes in hypothalamic pituitary adrenal (HPA) axis functioning. Cortisol is an end product of this neuroendocrine stress system. Purpose The aim of this study was to examine the cortisol levels and the awakening cortisol response (ACR) in obese persons showing binge eating after surgery for morbid obesity. Method Sixteen obese women with binge eating disorder (BED) and 18 obese women with...

  11. Premenstrual Syndrome and Psychiatric Co-morbidities.

    Directory of Open Access Journals (Sweden)

    Ziba Taghizadeh

    2009-04-01

    Full Text Available "n    "nObjective: Premenstrual syndrome (PMS is a common disorder with prevalence rate of approximately 30%; its concurrence with psychiatric symptoms will make it a disabling condition that resists usual treatment. Objective: This study was enrolled to assess the co-morbidity of PMS and psychiatric disorders in a sample of girls with PMS compared to those without PMS. "n    "nMaterial and method : This study was conducted through a cross sectional method with 362 participants (166 with PMS and 196 healthy girls who were selected randomly and completed the demographic questionnaire, premenstrual syndrome symptom daily record scale and the symptom checklist 90-revised (SCL-90-R. "n    "nResult: According to the result of the independent t test, the mean score of all the psychiatric symptoms in the PMS group was significantly higher than those in healthy group (P<0.001. According to SCL-90-R measurement, most of the participants in the PMS group were categorized as extremely sick for somatization (44% ,obsessive-compulsive (59%, depression (58.4%, anxiety (64.5%, hostility (47% and psychoticism (69.3%; most of the participants were diagnosed as having borderline severity of disorders for interpersonal sensitivity (44.6% and paranoid (42.8% and most of the respondents with PMS (46.4% were diagnosed as healthy only for phobic anxiety. "n    "nConclusion: There is a considerable relationship between PMS and different psychiatric symptoms that can complicate the diagnosis of PMS and its treatment for the health care providers. Therefore, all health care providers who are in contact with women in their reproductive age should be sensitive to mental health status in women with PMS.

  12. Associations between vascular co-morbidities and depression in insulin-naive diabetes patients

    DEFF Research Database (Denmark)

    Koopmans, B; Pouwer, F; de Bie, Rob A

    2009-01-01

    AIMS/HYPOTHESIS: The aim of the study was to determine the prevalence of depression in insulin-naive diabetes patients and to investigate the associations between different forms of vascular co-morbidity and depression. METHODS: Cross-sectional data were used from a primary-care sample of 1......,269 insulin-naive (i.e. not using insulin therapy) diabetes patients participating in the DIAZOB Primary Care Diabetes study. Demographics, vascular co-morbidities, clinical and lifestyle characteristics, and psychosocial factors were assessed. Depression symptoms were measured with the Edinburgh Depression.......2% vs 10.0%). Single vascular co-morbidities were not associated with increased rates of depression. The final model predicting depression included: having multiple vascular co-morbidities compared with none; having less social support; having experienced a recent stressful life event; female sex...

  13. Morbidity and Mortality in 7,684 Women According to Personal Hair Dye Use

    DEFF Research Database (Denmark)

    Vedel-Krogh, Signe; Nielsen, Sune F; Schnohr, Peter

    2016-01-01

    BACKGROUND: Permanent hair dye contains aromatic amines which are carcinogenic, and can cause allergic skin reactions. In the long term personal use of hair dye might therefore influence both morbidity and mortality. OBJECTIVES: We tested the hypothesis that personal use of hair dye in women...... is associated with increased morbidity and mortality in the general population. METHODS: We included 7,684 women from the Copenhagen City Heart Study with information on the use of personal hair dye. We assessed the risk of cancer, skin diseases, other morbidities, and mortality during a median follow-up of 27...... years (range 0-37). RESULTS: The multivariable adjusted hazard ratio for malignant melanoma in women with versus without personal use of hair dye was 2.07 (95% confidence interval 1.25-3.42). There was no increased risk of other cancer types. For other skin diseases and other major causes of morbidity...

  14. Are alexithymia and schizoid personality disorder synonymous diagnoses?

    Science.gov (United States)

    Coolidge, Frederick L; Estey, Alisa J; Segal, Daniel L; Marle, Peter D

    2013-02-01

    Relationships among alexithymia, personality disorders, and higher-order psychopathological and interpersonal dimensions were examined in 199 college students and a close relative of each. Alexithymia, the difficulty to express and identify emotions, was measured by the Observer Alexithymia Scale (OAS; [Haviland, M. G., Warren, W. L., & Riggs, M. L. (2000). An observer scale to measure alexithymia. Psychosomatics, 41, 385-392]), which was completed by each student's relative. Each student completed three self-report measures: the Coolidge Axis II Inventory (CATI; [Coolidge, F. L. (2000). Coolidge Axis II Inventory: Manual. Colorado Springs, CO: Author.), the Five Dimensional Personality Test (5DPT; [van Kampen, D. (2009). Personality and psychopathology: A theory-based revision of Eysenck's PEN model. Clinical Practice and Epidemiology in Mental Health, 5, 9-21]), and the Horney-Coolidge Tridimensional Inventory (HCTI; [Coolidge, F. L. (1998). Horney-Coolidge Tridimensional Inventory: Manual. Colorado Springs, CO: Author]). Results indicated that higher levels of alexithymia are associated with personality disorders and their traits, such as schizoid, avoidant, and paranoid. With regard to the issue of the similarity and difference between alexithymia and schizoid personality disorder, there was sufficient evidence across all of the measures to suggest that they are not synonymous entities. Finally, alexithymic traits were associated with concurrent depressive traits even in a non-clinical sample. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. The co-occurrence of mental disorders in children and adolescents with intellectual disability/intellectual developmental disorder.

    Science.gov (United States)

    Munir, Kerim M

    2016-03-01

    The study summarizes supportive epidemiological data regarding the true co-occurrence (comorbidity) and course of mental disorders in children with intellectual disability/intellectual developmental disorders (ID/IDD) across the lifespan. Published studies involving representative populations of children and adolescents with ID/IDD have demonstrated a three to four-fold increase in prevalence of co-occurring mental disorders. The effect of age, sex, and severity (mild, moderate, severe, and profound) and socioeconomic status on prevalence is currently not clearly understood. To date there are no prevalence estimates of co-occurring mental disorders in youth identified using the new DSM-5 (and proposed ICD-11) definition of ID/IDD using measures of intellectual functions and deficits in adaptive functioning with various severity levels defined on the basis of adaptive functioning, and not intellectual quotient scores. The true relationship between two forms of morbidity remains complex and causal relationships that may be true for one disorder may not apply to another. The new conceptualization of ID/IDD offers a developmentally better informed psychobiological approach that can help distinguish co-occurrence of mental disorders within the neurodevelopmental section with onset during the developmental period as well as the later onset of other mental disorders.

  16. PATTERN OF PSYCHIATRIC CO-MORBIDITY IN CHILDREN, AN EPIDEMIOLOGICAL STUDY, AT SIR C. J. INSTITUTE OF PSYCHIATRY, HYDERABAD.

    OpenAIRE

    Dr. Syed Qalb-I-Hyder Naqvi*, Dr. Aysha Nighat, Dr. Nisar Ahmed Shah, Summaiya Shahid, Dr. Moin Ahmed Ansari, Syeda Maryam Hyder Naqvi, Dr.Zulfiqar Siddiqui

    2018-01-01

    Background: According to the World Health Organization (WHO), now a day’s mental health disorders are the leading causes of disability worldwide. Most of the psychiatric disorders start in child hood and adolescent. In general population 9.3% of the children had mental health problem and presence of comorbidity complicate the diagnosis and treatment. Objective: This study was aimed to determine the frequency of psychiatric co-morbidity in children and to identify the common Socio demographic ...

  17. Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital.

    Science.gov (United States)

    Ray, Pradip K; Ray Bhattacharya, Sampa; Makhal, Manabendra; Majumder, Uttam; De, Shantanu; Ghosh, Subhankar

    2015-01-01

    Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1(st) November 2013 to 30(th) April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

  18. Effects of symptoms of co-morbid psychopathology on challenging behaviours among infants and toddlers with Autistic Disorder and PDD-NOS as assessed with the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT).

    Science.gov (United States)

    Matson, Johnny L; Mahan, Sara; Fodstad, Jill C; Worley, Julie A; Neal, Daniene; Sipes, Megan

    2011-01-01

    To examine whether level of symptoms of co-morbid psychopathology exacerbated challenging behaviours in young children with autism spectrum disorders (ASD). Using the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT)-Part 2 which measures co-morbid symptoms and the BISCUIT- Part 3 which examines challenging behaviours, 362 infants and toddlers with ASD were evaluated. Findings showed that participants scoring high on symptoms of Avoidance and Tantrum/Conduct problems had greater rates of aggressive/destructive behaviours, self-injurious behaviours (SIB) and stereotypies compared to those with low scores. Participants with high levels of Inattention/Impulsivity or Eat/Sleep concerns, compared to those with low levels, demonstrated greater aggressive/destructive behaviour and stereotypies. For symptoms of Anxiety/Repetitive Behaviours, participants with high scores displayed greater levels of stereotypies. Symptoms of co-morbid psychopathology are present at a very early age for children with ASD and elevated levels of these symptoms may exacerbate challenging behaviours.

  19. Long-acting intramuscular naltrexone for opioid use disorder: Utilization and association with multi-morbidity nationally in the Veterans Health Administration.

    Science.gov (United States)

    Kelly, Megan M; Reilly, Erin; Quiñones, Timothy; Desai, Nitigna; Rosenheck, Robert

    2018-02-01

    Long acting intramuscular (IM) naltrexone is an effective treatment for opioid use disorder (OUD), but rates and correlates of its use have not been studied. National administrative from the Veterans Health Administration (VHA) from Fiscal Year 2012 identified only 16 VHA facilities that prescribed IM naltrexone to 5 or more veterans diagnosed with OUD. Data from these facilities were used to identify sociodemographic, diagnostic, and service use characteristics, including use of psychotropic medication, that were characteristic of veterans who filled prescriptions for IM naltrexone. This was in comparison to users of opiate agonist treatments (methadone or buprenorphine) or veterans with no pharmacologic treatment for OUD. Comparisons were made using both bi-variate analyses and multivariable logistic regression. Only 179 of 16,402 veterans with OUD (1%) at these 16 facilities filled a prescription for IM naltrexone and only 256 of 99,394 (0.26%) nationally. These veterans were characterized by past homelessness, co-morbid alcohol use disorder, multiple psychiatric disorders, and a greater likelihood of psychiatric hospitalization, as well as mental health outpatient and antidepressant medication use. IM naltrexone is rarely used for OUD and is primarily used for patients with multiple co-morbidities, especially alcohol use disorder and serious mental illness. The use of this treatment illustrates many of the principles identified by the emerging focus on multi-morbidity as a critical feature of clinical practice. Copyright © 2017. Published by Elsevier B.V.

  20. Morbidities in rapid eye movement sleep behavior disorder

    DEFF Research Database (Denmark)

    Jennum, Poul; Mayer, Geert; Ju, Yo-El

    2013-01-01

    Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD, RBD without any obvious comorbid major neurological disease), is strongly associated with numerous comorbid conditions. The most prominent is that with neurodegenerative disorders, especially synuclein-mediated disorders, above all...... function, neuropsychiatric manifestations and sleep complaints. Furthermore, patients with PD and RBD may have worse prognosis in terms of impaired cognitive function and overall morbidity/mortality; in dementia, the presence of RBD is strongly associated with clinical hallmarks and pathological findings...

  1. Study of morbidity in persons subjected to combined effect of low dose irradiation and alcohol

    International Nuclear Information System (INIS)

    Mashneva, N.I.; Zakharov, A.A.

    1990-01-01

    Materials related to study of morbidity in persons from one of the controled areas subjected to combined effect of low dose ionizing radiation and alcohol are presented. The group under control included persons living in the same area but not misusing alcohol. The morbidity analysis for the period of two years before the accident showed that the number of morbidity cases and days characterized by incapacity for work among 100 working persons was 1.2 and 1.35 times higher as compared to persons not misusing alcohol. Two years after the accident these values constitute 1.6 and 1.75 correspondingly. It is established on the basis of the dispensary examnations, that taking into account other equal conditions the number of morbidity cases related to cardiovasular deseases among the persons misusing alcohol increased (11 % against 6.8 % bycontrol). The number of other chronic morbidity cases does not differ from control values. 7 refs.; 2 tabs

  2. Peer Substance Use Associated with the Co-Occurrence of Borderline Personality Disorder Features and Drug Use Problems in College Students

    Science.gov (United States)

    Pizzarello, Scott; Taylor, Jeanette

    2011-01-01

    Objective: To determine if the substance use patterns of one's close friends and romantic partners would be a significant contributor to the co-occurrence of borderline personality disorder (BPD) features and drug use problems above and beyond impulsivity and negative emotionality. Participants: Participants were 2,202 undergraduates who attended…

  3. Borderline Personality Disorder in Young People : Complexities in Understanding of and Relating to Others

    NARCIS (Netherlands)

    Hessels, C.J.

    2017-01-01

    The expanding research on Borderline personality disorder (BPD) increasingly confirms continuity from adolescence to adulthood, in phenomenology, structure, stability, validity and morbidity. This has led to a more developmental perspective on BPD. The current thesis aims to contribute to the

  4. Quality of life in rheumatological patients: The impact of personality disorders.

    Science.gov (United States)

    Uguz, Faruk; Kucuk, Adem; Cicek, Erdinc; Kayhan, Fatih; Salli, Ali; Guncu, Hatice; Çilli, Ali Savas

    2015-01-01

    Rheumatological diseases are associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently observed in these patients. This study examined the impact of personality disorders on the QoL of patients with rheumatological diseases. The study sample consisted of 142 participants including patients suffering from rheumatological disease with a personality disorder (n = 30), without any personality disorder (n = 112), and healthy control participants without physical or psychiatric disorders (n = 60). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-II) were used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief. The subscale scores of physical health, psychological health, and social relationships were significantly lower in patients with rheumatological disease regardless of the existence of personality disorder compared with the control participants. Rheumatological patients with a personality disorder had significantly lower subscale scores of psychological health (p = 0.003) and social relationships (p personality disorder. Personality disorders seem to be a relevant factor that maybe associated with QoL in patients suffering from rheumatological disease. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. The assessment of personality disorders : Implications for cognitive and behavior therapy

    NARCIS (Netherlands)

    VanVelzen, CJM; Emmelkamp, PMG

    This article reviews the comorbidity of personality disorders (PDs) and Axis I disorders and discusses implications for assessment and treatment. Pros and cons of various assessment methods are discussed. The co-occurrence of PDs with Axis I disorders is considerable; roughly half of patients with

  6. ADHD characteristics: I. Concurrent co-morbidity patterns in children & adolescents

    Directory of Open Access Journals (Sweden)

    Ambrosini Paul

    2008-07-01

    Full Text Available Abstract Objective 342 Caucasian subjects with attention deficit/hyperactivity disorder (ADHD were recruited from pediatric and behavioral health clinics for a genetic study. Concurrent comorbidity was assessed to characterize the clinical profile of this cohort. Methods Subjects 6 to 18 years were diagnosed with the Schedule for Affective Disorders & Schizophrenia for School aged Children (K-SADS-P IVR. Results The most prevalent diagnoses co-occurring with ADHD were Oppositional Defiant Disorder (ODD (40.6%, Minor Depression/Dysthymia (MDDD (21.6%, and Generalized Anxiety Disorder (GAD (15.2%. In Inattentive ADHD (n = 106, 20.8% had MDDD, 20.8% ODD, and 18.6% GAD; in Hyperactive ADHD (n = 31 41.9% had ODD, 22.2% GAD, and 19.4% MDDD. In Combined ADHD, (n = 203, 50.7% had ODD, 22.7% MDDD and 12.4% GAD. MDDD and GAD were equally prevalent in the ADHD subtypes but, ODD was significantly more common among Combined and Hyperactive ADHD compared to Inattentive ADHD. The data suggested a subsample of Irritable prepubertal children exhibiting a diagnostic triad of ODD, Combined ADHD, and MDDD may account for the over diagnosing of Bipolar Disorder. Conclusion Almost 2/3rd of ADHD children have impairing comorbid diagnoses; Hyperactive ADHD represents less than 10% of an ADHD sample; ODD is primarily associated with Hyperactive and Combined ADHD; and, MDDD may be a significant morbidity for ADHD youths from clinical samples.

  7. Down syndrome and personalized medicine: changing paradigms from genotype to phenotype to treatment.

    Science.gov (United States)

    McCabe, Linda L; McCabe, Edward R B

    2013-03-01

    Personalized Medicine represents a paradigm shift in the conceptual framework of research and clinical care. This shift argues that Down syndrome is a treatable condition, and therefore we must invest in research to improve outcomes. Individuals with Down syndrome have varying levels of increased risk for a number of co-morbidities, including infantile spasms and early onset Alzheimer's disease. We will review research in these associated conditions to show how investigators are attempting to identify biomarkers, including genomic, epigenomic, proteomic and metabolomic "signatures" that will predict who may be at risk to develop a specific co-morbidity prior to onset and will provide novel targets for therapeutic development. This Personalized Medicine approach will permit predictive and preventive approaches for individuals at increased risk for co-morbidities. The support for clinical trials among individuals with Down syndrome is beginning to overcome the "culture of intractability" that has surrounded this disorder. © 2012 The Authors. Congenital Anomalies © 2012 Japanese Teratology Society.

  8. Physician styles of decision-making for a complex condition: Type 2 diabetes with co-morbid mental illness.

    Science.gov (United States)

    Trachtenberg, Felicia L; Pober, David M; Welch, Lisa C; McKinlay, John B

    Variation in physician decisions may reflect personal styles of decision-making, as opposed to singular clinical actions and these styles may be applied differently depending on patient complexity. The objective of this study is to examine clusters of physician decision-making for type 2 diabetes, overall and in the presence of a mental health co-morbidity. This randomized balanced factorial experiment presented video vignettes of a "patient" with diagnosed, but uncontrolled type 2 diabetes. "Patients" were systematically varied by age, sex, race and co-morbidity (depression, schizophrenia with normal or bizarre affect, eczema as control). Two hundred and fifty-six primary care physicians, balanced by gender and experience level, completed a structured interview about clinical management. Cluster analysis identified 3 styles of diabetes management. "Minimalists" (n=84) performed fewer exams or tests compared to "middle of the road" physicians (n=84). "Interventionists" (n=88) suggested more medications and referrals. A second cluster analysis, without control for co-morbidities, identified an additional cluster of "information seekers" (n=15) who requested more additional information and referrals. Physicians ranking schizophrenia higher than diabetes on their problem list were more likely "minimalists" and none were "interventionists" or "information seekers". Variations in clinical management encompass multiple clinical actions and physicians subtly shift these decision-making styles depending on patient co-morbidities. Physicians' practice styles may help explain persistent differences in patient care. Training and continuing education efforts to encourage physicians to implement evidence-based clinical practice should account for general styles of decision-making and for how physicians process complicating comorbidities.

  9. Development of an integrated model of personality, personality disorders and severe axis I disorders, with special reference to major affective disorders.

    Science.gov (United States)

    von Zerssen, Detlev

    2002-04-01

    A unidimensional model of the relationships between normal temperament, psychopathic variants of it and the two main forms of so-called endogenous psychoses (major affective disorders and schizophrenia) was derived from Kretschmer's constitutional typology. It was, however, not confirmed by means of a biometric approach nor was Kretschmer's broad concept of cyclothymia as a correlate of physical stoutness on the one hand and major affective disorders on the other supported by empirical data. Yet the concept of the 'melancholic type' of personality of patients with severe unipolar major depression (melancholia) which resembles descriptions by psychoanalysts could be corroborated. This was also true for the 'manic type' of personality as a (premorbid) correlate of predominantly manic forms of a bipolar I disorder. As predicted from a spectrum concept of major affective disorders, the ratio of traits of either type co-varied with the ratio of the depressive and the manic components in the long-term course of such a disorder. The two types of premorbid personality and a rare variant of the 'manic type', named 'relaxed, easy-going type', were conceived as 'affective types' dominating in major affective disorders. They are opposed to three 'neurotoid types' prevailing in so-called neurotic disorders as well as in schizophrenic psychoses. The similarity among the types can be visualized as spatial relationships in a circular, i.e. a two-dimensional, model (circumplex). Personality disorders as maladapted extreme variants of personality are, by definition, located outside the circle, mainly along its 'neurotoid' side. However, due to their transitional nature, axis I disorders cannot be represented adequately within the plane which represents (adapted as well as maladapted) forms of habitual behaviour (personality types and disorders, respectively). To integrate them into the spatial model of similarity interrelations, a dimension of actual psychopathology has to be added

  10. Psychopathy/antisocial personality disorder conundrum.

    Science.gov (United States)

    Ogloff, James R P

    2006-01-01

    Psychopathy has traditionally been characterised as a disorder primarily of personality (particularly affective deficits) and, to a lesser extent, behaviour. Although often used interchangeably, the diagnostic constructs of psychopathy, antisocial personality disorder, and dissocial personality disorder are distinct. In this article, the relevant historical and contemporary literature concerning psychopathy is briefly reviewed. The diagnostic criteria for psychopathy, antisocial personality disorder, and dissocial personality disorder are compared. Consideration is given to the assessment, prevalence, and implications of psychopathy for violence risk and treatment efficacy. The DSM-IV-TR criteria for antisocial personality disorder, in particular, are largely behaviourally based. The ICD criteria for dissocial personality disorder, while paying more attention to affective deficits, also do not represent the broad personality and behavioural components of psychopathy. Since 1980, a great deal of research on these disorders has been conducted, using the Hare Psychopathy Checklist, Revised (PCL-R). The PCL-R assesses both personality (interpersonal and affective) and behavioural (lifestyle and antisocial) deficits. As such, the research and clinical implications of psychopathy, as operationalised by the PCL-R, cannot be readily extrapolated to the diagnoses of antisocial personality disorder and dissocial personality disorder. As currently construed, the diagnosis of antisocial personality disorder grossly over-identifies people, particularly those with offence histories, as meeting the criteria for the diagnosis. For example, research shows that between 50% and 80% of prisoners meet the criteria for a diagnosis of antisocial personality disorder, yet only approximately 15% of prisoners would be expected to be psychopathic, as assessed by the PCL-R. As such, the characteristics and research findings drawn from the psychopathy research may not be relevant for those

  11. Personality disorder moderates outcome in short- and long-term group analytic psychotherapy: A randomized clinical trial.

    Science.gov (United States)

    Lorentzen, Steinar; Ruud, Torleif; Fjeldstad, Anette; Høglend, Per A

    2015-06-01

    In a randomized clinical trial, short- and long-term psychodynamic group psychotherapy (STG and LTG, respectively) schedules were equally effective for the 'typical' patient during a 3-year study period. Although several studies have reported good effects for patients with personality disorders (PD) in diverse forms of psychotherapy, the significance of treatment duration is unclear. Therefore, we tested the hypothesis that PD patients would improve more during and after LTG than STG. A randomized, longitudinal, prospective study contrasting the outcomes during and after short- and long-term dynamic group psychotherapies. One hundred and sixty-seven outpatients with mood disorders, anxiety disorders, or PD were randomized to STG or LTG (respectively, 20 or 80 weekly sessions of 90 min each). Outcome measures are as follows: symptoms (SCL-90-R), interpersonal problems (IIP-C), and psychosocial functioning (GAF split version: GAF-Symptom and GAF-Function). PD pathology (number of PD criteria items) was selected a priori as a putative moderator of treatment effects. Change during the 3-year study period was assessed using linear mixed models. The study was registered at ClinicalTrials.gov as NCT 00021417. Our hypothesis was supported, as patients with PD improved significantly more regarding all outcome variables in LTG than STG. For patients without PD, the rate of change was similar across 3 years; however, the rate of change in symptoms and interpersonal problems was higher in STG during the first 6 months. The effectiveness of LTG is higher for patients with co-morbid PD. Patients without PD do not appear to experience additional gain from LTG. Clinical implications: LTG demonstrates better effectiveness than STG for patients with personality disorder co-morbidity (PD). Patients without PD do not appear to experience additional gain from attending LTG. Correct initial allocation to treatment duration may prevent disruptive breaks in relationships and lead to both

  12. Treatment of personality disorder.

    Science.gov (United States)

    Bateman, Anthony W; Gunderson, John; Mulder, Roger

    2015-02-21

    The evidence base for the effective treatment of personality disorders is insufficient. Most of the existing evidence on personality disorder is for the treatment of borderline personality disorder, but even this is limited by the small sample sizes and short follow-up in clinical trials, the wide range of core outcome measures used by studies, and poor control of coexisting psychopathology. Psychological or psychosocial intervention is recommended as the primary treatment for borderline personality disorder and pharmacotherapy is only advised as an adjunctive treatment. The amount of research about the underlying, abnormal, psychological or biological processes leading to the manifestation of a disordered personality is increasing, which could lead to more effective interventions. The synergistic or antagonistic interaction of psychotherapies and drugs for treating personality disorder should be studied in conjunction with their mechanisms of change throughout the development of each. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Increased detection of co-morbidities with evaluation at a dedicated adult Turner syndrome clinic.

    Science.gov (United States)

    Vincent, A J; Nguyen, H H; Ranasinha, S; Vollenhoven, B

    2017-10-01

    Turner syndrome (TS), resulting from complete/partial X chromosomal monosomy, is associated with multiple co-morbidities and increased mortality. Although multidisciplinary management is recommended, TS women's health care is sub-optimal. This study evaluates a multidisciplinary adult TS service. Retrospective cohort study of 82 patients attending the quarterly TS clinic from December 2003 to December 2014. Evaluation included (1) demographics, (2) TS standardized co-morbidity screening, and (3) estrogen therapy use. Data analysis involved frequency statistics, T tests and polychoric correlation analysis. Median age at TS diagnosis was 14 years (range 0-65 years), with 12% of women aged >18 years. Median age at initial consultation was 31 years (range 16-65 years). Only 14% of patients were transition program referrals. XO karyotype occurred in 30%. Primary amenorrhea predominated; however, 37% of TS women were not taking estrogen therapy. The proportion of patients not previously screened (44-76%) and those with positive screening diagnoses (5-53%) varied according to co-morbidity. The mean (± standard deviation) number of co-morbidities identified increased following TS clinic screening (7.0 ± 2.6 post-screening vs. 4.4 ± 2.3 pre-screening; p < 0.0001). Polychoric correlation analysis identified particular co-morbidity groupings (including metabolism-related) and increased co-morbidities with primary amenorrhea. A multidisciplinary adult TS clinic improves health surveillance with increased identification of co-morbidities and initiation of estrogen therapy.

  14. Psychological and physical co-morbidity among urban South African women.

    Directory of Open Access Journals (Sweden)

    Emily Mendenhall

    Full Text Available There is substantial evidence for the links between poverty and both physical and mental health; but limited research on the relationship of physical and mental health problems exists in low- and middle-income countries. The objective of this paper is to evaluate the prevalence and co-morbidity of psychological distress among women with common physical diseases in a socio-economically disadvantaged urban area of South Africa.Women enrolled in the Birth to twenty (Bt20 cohort study were evaluated for this paper. Bt20 was founded in 1990 and has followed more than 3,000 children and their caregivers since birth; this study evaluates the health of the caregivers (average age 44 of these children. Psychological distress was evaluated by administering the General Health Questionnaire (GHQ-28 and we evaluated the presence of physical disease by self-report.Forty percent of the sample presented with psychological distress using the GHQ scoring method. More than half of the women who reported a history of a physical disease, including diabetes, heart attack, asthma, arthritis, osteoporosis, epilepsy, and tuberculosis, reported psychological disorder. Presence of one physical disease was not associated with increased rates of psychological distress. However, women who reported two diseases had increased rates of psychological symptoms, and this upward trend continued with each additional physical disease reported (measured to five.These data indicate high prevalence rates of co-morbid psychological distress among women with physical disease. This argues for the need of greater mental health support for women living with physical diseases.

  15. Psychiatric morbidity among inmates of center for destitutes: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Raghavendra B Nayak

    2015-01-01

    Full Text Available Context: One percent of the population in India is homeless (destitutes which include beggars, commercial sex workers, homeless mentally ill, elderly women with dependent children, street children, and persons with disability. Psychiatric disorders are generally seen to be common among homeless individuals. The data are limited regarding psychiatric morbidity and its prevalence in this populace in Indian context. Aim: The aim was to study the prevalence of psychiatric morbidity among the inmates of a center for destitutes. Settings and Design: Cross-sectional study. Materials and Methods: The study included all the residents (n = 50 of a center of destitutes. Psychiatric evaluation was done by qualified practicing psychiatrist. Brief Psychiatric Rating Scale and Global Assessment of Functioning instruments were used to assess the severity of psychiatric symptoms and general functioning of the individuals with mental disorders. Statistical Analysis Used: SPSS version 13 was used for statistical analysis. Results: All residents (n = 50 of center of destitutes were evaluated for psychiatric co-morbidity. 42 (84% inmates were suffering from psychiatric disorders. Most common psychiatric disorder among them was psychotic disorders in 19 (38%, followed by affective disorders, mainly depression in 16 (32%, somatoform disorders in 5 (10%, and anxiety disorders in 2 (4%. No significant gender differences were noted (P = 0.335. Substance abuse was present in 22 (44% of the inmates. A significant negative correlation between psychiatric symptoms and functioning of the subject was seen, (P < 0.001. Conclusion: Psychiatric disorders and in particular substance abuse, are common among the homeless people who stay in the center of destitutes. Psychiatric disorders are likely to be the cause significant functional impairment.

  16. Personality Disorders in patients with disorders in eating behaviors

    Directory of Open Access Journals (Sweden)

    Vanesa Carina Góngora

    2016-02-01

    Full Text Available The interest for the systematic study of personality disorder in patients with eating disorders starts in 1980 with the edition of the DSM III multiaxial classification system. Since then, several publications have been focused on the prevalence and the effect on treatment of personality disorders in bulimic and anorexic patients. These researches showed inconsistent results due to conceptual and methodological divergences. In this paper, the more relevant findings of these studies are presented and the possible sources of discrepancy are analyzed. In general, there is a moderate comorbidity between personality disorders and eating disorders. The most frequent disorders are borderline, histrionic, obsessive-compulsive, dependent and avoidant personality disorders. Borderline and histrionic personality disorders are more frequently associated with bulimia, whereas avoidant and obsessive- compulsive personality disorders are more characteristic of anorexia nervosa. Nevertheless, the effect of the relationship between eating disorders and personality disorders in treatment remains uncertain, giving raise to several controversies and researches. 

  17. The Impact of Criminal Justice Involvement and Housing Outcomes Among Homeless Persons with Co-occurring Disorders.

    Science.gov (United States)

    Mitchell, Jessica N; Clark, Colleen; Guenther, Christina C

    2017-11-01

    The relationship between criminal justice involvement and housing among homeless persons with co-occurring disorders was examined. Program participants assisted in moving to stable housing were interviewed at baseline, six months, and discharge. Those who remained homeless at follow-up and discharge had significantly more time in jail in the past month than those who were housed. However, criminal justice involvement was not significantly related to housing status at the six month follow-up or discharge. Findings suggest that housing people with complex behavioral health issues reduces the likelihood of further criminal justice involvement.

  18. Modified Therapeutic Community Treatment for Offenders with MICA Disorders: Antisocial Personality Disorder and Treatment Outcomes

    Science.gov (United States)

    McKendrick, Karen; Sullivan, Christopher; Banks, Steven; Sacks, Stanley

    2006-01-01

    Treatment outcomes 1 year after release from prison were compared for two subgroups of male inmates with co-occurring serious mental illness and chemical abuse (MICA) disorders, those with a diagnosis for Antisocial Personality Disorder (APD), and those without a diagnosis of APD. The foundation study had randomly assigned inmates to either…

  19. TO DETERMINE THE PERSONALITY TRAITS, CLINICAL CHARACTERISTICS AND COGNITIVE FUNCTIONS IN BIPOLAR DISORDER PATIENTS WITH COMORBID ALCOHOL USE DISORDERS

    Directory of Open Access Journals (Sweden)

    Ahalya Thinaharan

    2016-12-01

    Full Text Available BACKGROUND Comorbidity of bipolar disorder and substance use disorder is common. It is difficult to treat bipolar disorder patients with comorbid alcohol use disorder since the disease course is more severe and they have greater difficulties in cognitive functions than those without alcohol use. Whether alcohol negatively affects specific cognitive functions or the deficits are more diffuse in nature is unclear. Alcoholic bipolar patients present with high scores in openness to experience and neuroticism personality traits. Personality to an extent mediates the co-occurrence of substance use in bipolar disorder. Thus, identifying these personality traits in bipolar or substance use disorder patients, will help us to prevent the co-occurrence of the second disorder. The aim of the study is to evaluate the clinical characteristics, personality traits and cognitive functions of patients with bipolar and comorbid alcohol use disorders. MATERIALS AND METHODS A sample of 100 patients, 50 with bipolar and alcohol use disorder (cases and 50 with bipolar disorder (controls attending tertiary care hospital outpatient department at Chennai was selected. Alcohol status was assessed using AUDIT (alcohol use disorder identification test and SADQ (severity of alcohol dependence questionnaire. Personality was assessed using NEO-five factor inventory. Cognition was assessed using frontal lobe assessment battery, Stroop test, DSST (digit symbol substitution test and verbal N back test. RESULTS The cases group had more number of hospitalisations and mixed episodes than control group. They also performed poorer on frontal lobe assessment battery, Stroop test and digit symbol substitution test. Duration of alcohol use was associated positively with total number of hospitalisations and number of episodes. The cases group scored significantly higher on the personality traits of neuroticism and openness to experience. CONCLUSION The study confirmed the higher

  20. The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality

    DEFF Research Database (Denmark)

    Ruwald, Anne Christine; Vinther, Michael; Gislason, Gunnar H

    2017-01-01

    -ICD indication-related co-morbidities including atrial fibrillation, diabetes, chronic obstructive pulmonary disease, chronic renal disease, liver disease, cancer, chronic psychiatric disease, and peripheral and/or cerebrovascular disease, and divided into four groups (co-morbidity burden 0, 1, 2, and ≥3......). Through Cox models, we assessed the impact of co-morbidity burden on appropriate ICD therapy and mortality. Increasing co-morbidity burden was not associated with increased risk of appropriate therapy, irrespective of implant indication [all hazard ratios (HRs) 1.0-1.4, P = NS]. Using no co...

  1. Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: a 2-year randomized trial of dialectical behavior therapy versus community treatment by experts.

    Science.gov (United States)

    Harned, Melanie S; Chapman, Alexander L; Dexter-Mazza, Elizabeth T; Murray, Angela; Comtois, Katherine A; Linehan, Marsha M

    2008-12-01

    This study evaluated whether dialectical behavior therapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal individuals with borderline personality disorder (BPD). Women with BPD and recent and repeated suicidal and/or self-injurious behavior (n = 101) were randomly assigned to 1 year of DBT or community treatment by experts (CTBE), plus 1 year of follow-up assessment. For substance dependence disorders (SDD), DBT patients were more likely to achieve full remission, spent more time in partial remission, spent less time meeting full criteria, and reported more drug- and alcohol-abstinent days than did CTBE patients. These findings suggest that improvements in co-occurring SDD among suicidal BPD patients are specific to DBT and cannot be attributed to general factors associated with nonbehavioral expert psychotherapy. Further, group differences in SDD remission were not explained by either psychotropic medication usage or changes in BPD criterion behaviors. DBT and CTBE did not significantly differ in the reduction of anxiety disorders, eating disorders, or major depressive disorder.

  2. Disorder-specific characteristics of borderline personality disorder with co-occurring depression and its comparison with major depression: An fMRI study with emotional interference task

    Directory of Open Access Journals (Sweden)

    Natalia Chechko

    2016-01-01

    Thus, our data indicate dysfunctionality in the neural circuitry responsible for emotional conflict control in both disorders. The enhanced visual cortex activation in BPD + MDD suggests the visual system's hyperresponsiveness to faces at an early perceptual level. Not being associated with co-occurring depression, this effect in BPD + MDD appears to represent specific personality traits such as disturbed reactivity toward emotionally expressive facial stimuli.

  3. Investigation of Personality Disordes and Personality Traits in Men with Gender Identity Disorder

    Directory of Open Access Journals (Sweden)

    Nahid Noorian

    2008-04-01

    Full Text Available Objective: The purpose of this study is to investigation of personality disorders and personality traits in men who have gender identity disorder (GID. Identification of personality disorders can be useful for enhancement of the quality of help to the patients. Materials & Methods: This analytical and cross-sectional study was a comparative and case – control research. 40 men with gender identity disorder were selected by convenient sampling from individuals who have been referred to Tehran Navab Safavi welfare center. Also, 40 available individuals who have no any diagnostic criteria about gender identity disorder in DSM-IV-TR and worked in Islamic Azad University (Tehran Sciences and Researches Unit were selected as control group and matched with patients. Personality disorders and those frequencies were evaluated with Millon Clinical Multiaxial Inventory-II (MCMI-II. Data were analyzed using by Chi-square and Independent T tests. Results: The results showed that gender identity disorder patients get higher scores as compared to control group in scales “Dependent” (P=0/038, “Histrionic” (P<0/001, “Antisocial” (P=0/017, “Passive – aggressive” (P=0/007, “Borderline” (P<0/001 and “Paranoid” (P=0/021 and their difference was significant. Conclusion: Generally, the results of this study showed persons who have gender identity disorder also have some symptoms of personality disorders more than normal people.

  4. Personality disorder and treatment outcome in alcohol use disorder.

    Science.gov (United States)

    Newton-Howes, Giles; Foulds, James

    2018-01-01

    As personality disorder impacts the outcome of most major mental disorders, it would be consistent for it to impact negatively on the outcome of alcohol use disorders (AUDs). This update is to provide an up-to-date overview of the recent literature examining the impact of personality disorder and personality traits on the treatment outcome of AUDs. Comorbidity between personality disorder and AUD is significant and approaches 50%. Patients with AUD and comorbid personality disorder are substantially less likely to remain in treatment, drink more per drinking day and drink more frequently. If retained in treatment, comorbidity does not, however, lead to poorer outcomes. Relapse to drinking is more common in patient with high novelty seeking and lower reward dependence and persistence. Reporting from most studies is of moderate-to-poor quality and a single high-quality study may alter these findings. Landmark alcohol studies are notably quiet on the impact of personality on AUD treatment outcome. Both personality disorder and higher novelty seeking impact negatively on the treatment outcome of AUD. As personality disorder is common in this group, clinicians engaged in AUD treatment should screen for personality disturbance, either disorder or high novelty seeking.

  5. Trajectories of physical and mental health among persons with morbid obesity and persons with COPD: a longitudinal comparative study

    Directory of Open Access Journals (Sweden)

    Bonsaksen T

    2016-04-01

    Full Text Available Tore Bonsaksen,1 May Solveig Fagermoen,2 Anners Lerdal2,3 1Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, 2Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, 3Department for Patient Safety and Development, Lovisenberg Diakonale Hospital, Oslo, NorwayBackground: Morbid obesity and chronic obstructive pulmonary disease (COPD are prevalent diseases associated with impaired health-related quality of life (HRQoL. Research generally indicates that persons with morbid obesity increase their HRQoL following intervention, whereas evidence of increases in HRQoL in persons with COPD is mixed. Examining the patterns of change over time instead of merely examining whether HRQoL changes will add to the knowledge in this field.Methods: A sample of persons with morbid obesity and persons with COPD was recruited from learning and mastery courses and rehabilitation centers in Norway. The data were collected by self-report questionnaires at the start of patient education and at four subsequent time points during the 1-year follow-up. HRQoL was measured with the Short Form 12, version 2, and repeated measures analysis of variance was employed in the statistical analysis.Results: Participants with morbid obesity linearly increased their physical HRQoL during the 1-year follow-up, whereas participants with COPD showed no change. None of the groups changed their mental HRQoL during follow-up. In all subdomains of HRQoL, the participants with morbid obesity showed favorable, linearly increasing trajectories across the follow-up period. Among the participants with COPD, no change patterns occurred in the subdomains of HRQoL, except for a fluctuating pattern in the mental health domain. Age, sex, and work status did not influence the trajectories of HRQoL in any of the domains.Conclusion: A more favorable trajectory

  6. The Stigma of Personality Disorders.

    Science.gov (United States)

    Sheehan, Lindsay; Nieweglowski, Katherine; Corrigan, Patrick

    2016-01-01

    This article reviews the recent literature on the stigma of personality disorders, including an overview of general mental illness stigma and an examination of the personality-specific stigma. Overall, public knowledge of personality disorders is low, and people with personality disorders may be perceived as purposefully misbehaving rather than experiencing an illness. Health provider stigma seems particularly pernicious for those with borderline personality disorder. Most stigma research on personality disorders has been completed outside the USA, and few stigma-change interventions specific to personality disorder have been scientifically tested. Limited evidence suggests that health provider training can improve stigmatizing attitudes and that interventions combining positive messages of recovery potential with biological etiology will be most impactful to reduce stigma. Anti-stigma interventions designed specifically for health providers, family members, criminal justice personnel, and law enforcement seem particularly beneficial, given these sources of stigma.

  7. [Personality disorders, violence and criminal behaviour].

    Science.gov (United States)

    Palmstierna, Tom

    2016-12-06

    Personality disorders, violence and criminal behaviour The importance of personality disorders for violent and criminal behaviour is illustrated by their high prevalence in prison populations. Especially antisocial personality disorder and antisocial personality traits are linked to violence. During diagnostic assessment of personality disorders, violence risk screening is recommended. Cognitive behaviour treatment focused on violent behaviour has some effect in criminal populations, but the antisocial personality traits are resistant to treatment. Evidence for pharmacological treatment of repetitive aggressive behaviour is weak. But, bensodiazepines seem to increase the risk of violent behaviour among patients with personality disorders. Antisocial personality traits diminish over time. This spontaneous decrease can be delayed by comorbidity such as other personality disorder, substance use disorder, psychosis and attention deficit disorders. Therefore it is recommended to actively treat these comorbid conditions.

  8. Prevalence of psychiatric and physical morbidity in an urban geriatric population.

    Science.gov (United States)

    Seby, K; Chaudhury, Suprakash; Chakraborty, Rudraprosad

    2011-04-01

    With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Cross-sectional, epidemiological study. All the consenting elderly persons in a municipal ward division (n=202) were enrolled after surveying a total adult population of 7239 people. A door to door survey was undertaken where the participants were interviewed and physically examined. General Health Questionnaire-12, Mini Mental State Examination, CAGE Questionnaire and Geriatric Depression Scale were used in the interview apart from consulting the available documents. Other family members were also interviewed to verify the information. Chi-square test with Yates correction. Psychiatric illnesses were detected in 26.7% while physical illnesses were present in 69.8% of the population surveyed. Predominant psychiatric diagnoses were depressive disorders, dementia, generalized anxiety disorder, alcohol dependence and bipolar disorder. The most common physical illness was visual impairment, followed by cardiovascular disease, rheumatic illnesses, pulmonary illnesses, hearing impairment, genitourinary diseases and neurological disorders. Presence of dementia was associated with increased age, single/widowed/separated status, nuclear family, economic dependence, low education, cardiovascular disorders, rheumatic disorders and neurological disorders. Depression was associated with female sex, single/widowed/separated status, staying in nuclear families, economic dependence on others and co-morbid physical illnesses, specifically cardiovascular disorders and visual impairment. This study presented a higher rate of dementia and old age depression. The interesting

  9. PSYCHIATRIC MORBIDITY PATTERN OF THE FIRST-DEGREE RELATIVES OF SCHIZOPHRENICS: CROSS-SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Alexander Gnana Durai

    2015-11-01

    Full Text Available : CONTEXT: Family, Twin and Adoption studies show the inheritance patterns of schizophrenia. The findings from these studies provide support to the claim that familial clustering of schizophrenia is a combined expression of genetic and environmental factors. AIMS: Following the line of previous research, this study attempts to find out any difference in the psychiatric morbidity pattern among the first-degree relatives of familial and sporadic schizophrenics. SETTINGS AND DESIGN: We conducted a cross-sectional survey among a convenience sample of 100 first-degree relatives (age between 18 to 55 years of familial (n=22 and sporadic (n=29 schizophrenics from psychiatric outpatient clinic, of a Government Hospital, India. The schizophrenics satisfied the DSM-IV criteria and all the first degree relatives interviewed never had any psychiatric consultation before or were abusing alcohol or other substances or having any organic pathology. METHODS AND MATERIAL: Informed consent from the patients and relatives was obtained. Survey questionnaires were administered and no personal identifying information was collected. Middle Sex Hospital Questionnaire (MHQ, Eysenck's Personality Questionnaire (EPQ, Multi-Phasic Personality Questionnaire (MPQ and Screening Test for Co-Morbid Personality Disorders (STCPD were administered to the participants.

  10. [Psychopathy and associated personality disorders: searching for a particular effect of the borderline personality disorder?].

    Science.gov (United States)

    Nioche, A; Pham, T H; Ducro, C; de Beaurepaire, C; Chudzik, L; Courtois, R; Réveillère, C

    2010-06-01

    Recent clinical and empirical works are based on Cleckley's clinical observations in which psychopathy is viewed as a personality disorder, characterised by a lack of emotions, callousness, unreliability and superficiality. Hare operationalised Cleckley's concept of psychopathy by developing the Psychopathy Checklist-Revised composed of 20 items that load on two factors in majority: factor 1 (personality aspects of psychopathy) and factor 2 (behavioural manifestations), close to the antisocial personality disorder (DSM-IV criteria). Comorbidity is strong with antisocial personality disorder but also with histrionic, narcissistic and borderline disorders. As results of categorical studies relative to comorbidity suggest a strong comorbidity between psychopathy and other personality disorders, and particularly cluster B disorders (axis II, DSM-IV), this study assesses the relationships between psychopathy (dimensional approach) and personality disorders (categorical approach) and particularly with the borderline personality disorder. The aim of this study is also to underline the complementarity of categorical (SCID-II) and dimensional approaches (PCL-R), and the utility of the standardised clinical examination. We hypothesised positive associations between psychopathy and other personality disorders, mainly with the cluster B axis II (narcissistic, antisocial, histrionic, and borderline). Among those disorders, a particular link exists with the borderline personality disorder, considering that their association may attenuate the pathological level of the psychopathy. The sample included 80 male inmates from French prisons (age: M=31.48; SD=11.06). Each participant was evaluated with the PCL-R to assess the level of psychopathy and the SCID-II to assess the possible presence of personality disorders. The MINI and the WAIS-III were used to exclude respectively those who presented an axis I comorbidity (mood disorders and psychotic disorders established at the moment

  11. Clinical study of the relation of borderline personality disorder to Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders.

    Science.gov (United States)

    Hudziak, J J; Boffeli, T J; Kreisman, J J; Battaglia, M M; Stanger, C; Guze, S B; Kriesman, J J

    1996-12-01

    The criteria for borderline personality disorder seem to select patients with very high rates of Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders. This study was undertaken to determine whether systematic assessment of patients with borderline personality disorder would reveal characteristic features of that condition which would distinguish it from these other disorders. Eighty-seven white female patients (75 in St. Louis and 12 in Milan, Italy) who had borderline personality disorder according to both the DSM-III-R criteria and the Revised Diagnostic Interview for Borderlines were further examined with the DSM-III-R Checklist and the Perley-Guze Hysteria Checklist to determine their patterns of psychiatric comorbidity. Every patient had at least one additional DSM diagnosis. Patients in St. Louis and Milan averaged five and four additional diagnoses, respectively. Eighty-four percent of the patients in St. Louis met criteria for either somatization disorder, Briquet's syndrome, antisocial personality disorder, or substance abuse disorders. Patterns of comorbidity for panic (51%), generalized anxiety disorder (55%), and major depression (87%) in St. Louis were consistent with those in other studies. The data indicate that the boundaries for the borderline condition are not specific and identify a high percentage of patients with these other disorders. Furthermore, the comorbidity profiles closely resemble the psychiatric profiles of patients with these disorders. If the borderline syndrome is meant to include all of these disorders, its usefulness as a diagnosis is limited. Until the fundamental features of borderline personality disorder that distinguish it from the others are identified, it is recommended that clinicians carefully assess patients for these other diagnoses. Efforts should be made to change the borderline personality disorder criteria by shifting away from overlap with the

  12. Impulsivity, aggression and brain structure in high and low lethality suicide attempters with borderline personality disorder.

    Science.gov (United States)

    Soloff, Paul; White, Richard; Diwadkar, Vaibhav A

    2014-06-30

    Impulsivity and aggressiveness are trait dispositions associated with the vulnerability to suicidal behavior across diagnoses. They are associated with structural and functional abnormalities in brain networks involved in regulation of mood, impulse and behavior. They are also core characteristics of borderline personality disorder (BPD), a disorder defined, in part, by recurrent suicidal behavior. We assessed the relationships between personality traits, brain structure and lethality of suicide attempts in 51 BPD attempters using multiple regression analyses on structural MRI data. BPD was diagnosed by the Diagnostic Interview for Borderline Patients-revised, impulsivity by the Barratt Impulsiveness Scale (BIS), aggression by the Brown-Goodwin Lifetime History of Aggression (LHA), and high lethality by a score of 4 or more on the Lethality Rating Scale (LRS). Sixteen High Lethality attempters were compared to 35 Low Lethality attempters, with no significant differences noted in gender, co-morbidity, childhood abuse, BIS or LHA scores. Degree of medical lethality (LRS) was negatively related to gray matter volumes across multiple fronto-temporal-limbic regions. Effects of impulsivity and aggression on gray matter volumes discriminated High from Low Lethality attempters and differed markedly within lethality groups. Lethality of suicide attempts in BPD may be related to the mediation of these personality traits by specific neural networks. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Using personality neuroscience to study personality disorder.

    Science.gov (United States)

    Abram, Samantha V; DeYoung, Colin G

    2017-01-01

    Personality neuroscience integrates techniques from personality psychology and neuroscience to elucidate the neural basis of individual differences in cognition, emotion, motivation, and behavior. This endeavor is pertinent not only to our understanding of healthy personality variation, but also to the aberrant trait manifestations present in personality disorders and severe psychopathology. In the current review, we focus on the advances and limitations of neuroimaging methods with respect to personality neuroscience. We discuss the value of personality theory as a means to link specific neural mechanisms with various traits (e.g., the neural basis of the "Big Five"). Given the overlap between dimensional models of normal personality and psychopathology, we also describe how researchers can reconceptualize psychopathological disorders along key dimensions, and, in turn, formulate specific neural hypotheses, extended from personality theory. Examples from the borderline personality disorder literature are used to illustrate this approach. We provide recommendations for utilizing neuroimaging methods to capture the neural mechanisms that underlie continuous traits across the spectrum from healthy to maladaptive. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Comorbidity of Anxiety Disorders and Substance Abusewith Bipolar Mood Disorders and Relationship with ClinicalCourse

    Directory of Open Access Journals (Sweden)

    Ali Reza Shafiee-Kandjani

    2009-12-01

    Full Text Available "n Objective: Patients with bipolar mood disorder constitute a relatively large number of individuals hospitalized in psychiatric hospitals. This disorder is highly co-morbid with other psychiatric disorders and may effect their clinical course. The goal of this study was to determine the co-occurrence rate of anxiety disorders and substance abuse with bipolar mood disorders and their impact on clinical course. "n Methods: 153 bipolar patients (type I were selected among the hospitalized patients at Razi Psychiatric Hospital in Tabriz, Iran, from September 2007 to October 2008 through convenience sampling method. The participants were evaluated by a structured clinical interview based on DSM-IV criteria (SCID, Hamilton Rating Scale for Depression (HRSD and Young Mania Rating Scale (YMRS. Results: Co-morbidity of anxiety disorders was 43% . Occurrence of anxiety disorders was 26% for obsessive-compulsive disorder, 24.8% for generalized anxiety disorder, 3.9% for phobia and 2% for panic disorder. Co-morbidity of substance abuse was 7.2% and the highest occurrence of substance abuse was 5.2% for alcoholism and 3.9% for opium. No significant difference was observed between the severity of disease and duration of hospitalization in bipolar patients with or without anxiety disorder. The severity of disease and duration of hospitalization in bipolar patients with substance abuse was higher compared to bipolar patients without substance abuse (P<0.05. "nConclusions: This study suggests that there is a high co-morbidity between anxiety disorders and substance abuse with bipolar disorder. Further, this study suggests that co-occurrence of substance abuse disorder with bipolar disorder increases the severity of the disease and duration of hospitalization.

  15. Predicting Personality Disorder Functioning Styles by the Five-Factor Nonverbal Personality Questionnaire in Healthy Volunteers and Personality Disorder Patients.

    Science.gov (United States)

    Gao, Qianqian; Ma, Guorong; Zhu, Qisha; Fan, Hongying; Wang, Wei

    2016-01-01

    Detecting personality disorders in the illiterate population is a challenge, but nonverbal tools measuring personality traits such as the Five-Factor Nonverbal Personality Questionnaire (FFNPQ) might help. We hypothesized that FFNPQ traits are associated with personality disorder functioning styles in a predictable way, especially in a sample of personality disorder patients. We therefore invited 106 personality disorder patients and 205 healthy volunteers to answer the FFNPQ and the Parker Personality Measure (PERM) which measures 11 personality disorder functioning styles. Patients scored significantly higher on the FFNPQ neuroticism and conscientiousness traits and all 11 PERM styles. In both groups, the 5 FFNPQ traits displayed extensive associations with the 11 PERM styles, respectively, and the associations were more specific in patients. Associations between neuroticism, extraversion and agreeableness traits and most PERM styles were less exclusive, but conscientiousness was associated with antisocial (-) and obsessive-compulsive styles, and openness to experience with schizotypal and dependent (-) styles. Our study has demonstrated correlations between FFNPQ traits and PERM styles, and implies the nonverbal measure of personality traits is capable of aiding the diagnoses of personality disorders in the illiterate population. Enlarging sample size and including the illiterate might make for more stable results. © 2016 S. Karger AG, Basel.

  16. The Natural History of Antisocial Personality Disorder.

    Science.gov (United States)

    Black, Donald W

    2015-07-01

    Antisocial personality disorder (ASPD) is characterized by a pattern of socially irresponsible, exploitative, and guiltless behaviour. ASPD is associated with co-occurring mental health and addictive disorders and medical comorbidity. Rates of natural and unnatural death (suicide, homicide, and accidents) are excessive. ASPD is a predictor of poor treatment response. ASPD begins early in life, usually by age 8 years. Diagnosed as conduct disorder in childhood, the diagnosis converts to ASPD at age 18 if antisocial behaviours have persisted. While chronic and lifelong for most people with ASPD, the disorder tends to improve with advancing age. Earlier onset is associated with a poorer prognosis. Other moderating factors include marriage, employment, early incarceration (or adjudication during childhood), and degree of socialization.

  17. Personality disorders

    DEFF Research Database (Denmark)

    Simonsen, Sebastian; Heinskou, Torben; Sørensen, Per

    2017-01-01

    BACKGROUND: In this naturalistic study, patients with personality disorders (N = 388) treated at Stolpegaard Psychotherapy Center, Mental Health Services, Capital Region of Denmark were allocated to two different kinds of treatment: a standardized treatment package with a preset number of treatment...... characteristics associated with clinicians' allocation of patients to the two different personality disorder services. METHODS: Patient characteristics across eight domains were collected in order to study whether there were systematic differences between patients allocated to the two different treatments....... Patient characteristics included measures of symptom severity, personality pathology, trauma and socio-demographic characteristics. Significance testing and binary regression analysis were applied to identify important predictors. RESULTS: Patient characteristics on fifteen variables differed...

  18. Psycho-education for substance use and antisocial personality disorder

    DEFF Research Database (Denmark)

    Thylstrup, Birgitte; Schrøder, Sidsel; Hesse, Morten

    2015-01-01

    Background: Antisocial personality disorder often co-exists with drug and alcohol use disorders. Methods: This trial examined the effectiveness of offering psycho-education for antisocial personality disorder in community substance use disorder treatment centers in Denmark. A total of 176 patients......%) of participants randomized to psycho-education attended at least one counselling session, and 21 (23%) attended all six sessions. The Median number of sessions was 2. All patients reduced drug and alcohol problems at 9 months with small within-group effect sizes. Intention-to-treat analyses indicated significant...... differences between ILC and TAU in mean drugs composite score (p = .018) and in PDA (p = .041) at 3 months. Aggression declined in both groups, but no differences between ILC and TAU were observed in terms of alcohol problems or aggression at any follow-up. Conclusions: Moderate short-term improvements...

  19. Morbidity prior to a Diagnosis of Sleep-Disordered Breathing

    DEFF Research Database (Denmark)

    Jennum, Poul; Ibsen, Rikke Falkner; Kjellberg, Jakob

    2013-01-01

    Sleep-disordered breathing (SDB) causes burden to the sufferer, the healthcare system, and society. Most studies have focused on cardiovascular diseases (CVDs) after a diagnosis of obstructive sleep apnea (OSA) or obesity hypoventilation syndrome (OHS); however, the overall morbidity prior...

  20. Systemic lupus erythematosus presenting as morbid jealousy.

    Science.gov (United States)

    Ravindran, A.; Carney, M. W.; Denman, A. M.

    1980-01-01

    A patient fulfilling the diagnostic criteria for systemic lupus erythematosus and presenting with morbid jealousy is described. There was evidence of cerebral lupus. Her physical and mental symptoms responded to a combination of chlorpromazine and steroids. The morbid mental process was probably caused by her physical condition while the content of her disordered thought and behaviour was determined by her introverted premorbid personality, religiosity, unhappy childhood experiences and frustrated desire for children. PMID:7413541

  1. Associations linking parenting styles and offspring personality disorder are moderated by parental personality disorder, evidence from China.

    Science.gov (United States)

    Cheng, Hui Green; Huang, Yueqin; Liu, Zhaorui; Liu, Baohua

    2011-08-30

    The aim of the study is to examine the association linking parenting and personality disorder controlling for parental personality disorder, and whether this association is moderated by parental PD. Data were from community-dwelling high school students aged 18 and above and their parents living in Beijing, China. A total of 181 cases and 2,605 controls were included in this study. Personality disorder in students was assessed via a two-stage approach, Personality Diagnostic Questionnaire as a screening tool and International Personality Disorder Examination as the diagnostic tool. Information about parenting was collected from students using Egna Minnen av. Betraffande Uppfostran. Negative parenting styles, e.g. rejective or over-protective parenting, were found to be associated with the occurrence of personality disorder. Conflictive parenting styles were also found to be associated with personality disorder. Generally stronger associations were found for students with parental personality disorder as compared to students without parental personality disorder. Findings from this study support the role of parenting in the occurrence of PD, especially for children with family history of personality disorder. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Personality disorders

    NARCIS (Netherlands)

    van den Bosch, L.M.C.; Verheul, R.; Verster, J.C.; Brady, K.; Galanter, M.; Conrod, P.

    2012-01-01

    Subject of this chapter is the often found combination of personality disorders and ­substance abuse disorders. The serious nature of this comorbidity is shown through the discussion of prevalence and epidemiological data. Literature shows that the comorbidity, hampering the diagnostic process, is

  3. Delusional patterns and its pre-morbid personality linkages in ...

    African Journals Online (AJOL)

    DSM IVTR, psychological tests: MMPI, SCL-90R and clinical observations were used for the diagnosis of the patients according to the centre policy. Two recording scales designed by the researchers were used to assign the participants to different types of delusions and pre-morbid personalities. The study design was a ...

  4. GENDER ROLE AND PERSONALITY DISORDERS

    Science.gov (United States)

    Klonsky, E. David; Jane, J. Serrita; Turkheimer, Eric; Oltmanns, Thomas F.

    2015-01-01

    Many researchers have hypothesized relationships between personality disorders and gender role (i.e., masculinity and femininity). However, research has not addressed if people who are masculine or feminine more often meet the criteria for personality disorders. The present study examined whether college students (N = 665, 60% women) higher in masculinity or femininity more often exhibited features of the 10 DSM-IV personality disorders. Feminine men exhibited more features of all the personality disorders except antisocial. Dependent traits were associated with higher femininity and lower masculinity. Antisocial traits were associated with masculinity. Both men and women who typically behaved consistent with their gender had more narcissistic and histrionic features, whereas participants who typically behaved unlike their gender had more features of the Cluster A personality disorders. PMID:12489312

  5. Personality disorders and traits in patients with body dysmorphic disorder.

    Science.gov (United States)

    Phillips, K A; McElroy, S L

    2000-01-01

    Individuals with body dysmorphic disorder (BDD) have been postulated to have schizoid, narcissistic, and obsessional personality traits and to be sensitive, introverted, perfectionistic, and insecure. However, data on personality traits and disorders in BDD are limited. This study assessed 148 subjects with BDD, 26 of whom participated in a fluvoxamine treatment study; 74 subjects were assessed for personality disorders with the Structured Clinical Interview for DSMIII-R Personality Disorders (SCID-II), 100 subjects completed the NEO-Five Factor Inventory (NEO-FFI), and 51 subjects completed the Rathus Assertiveness Scale. Forty-two subjects (57%) had one or more personality disorders, with avoidant personality disorder (43%) being most common, followed by dependent (15%), obsessive-compulsive (14%), and paranoid (14%) personality disorders. On the NEO-FFI, the mean scores were in the very high range for neuroticism, the low range for extraversion and conscientiousness, the low-average range for agreeableness, and the average range for openness to experience. On the Rathus Assertiveness Scale, the mean score was -17.1 +/- 32.0 for women and -17.0 +/- 32.3 for men. Among fluvoxamine responders, the number of personality disorders significantly decreased between the study baseline and endpoint. These findings suggest that the rate of personality disorders in BDD is relatively high, with avoidant personality disorder being most common. The high neuroticism scores and low extraversion scores are consistent with this finding.

  6. Is severity of motor coordination difficulties related to co-morbidity in children at risk for developmental coordination disorder?

    Science.gov (United States)

    Schoemaker, Marina M; Lingam, Raghu; Jongmans, Marian J; van Heuvelen, Marieke J G; Emond, Alan

    2013-10-01

    Aim of the study was to investigate whether 7-9 year old children with severe motor difficulties are more at risk of additional difficulties in activities in daily living, academic skills, attention and social skills than children with moderate motor difficulties. Children (N=6959) from a population based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), were divided into three groups based on their scores on the ALSPAC Coordination Test at age 7: control children (scores above 15th centile; N=5719 [82.1%]); children with moderate (between 5th and 15th centile; N=951 [13.7%]); and children with severe motor difficulties (below 5th centile N=289 [4.2%]). Children with neurological disorders or an IQactivities of daily living (ADL); academic skills (reading, spelling and handwriting); attention; social skills (social cognition and nonverbal skills). Children with severe motor difficulties demonstrated a higher risk of difficulties in ADL, handwriting, attention, reading, and social cognition than children with moderate motor difficulties, who in turn had a higher risk of difficulties than control children in five out of seven domains. Screening and intervention of co-morbid problems is recommended for children with both moderate and severe motor difficulties. Copyright © 2013. Published by Elsevier Ltd.

  7. Improving the Recognition of Borderline Personality Disorder in a Bipolar World.

    Science.gov (United States)

    Zimmerman, Mark

    2016-06-01

    Both bipolar disorder and borderline personality disorder (BPD) are serious mental health disorders resulting in significant psychosocial morbidity, reduced health-related quality of life, and excess mortality. Yet research on BPD has received much less funding from the National Institute of Health (NIH) than has bipolar disorder during the past 25 years. Why hasn't the level of NIH research funding for BPD been commensurate with the level of psychosocial morbidity, mortality, and health expenditures associated with the disorder? In the present article, the author illustrates how the bipolar disorder research community has done a superior job of "marketing" their disorder. Studies of underdiagnosis, screening, diagnostic spectra, and economics are reviewed for both bipolar disorder and BPD. Researchers of bipolar disorder have conducted multiple studies highlighting the problem with underdiagnosis, developed and promoted several screening scales, published numerous studies of the operating characteristics of these screening measures, attempted to broaden the definition of bipolar disorder by advancing the concept of the bipolar spectrum, and repeatedly demonstrated the economic costs and public health significance of bipolar disorder. In contrast, researchers of BPD have almost completely ignored each of these four issues and research efforts. Although BPD is as frequent as (if not more frequent than) bipolar disorder, as impairing as (if not more impairing than) bipolar disorder, and as lethal as (if not more lethal than) bipolar disorder, it has received less than one-tenth the level of funding from the NIH and has been the focus of many fewer publications in the most prestigious psychiatric journals. The researchers of BPD should consider adopting the strategy taken by researchers of bipolar disorder before the diagnosis is eliminated in a future iteration of the DSM or the ICD.

  8. Clinical status of comorbid bipolar disorder and borderline personality disorder.

    Science.gov (United States)

    Parker, Gordon; Bayes, Adam; McClure, Georgia; Del Moral, Yolanda Romàn Ruiz; Stevenson, Janine

    2016-09-01

    The status and differentiation of comorbid borderline personality disorder and bipolar disorder is worthy of clarification. To determine whether comorbid borderline personality disorder and bipolar disorder are interdependent or independent conditions. We interviewed patients diagnosed with either a borderline personality disorder and/or a bipolar condition. Analyses of participants grouped by DSM diagnoses established that those with comorbid conditions scored similarly to those with a borderline personality disorder alone on all key variables (i.e. gender, severity of borderline personality scores, developmental stressors, illness correlates, self-injurious behaviour rates) and differed from those with a bipolar disorder alone on nearly all non-bipolar item variables. Similar findings were returned for groups defined by clinical diagnoses. Comorbid bipolar disorder and borderline personality disorder is consistent with the formal definition of comorbidity in that, while coterminous, individuals meeting such criteria have features of two independent conditions. © The Royal College of Psychiatrists 2016.

  9. Narcissistic personality disorder: effect on relationships.

    Science.gov (United States)

    Roark, Sybil V

    Personality disorders, by definition, affect relationships. Narcissistic Personality Disorder can negatively impact relationships in all areas of life: the workplace, the community, and the family. A clear understanding of the types and extent of interpersonal impairment can assist nurses in establishing therapeutic relationships with those diagnosed with Narcissistic Personality Disorder. The purpose of this activity is to examine the negative impact of Narcissistic Personality Disorder on interpersonal relationships. A review of literature connecting Narcissistic Personality Disorder to impairment in relationships. Research findings show that Narcissistic Personality Disorder symptoms and behaviors will negatively impact interpersonal relationships across all areas of life. CONCLUSIONS AND COMMENT: Nurses interact with diverse populations in a variety of settings. Establishment of a therapeutic relationship with individuals who have Narcissistic Personality Disorder can be aided by a clear understanding of the associated relationship issues.

  10. Mood disorder history and personality assessment in premenstrual dysphoric disorder.

    Science.gov (United States)

    Critchlow, D G; Bond, A J; Wingrove, J

    2001-09-01

    Menstrually related dysphoria is known to be associated with other affective disorders, notably major depressive disorder and puerperal depression. The relationship between premenstrual dysphoric disorder (PMDD) and maladaptive personality disorders and traits, however, is less established, at least in part because of the methodological and nosologic difficulties in the diagnosis of both PMDD and personality disorders. This study seeks to address this problem to elucidate the relationship between PMDD, other affective disturbances commonly experienced by women, and maladaptive personality. Axis I and II disorders were examined using standardized instruments and stringent diagnostic criteria (DSM-IV and the International Personality Disorders Examination) in 34 women with DSM-IV PMDD and 22 healthy women without severe premenstrual mood changes. Seventy-seven percent of the PMDD group had suffered from a past Axis I disorder in comparison with 17% of the control group. Two thirds of the parous women with PMDD had suffered from major depressive disorder in the puerperium. Personality disorder diagnoses were not highly represented in either group of women. The women with PMDD had significantly more obsessional personality traits (p personality disorder diagnoses. Obsessional symptoms are known to cluster with the affective disorders and may reflect underlying temperamental and biological vulnerability. This study provides further evidence of the link between serotonergic dysregulation, personality vulnerability, and mood changes related to the female reproductive cycle.

  11. Developmental aspects of borderline personality disorder.

    Science.gov (United States)

    Reich, D B; Zanarini, M C

    2001-01-01

    This study examined whether patients with borderline personality disorder and controls with other personality disorders remember their childhoods differently with respect to separation difficulties, evocative memory, temperamental factors such as frustration tolerance and mood reactivity, and onset of symptoms. Two hundred and ninety patients with borderline personality disorder and 72 with other personality disorders were assessed using an instrument to rate memories of separation difficulties, temperamental problems, and onset of symptoms before age 18. Patients with borderline personality disorder remembered more difficulties with separation between ages 6 and 17 years, more mood reactivity and poorer frustration tolerance between ages 6 and 17, and the onset of more symptoms (most prominently sadness, depression, anxiety, and suicidality) before age 18 than did patients with other personality disorders. The groups did not differ in reports of evocative memory before age 18. These results indicate that many of the features of adult patients with borderline personality disorder may initially appear during childhood and adolescence and that these features may be used to differentiate borderline from other personality disorders.

  12. Improved accuracy of co-morbidity coding over time after the introduction of ICD-10 administrative data.

    Science.gov (United States)

    Januel, Jean-Marie; Luthi, Jean-Christophe; Quan, Hude; Borst, François; Taffé, Patrick; Ghali, William A; Burnand, Bernard

    2011-08-18

    Co-morbidity information derived from administrative data needs to be validated to allow its regular use. We assessed evolution in the accuracy of coding for Charlson and Elixhauser co-morbidities at three time points over a 5-year period, following the introduction of the International Classification of Diseases, 10th Revision (ICD-10), coding of hospital discharges. Cross-sectional time trend evaluation study of coding accuracy using hospital chart data of 3'499 randomly selected patients who were discharged in 1999, 2001 and 2003, from two teaching and one non-teaching hospital in Switzerland. We measured sensitivity, positive predictive and Kappa values for agreement between administrative data coded with ICD-10 and chart data as the 'reference standard' for recording 36 co-morbidities. For the 17 the Charlson co-morbidities, the sensitivity - median (min-max) - was 36.5% (17.4-64.1) in 1999, 42.5% (22.2-64.6) in 2001 and 42.8% (8.4-75.6) in 2003. For the 29 Elixhauser co-morbidities, the sensitivity was 34.2% (1.9-64.1) in 1999, 38.6% (10.5-66.5) in 2001 and 41.6% (5.1-76.5) in 2003. Between 1999 and 2003, sensitivity estimates increased for 30 co-morbidities and decreased for 6 co-morbidities. The increase in sensitivities was statistically significant for six conditions and the decrease significant for one. Kappa values were increased for 29 co-morbidities and decreased for seven. Accuracy of administrative data in recording clinical conditions improved slightly between 1999 and 2003. These findings are of relevance to all jurisdictions introducing new coding systems, because they demonstrate a phenomenon of improved administrative data accuracy that may relate to a coding 'learning curve' with the new coding system.

  13. Narcissism and Narcissistic Personality Disorder

    OpenAIRE

    Gerhard Dammann

    2017-01-01

    This a video is one of the series of lectures about personality disorders. It covers the concept of narcissism and the concept of narcissism personality disorder.  The lecture is mainly focused on the differences between normal and pathological narcissism as well as etiology, diagnosis and practical recommendations on treatment of narcissism personality disorder.

  14. Is alexithymia a risk factor for major depression, personality disorder, or alcohol use disorders? A prospective population-based study.

    Science.gov (United States)

    Honkalampi, Kirsi; Koivumaa-Honkanen, Heli; Lehto, Soili M; Hintikka, Jukka; Haatainen, Kaisa; Rissanen, Teemu; Viinamäki, Heimo

    2010-03-01

    Disagreements concerning the stability of alexithymia and its ability to predict subsequent psychiatric disorders prevail. The aim of this 7-year follow-up study was to examine whether alexithymia predicts subsequent major depression, personality disorder, or alcohol use disorders in a population-based sample. The four-phase Kuopio Depression Study (KUDEP) was conducted in the eastern part of Central Finland. The study population (aged 25-64, n=2050) was randomly selected from the National Population Register. Data were collected in 1998, 1999, and 2001. In 2005, a subsample (n=333, 43 were excluded) of the 3-year follow-up population (1998-2001) was gathered and their diagnoses of mental disorders were confirmed by the Structure Clinical Interview for DSM-IV Axis I (SCID-I). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20) and depressive symptoms using the Beck Depression Inventory (BDI-21). For both of these measures, two groups were formed based on the median of their sum score (summing the 1998, 1999, and 2001 scores). Logistic regression analyses were performed. BDI sum scores, but not those of TAS, were associated with subsequent major depressive disorder, personality disorder, and alcohol use disorders in 2005. The BDI sum scores explained 35.7% of the variation in concurrent TAS sum scores. Alexithymia did not predict diagnoses of major depressive disorder, personality disorder, or alcohol use disorders. Alexithymia was closely linked to concurrent depressive symptoms. Thus, depressive symptoms may act as a mediator between alexithymia and psychiatric morbidity. Copyright 2010 Elsevier Inc. All rights reserved.

  15. HTR3B is associated with alcoholism with antisocial behavior and alpha EEG power--an intermediate phenotype for alcoholism and co-morbid behaviors.

    Science.gov (United States)

    Ducci, Francesca; Enoch, Mary-Anne; Yuan, Qiaoping; Shen, Pei-Hong; White, Kenneth V; Hodgkinson, Colin; Albaugh, Bernard; Virkkunen, Matti; Goldman, David

    2009-02-01

    Alcohol use disorders (AUD) with co-morbid antisocial personality disorder (ASPD) have been associated with serotonin (5-HT) dysfunction. 5-HT3 receptors are potentiated by ethanol and appear to modulate reward. 5-HT3 receptor antagonists may be useful in the treatment of early-onset alcoholics with co-morbid ASPD. Low-voltage alpha electroencephalogram (EEG) power, a highly heritable trait, has been associated with both AUD and ASPD. A recent whole genome linkage scan in one of our samples, Plains American Indians (PI), has shown a suggestive linkage peak for alpha power at the 5-HT3R locus. We tested whether genetic variation within the HTR3A and HTR3B genes influences vulnerability to AUD with comorbid ASPD (AUD+ASPD) and moderates alpha power. Our study included three samples: 284 criminal alcoholic Finnish Caucasians and 234 controls; two independent community-ascertained samples with resting EEG recordings: a predominantly Caucasian sample of 191 individuals (Bethesda) and 306 PI. In the Finns, an intronic HTR3B SNP rs3782025 was associated with AUD+ASPD (P=.004). In the Bethesda sample, the same allele predicted lower alpha power (P=7.37e(-5)). Associations between alpha power and two other HTR3B SNPs were also observed among PI (P=.03). One haplotype in the haplotype block at the 3' region of the gene that included rs3782025 was associated with AUD+ASPD in the Finns (P=.02) and with reduced alpha power in the Bethesda population (P=.00009). Another haplotype in this block was associated with alpha power among PI (P=.03). No associations were found for HTR3A. Genetic variation within HTR3B may influence vulnerability to develop AUD with comorbid ASPD. 5-HT3R might contribute to the imbalance between excitation and inhibition that characterize the brain of alcoholics.

  16. Cardiac morbidity risk and depression and anxiety

    DEFF Research Database (Denmark)

    Tully, Phillip J; Pedersen, Susanne S.; Winefield, Helen R

    2011-01-01

    The aim of this study was to examine depression and anxiety disorders and their characteristic symptoms (anhedonia/low positive affect and anxious arousal, respectively), along with measures of state negative affect (NA) and Type D personality, in relation to cardiac surgery related morbidity....... Patients awaiting elective coronary artery bypass graft surgery (n=158; 20.9% female; 11.4% concomitant valve surgery; age M=64.7, SD=10.6) underwent the structured MINI International Neuropsychiatric Interview to determine current affective disorders. Patients also completed the Mood and Anxiety Symptom.......3% of total). After adjustment for age, recent myocardial infarction, heart failure, hypertension, urgency of surgery and time spent on cardiopulmonary bypass generalized anxiety disorder was associated with cardiac morbidity (odds ratio [OR]=3.26, 95% confidence interval [CI] 1.10-9.67, p=0.03). Adjusted...

  17. Childhood antecedents of adolescent personality disorders.

    Science.gov (United States)

    Bernstein, D P; Cohen, P; Skodol, A; Bezirganian, S; Brook, J S

    1996-07-01

    The purpose of this study was to investigate the childhood antecedents of personality disorders that are diagnosed in adolescence. A randomly selected community sample of 641 youths was assessed initially in childhood and followed longitudinally over 10 years. Childhood behavior ratings were based on maternal report; diagnoses of adolescent personality disorders were based on data obtained from both maternal and youth informants. Four composite measures of childhood behavior problems were used: conduct problems, depressive symptoms, anxiety/fear, and immaturity. Adolescent personality disorders were considered present only if the disorders persisted over a 2-year period. For all analyses, personality disorders were grouped into the three clusters (A, B, and C) of DSM-III-R. Logistic regression analyses indicated that all four of the putative childhood antecedents were associated with greater odds of an adolescent personality disorder 10 years later. Childhood conduct problems remained an independent predictor of personality disorders in all three clusters, even when other childhood problems were included in the same regression model. Additionally, depressive symptoms emerged as an independent predictor of cluster A personality disorders in boys, while immaturity was an independent predictor of cluster B personality disorders in girls. No moderating effects of age at time of childhood assessment were found. These results support the view that personality disorders can be traced to childhood emotional and behavioral disturbances and suggest that these problems have both general and specific relationships to adolescent personality functioning.

  18. The continuum between Bipolar Disorder and Borderline Personality Disorder.

    Science.gov (United States)

    Elisei, Sandro; Anastasi, Serena; Verdolini, Norma

    2012-09-01

    Several studies have been carried out regarding the possible overlap between Bipolar Disorder and borderline personality disorder. Up to now, it is not possible to provide a definitive picture. In fact, there is currently significant debate about the relationship between Borderline Personality Disorder and Bipolar Disorder. MEDLINE searches were performed to identify the latest studies of these disorders, considering psychodynamic aspects. Bipolar disorder and borderline personality disorder share common clinical features, namely affective instability and impulsivity which however differ in quality. Consequently, to better understand these aspects, it is necessary to trace the stages of childhood psychological development. It has been claimed that Bipolar Disorder Type II can be divided into two subtypes: one stable and functional between episodes and one unstable between episodes which is related to Borderline Personality Disorder. However, better diagnostic theories, psychiatrist's empathy and patience remain the essential tool to understand and to face human suffering.

  19. Narcissism and Narcissistic Personality Disorder

    Directory of Open Access Journals (Sweden)

    Gerhard Dammann

    2017-04-01

    Full Text Available This a video is one of the series of lectures about personality disorders. It covers the concept of narcissism and the concept of narcissism personality disorder.  The lecture is mainly focused on the differences between normal and pathological narcissism as well as etiology, diagnosis and practical recommendations on treatment of narcissism personality disorder.

  20. Co-Occurring Disorders

    Science.gov (United States)

    ... the mental health field. Alcohol and Drug Abuse, Addiction and Co-occurring Disorders: Co-occurring Disorders and ... 500 Montgomery Street, Suite 820 Alexandria, VA 22314 Phone (703) 684.7722 Toll Free (800) 969.6642 ...

  1. Obsessive-compulsive personality disorder: a current review.

    Science.gov (United States)

    Diedrich, Alice; Voderholzer, Ulrich

    2015-02-01

    This review provides a current overview on the diagnostics, epidemiology, co-occurrences, aetiology and treatment of obsessive-compulsive personality disorder (OCPD). The diagnostic criteria for OCPD according to the recently published Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include an official set of criteria for clinical practice and a new, alternative set of criteria for research purposes. OCPD is a personality disorder prevalent in the general population (3-8 %) that is more common in older and less educated individuals. Findings on sex distribution and course of OCPD are inconsistent. OCPD is comorbid with several other medical and psychological conditions. As for causes of OCPD, most empirical evidence provides support for disturbed attachment as well as the heritability of OCPD. So far, cognitive (behavioural) therapy is the best validated treatment of OCPD. Self-esteem variability, stronger early alliances as well as the distress level seem to predict cognitive (behavioural) therapy outcome. Future research is needed to further advance knowledge in OCPD and to resolve inconsistencies.

  2. Obsessive compulsive personality disorder and obsessive compulsive disorder: clinical characteristics, diagnostic difficulties, and treatment.

    Science.gov (United States)

    Mancebo, Maria C; Eisen, Jane L; Grant, Jon E; Rasmussen, Steven A

    2005-01-01

    The overlap between obsessive compulsive personality disorder (OCPD) and obsessive compulsive disorder (OCD) has received increasing recognition and continues to be a source of much debate. With the advent of new research methodologies, researchers have attempted to distinguish whether OCPD and OCD are two distinct phenomena that can co-occur or whether they are similar, overlapping constructs. MEDLINE was used to systematically review the OCPD and OCD literature published between 1991 and 2004. Using the more stringent DSM-IV criteria, results from OCD clinical samples suggest that the majority of individuals with OCD (75%) do not have OCPD. Similarly, results from personality disorder samples suggest that the majority of individuals with OCPD (80%) do not have OCD. While there is evidence that OCD and OCPD are linked, the literature does not support either one as a necessary or sufficient component of the other.

  3. Peer substance use associated with the co-occurrence of borderline personality disorder features and drug use problems in college students.

    Science.gov (United States)

    Pizzarello, Scott; Taylor, Jeanette

    2011-01-01

    To determine if the substance use patterns of one's close friends and romantic partners would be a significant contributor to the co-occurrence of borderline personality disorder (BPD) features and drug use problems above and beyond impulsivity and negative emotionality. Participants were 2,202 undergraduates who attended a large southeastern university between 2003 and 2006. All subjects completed measures assessing the presence of BPD symptoms, drug use problems, general personality traits, and the proportion of their friends and partners who had used illicit drugs within the past 12 months. The illicit drug use patterns of one's friends and romantic partners was a significant contributor to the co-occurrence of BPD features and drug use problems even when controlling for levels of impulsivity and negative emotionality. These findings suggest possible additional avenues for treatment focusing on helping students with BPD and drug use problems modify their social group.

  4. Personal recovery in individuals diagnosed with substance use disorder (SUD) and co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD)

    NARCIS (Netherlands)

    Kronenberg, Linda M.; Verkerk-Tamminga, Roeliene; Goossens, Peter J. J.; van den Brink, Wim; van Achterberg, Theo

    2015-01-01

    The process of personal recovery in people diagnosed with substance use disorder and comorbid attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) was mapped. Four general themes representing four consecutive stages in the recovery process were identified in both client

  5. Asking for work adjustments or initiating behavioural changes - what makes a 'problematic co-worker' score Brownie points? An experimental study on the reactions towards colleagues with a personality disorder.

    Science.gov (United States)

    Muschalla, Beate; Fay, Doris; Seemann, Anne

    2016-10-01

    People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues' reactions towards a problematic worker dependent on the returning person's reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.

  6. Brief Report: Major Depressive Disorder with Psychotic Features in Williams Syndrome--A Case Series

    Science.gov (United States)

    Valdes, Francisca; Keary, Christopher J.; Mullett, Jennifer E.; Palumbo, Michelle L.; Waxler, Jessica L.; Pober, Barbara R.; McDougle, Christopher J.

    2018-01-01

    Descriptions of individuals with Williams syndrome (WS) and co-morbid major depressive disorder (MDD) with psychotic features have not appeared in the literature. In addition to reviewing previous reports of psychotic symptoms in persons with WS, this paper introduces clinical histories and therapeutic management strategies for three previously…

  7. Vocal cord paralysis post patent ductus arteriosus ligation surgery: risks and co-morbidities.

    Science.gov (United States)

    Rukholm, Gavin; Farrokhyar, Forough; Reid, Diane

    2012-11-01

    1. To determine the prevalence of left vocal cord paralysis (LVCP) post patent ductus arteriosus (PDA) ligation at a Tertiary Care Centre. 2. To identify risk factors associated with LVCP. 3. To identify co-morbidities associated with LVCP. 4. To determine the frequency of pre- and post-operative nasopharyngolaryngoscopic (NPL) examination in this patient population. Retrospective chart review of all infants who underwent PDA ligation surgery at a tertiary care academic hospital between July 2003 and July 2010. Data on patient age, gender, weight, method of PDA ligation, and results of NPL scoping were collected, as well as patient co-morbidities post PDA ligation. One hundred and fifteen patients underwent PDA ligation surgery. Four patients were excluded due to bilateral vocal cord paralysis. Of the remaining 111 patients, nineteen patients (17.1%) were found to have LVCP. Low birth weight was identified as a significant risk factor for LVCP (p=0.002). Gastroesophageal reflux was identified as a significant co-morbidity associated with LVCP post PDA ligation (p=0.002). Only 0.9% of patients were scoped pre-operatively, and 27.9% were scoped postoperatively. LVCP is associated with multiple morbidities. The authors strongly recommend routine post-operative scoping of all patients post PDA ligation surgery, and preoperative scoping when possible. A prospective study is warranted, in order to confirm the prevalence of LVCP as well as risk factors and associated co-morbidities. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  8. Anxiety Disorders Comorbidity in Iranian Patients with Mood Disorders and Its' Relationship with Suicidal Attempt

    Directory of Open Access Journals (Sweden)

    Amir Shabani

    2007-08-01

    Full Text Available     Objective: Several studies show co morbidity of anxiety disorders amongst patients with bipolar and unipolar disorders. It is associated with an intensification of symptoms, insufficient treatment response, non recovery, poor functional outcome and suicidality. The aim of this study was to show the frequency of anxiety disorders comorbidity and the relationship between comorbidity and suicide attempt in these patients.         Method: In a descriptive study, 152 patients with bipolar and unipolar disorders in a psychiatric center were assessed with SCID. Current and lifetime comorbidity in bipolar and unipolar patients were analyzed.         Results: One hundred fifty two subjects aged 18-60 years were included in the study and102 bipolar I, 11 bipolar II, and 39 unipolar patients were diagnosed.Co morbidity in each group was 21.2%, 11.5%, and 43.5%. Suicide attempt in patients with bipolar disorders and anxiety disorders comorbidity was significantly more than patients with bipolar disorders without co morbidity.     Conclusions: Significant proportions of patients with bipolar and unipolar disorder had co morbid anxiety disorders. Moreover, anxiety disorders comorbidity may be associated with more suicide attempt in bipolar patients,highlighting the need for greater clinical attention to anxiety in this population, particularly for enhanced clinical monitoring of suicidality. In addition, it is important to determine whether an effective treatment of anxiety symptoms can reduce suicidality.

  9. Premorbid Personality Disorders in Male Schizophrenic Patients with or without Comorbid Substance Use Disorder: Is Dual Diagnosis Mediated by Personality Disorder?

    Science.gov (United States)

    Altunsoy, Neslihan; Şahiner, Şafak Yalçın; Cingi Külük, Merve; Okay, Tuncer; Ulusoy Kaymak, Semra; Aydemir, Çiğdem; Göka, Erol

    2015-09-01

    Although substance abuse is an important clinical problem in schizophrenic patients, very little evidence explains why these patients use drugs and alcohol. This study therefore aimed to examine whether premorbid personality disorders affect substance abuse. The sample included 40 male schizophrenic patients with and 40 male schizophrenic patients without substance use disorder comorbidity who had applied to Ankara Numune Research and Training Hospital. Each participant and a family member were interviewed in a structured clinical interview that addressed premorbid personality disorders. Altogether, 32 patients (80%) in the group with comorbidity and 28 (70%) in the group without comorbidity had a premorbid personality disorder. Antisocial (35% vs. 0%; ppersonality disorders were more often detected in the group with comorbidity, while avoidant (10% vs. 35%; p=.014) and obsessive-compulsive (0% vs. 15%; p=.026) personality disorders were less frequently found in this group. Comparing the group with comorbidity with premorbid personality types, schizophrenic patients with premorbid antisocial personality disorder were more frequently unemployed and hospitalized as well as had an earlier onset age of schizophrenia (p=.034, p=.038 and p=.035, respectively). Schizophrenic patients with premorbid borderline personality disorder had a significantly earlier onset age of substance use (19±5; p=.028). Schizophrenic patients with substance use comorbidity variously differ from those without comorbidity and some of these differences may be associated with premorbid personality disorders.

  10. Histrionic personality disorder and antisocial personality disorder: sex-differentiated manifestations of psychopathy?

    Science.gov (United States)

    Cale, Ellison M; Lilienfeld, Scott O

    2002-02-01

    Little is known about the etiology of histrionic personality disorder (HPD) or its relation to other personality disorders. In this study, we examined whether HPD is etiologically related to psychopathy and more specifically whether HPD and antisocial personality disorder (ASPD) are sex-typed alternative manifestations of psychopathy. In addition, based on Newman's (1987) response modulation hypothesis of psychopathy, we examined the associations between psychopathic, HPD, and ASPD features and performance on laboratory measures of passive avoidance errors and interference effects. Seventy-five live theater actors completed self-report questionnaires and two laboratory measures of response modulation, and peers completed questionnaires concerning the participants' personality disorder features. The results provided weak and inconsistent support for the hypotheses that HPD is a female-typed variant of psychopathy and that ASPD is a male-typed variant of psychopathy. Contrary to previous findings, scores on response modulation tasks were not significantly related to psychopathy, or to either HPD or ASPD. The limitations of this study and possibilities for future research in this area are outlined.

  11. Clinical Characteristics of Comorbid Narcissistic Personality Disorder in Patients With Borderline Personality Disorder.

    Science.gov (United States)

    Hörz-Sagstetter, Susanne; Diamond, Diana; Clarkin, John F; Levy, Kenneth N; Rentrop, Michael; Fischer-Kern, Melitta; Cain, Nicole M; Doering, Stephan

    2017-07-31

    This study examines psychopathology and clinical characteristics of patients with borderline personality disorder (BPD) and comorbid narcissistic personality disorder (NPD) from two international randomized controlled trials. From a combined sample of 188 patients with BPD, 25 also fulfilled criteria for a comorbid diagnosis of NPD according to DSM-IV. The BPD patients with comorbid NPD, compared to the BPD patients without comorbid NPD, showed significantly more BPD criteria (M = 7.44 vs. M = 6.55, p personality disorders, and were more likely to meet criteria for full histrionic PD diagnosis (44.0% vs. 14.2%, p disorders (M = 2.68 vs. M = 3.75, p = .033). No differences could be found in general functioning, self-harming behavior, and suicide attempts.

  12. The prevalence of personality disorders in hypochondriasis.

    Science.gov (United States)

    Sakai, Reiko; Nestoriuc, Yvonne; Nolido, Nyryan V; Barsky, Arthur J

    2010-01-01

    Although Axis I hypochondriasis is closely related to certain personality characteristics, the nature and extent of personality dysfunction in these patients still needs clarification. This study assessed the prevalence of personality disorders observed in hypochondriacal patients, described the types and comorbidity of personality disorders, and compared the psychological distress of patients with and without the most common comorbid personality disorder. One hundred fifteen patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for hypochondriasis completed self-administered assessments, including the Personality Diagnostic Questionnaire-4+ (PDQ-4+), the Hopkins Symptom Checklist-90-Revised (SCL-90-R), the Whiteley Index, and the Somatic Symptom Inventory. These data were taken from a study conducted between September 1997 and November 2001. Eighty-eight patients (76.5%) had 1 or more personality disorders, whereas 27 patients (23.5%) had no personality disorders. Fifty-one patients (44.3%) had more than 3 personality disorders. The most common personality disorder in the hypochondriacal patients was obsessive-compulsive personality disorder (OCPD; 55.7%), followed by avoidant personality disorder (40.9%). The comorbidity of OCPD and avoidant personality disorder was 53.1% (34 of 64 patients with OCPD). The total PDQ-4+ score of the 64 patients with OCPD was significantly higher than that of the 51 patients without OCPD. On the SCL-90-R, the 64 patients with OCPD showed significantly higher scores on all of 3 global indices and 7 of 10 primary symptom dimensions (paranoid ideation, depression, anxiety, phobic anxiety, obsessive-compulsive, interpersonal sensitivity, and psychoticism) on the SCL-90-R compared to the 51 patients without OCPD. The high prevalence of personality disorders, particularly OCPD, among patients with hypochondriasis suggests that consideration of personality features is important in assessment and

  13. Predictors of comorbid personality disorders in patients with panic disorder with agoraphobia.

    Science.gov (United States)

    Latas, M; Starcevic, V; Trajkovic, G; Bogojevic, G

    2000-01-01

    The aim of this study was to ascertain predictors of comorbid personality disorders in patients with panic disorder with agoraphobia (PDAG). Sixty consecutive outpatients with PDAG were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) for the purpose of diagnosing personality disorders. Logistic regressions were used to identify predictors of any comorbid personality disorder, any DSM-IV cluster A, cluster B, and cluster C personality disorder. Independent variables in these regressions were gender, age, duration of panic disorder (PD), severity of PDAG, and scores on self-report instruments that assess the patient's perception of their parents, childhood separation anxiety, and traumatic experiences. High levels of parental protection on the Parental Bonding Instrument (PBI), indicating a perception of the parents as overprotective and controlling, emerged as the only statistically significant predictor of any comorbid personality disorder. This finding was attributed to the association between parental overprotection and cluster B personality disorders, particularly borderline personality disorder. The duration of PD was a significant predictor of any cluster B and any cluster C personality disorder, suggesting that some of the cluster B and cluster C personality disorders may be a consequence of the long-lasting PDAG. Any cluster B personality disorder was also associated with younger age. In conclusion, despite a generally nonspecific nature of the relationship between parental overprotection in childhood and adult psychopathology, the findings of this study suggest some specificity for the association between parental overprotection in childhood and personality disturbance in PDAG patients, particularly cluster B personality disorders.

  14. [Narcissistic personality disorder].

    Science.gov (United States)

    Lammers, C-H; Vater, A; Roepke, S

    2013-07-01

    Narcissism is a multifaceted term which encompasses traits of normal personality as well as a specific personality disorder. While much research has been concerned with narcissism as a trait there are only few empirical studies available on narcissistic personality disorder (NPS). The current diagnostic of NPS according to DSM-IV-TR focuses on grandiose type narcissism whereas vulnerable narcissism, which has been described by clinicians and researchers has not yet been recognised. Psychotherapy of narcissistic patients through different psychotherapeutic schools focuses mainly on processes in the therapeutic relationship, the analysis and change of grandiose and vulnerable schemas, emotion regulation techniques and correction of narcissistic behavior in favor of prosocial interactions.

  15. The complexity of bipolar and borderline personality: an expression of 'emotional frailty'?

    Science.gov (United States)

    McDermid, Joanna; McDermid, Robert C

    2016-01-01

    The purpose of this article is to review recent findings regarding the comorbidity of bipolar disorder with borderline personality disorder (BPD). The conceptualization of the comorbid condition is explored in the context of complexity theory. Recent studies highlight distinguishing features between the two disorders. The course of illness of the comorbid condition is generally considered to be more debilitating than bipolar disorder alone. Some of the differentiating features of bipolar disorder and BPD are highlighted. It is also crucial to consider a co-morbid diagnosis as worse outcomes may be anticipated than for bipolar disorder alone. The concept of 'emotional frailty' is introduced and the comorbid bipolar disorder-BPD condition is considered an expression of this syndrome.

  16. GENDER ROLE AND PERSONALITY DISORDERS

    OpenAIRE

    Klonsky, E. David; Jane, J. Serrita; Turkheimer, Eric; Oltmanns, Thomas F.

    2002-01-01

    Many researchers have hypothesized relationships between personality disorders and gender role (i.e., masculinity and femininity). However, research has not addressed if people who are masculine or feminine more often meet the criteria for personality disorders. The present study examined whether college students (N = 665, 60% women) higher in masculinity or femininity more often exhibited features of the 10 DSM-IV personality disorders. Feminine men exhibited more features of all the persona...

  17. Childhood maltreatment, personality disorders and 3-year persistence of adult alcohol and nicotine dependence in a national sample.

    Science.gov (United States)

    Elliott, Jennifer C; Stohl, Malka; Wall, Melanie M; Keyes, Katherine M; Skodol, Andrew E; Eaton, Nicholas R; Shmulewitz, Dvora; Goodwin, Renee D; Grant, Bridget F; Hasin, Deborah S

    2016-05-01

    Persistent cases of alcohol and nicotine dependence are associated with considerable morbidity and mortality, and are predicted by childhood maltreatment and personality disorders. Our aim was to test whether personality disorders (individually or conjointly) mediate the relationship between childhood maltreatment and the persistence of dependence. Personality disorders, modeled dimensionally, were tested as mediators of the relationship between childhood maltreatment and the 3-year persistence of alcohol and nicotine dependence in participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who had current alcohol and nicotine dependence in their baseline interview. Individual personality disorders were assessed in separate models. Then, those that were significant were examined jointly in multiple mediator models to determine their total and unique effects. A large, nationally representative US survey. Participants ≥ 18 years who completed baseline and 3-year follow-up NESARC interviews who had baseline alcohol dependence (n = 1172; 68% male) or nicotine dependence (n = 4017; 52.9% male). Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-IV) measures of childhood maltreatment, personality disorders and alcohol/nicotine dependence. Individual models indicated that many personality disorders mediated the relationship between childhood maltreatment and the 3-year persistence of alcohol and nicotine dependence (each explaining 6-46% of the total effect, Ps Personality disorder symptoms (especially borderline and antisocial) help explain the association between childhood maltreatment and persistent alcohol and nicotine dependence. © 2016 Society for the Study of Addiction.

  18. Management of co-morbidity of depression and chronic non ...

    African Journals Online (AJOL)

    Methods: The study used an action research design involving a research team of 14 health care professionals to collaboratively identify existing protocols or interventions for managing co-morbidity of depression and NCDs in Rwanda. Focus group discussion using a structured interview guide was used to collect qualitative ...

  19. Establishing the severity of personality disorder.

    Science.gov (United States)

    Tyrer, P; Johnson, T

    1996-12-01

    The authors developed a simplified method of rating the severity of personality disorder. The new rating method is based on four levels of severity: no personality disorder, personality difficulty, simple personality disorder, and diffuse personality disorder. The new method was applied to different diagnostic systems and was then compared with an old rating system based on six severity levels. Data were derived from a longitudinal study in which 163 patients with anxiety and depressive disorders had initial assessments of personality status and were followed up over 2 years. Ratings of psychiatric symptoms were made by using the Comprehensive Psychopathological Rating Scale over this period. The results were analyzed with special attention to linear and quadratic trends. The new system was clinically useful in separating patients' initial assessments and outcomes. Patients with no personality disorder had the lowest initial symptom scores and the best outcomes, and those with diffuse personality disorder had the highest initial levels of symptoms and improved least over the 2 years. When the patients were separated by the old classification system, 72% of the variation between groups was accounted for by linear and quadratic trends; the comparable percentage was 97% when the patients were categorized by the new system. The new system of rating severity of personality disturbance is an improvement on existing methods and allows ratings to be made easily from DSM-IV and ICD-10.

  20. Personality disorders in first-episode psychosis

    DEFF Research Database (Denmark)

    Simonsen, Erik; Haahr, Ulrik; Mortensen, Erik Lykke

    2008-01-01

    or more personality disorders, while one-third of the patients did not fulfil the criteria for any personality disorder. The schizoid and the avoidant were the most frequent personality disorders and both were associated with social withdrawal during childhood and adolescence. The limitation of the study...

  1. [The efficacy and tolerability of pericyazine in the treatment of patients with schizotypal disorder, organic personality disorders and pathocharacterological changes within personality disorders].

    Science.gov (United States)

    Danilov, D S

    To assess the efficacy and tolerability of pericyazine in the treatment of patients with mental disorders manifesting with psychopathic-like symptoms and correction of pathocharacterological disorders in patients with personality disorders during the short-term admission to the hospital or the long-term outpatient treatment. Sixty-three patients with schizotypal personality disorder and organic personality disorder with psychopathic-like symptoms and pathocharacterological changes within the diagnosis of dissocial personality disorder and borderline personality disorder were examined. Patients received pericyazine during the short-term admission to the hospital (6 weeks) or the long-term outpatient treatment (6 month). Efficacy, tolerability and compliance were assessed in the study. Treatment with pricyazine was effective in all patients. The improvement was seen in patients with organic personality disorders and patients with personality disorders (psychopathy). The maximal effect was observed in inpatients and this effect remained during outpatient treatment. The improvement of mental state of patients with schizotypal personality disorder achieved during inpatient treatment with pericyazine continued during the long-term outpatient treatment. Side-effects were restricted to extrapyramidal symptoms, the frequency of metabolic syndrome was low. During outpatient treatment, the compliance was higher if the patient was managed by the same psychiatrist during inpatient- and outpatient treatment.

  2. Personality disorder: still the patients psychiatrists dislike?

    Science.gov (United States)

    Chartonas, Dimitrios; Kyratsous, Michalis; Dracass, Sarah; Lee, Tennyson; Bhui, Kamaldeep

    2017-02-01

    Aims and method In 1988, Lewis and Appleby demonstrated that psychiatrists hold negative attitudes towards patients with personality disorder. We assessed the attitudes of psychiatry trainees towards patients with borderline personality disorder and depression, expecting an improvement. 166 trainees were block randomised to receive one of four case vignettes that varied by diagnosis and ethnic group. We used Lewis and Appleby's original questionnaire and the Attitudes to Personality Disorder Questionnaire (APDQ). Results We received 76 responses. Lewis and Appleby's questionnaire showed more negative attitudes towards personality disorder than depression, with no significant patient ethnic group effects, and the APDQ also showed a (weak) trend towards more negative attitudes to personality disorder. In subgroup analysis, only in the White British patient group were there significantly more negative attitudes to personality disorder. Factor analysis showed significantly less sense of purpose when working with personality disorder. Clinical implications The perceived greater lack of purpose in working with personality disorder should be the target of clinical training and intervention. Targeted interventions that include training in managing personality disorder, supervision and practice in non-specialist, general psychiatry settings are important.

  3. Posttraumatic stress disorder following asthma attack: the role of agency beliefs in mediating psychiatric morbidity.

    Science.gov (United States)

    Wagner, Ernest H; Hoelterhoff, Mark; Chung, Man Cheung

    2017-08-01

    The link between serious illness and subsequent posttraumatic stress disorder (PTSD) and psychiatric comorbidity has been established. In populations with asthma, however, few studies have investigated this link, or what psychological mechanisms mediate it. Healthcare guidance for chronic conditions, and PTSD literature, highlight "agency beliefs" as a direction for investigation. To determine the prevalence of PTSD following asthma attack, and investigate whether agency beliefs mediate PTSD and comorbid psychiatric symptoms in this population. We recruited 110 adults with asthma from online peer support forums. Participants completed the Asthma Symptom Checklist, PTSD Checklist, GHQ-28, General Self-Efficacy scale, and Multidimensional Health Locus of Control scale. 20% of our sample met criteria for PTSD. Regression results indicated that higher asthma severity significantly predicted PTSD and psychiatric co-morbidity. Lower self-efficacy significantly predicted PTSD symptoms while controlling for asthma severity, however Locus of Control (LoC) did not improve the model further. Self-efficacy, but not LoC, significantly partially mediated the effect of asthma severity on PTSD severity and psychiatric co-morbidity. PTSD and other psychiatric symptoms in asthma populations are mediated in part by self-efficacy. Safeguarding and improving self-efficacy in this population is an important area for future research and intervention.

  4. PREVALENCE OF OCCULT DEPRESSION IN ELDERLY WITH CHRONIC CO - MORBIDS

    Directory of Open Access Journals (Sweden)

    Sachin

    2015-02-01

    Full Text Available BACKGROUND: Growth in elderly population has led to an increase in age related diseases and mainly depression which is affecting the quality of life. Depression is more prevalent amongst elderly individuals with medical illnesses and emerging public health problem leading to increased morbidity and disability worldwide. AIMS AND OBJE CTIVES: To assess the prevalence of occult depression in elderly patients with chronic co - morbid medical conditions. MATERIALS AND METHODS: It was a cross - sectional study conducted in tertiary hospital. Total 100 elderly patients with underlying chronic me dical illnesses were included. Depression in study population was assessed by geriatric depression scale and analyzed. RESULT: Out of 100 patients 23(23% had depression. Females 12/39(30.76% were affected more than males 11/61 (18.03%. Depression was mo re prevalent among patients with 3 or more co - morbid conditions (45.4% as compared to <3 (11.9%. CONCLUSION: Elderly patients with multiple chronic medical illnesses may have associated occult depression. Screening of these patients for depression couple d with appropriate psychiatric referral should be an integral part of Geriatric service

  5. Predicting personality disorder functioning styles by the Chinese Adjective Descriptors of Personality: a preliminary trial in healthy people and personality disorder patients.

    Science.gov (United States)

    Fan, Hongying; Zhu, Qisha; Ma, Guorong; Shen, Chanchan; Zhang, Bingren; Wang, Wei

    2016-08-30

    Cultural and personality factors might contribute to the clinical differences of psychiatric patients all over the world including China. One cultural oriented Chinese Adjective Descriptors of Personality (CADP) designed to measure normal personality traits, might be specifically associated with different personality disorder functioning styles. We therefore have invited 201 healthy volunteers and 67 personality disorder patients to undergo CADP, the Parker Personality Measure (PERM), and the Plutchik-van Praag Depression Inventory (PVP) tests. Patients scored significantly higher on PVP scale and all 11 PERM personality disorder functioning styles, as well as CADP Emotional and Unsocial traits. The PVP was significantly correlated with some CADP traits and PERM styles in both groups. In healthy volunteers, only one CADP trait, Unsocial, prominently predicted 11 PERM styles. By contrast in patients, CADP Intelligent predicted the PERM Narcissistic and Passive-Aggressive styles; CADP Emotional the PERM Paranoid, Borderline, and Histrionic styles; CADP Conscientious the PERM Obsessive-Compulsive style; CADP Unsocial the PERM Schizotypal, Antisocial, Narcissistic, Avoidant, Dependent, and Passive-Aggressive styles; CADP Agreeable the PERM Antisocial style. As a preliminary study, our results demonstrated that, in personality disorder patients, all five CADP traits were specifically associated with almost all 11 personality disorder functioning styles, indicating that CADP might be used as an aid to diagnose personality disorders in China.

  6. Conscientiousness and Obsessive-Compulsive Personality Disorder

    OpenAIRE

    Samuel, Douglas B; Widiger, Thomas A

    2011-01-01

    A dimensional perspective on personality disorder hypothesizes that the current diagnostic categories represent maladaptive variants of general personality traits. However, a fundamental foundation of this viewpoint is that dimensional models can adequately account for the pathology currently described by these categories. While most of the personality disorders have well established links to dimensional models that buttress this hypothesis, obsessive-compulsive personality disorder (OCPD) ha...

  7. Prevalence of psychiatric morbidity among medical practitioners in ...

    African Journals Online (AJOL)

    Background: Mental health problems can affect anybody including Doctors. It can be related to nature of our work and personal factors. Mental ill health includes a range of conditions like depression, bipolar disorder, anxiety and psychosis. Objective: To determine the prevalence of psychiatric morbidity among Medical ...

  8. Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial.

    Science.gov (United States)

    Shiranibidabadi, Shahrzad; Mehryar, Amirhooshang

    2015-09-15

    Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to date. In a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n = 15) or standard treatment only (n = 15) for one month. Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month. Thirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy+standard treatment: 12.4 ± 1.9 vs standard treatment only: 15.1 ± 1.7, p Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy + standard treatment: 16.9 ± 7.4 vs standard treatment only: 22.9 ± 4.6, p music therapy + standard treatment: 10.8 ± 3.8 vs standard treatment: 17.1 ± 3.7, p music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms. Copyright © 2015. Published by Elsevier B.V.

  9. Impact of pre-existing co-morbidities on mortality in granulomatosis with polyangiitis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Ahlström, Magnus Glindvad; Lindhardsen, Jesper

    2016-01-01

    of pre-existing co-morbidities among the patients was quantified according to the Charlson Comorbidity Index (CCI). Each patient was matched with five age- and gender-matched population controls with no pre-existing co-morbidities captured by the CCI (CCI score = 0). The study subjects were followed...... throughout 2010. Cox regression analyses were used to calculate mortality rate ratios (MRRs). RESULTS: The median duration of follow-up in the GPA cohort was 5.8 years (interquartile range 2.3-10.0). Compared with their matched population controls, the MRR for patients presenting with a CCI score of 0 (n...

  10. Child development and personality disorder.

    Science.gov (United States)

    Cohen, Patricia

    2008-09-01

    The evidence is surprisingly strong that even early adolescent personality disorders or elevated personality disorder symptoms have a broad range of negative effects well into adulthood, for the most part comparable to or even larger than those of Axis I disorders. Current evidence suggests that the most severe long-term prognosis is associated with borderline and schizotypal PDs and elevated symptoms. And of course, childhood conduct disorder is in a peculiar status, disappearing in adulthood to be manifest as a very severe disorder-antisocial PD-in a minority of those with the adolescent disorder.

  11. The relationship between trauma centrality, self-efficacy, posttraumatic stress and psychiatric co-morbidity among Syrian refugees: Is gender a moderator?

    Science.gov (United States)

    Chung, Man Cheung; AlQarni, Nowf; Al Muhairi, Shamsa; Mitchell, Britt

    2017-11-01

    This study examined the inter-relationship between trauma centrality, self-efficacy, posttraumatic stress disorder (PTSD) and psychiatric co-morbidity among a group of Syrian refugees living in Turkey, and whether gender would moderate the mediational effect of self-efficacy on the impact of trauma centrality on distress. Seven hundred and ninety-two Syrian refugees completed the Harvard Trauma Questionnaire, General Health Questionnaire-28, Centrality of Event Scale and Generalized Self-Efficacy Scale. The results showed that 52% met the cutoff for PTSD. Trauma centrality was positively correlated with PTSD, psychiatric co-morbidity and self-efficacy. Self-efficacy was negatively correlated with PTSD only. Gender did not moderate the mediational effect of self-efficacy on the path between trauma centrality and distress outcomes. To conclude, following exposure to traumatic events, more than half reported PTSD. Perception of the future and identity construction was affected. Signs of psychological distress were evident, alongside resilience, regardless of gender. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Avoidant Personality Disorder is a Separable Schizophrenia Spectrum Personality Disorder even when Controlling for the Presence of Paranoid and Schizotypal Personality Disorders

    OpenAIRE

    Fogelson, D. L.; Nuechterlein, K. H.; Asarnow, R. A.; Payne, D. L.; Subotnik, K. L.; Jacobson, K. C.; Neale, M. C.; Kendler, K. S.

    2007-01-01

    It is unresolved whether avoidant personality disorder (APD) is an independent schizophrenia (Sz)-spectrum personality disorder (PD). Some studies find APD and social anxiety symptoms (Sxs) to be a separable dimension of psychopathology in relatives (Rels) of schizophrenics while other studies find avoidant Sxs to be correlated with schizotypal and paranoid Sxs.

  13. Psychiatric morbidity in patients with chronic whiplash-associated disorder.

    Science.gov (United States)

    Kivioja, Jouko; Själin, Mikael; Lindgren, Urban

    2004-06-01

    Prospective cohort with age- and gender-matched controls. To compare psychiatric morbidity between two groups: patients having chronic symptoms after a whiplash injury and patients who recovered completely. Psychiatric morbidity may influence the outcome of somatic diseases, and it has been suggested that psychological factors are often involved in the development of chronic symptoms after whiplash injuries, but there is no study assessing psychiatric morbidity in whiplash-associated disorder (WAD) using the Structured Clinical Interview for DSM-IV. We studied a consecutive sample of 278 patients with a whiplash injury. Eighty-five had persisting neck pain after 1 year, and 38 of these participated in this study. For each patient with chronic neck pain at the 1 year follow-up, a gender- and age-matched recovered patient was selected from the study cohort of 278 cases. Psychiatric morbidity was determined using the Structured Clinical Interview for DSM-IV (SCID). The interview was conducted at 1 year after the accident (360 days, SD 2 days). The chronic WAD group had a significantly (P factor for chronic symptoms after a whiplash injury. The development of chronic symptoms after awhiplash injury seems to be associated with psychiatric vulnerability.

  14. Longitudinal associations between social anxiety disorder and avoidant personality disorder: A twin study.

    Science.gov (United States)

    Torvik, Fartein Ask; Welander-Vatn, Audun; Ystrom, Eivind; Knudsen, Gun Peggy; Czajkowski, Nikolai; Kendler, Kenneth S; Reichborn-Kjennerud, Ted

    2016-01-01

    Social anxiety disorder (SAD) and avoidant personality disorder (AvPD) are frequently co-occurring psychiatric disorders with symptomatology related to fear of social situations. It is uncertain to what degree the 2 disorders reflect the same genetic and environmental risk factors. The current study addresses the stability and co-occurrence of SAD and AvPD, the factor structure of the diagnostic criteria, and genetic and environmental factors underlying the disorders at 2 time points. SAD and AvPD were assessed in 1,761 young adult female twins at baseline and 1,471 of these approximately 10 years later. Biometric models were fitted to dimensional representations of SAD and AvPD. SAD and AvPD were moderately and approximately equally stable from young to middle adulthood, with increasing co-occurrence driven by environmental factors. At the first wave, approximately 1 in 3 individuals with AvPD had SAD, increasing to 1 in 2 at follow-up. The diagnostic criteria for SAD and AvPD had a two-factor structure with low cross-loadings. The relationship between SAD and AvPD was best accounted for by a model with separate, although highly correlated (r = .76), and highly heritable (.66 and .71) risk factors for each disorder. Their genetic and environmental components correlated .84 and .59, respectively. The finding of partially distinct risk factors indicates qualitative differences in the etiology of SAD and AvPD. Genetic factors represented the strongest time-invariant influences, whereas environmental factors were most important at the specific points in time. (c) 2016 APA, all rights reserved.

  15. The Relationship of Hypochondriasis to Anxiety, Depressive, and Somatoform Disorders

    Science.gov (United States)

    Scarella, Timothy M.; Laferton, Johannes A. C.; Ahern, David K.; Fallon, Brian A.; Barsky, Arthur

    2015-01-01

    Background Though the phenotype of anxiety about medical illness has long been recognized, there continues to be debate as to whether it is a distinct psychiatric disorder and, if so, to which diagnostic category it belongs. Our objective was to investigate the pattern of psychiatric co-morbidity in hypochondriasis and to assess the relationship of health anxiety to anxiety, depressive, and somatoform disorders. Methods Data were collected as part of a clinical trial on treatment methods for hypochondriasis. 194 participants meeting criteria for DSM-IV hypochondriasis were assessed by sociodemographic variables, results of structured diagnostic interviews, and validated instruments for assessing various symptom dimensions of psychopathology. Results The majority of individuals with hypochondriasis had co-morbid psychiatric illness; the mean number of co-morbid diagnoses was 1.4, and 35.1% had hypochondriasis as their only diagnosis. Participants were more likely to have only co-morbid anxiety disorders than only co-morbid depressive or somatoform disorders. Multiple regression analysis of continuous measures of symptoms revealed the strongest correlation of health anxiety with anxiety symptoms, and a weaker correlation with somatoform symptoms; in multiple regression analysis, there was no correlation between health anxiety and depressive symptoms. Conclusion Our findings suggest that the entity of health anxiety (Hypochondriasis in DSM-IV, Illness Anxiety Disorder in DSM-5) is a clinical syndrome distinct from other psychiatric disorders. Analysis of co-morbidity patterns and continuous measures of symptoms suggest its appropriate classification is with anxiety rather than somatoform or mood disorders. PMID:26785798

  16. DSM-5 Personality Traits and DSM-IV Personality Disorders

    Science.gov (United States)

    Hopwood, Christopher J.; Thomas, Katherine M.; Markon, Kristian E.; Wright, Aidan G.C.; Krueger, Robert F.

    2014-01-01

    Two issues pertinent to the DSM-5 proposal for personality pathology, the recovery of DSM-IV personality disorders (PDs) by proposed DSM-5 traits and the validity of the proposed DSM-5 hybrid model which incorporates both personality pathology symptoms and maladaptive traits, were evaluated in a large undergraduate sample (N = 808). Proposed DSM-5 traits as assessed with the Personality Inventory for DSM-5 explained a substantial proportion of variance in DSM-IV PDs as assessed with the Personality Diagnostic Questionnaire-4+, and trait indicators of the six proposed DSM-5 PDs were mostly specific to those disorders with some exceptions. Regression analyses support the DSM-5 hybrid model in that pathological traits and an indicator of general personality pathology severity provided incremental information about PDs. Findings are discussed in the context of broader issues around the proposed DSM-5 model of personality disorders. PMID:22250660

  17. Avoidant personality disorder: current insights

    Directory of Open Access Journals (Sweden)

    Lampe L

    2018-03-01

    Full Text Available Lisa Lampe,1 Gin S Malhi2 1Discipline of Psychiatry, University of Newcastle, Newcastle, NSW, Australia; 2Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia Abstract: Avoidant personality disorder (AVPD is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD, schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the “severity continuum hypothesis”, in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, factors of possible etiological significance such as early parenting experiences, attachment style, temperament, and cognitive processing. Self-concept, avoidant behavior, early attachments, and attachment style may represent points of difference from SAD that also have relevance to treatment. Additional areas of research not focused specifically on AVPD, including the literature on social cognition as it relates to attachment and personality style, report findings that are promising for future research aimed at better delineating AVPD and informing treatment. Keywords: avoidant personality disorder, social anxiety disorder, social cognition, psychotherapy, attachment

  18. Increasing risk of psychiatric morbidity after childhood onset type 1 diabetes

    DEFF Research Database (Denmark)

    Dybdal, Daniel; Tolstrup, Janne S; Sildorf, Stine M

    2018-01-01

    AIMS/HYPOTHESIS: The aim of this study was to investigate psychiatric morbidity following childhood onset of type 1 diabetes. METHODS: In a matched, population-based cohort study based on Danish national registers, we identified children and adolescents who had been diagnosed as an in- or outpati......AIMS/HYPOTHESIS: The aim of this study was to investigate psychiatric morbidity following childhood onset of type 1 diabetes. METHODS: In a matched, population-based cohort study based on Danish national registers, we identified children and adolescents who had been diagnosed as an in...... of psychiatric disorders as well as the effects of age at onset and duration of type 1 diabetes on the risk of subsequently developing psychiatric morbidities. RESULTS: An increased risk of being diagnosed with mood disorders and anxiety, dissociative, eating, stress-related and somatoform disorders was observed....... CONCLUSIONS/INTERPRETATION: In the years following type 1 diabetes onset, an increased risk of eating disorders, anxiety and mood disorders, substance misuse, and personality disorders was found. These findings highlight a clinical need to monitor the mental health of children and adolescents in the years...

  19. Long-term outcome of hypochondriacal personality disorder.

    Science.gov (United States)

    Tyrer, P; Seivewright, N; Seivewright, H

    1999-02-01

    Hypochondriacal personality disorder diagnosed according to the Personality Assessment Schedule, a structured clinical interview, was related to outcome after 2 years and 5 years in a randomized, controlled trial of treatment of generalized anxiety, panic, and dysthymic disorders. Seventeen individuals (9%) from a population of 181 patients had hypochondriacal personality disorder and they experienced a significantly worse outcome than other patients, including those with other personality disorders, in terms of symptomatic change and health service utilization. This lack of improvement was associated with persistent somatization in hypochondriacal personality disorder. The results give further support to the belief that hypochondriacal personality disorder is a valid clinical diagnosis that has important clinical correlates, but further work is needed to establish the extent of its overlap with hypochondriasis as a mental state disorder.

  20. The effects of co-morbidity in defining major depression subtypes associated with long-term course and severity.

    Science.gov (United States)

    Wardenaar, K J; van Loo, H M; Cai, T; Fava, M; Gruber, M J; Li, J; de Jonge, P; Nierenberg, A A; Petukhova, M V; Rose, S; Sampson, N A; Schoevers, R A; Wilcox, M A; Alonso, J; Bromet, E J; Bunting, B; Florescu, S E; Fukao, A; Gureje, O; Hu, C; Huang, Y Q; Karam, A N; Levinson, D; Medina Mora, M E; Posada-Villa, J; Scott, K M; Taib, N I; Viana, M C; Xavier, M; Zarkov, Z; Kessler, R C

    2014-11-01

    Although variation in the long-term course of major depressive disorder (MDD) is not strongly predicted by existing symptom subtype distinctions, recent research suggests that prediction can be improved by using machine learning methods. However, it is not known whether these distinctions can be refined by added information about co-morbid conditions. The current report presents results on this question. Data came from 8261 respondents with lifetime DSM-IV MDD in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Outcomes included four retrospectively reported measures of persistence/severity of course (years in episode; years in chronic episodes; hospitalization for MDD; disability due to MDD). Machine learning methods (regression tree analysis; lasso, ridge and elastic net penalized regression) followed by k-means cluster analysis were used to augment previously detected subtypes with information about prior co-morbidity to predict these outcomes. Predicted values were strongly correlated across outcomes. Cluster analysis of predicted values found three clusters with consistently high, intermediate or low values. The high-risk cluster (32.4% of cases) accounted for 56.6-72.9% of high persistence, high chronicity, hospitalization and disability. This high-risk cluster had both higher sensitivity and likelihood ratio positive (LR+; relative proportions of cases in the high-risk cluster versus other clusters having the adverse outcomes) than in a parallel analysis that excluded measures of co-morbidity as predictors. Although the results using the retrospective data reported here suggest that useful MDD subtyping distinctions can be made with machine learning and clustering across multiple indicators of illness persistence/severity, replication with prospective data is needed to confirm this preliminary conclusion.

  1. The Netherlands study of depression in older persons (NESDO; a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Comijs Hannie C

    2011-12-01

    Full Text Available Abstract Background To study late-life depression and its unfavourable course and co morbidities in The Netherlands. Methods We designed the Netherlands Study of Depression in Older Persons (NESDO, a multi-site naturalistic prospective cohort study which makes it possible to examine the determinants, the course and the consequences of depressive disorders in older persons over a period of six years, and to compare these with those of depression earlier in adulthood. Results From 2007 until 2010, the NESDO consortium has recruited 510 depressed and non depressed older persons (≥ 60 years at 5 locations throughout the Netherlands. Depressed persons were recruited from both mental health care institutes and general practices in order to include persons with late-life depression in various developmental and severity stages. Non-depressed persons were recruited from general practices. The baseline assessment included written questionnaires, interviews, a medical examination, cognitive tests and collection of blood and saliva samples. Information was gathered about mental health outcomes and demographic, psychosocial, biological, cognitive and genetic determinants. The baseline NESDO sample consists of 378 depressed (according to DSM-IV criteria and 132 non-depressed persons aged 60 through 93 years. 95% had a major depression and 26.5% had dysthymia. Mean age of onset of the depressive disorder was around 49 year. For 33.1% of the depressed persons it was their first episode. 41.0% of the depressed persons had a co morbid anxiety disorder. Follow up assessments are currently going on with 6 monthly written questionnaires and face-to-face interviews after 2 and 6 years. Conclusions The NESDO sample offers the opportunity to study the neurobiological, psychosocial and physical determinants of depression and its long-term course in older persons. Since largely similar measures were used as in the Netherlands Study of Depression and Anxiety (NESDA; age

  2. The contribution of work and non-work stressors to common mental disorders in the 2007 Adult Psychiatric Morbidity Survey

    OpenAIRE

    Clark, C.; Pike, C.; McManus, S.; Harris, J.; Bebbington, P.; Brugha, T.; Jenkins, R.; Meltzer, H.; Weich, S.; Stansfeld, S.

    2012-01-01

    Evidence for an effect of work stressors on common mental disorders (CMD) has increased over the past decade. However, studies have not considered whether the effects of work stressors on CMD remain after taking co-occurring non-work stressors into account.\\ud \\ud Method. Data were from the 2007 Adult Psychiatric Morbidity Survey, a national population survey of participants\\ud >= 16 years living in private households in England. This paper analyses data from employed working age\\ud participa...

  3. Uncovering genomic causes of co-morbidity in epilepsy: gene-driven phenotypic characterization of rare microdeletions.

    Directory of Open Access Journals (Sweden)

    Dalia Kasperavičiūtė

    Full Text Available Patients with epilepsy often suffer from other important conditions. The existence of such co-morbidities is frequently not recognized and their relationship with epilepsy usually remains unexplained.We describe three patients with common, sporadic, non-syndromic epilepsies in whom large genomic microdeletions were found during a study of genetic susceptibility to epilepsy. We performed detailed gene-driven clinical investigations in each patient. Disruption of the function of genes in the deleted regions can explain co-morbidities in these patients.Co-morbidities in patients with epilepsy can be part of a genomic abnormality even in the absence of (known congenital malformations or intellectual disabilities. Gene-driven phenotype examination can also reveal clinically significant unsuspected condition.

  4. Comparing Diagnostic Tools in Personality Disorders

    Directory of Open Access Journals (Sweden)

    Emel AKGUN AKTAS

    2016-04-01

    Full Text Available Personality Disorder is defined as; continually self experience and behavioral pattern which has great variations of individual cultural normal expectations. Several diagnostic tools were developed for diagnosing personality disorders. In our study consistency of different diagnostic tools used for thhe diagnosis of personality disorders were evaluated. 39 inpatients diagnosed as personality disorder from Diskapi Yildirim Beyazit Traning and Reseach Hospital were recruited into the study. Psychotic patients are excluded from the study. Sociodemographic Information Form, MMPI and PBQ scales were given all the patients. Both PBQ personality subscales and MMPI PD scales were compared with semi-structured SCID-II interview diagnoses. Findings suggest less correlation than expected. Relatively higher correlation was found between PBQ personality subscales and MMPI-PD. Most common psychiatric comorbid disorder was depression. These findings suggest that further studies are needed for the development of diagnostic tools which take the differences of self report scales and clinical evalution into consideration. Beside, the differences of the categorical and dimensional classification of personality disorders should be bear in mind in evaluation of this patient group. [JCBPR 2016; 5(1.000: 22-27

  5. The Natural Course of Bulimia Nervosa and Eating Disorder not Otherwise Specified is not Influenced by Personality Disorders

    Science.gov (United States)

    Grilo, Carlos M.; Sanislow, Charles A.; Shea, M. Tracie; Skodol, Andrew E.; Stout, Robert L.; Pagano, Maria E.; Yen, Shirley; McGlashan, Thomas H.

    2013-01-01

    Objective To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) and to test the effects of personality disorder (PD) comorbidity on the outcomes. Method Ninety-two female patients with current BN (N = 23) or EDNOS (N = 69) were evaluated at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study (CLPS). Eating disorders (EDs) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders. Personality disorders (PDs) were assessed with the Diagnostic Interview for DSM-IV PD (DIPD-IV). The course of BN and EDNOS was assessed with the Longitudinal Interval Follow-up Evaluation and the course of PDs was evaluated with the Follow-Along version of the DIPD-IV at 6, 12, and 24 months. Results Probability of remission at 24 months was 40% for BN and 59% for EDNOS. To test the effects of PD comorbidity on course, ED patients were divided into groups with no, one, and two or more PDs. Cox proportional regression analyses revealed that BN had a longer time to remission than EDNOS (p < .05). The number of PDs was not a significant predictor of time to remission, nor was the presence of Axis I psychiatric comorbidity or Global Assessment of Functioning scores. Analyses using proportional hazards regression with time-varying covariates revealed that PD instability was unrelated to changes in ED. Conclusions BN has a worse 24-month course (longer time to remission) than EDNOS. The natural course of BN and EDNOS is not influenced significantly by the presence, severity, or time-varying changes of co-occurring PDs, co-occurring Axis I disorders, or by global functioning. PMID:12949923

  6. Personality disorder across the life course.

    Science.gov (United States)

    Newton-Howes, Giles; Clark, Lee Anna; Chanen, Andrew

    2015-02-21

    The pervasive effect of personality disorder is often overlooked in clinical practice, both as an important moderator of mental state and physical disorders, and as a disorder that should be recognised and managed in its own right. Contemporary research has shown that maladaptive personality (when personality traits are extreme and associated with clinical distress or psychosocial impairment) is common, can be recognised early in life, evolves continuously across the lifespan, and is more plastic than previously believed. These new insights offer opportunities to intervene to support more adaptive development than before, and research shows that such intervention can be effective. Further research is needed to improve classification, assessment, and diagnosis of personality disorder across the lifespan; to understand the complex interplay between changes in personality traits and clinical presentation over time; and to promote more effective intervention at the earliest possible stage of the disorder than is done at present. Recognition of how personality disorder relates to age and developmental stage can improve care of all patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Quality of diabetes care in Dutch care groups: no differences between diabetes patients with and without co-morbidity

    Directory of Open Access Journals (Sweden)

    Simone R de Bruin

    2013-12-01

    Full Text Available Objective: To evaluate the relationship between presence and nature of co-morbidity and quality of care for diabetes patients enrolled in diabetes disease management programmes provided by care groups.Methods: We performed an observational study within eight Dutch diabetes care groups. Data from patient record systems of care groups and patient questionnaires were used to determine quality of care. Quality of care was measured as provision of the recommended diabetes care, patients’ achievement of recommended clinical outcomes and patients’ perception of coordination and integration of care.Results: 527 diabetes patients without and 1187 diabetes patients with co-morbidity were included. Of the co-morbid patients, 7.8% had concordant co-morbid conditions only, 63.8% had discordant co-morbid diseases only and 28.4% had both types of conditions. Hardly any differences were observed between patients with and without co-morbidity in terms of provided care, achievement of clinical outcomes and perceived coordination and integration of care.Conclusions: Our study implies that care groups are able to provide similar quality of diabetes care for diabetes patients with and without co-morbidity. Considering the expected developments regarding additional disease management programmes in care groups, it is of importance to monitor quality of care, including patient experiences, for all chronic diseases. It will then become clear whether accountable provider-led organisations such as care groups are able to ensure quality of care for the increasing number of patients with multiple chronic conditions.

  8. Paroxetine in the treatment of dysthymic disorder without co-morbidities: A double-blind, placebo-controlled, flexible-dose study.

    Science.gov (United States)

    Ravindran, Arun V; Cameron, Colin; Bhatla, Raj; Ravindran, Lakshmi N; da Silva, Tricia L

    2013-04-01

    Few published studies have evaluated selective serotonin reuptake inhibitors in dysthymia without current co-morbid major depression. In this 12-week study, 40 dysthymic patients were randomly assigned to either placebo (n=19) or 20-40 mg/day of paroxetine (n=21). At endpoint, the paroxetine group showed significantly greater improvement on the Clinical Global Impression Scale, Beck Depression Inventory, and Quality of Life Enjoyment and Satisfaction Questionnaire (pdysthymia, and is generally tolerable. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Review: An Australian model of care for co-morbid diabetes and chronic kidney disease.

    Science.gov (United States)

    Lo, Clement; Zimbudzi, Edward; Teede, Helena; Cass, Alan; Fulcher, Greg; Gallagher, Martin; Kerr, Peter G; Jan, Stephen; Johnson, Greg; Mathew, Tim; Polkinghorne, Kevan; Russell, Grant; Usherwood, Tim; Walker, Rowan; Zoungas, Sophia

    2018-02-05

    Diabetes and chronic kidney disease (CKD) are two of the most prevalent co-morbid chronic diseases in Australia. The increasing complexity of multi-morbidity, and current gaps in health-care delivery for people with co-morbid diabetes and CKD, emphasise the need for better models of care for this population. Previously, proposed published models of care for co-morbid diabetes and CKD have not been co-designed with stake-holders or formally evaluated. Particular components of health-care shown to be effective in this population are interventions that: are structured, intensive and multifaceted (treating diabetes and multiple cardiovascular risk factors); involve multiple medical disciplines; improve self-management by the patient; and upskill primary health-care. Here we present an integrated patient-centred model of health-care delivery incorporating these components and co-designed with key stake-holders including specialist health professionals, general practitioners and Diabetes and Kidney Health Australia. The development of the model of care was informed by focus groups of patients and health-professionals; and semi-structured interviews of care-givers and health professionals. Other distinctives of this model of care are routine screening for psychological morbidity; patient-support through a phone advice line; and focused primary health-care support in the management of diabetes and CKD. Additionally, the model of care integrates with the patient-centred health-care home currently being rolled out by the Australian Department of Health. This model of care will be evaluated after implementation across two tertiary health services and their primary care catchment areas. Copyright © 2018 John Wiley & Sons, Ltd. This article is protected by copyright. All rights reserved.

  10. delusional patterns and its pre-morbid personality linkages in ...

    African Journals Online (AJOL)

    FBL

    Thus, this study was to examine the patterns at which those common delusional disorders appear to manifest in Nigerian psychotic patients and the contributions of premorbid personality of the individual. Africa has for some time now advocated for proper understanding of their personalities as it relates to mental health.

  11. The PsyCoLaus study: methodology and characteristics of the sample of a population-based survey on psychiatric disorders and their association with genetic and cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Middleton Lefkos

    2009-03-01

    Full Text Available Abstract Background The Psychiatric arm of the population-based CoLaus study (PsyCoLaus is designed to: 1 establish the prevalence of threshold and subthreshold psychiatric syndromes in the 35 to 66 year-old population of the city of Lausanne (Switzerland; 2 test the validity of postulated definitions for subthreshold mood and anxiety syndromes; 3 determine the associations between psychiatric disorders, personality traits and cardiovascular diseases (CVD, 4 identify genetic variants that can modify the risk for psychiatric disorders and determine whether genetic risk factors are shared between psychiatric disorders and CVD. This paper presents the method as well as sociodemographic and somatic characteristics of the sample. Methods All 35 to 66 year-old persons previously selected for the population-based CoLaus survey on risk factors for CVD were asked to participate in a substudy assessing psychiatric conditions. This investigation included the Diagnostic Interview for Genetic Studies to elicit diagnostic criteria for threshold disorders according to DSM-IV and algorithmically defined subthreshold syndromes. Complementary information was collected on potential risk and protective factors for psychiatric disorders, migraine and on the morbidity of first-degree relatives, whereas the collection of DNA and plasma samples was already part of the original CoLaus survey. Results A total of 3,691 individuals completed the psychiatric evaluation (67% participation. The gender distribution of the sample did not differ significantly from that of the general population in the same age range. Although the youngest 5-year band of the cohort was underrepresented and the oldest 5-year band overrepresented, participants of PsyCoLaus and individuals who refused to participate revealed comparable scores on the General Health Questionnaire, a self-rating instrument completed at the somatic exam. Conclusion Despite limitations resulting from the relatively low

  12. Personality functioning in patients with avoidant personality disorder and social phobia.

    Science.gov (United States)

    Eikenaes, Ingeborg; Hummelen, Benjamin; Abrahamsen, Gun; Andrea, Helene; Wilberg, Theresa

    2013-12-01

    Avoidant personality disorder (APD) and social phobia (SP) are closely related, such that they are suggested to represent different severity levels of one social anxiety disorder. This cross-sectional study aimed to compare patients with APD to patients with SP, with particular focus on personality dysfunction. Ninety-one adult patients were examined by diagnostic interviews and self-report measures, including the Index of Self-Esteem and the Severity Indices of Personality Problems. Patients were categorized in three groups; SP without APD (n = 20), APD without SP (n = 15), and APD with SP (n = 56). Compared to patients with SP without APD, patients with APD reported more symptom disorders, psychosocial problems, criteria of personality disorders, and personality dysfunction regarding self-esteem, identity and relational problems. These results indicate that APD involves more severe and broader areas of personality dysfunction than SP, supporting the conceptualization of APD as a personality disorder as proposed for DSM-5.

  13. Relationships Among Avoidant Personality Disorder, Social Anxiety Disorder, and Normative Personality Traits: A Twin Study.

    Science.gov (United States)

    Welander-Vatn, Audun; Torvik, Fartein Ask; Czajkowski, Nikolai; Kendler, Kenneth S; Reichborn-Kjennerud, Ted; Knudsen, Gun Peggy; Ystrom, Eivind

    2018-03-05

    Avoidant personality disorder (AvPD) and social anxiety disorder (SAD) share risk factors to a substantial degree, and both are characterized by the experience of anxiety in social situations. The authors investigated whether these disorders are differentially related to the Big Five personality traits. They also examined the underlying genetic and environmental influences on these associations. A population-based sample of 1,761 female twins was interviewed at baseline, and 1,471 of these were re-interviewed 10 years later. Associations between AvPD, SAD, and personality traits were investigated with multivariate biometric analyses. The authors found that AvPD and SAD are differentially related to several personality traits at the phenotypic, genetic, and environmental level. The genetic and environmental liability to AvPD could be fully accounted for by the genetic and environmental factors influencing SAD and personality. The findings may increase current etiological understanding of these disorders and inform future classification and treatment efforts.

  14. [Personality disorders, psychopathy and serial killers].

    Science.gov (United States)

    Morana, Hilda C P; Stone, Michael H; Abdalla-Filho, Elias

    2006-10-01

    To illustrate the basic characteristics of several specific personality disorders, focusing mainly in antisocial personality disorder. The differences between antisocial personality disorder and psychopathy are highlighted. Serial killers and its psychopathic aspects are also discussed. A bibliographic review was completed in order to outline convergences and divergences among different authors about this controversial issue, especially those concerning the possibility of treatment. While anti-social personality disorder is a medical diagnosis, the term "psychopathy" (which belongs to the sphere of forensic psychiatry) may be understood as a "legal diagnosis". It is not still possible to identify an effective treatment for serial killers. Personality disorders, especially of the antisocial type, still represent a formidable challenge to forensic psychiatry today. Questions as yet unanswered include the best and most humane place for patients with this condition and the nature of a standardised treatment recommendation.

  15. Modified crisis intervention for personality disorder.

    Science.gov (United States)

    Rudnick, A

    1998-01-01

    This study proposes that the goal of crisis intervention for persons with personality disorders should be to return them to their pre-crisis level of functioning, even though this is maladaptive. This is contrasted with standard crisis intervention, which aims to return normal or neurotic persons to their pre-crisis normal or neurotic functioning, usually by means of few and short-term therapeutic encounters. The modification proposed costs more time and resources in persons with personality disorders in crisis and fits the intervention to the personality type. This is illustrated by the case of Eve, a patient in crisis, whose pre-crisis functioning was maladaptive because of a dependent personality disorder. The goal of (modified) crisis intervention in this case was to return the patient to her dependent lifestyle, by means of pharmacotherapy combined with intensive supportive psychotherapy during 3-4 months of partial (day) hospitalization. The special nature of crisis in personality disorders is discussed.

  16. Factors associated with self-esteem in persons with morbid obesity and in persons with chronic obstructive pulmonary disease: a cross-sectional study.

    Science.gov (United States)

    Bonsaksen, Tore; Fagermoen, May Solveig; Lerdal, Anners

    2015-01-01

    Living with chronic illnesses can be stressful and may negatively impact persons' self-esteem. Personal factors, like self-efficacy and illness perceptions, and also factors related to the environment, activity, and participation may be associated with self-esteem in chronic illness populations. This cross-sectional comparative study explored sociodemographic variables, work, physical activity, illness perceptions, and general self-efficacy in relation to self-esteem in persons with morbid obesity and in persons with chronic obstructive pulmonary disease (COPD). The study had a cross-sectional design. A total of 223 eligible participants were recruited from patient education courses, and data were collected at baseline. Self-esteem was measured with The Rosenberg self-esteem scale; the general self-efficacy scale was used to measure self-efficacy, and brief illness perception questionnaire was also used. This is an instrument assessing cognitions about the illness and emotional responses towards it. Multivariate linear regression was used in the statistical analyses. In obese participants (n = 134), higher self-esteem was associated with lower emotional response, a shorter timeline, and higher general self-efficacy. In COPD participants (n = 89), higher self-esteem was associated with higher general self-efficacy. The independent variables accounted for 42.9% (morbid obesity) and 49.4% (COPD) of the self-esteem variance. In participants in both illness groups, higher self-efficacy was associated with increased self-esteem. A shorter timeline and lower emotional response to illness was related to higher self-esteem only for the obese participants. The results indicate that believing in one's capacity to cope with everyday challenges is important for self-esteem in persons with morbid obesity and in persons with COPD, whereas illness perceptions related to the duration of illness and the coping with emotions also is important for self-esteem in persons with morbid

  17. The Prevalence of Comorbid Personality Disorders in Treatment-Seeking Problem Gamblers: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Dowling, Nicki A; Cowlishaw, S; Jackson, A C; Merkouris, S S; Francis, K L; Christensen, D R

    2015-12-01

    The aim of this study was to systematically review and meta-analyze the prevalence of comorbid personality disorders among treatment-seeking problem gamblers. Almost one half (47.9%) of problem gamblers displayed comorbid personality disorders. They were most likely to display Cluster B disorders (17.6%), with smaller proportions reporting Cluster C disorders (12.6%) and Cluster A disorders (6.1%). The most prevalent personality disorders were narcissistic (16.6%), antisocial (14.0%), avoidant (13.4%), obsessive-compulsive (13.4%), and borderline (13.1%) personality disorders. Sensitivity analyses suggested that these prevalence estimates were robust to the inclusion of clinical trials and self-selected samples. Although there was significant variability in reported rates, subgroup analyses revealed no significant differences in estimates of antisocial personality disorder according to problem gambling severity, measure of comorbidity employed, and study jurisdiction. The findings highlight the need for gambling treatment services to conduct routine screening and assessment of co-occurring personality disorders and to provide treatment approaches that adequately address these comorbid conditions.

  18. Avoidant personality disorder: current insights.

    Science.gov (United States)

    Lampe, Lisa; Malhi, Gin S

    2018-01-01

    Avoidant personality disorder (AVPD) is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD), schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the "severity continuum hypothesis", in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, factors of possible etiological significance such as early parenting experiences, attachment style, temperament, and cognitive processing. Self-concept, avoidant behavior, early attachments, and attachment style may represent points of difference from SAD that also have relevance to treatment. Additional areas of research not focused specifically on AVPD, including the literature on social cognition as it relates to attachment and personality style, report findings that are promising for future research aimed at better delineating AVPD and informing treatment.

  19. Avoidant personality disorder: current insights

    Science.gov (United States)

    Lampe, Lisa; Malhi, Gin S

    2018-01-01

    Avoidant personality disorder (AVPD) is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD), schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the “severity continuum hypothesis”, in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, factors of possible etiological significance such as early parenting experiences, attachment style, temperament, and cognitive processing. Self-concept, avoidant behavior, early attachments, and attachment style may represent points of difference from SAD that also have relevance to treatment. Additional areas of research not focused specifically on AVPD, including the literature on social cognition as it relates to attachment and personality style, report findings that are promising for future research aimed at better delineating AVPD and informing treatment. PMID:29563846

  20. Mood, anxiety, and personality disorders among first and second-generation immigrants to the United States

    Science.gov (United States)

    Salas-Wright, Christopher P.; Kagotho, Njeri; Vaughn, Michael G.

    2014-01-01

    A careful examination of the multigenerational relationship between immigrant status and mental disorders can provide important information about the robustness and nature of the immigrant-mental health link. We examine immigrant status as a protective factor against mental illness, assess intergenerational effects, examine differences across race/ethnicity, and report the prevalence of mood, anxiety, and personality disorders of immigrants across major world regions. We employ data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and compare first (n = 5,363) and second-generation (n = 4826) immigrants from Asia, Africa, Europe, and Latin America to native-born Americans (n = 24,461) with respect to mental disorders. First-generation immigrants are significantly less likely than native-born Americans to be diagnosed with a mood, anxiety, or personality disorder, though the prevalence of mental health diagnoses increases among second generation immigrants. Similar results were observed for immigrants from major world regions as the prevalence of psychiatric morbidity was lower among immigrants from Africa, Latin America, Europe, and Asia compared to native-born Americans. Findings provide evidence in support of the notion that the immigrant paradox may be extended to include mood, anxiety, and personality disorders in the United States. PMID:25223256

  1. Investigating the prevalence of personality disorders and its relationship with personality traits among students

    Directory of Open Access Journals (Sweden)

    Davod Ghaderi

    2016-04-01

    Full Text Available The present study was aimed to investigate the prevalence of personality disorders and its relationship with personality traits among students. This research was among epidemiological-correlational descriptive studies. Method: For this purpose, 389 male students were selected via a multi-stage cluster sampling method. All subjects completed Millon's personality disorder (1987 and five-factor personality Costaand McCrae's questionnaires (1989. Results: The results showed that the prevalence of personality disorders is among students. It was also found that there existed a positive correlation between schizoid, avoidant, dependent, schizotypal, borderline and paranoid personality disorders with Neuroticism factor (r = .1. There was a significant negative correlation between schizoid, avoidant and schizotypal personality disorders with extraversion factor (r = .1 and significant positive correlation between histrionic disorders and extraversion (r = .1. There was a significant negative correlation between dependent personality disorder and Openness factor (r = .1 , significant negative correlation between narcissistic, antisocial and paranoid personality disorders with agree ableness factor (r = .1 and finally, significant negative correlation between antisocial, passive-aggressive and borderline personality disorders with accountability factor (r = .1and a significant positive correlation between accountability factor and compulsive personality disorder (r = .1. Conclusion: The results suggest a prevalence of personality disorders among students and significant correlation between some disorders with personality factors. Further studies in this area could provide more insightful findings in the field.

  2. Obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital in South-Eastern, Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel Uche Pascal Iloh

    2013-01-01

    Full Text Available Background: Obesity once thought the medical problem of affluent countries now exist in Nigeria and has been described as a time bomb for the future explosion in the frequency of cardio-metabolic diseases. The most deleterious health consequences of obesity are on the cardiovascular system and associated disorder of lipid and glucose homeostasis. Aim: This study was designed to determine the magnitude of obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital South-Eastern, Nigeria. Materials and Methods: A cross-sectional study carried out on 2391 adult Nigerians who were assessed for obesity using body mass index (BMI criterion. 206 patients who had BMI ΃30kg/m 2 were screened for cardio-metabolic co-morbidities. The data collected included basic demographic variables, weight, height, blood pressure; fasting plasma glucose and lipid profile. Results: The prevalence of obesity was 8.6%. Grade I obesity (67.5% was the most common pattern; others included grade II obesity (23.3% and grade III obesity (9.2%. Hypertension (42.7% was the most common cardio-metabolic morbidity. Others included low HDL-cholesterol (22.8%, diabetes mellitus (15.1%, high triglyceride (12.6%, high total cholesterol (9.2%, and high LDL-cholesterol (6.8%. Conclusion: Obesity and its cardio-metabolic morbidities exist among the study population. Anthropometric determination of obesity and screening for its associated cardio-metabolic co-morbidities should constitute clinical targets for intervention in primary care clinics.

  3. Taking it one day at a time: African American women aging with HIV and co-morbidities.

    Science.gov (United States)

    Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

    2014-07-01

    Self-managing HIV/AIDS presents challenges for anyone infected. These challenges may be further complicated for older HIV-infected African American women who acquired the disease at younger ages and now have co-morbidities. Little is known regarding how women's age identity, social responsibilities, co-morbidities, and romantic relationship status influence their HIV self-management. Five focus groups were conducted in Washington DC, with HIV-positive African American women aged 52-65. Topics included HIV and co-morbidity self-management, social support needs, medication adherence, and future plans for old age. A constant comparison approach was applied during data analysis. Co-morbidities, including diabetes and hypertension, were perceived to be more difficult to self-manage than HIV. This difficulty was not attributed to aging but to daily struggles such as lack of income and/or health insurance, an inflexible work schedule, and loneliness. Social responsibilities, including caring for family, positively impacted participants' ability to self-manage HIV by serving as motivation to stay healthy in order to continue to help family members. In contrast, inflexible work schedules negatively impacted women's ability to sustain medication adherence. Overall, this study demonstrates that HIV and co-morbidity self-management are inextricably linked. We can no longer afford to view engagement in HIV care as a single-disease issue and hope to attain optimal health and well-being in our HIV-affected populations. Optimal HIV self-management must be framed within a larger context that simultaneously addresses HIV and co-morbidities, while considering how social and cultural factors uniquely intersect to influence older African American women's self-management strategies.

  4. The impact of co-morbidity on health-related quality of life in breast cancer survivors and controls.

    Science.gov (United States)

    Schoormans, Dounya; Czene, Kamila; Hall, Per; Brandberg, Yvonne

    2015-05-01

    The objective of this study was: 1) to compare health-related quality of life (HRQoL) scores of breast cancer survivors to matched controls; and 2) to examine the relative impact (explained variance) of the type and number of co-morbidities on HRQoL. Data from the KARMA project was used in this cross-sectional study. For each woman diagnosed with breast cancer (n = 2552) there were two healthy age- and geographically matched females (n = 5104). Breast cancer survivors were categorized according to time since diagnosis: recently diagnosed (0-1 year), short- (2-5 years), mid- (6-10 years), and long-term survivors (> 10 years). Women completed a questionnaire addressing demographics (age, educational level, and geographical location), lifestyle factors (body mass index (BMI) and smoking), co-morbidities, and HRQoL. The difference in explained variance in six HRQoL-domains between demographics, lifestyle factors, and co-morbidity in women with breast cancer and matched controls was examined by hierarchical regression analyses. Women recently diagnosed (n = 63), reported the worst HRQoL followed by short-term survivors (2-5 years, n = 863). Thereafter, HRQoL scores further improved (6-10 years, n = 726), and were comparable to healthy females after 10 years (n = 893). Co-morbidity has a negative impact on HRQoL, which increased with time after diagnosis. Cardiovascular disease and depression were the strongest associates. Breast cancer survivors report clinically significant improvement in HRQoL scores six years after diagnosis. Co-morbidity has a negative impact on HRQoL, which increases with time after diagnosis, even though the number of co-morbidities remains stable. In long-term survivors there should be increasing awareness of co-morbidity and its impact on HRQoL.

  5. The relationship between borderline personality disorder and bipolar disorder

    Science.gov (United States)

    Zimmerman, Mark; Morgan, Theresa A.

    2013-01-01

    It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. Likewise, approximately 20% of bipolar II patients were diagnosed with BPD, though only 10% of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is nontheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum. PMID:24174890

  6. Personality Pathology of Adults With Autism Spectrum Disorder Without Accompanying Intellectual Impairment in Comparison to Adults With Personality Disorders.

    Science.gov (United States)

    Strunz, Sandra; Westphal, Linda; Ritter, Kathrin; Heuser, Isabella; Dziobek, Isabel; Roepke, Stefan

    2015-12-01

    Differentiating autism spectrum disorders (ASDs) without accompanying intellectual impairment from personality disorders is often challenging. Identifying personality traits and personality pathology specific to ASD might facilitate diagnostic procedure. We recruited a sample of 59 adults with ASD without accompanying intellectual impairment, 62 individuals with narcissistic personality disorder, 80 individuals with borderline personality disorder, and 106 nonclinical controls. Personality traits, measured with the neo-personality inventory-revised (NEO-PI-R), and personality pathology, measured with the dimensional assessment of personality pathology (DAPP-BQ), were assessed. Personality traits and personality pathology specific to ASD could be identified. ASD individuals scored significantly lower on the NEO-PI-R scales extraversion and openness to experience and significantly higher on the DAPP-BQ scales inhibitedness and compulsivity relative to all other groups. Diagnostic implications are discussed.

  7. Obsessive compulsive personality disorder and Parkinson's disease.

    Science.gov (United States)

    Nicoletti, Alessandra; Luca, Antonina; Raciti, Loredana; Contrafatto, Donatella; Bruno, Elisa; Dibilio, Valeria; Sciacca, Giorgia; Mostile, Giovanni; Petralia, Antonio; Zappia, Mario

    2013-01-01

    To evaluate the frequency of personality disorders in Parkinson's disease (PD) patients and in a group of healthy controls. Patients affected by PD diagnosed according to the United Kingdom Parkinson's disease Society Brain Bank diagnostic criteria and a group of healthy controls were enrolled in the study. PD patients with cognitive impairment were excluded from the study. Structured Clinical Interview for Personality Disorders-II (SCID-II) has been performed to evaluate the presence of personality disorders. Presence of personality disorders, diagnosed according to the DSM-IV, was confirmed by a psychiatric interview. Clinical and pharmacological data were also recorded using a standardized questionnaire. 100 PD patients (57 men; mean age 59.0 ± 10.2 years) and 100 healthy subjects (52 men; mean age 58.1 ± 11.4 years) were enrolled in the study. The most common personality disorder was the obsessive-compulsive personality disorder diagnosed in 40 PD patients and in 10 controls subjects (p-valuepersonality disorder recorded in 14 PD patients and 4 control subjects (p-value 0.02). Obsessive-compulsive personality disorder was also found in 8 out of 16 de novo PD patients with a short disease duration. PD patients presented a high frequency of obsessive-compulsive personality disorder that does not seem to be related with both disease duration and dopaminergic therapy.

  8. Ethical aspects of personality disorders.

    Science.gov (United States)

    Bendelow, Gillian

    2010-11-01

    To review recent literature around the controversial diagnosis of personality disorder, and to assess the ethical aspects of its status as a medical disorder. The diagnostic currency of personality disorder as a psychiatric/medical disorder has a longstanding history of ethical and social challenges through critiques of the medicalization of deviance. More recently controversies by reflexive physicians around the inclusion of the category in the forthcoming revisions of International Classification of Diseases and Diagnostic and Statistical Manual of Mental Disorders classifications reflect the problems of value-laden criteria, with the diagnostic category being severely challenged from within psychiatry as well as from without. The clinical diagnostic criteria for extremely value-laden psychiatric conditions such as personality disorder need to be analyzed through the lens of values-based medicine, as well as through clinical evidence, as the propensity for political and sociolegal appropriation of the categories can render their clinical and diagnostic value meaningless.

  9. An evaluation of Knowledge and Understanding Framework personality disorder awareness training: can a co-production model be effective in a local NHS mental health Trust?

    Science.gov (United States)

    Davies, Julie; Sampson, Mark; Beesley, Frank; Smith, Debra; Baldwin, Victoria

    2014-05-01

    5 Boroughs Partnership NHS Foundation Trust, in the Northwest of England, has trained over 500 staff in the Knowledge and Understanding Framework, level 1 personality disorder awareness training. This is a 3-day nationally devised training programme delivered via an innovative co-production model (i.e. co-delivery and partnership working with service users who have lived experience). This paper provides quantitative and qualitative information on the effectiveness of training delivery and also serves to provide some insight into the impact of service-user involvement via such a co-production model. Information on 162 participants using the Knowledge and Understanding Framework bespoke questionnaire (Personality Disorder Knowledge, Attitudes and Skills Questionnaire) suggests that the training can be effectively delivered by and within a local NHS Mental Health Trust. Results immediately post-training suggest an improvement in levels of understanding and capability efficacy and a reduction in negative emotional reactions. Indications from a 3-month follow-up suggest that while understanding and emotional reaction remain improved, capability efficacy regresses back to pre-training levels, suggesting the need for ongoing supervision and/or support to consolidate skills. Discussion includes guidelines for the implementation of a truly integrated co-production model of training provision, as well as advice relating to the maximization of long-term benefits. Copyright © 2014 John Wiley & Sons, Ltd.

  10. Co-morbid anxiety disorders in patients with schizophrenia in a ...

    African Journals Online (AJOL)

    Anxiety disorder is a blanket term covering several dif- ferent forms of abnormal and ..... Identification of anxiety disorder by managing psychiatrist. N (%). Statistics p-value .... Fastenau P.S. and Bond G.R. Obsessive compulsive symptoms in ...

  11. A study of geriatric depression and co- morbidities among primary ...

    African Journals Online (AJOL)

    Depression in the elderly is very common but diagnostic rates among primary care physicians is poor. This is attributed to both patient and physician related factors. The patient factors include co-morbidities, aging and psychological mindedness which is culture related. Generally, there's paucity of psychological complaints ...

  12. Mechanisms shaping the development of personality and personality disorders in children and adolescents.

    Science.gov (United States)

    Lenkiewicz, Kamila; Srebnicki, Tomasz; Bryńska, Anita

    2016-01-01

    Until the end of the nineties last century personality disorders could not be diagnosed before the age of eighteen. Nevertheless, the results of studies published in the last decade have revealed that personality disorders can be observed in children and adolescents and that personality disorders diagnosed in adult patients had been present as early as in childhood. The knowledge of possible mechanisms shaping personality disorders in childhood is unsatisfactory and needs to be expanded. Developmental psychology explains the development of abnormal personality through inappropriate attachment patterns and abnormal transitions between developmental phases. Genetic and temperamental factors are also important in the aetiology of personality disorders as well as early maladaptive schemas resulting from personal experiences and interactions with others. The aim of this article is to review the current knowledge on the mechanisms shaping the development of personality and personality disorders in childhood and adolescence.

  13. The General Assessment of Personality Disorder (GAPD): factor structure, incremental validity of self-pathology, and relations to DSM-IV personality disorders.

    Science.gov (United States)

    Hentschel, Annett G; Livesley, W John

    2013-01-01

    Recent developments in the classification of personality disorder, especially moves toward more dimensional systems, create the need to assess general personality disorder apart from individual differences in personality pathology. The General Assessment of Personality Disorder (GAPD) is a self-report questionnaire designed to evaluate general personality disorder. The measure evaluates 2 major components of disordered personality: self or identity problems and interpersonal dysfunction. This study explores whether there is a single factor reflecting general personality pathology as proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), whether self-pathology has incremental validity over interpersonal pathology as measured by GAPD, and whether GAPD scales relate significantly to Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]) personality disorders. Based on responses from a German psychiatric sample of 149 participants, parallel analysis yielded a 1-factor model. Self Pathology scales of the GAPD increased the predictive validity of the Interpersonal Pathology scales of the GAPD. The GAPD scales showed a moderate to high correlation for 9 of 12 DSM-IV personality disorders.

  14. Salivary cortisol and binge eating disorder in obese women after surgery for morbid obesity.

    Science.gov (United States)

    Larsen, Junilla K; van Ramshorst, Bert; van Doornen, Lorenz J P; Geenen, Rinie

    2009-01-01

    Binge eating episodes characterized by loss of control are hypothesized to be accompanied by changes in hypothalamic pituitary adrenal (HPA) axis functioning. Cortisol is an end product of this neuroendocrine stress system. The aim of this study was to examine the cortisol levels and the awakening cortisol response (ACR) in obese persons showing binge eating after surgery for morbid obesity. Sixteen obese women with binge eating disorder (BED) and 18 obese women without BED participated in the study. Means+/-SD: age 43 +/- 15, body mass index 40 +/- 8. Salivary cortisol, anthropometric assessments, and the eating disorder examination interview were taken. Women with BED showed a significantly lower waist-to-hip ratio and cortisol levels during the day than women without BED, whereas the ACR did not differ. Our cross-sectional study in a small sample generates the hypothesis that neuroendocrine regulation differs between obese women with and without BED after obesity surgery. This finding needs replication in future studies that should also examine the causal direction of the observed association.

  15. [DSM-5 classification of personality disorders in older persons

    NARCIS (Netherlands)

    Alphen, S.P. van; Rossi, G.; Dierckx, E.; Oude Voshaar, R.C.

    2014-01-01

    BACKGROUND: Although it is generally agreed that personality disorders are an important topic in old-age psychiatry, DSM-5 has paid relatively little attention to older persons affected with this severe mental disorder. AIM: To look closely and carefully at several aspects of the way in which DSM-5

  16. Imagery Rescripting for Personality Disorders

    Science.gov (United States)

    Arntz, Arnoud

    2011-01-01

    Imagery rescripting is a powerful technique that can be successfully applied in the treatment of personality disorders. For personality disorders, imagery rescripting is not used to address intrusive images but to change the implicational meaning of schemas and childhood experiences that underlie the patient's problems. Various mechanisms that may…

  17. Psychiatric disorders, suicidality, and personality among young men by sexual orientation.

    Science.gov (United States)

    Wang, J; Dey, M; Soldati, L; Weiss, M G; Gmel, G; Mohler-Kuo, M

    2014-10-01

    Personality and its potential role in mediating risk of psychiatric disorders and suicidality are assessed by sexual orientation, using data collected among young Swiss men (n=5875) recruited while presenting for mandatory military conscription. Mental health outcomes were analyzed by sexual attraction using logistic regression, controlling for five-factor model personality traits and socio-demographics. Homo/bisexual men demonstrated the highest scores for neuroticism-anxiety but the lowest for sociability and sensation seeking, with no differences for aggression-hostility. Among homo/bisexual men, 10.2% fulfilled diagnostic criteria for major depression in the past 2weeks, 10.8% for ADHD in the past 12months, 13.8% for lifetime anti-social personality disorder (ASPD), and 6.0% attempted suicide in the past 12months. Upon adjusting (AOR) for personality traits, their odds ratios (OR) for major depression (OR=4.78, 95% CI 2.81-8.14; AOR=1.46, 95% CI 0.80-2.65) and ADHD (OR=2.17, 95% CI=1.31-3.58; AOR=1.00, 95% CI 0.58-1.75) lost statistical significance, and the odds ratio for suicide attempt was halved (OR=5.10, 95% CI 2.57-10.1; AOR=2.42, 95% CI 1.16-5.02). There are noteworthy differences in personality traits by sexual orientation, and much of the increased mental morbidity appears to be accounted for by such underlying differences, with important implications for etiology and treatment. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Parents' personality clusters and eating disordered daughters' personality and psychopathology.

    Science.gov (United States)

    Amianto, Federico; Ercole, Roberta; Marzola, Enrica; Abbate Daga, Giovanni; Fassino, Secondo

    2015-11-30

    The present study explores how parents' personality clusters relate to their eating disordered daughters' personality and psychopathology. Mothers and fathers were tested with the Temperament Character Inventory. Their daughters were assessed with the following: Temperament and Character Inventory, Eating Disorder Inventory-2, Symptom Checklist-90, Parental Bonding Instrument, Attachment Style Questionnaire, and Family Assessment Device. Daughters' personality traits and psychopathology scores were compared between clusters. Daughters' features were related to those of their parents. Explosive/adventurous mothers were found to relate to their daughters' borderline personality profile and more severe interoceptive awareness. Mothers' immaturity was correlated to their daughters' higher character immaturity, inadequacy, and depressive feelings. Fathers who were explosive/methodic correlated with their daughters' character immaturity, severe eating, and general psychopathology. Fathers' character immaturity only marginally related to their daughters' specific features. Both parents' temperament clusters and mothers' character clusters related to patients' personality and eating psychopathology. The cluster approach to personality-related dynamics of families with an individual affected by an eating disorder expands the knowledge on the relationship between parents' characteristics and daughters' illness, suggesting complex and unique relationships correlating parents' personality traits to their daughters' disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Increased Treatment Complexity for Major Depressive Disorder for Inpatients With Comorbid Personality Disorder.

    Science.gov (United States)

    Wiegand, Hauke F; Godemann, Frank

    2017-05-01

    The study examined inpatient treatment for major depressive disorder (MDD) when it is complicated by comorbid personality disorder. In this descriptive analysis of a large data sample from 2013 (German VIPP data set) of 58,913 cases from 75 hospitals, three groups were compared: patients with MDD, patients with MDD and a comorbid personality disorder, and patients with a main diagnosis of personality disorder. Compared with MDD patients, those with comorbid personality disorder had higher rates of recurrent depression and nearly twice as many readmissions within one year, despite longer mean length of stay. Records of patients with comorbidities more often indicated accounting codes for "complex diagnostic procedures," "crisis intervention," and "constant observation." Patients with comorbid disorders differed from patients with a main diagnosis of personality disorder in treatment indicator characteristics and distribution of personality disorder diagnoses. Personality disorder comorbidity made MDD treatment more complex, and recurrence of MDD episodes and hospital readmission occurred more often than if patients had a sole MDD diagnosis.

  20. Relating DSM-5 section III personality traits to section II personality disorder diagnoses.

    Science.gov (United States)

    Morey, L C; Benson, K T; Skodol, A E

    2016-02-01

    The DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DSM categorical diagnoses to be retained in this system - antisocial, avoidant, borderline, narcissistic, obsessive-compulsive and schizotypal personality disorders. The goal of the current study was to describe the empirical relationships between the DSM-5 section III pathological traits and DSM-IV/DSM-5 section II personality disorder diagnoses. Data were obtained from a sample of 337 clinicians, each of whom rated one of his or her patients on all aspects of the DSM-IV and DSM-5 proposed alternative model. Regression models were constructed to examine trait-disorder relationships, and the incremental validity of core personality dysfunctions (i.e. criterion A features for each disorder) was examined in combination with the specified trait clusters. Findings suggested that the trait assignments specified by the Work Group tended to be substantially associated with corresponding DSM-IV concepts, and the criterion A features provided additional diagnostic information in all but one instance. Although the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

  1. Co-morbid anxiety disorders in patients with schizophrenia in a ...

    African Journals Online (AJOL)

    Background: Anxiety disorders occur commonly in schizophrenia but are often overlooked by psychiatrists. Their presence may compound the challenges faced by these patients and may contribute to poor outcome. Objectives: The purpose of this study was to determine the prevalence of anxiety disorders among the ...

  2. A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder.

    Science.gov (United States)

    Furuta, Marie; Sandall, Jane; Bick, Debra

    2012-11-10

    The incidence of severe maternal morbidity is increasing in high-income countries as a consequence, in part, of increased obstetric intervention and increasingly complex medical needs of women who become pregnant. Access to emergency obstetric care means that for the majority of women in these countries, an experience of severe maternal morbidity is unlikely to result in loss of life. However, little is known about the subsequent impact on postnatal psychological health resulting in an evidence gap to support provision of appropriate care for these women. There has recently been increasing recognition that childbirth can be a cause of post-traumatic stress disorder (PTSD). The combination of experiencing a life-threatening complication and its management may culminate in psychological trauma. This systematic review examined the association between women's experience of severe maternal morbidity during labour, at the time of giving birth or within the first week following birth, and PTSD and its symptoms. Relevant literature was identified through multiple databases, including MEDLINE, PsycINFO, EMBASE, CINAHL, British Nursing Index, Web of Science, Cochrane library and the British Library, using predetermined search strategies. The search terms included "post-traumatic stress disorder", "PTSD", "stress disorders, post-traumatic", "maternal morbidity", "pregnancy complications" "puerperal disorders", "obstetric labo(u)r complication", "postpartum h(a)emorrhage", "eclampsia". Studies identified were categorised according to pre-defined inclusion and exclusion criteria. The quality of included studies was assessed using the relevant CASP appraisal tools. Eleven primary studies met review criteria. Evidence of a relationship between severe maternal morbidity and PTSD/PTSD symptoms was inconsistent and findings varied between studies. Nevertheless, there is some evidence that severe pre-eclampsia is a risk factor for PTSD and its symptoms, an association possibly

  3. Association of personal hygiene with common morbidities among upper primary school children in rural Odisha.

    Science.gov (United States)

    Paul, Kalyan Kumar; Panigrahi, Sandeep Kumar; Soodi Reddy, Arun Kiran; Sahu, Trilochan

    2017-01-01

    In India, children of upper primary school receive less attention from health-care providers. The majority of their health problems are preventable through hygienic practices. The aim of this study was to find out the association of personal hygiene with common morbidities among upper primary school children. A cross-sectional study conducted in a rural upper primary school of Odisha. A semi-structured schedule based on the Global School Health Survey Questionnaire and necessary instruments for clinical examination were used. Data were entered in Microsoft Excel 2007 and analyzed by SPSS version 20 software. Of 90 participants, 58 (64.4%) were girls. The mean age was 11.8 (±1.01) years. The mean body mass index of females was significantly higher than males (16.95 vs. 14.72; P = 0.001). More than 90% of children maintained good personal hygiene such as clean tongue, clean hair, handwashing, and using footwear. The most common morbidities found were dental caries (38.9%), history of worms in stool and lethargy (20%). A mean score of 6.14 ± 0.11 (out of 8) was seen for personal hygiene and not associated with any particular morbidity or gender. Brushing daily was significantly associated with reduced dental caries (χ 2 = 8.7; P personal hygiene. School health services should also focus on upper primary school children for improvement of personal hygiene.

  4. Prevalence of co-morbidity and its relationship to treatment among unselected patients with Hodgkin's disease and non-Hodgkin's lymphoma, 1993-1996

    NARCIS (Netherlands)

    van Spronsen, DJ; Janssen-Heijnen, MLG; Breed, WPM; Coebergh, JWW

    A population-based series of patients with cancer is likely to comprise more patients with serious co-morbidity than clinical trials because of restrictive eligibility criteria for the latter. Since co-morbidity may influence decision-making, we studied the age-specific prevalence of co-morbidity

  5. Binge eating disorder and morbid obesity are associated with lowered mu-opioid receptor availability in the brain.

    Science.gov (United States)

    Joutsa, Juho; Karlsson, Henry K; Majuri, Joonas; Nuutila, Pirjo; Helin, Semi; Kaasinen, Valtteri; Nummenmaa, Lauri

    2018-03-09

    Both morbid obesity and binge eating disorder (BED) have previously been linked with aberrant brain opioid function. Behaviorally these two conditions are however different suggesting also differences in neurotransmitter function. Here we directly compared mu-opioid receptor (MOR) availability between morbidly obese and BED subjects. Seven BED and nineteen morbidly obese (non-BED) patients, and thirty matched control subjects underwent positron emission tomography (PET) with MOR-specific ligand [ 11 C]carfentanil. Both subjects with morbid obesity and BED had widespread reduction in [ 11 C]carfentanil binding compared to control subjects. However, there was no significant difference in brain MOR binding between subjects with morbid obesity and BED. Thus, our results indicate that there is common brain opioid abnormality in behaviorally different eating disorders involving obesity. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Linking Career Counseling to Personality Disorders.

    Science.gov (United States)

    Kjos, Diane

    1995-01-01

    Relates personality disorders to career development issues and counseling interventions. Case examples suggesting career-focused treatment interventions for dependent, borderline, obsessive-compulsive, and passive-aggressive personality disorders are presented. (Author/JBJ)

  7. Disentangling depressive personality disorder from avoidant, borderline, and obsessive-compulsive personality disorders.

    Science.gov (United States)

    Huprich, Steven K; Zimmerman, Mark; Chelminski, Iwona

    2006-01-01

    Several studies have found that 3 personality disorders (PDs) tend to share moderate rates of comorbidity with depressive PD: avoidant, borderline, and obsessive-compulsive. This study sought to evaluate the diagnostic criteria of each disorder in an effort to understand where areas of overlap may occur and to modify criteria sets where reasonable to reduce any degree of overlap. One thousand two hundred psychiatric outpatients were interviewed with the Structured Interview for DSM-IV Personality Disorders. The highest degree of comorbidity was observed between avoidant PD and depressive PD. Logistic regression analyses indicated that 2 criteria-avoidant criterion 5 and depressive criterion 2-could be removed from the diagnostic criteria sets and reduce the rates of overlap by as much as 15%. A factor analysis of the criteria of all 4 PDs indicated that there is a common clustering of many of the symptoms of avoidant, borderline, depressive, and obsessive-compulsive PDs and that borderline symptoms tend to cluster together most consistently. Avoidant and obsessive-compulsive personality symptoms clustered in ways that may reflect a problem of how to engage with others, suggestive of an approach-avoidance conflict. Depressive PD symptoms clustered in a way suggestive of problems with anger that is directed toward oneself and others. The factor analysis results suggest that an organization of symptoms around themes of conflict may provide useful ways of understanding the personality patterns of these 4 disorders.

  8. Tic disorders: administrative prevalence and co-occurrence with attention-deficit/hyperactivity disorder in a German community sample.

    Science.gov (United States)

    Schlander, M; Schwarz, O; Rothenberger, A; Roessner, V

    2011-09-01

    Coexistence of tics and attention-deficit/hyperactivity disorder (ADHD) has important clinical and scientific implications. Existing data on the co-occurrence of tic disorders, Tourette Syndrome (TS), and ADHD are largely derived from small-scale studies in selected samples and therefore heterogeneous. The Nordbaden project captures the complete outpatient claims data of more than 2.2 million persons, representing 82% of the regional population in 2003. Based upon the number of diagnosed cases of tic disorders, TS, and ADHD, we determined 12-months administrative prevalence rates as well as rates of co-occurrence. Both tic disorders and ADHD were diagnosed most often in the age group 7-12 years (any tic disorder: 0.8%; ADHD: 5.0%). With increasing age, the administrative prevalence difference in favor of males disappeared, with tic disorders being somewhat more frequently reported in females than males in the age groups above 30 years. The highest rate of ADHD co-occurring with tic disorders was found in adolescents (age 13-18 years, 15.1%). Tic disorders were observed in 2.3% of patients with ADHD. Administrative prevalence rates of tic disorders and TS were substantially lower compared to rates found in community-based epidemiological studies, suggesting that a large number of cases remain undetected and untreated under present conditions of routine outpatient care. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  9. [Homicide and major mental disorder: what are the social, clinical, and forensic differences between murderers with a major mental disorder and murderers without any mental disorder?].

    Science.gov (United States)

    Richard-Devantoy, S; Chocard, A-S; Bourdel, M-C; Gohier, B; Duflot, J-P; Lhuillier, J-P; Garré, J-B

    2009-09-01

    ,6 versus 76,7%, p=0,008). The most major mental disorders' homicide was more likely to be against intimates than strangers. The application of the former article 64 or the present article 122-1 of the French Criminal Code are envisaged more often in the major mental disorder group than in the no mental disorder group. The main difference between murderers with a major mental disorder and murderers without any mental disorder is the psychopathology of the morbid process which underlies the homicide. Impairment of judgment at the time of the crime should be taken into account. As a clinician, we should focus our attention on general risk factors of violence and homicide (male, young, underprivileged class, abuse of alcohol) and on more specific factors (mental disorder co-morbidities...). To these factors should be added the dynamic characteristics of the meeting of the protagonists.

  10. Personality factors and weight preoccupation: a continuum approach to the association between eating disorders and personality disorders.

    Science.gov (United States)

    Davis, C; Claridge, G; Cerullo, D

    1997-01-01

    Evidence shows a high comorbidity of eating disorders and some forms of personality disorder. Adopting a dimensional approach to both, our study explored their connection among a non-clinical sample. 191 young women completed personality scales of general neuroticism, and of borderline, schizotypal, obsessive-compulsive, and narcissistic (both adjustive and maladaptive) traits. Weight preoccupation (WP), as a normal analogue of eating disorders, was assessed with scales from the Eating Disorder Inventory, and height and weight measured. The data were analysed with multiple regression techniques, with WP as the dependent variable. In low to normal weight subjects, after controlling for the significant influence of body mass, the specific predictors of WP in the regression model were borderline personality and maladaptive narcissism, in the positive direction, and adjustive narcissism and obsessive-compulsiveness in the negative direction. In heavier women, narcissism made no contribution--nor, more significantly, did body mass. Patterns of association between eating pathology and personality disorder, especially borderline and narcissism, can be clearly mapped across to personality traits in the currently non-clinical population. This finding has important implications for understanding dynamics of, and identifying individuals at risk for, eating disorders.

  11. The MCP-1, CCL-5 and SDF-1 chemokines as pro-inflammatory markers in generalized anxiety disorder and personality disorders.

    Science.gov (United States)

    Ogłodek, Ewa A; Szota, Anna M; Just, Marek J; Moś, Danuta M; Araszkiewicz, Aleksander

    2015-02-01

    The co-occurrence of generalized anxiety disorder and personality disorders suggests the existence of association between the neurobiological predispositions leading to the development of these disorders and activation of cytokine system. Pro-inflammatory chemokines such as CCL-5/RANTES (regulated upon activation normal T cell expressed and secreted) and CXCL12/SDF-1 (stromal derived factor) play an important role in immune response. A total of 160 participants were enrolled in the study, 120 of whom comprised the study group (people with the dual diagnosis of personality disorder and generalized anxiety disorder). The mean age was 41.4 ± 3.5 years (range: 20-44 years). The control group consisted of 40 healthy individuals in the mean age of 40.8 ± 3.1 years (range: 20-43 years). A blood sample was collected from each participant and the plasma levels of the CCL-2/MCP-1 (monocyte chemoattractant protein-1), RANTES and SDF-1 chemokines were determined by ELISA. Increased levels of MCP-1 and SDF-1 were found both in women and in men versus the control group for all types of personality disorders. The levels of CCL-5 in men were significantly increased versus the control group and significantly higher in women than in men. Neither women nor men with avoidant or obsessive-compulsive personality disorder showed any significant differences in MCP-1 or SFD-1 levels. In subjects with borderline personality disorder, the levels of the study chemokines were higher in women than in men. Our study has shown the need for determination of proinflammatory interleukins which are considered as biomarkers of personality disorders and generalized anxiety disorders. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  12. The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: findings from a controlled 10-year prospective longitudinal follow-up study.

    Science.gov (United States)

    Biederman, J; Petty, C R; Dolan, C; Hughes, S; Mick, E; Monuteaux, M C; Faraone, S V

    2008-07-01

    A better understanding of the long-term scope and impact of the co-morbidity with oppositional defiant disorder (ODD) and conduct disorder (CD) in attention deficit hyperactivity disorder (ADHD) youth has important clinical and public health implications. Subjects were assessed blindly at baseline (mean age=10.7 years), 1-year (mean age=11.9 years), 4-year (mean age=14.7 years) and 10-year follow-up (mean age=21.7 years). The subjects' lifetime diagnostic status of ADHD, ODD and CD by the 4-year follow-up were used to define four groups (Controls, ADHD, ADHD plus ODD, and ADHD plus ODD and CD). Diagnostic outcomes at the 10-year follow-up were considered positive if full criteria were met any time after the 4-year assessment (interval diagnosis). Outcomes were examined using a Kaplan-Meier survival function (persistence of ODD), logistic regression (for binary outcomes) and negative binomial regression (for count outcomes) controlling for age. ODD persisted in a substantial minority of subjects at the 10-year follow-up. Independent of co-morbid CD, ODD was associated with major depression in the interval between the 4-year and the 10-year follow-up. Although ODD significantly increased the risk for CD and antisocial personality disorder, CD conferred a much larger risk for these outcomes. Furthermore, only CD was associated with significantly increased risk for psychoactive substance use disorders, smoking, and bipolar disorder. These longitudinal findings support and extend previously reported findings from this sample at the 4-year follow-up indicating that ODD and CD follow a divergent course. They also support previous findings that ODD heralds a compromised outcome for ADHD youth grown up independently of the co-morbidity with CD.

  13. Neurobehavioral, neuropathological and biochemical profiles in a novel mouse model of co-morbid post-traumatic stress disorder and mild traumatic brain injury

    Science.gov (United States)

    Ojo, Joseph O.; Greenberg, M. Banks; Leary, Paige; Mouzon, Benoit; Bachmeier, Corbin; Mullan, Michael; Diamond, David M.; Crawford, Fiona

    2014-01-01

    Co-morbid mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) has become the signature disorder for returning combat veterans. The clinical heterogeneity and overlapping symptomatology of mTBI and PTSD underscore the need to develop a preclinical model that will enable the characterization of unique and overlapping features and allow discrimination between both disorders. This study details the development and implementation of a novel experimental paradigm for PTSD and combined PTSD-mTBI. The PTSD paradigm involved exposure to a danger-related predator odor under repeated restraint over a 21 day period and a physical trauma (inescapable footshock). We administered this paradigm alone, or in combination with a previously established mTBI model. We report outcomes of behavioral, pathological and biochemical profiles at an acute timepoint. PTSD animals demonstrated recall of traumatic memories, anxiety and an impaired social behavior. In both mTBI and combination groups there was a pattern of disinhibitory like behavior. mTBI abrogated both contextual fear and impairments in social behavior seen in PTSD animals. No major impairment in spatial memory was observed in any group. Examination of neuroendocrine and neuroimmune responses in plasma revealed a trend toward increase in corticosterone in PTSD and combination groups, and an apparent increase in Th1 and Th17 proinflammatory cytokine(s) in the PTSD only and mTBI only groups respectively. In the brain there were no gross neuropathological changes in any groups. We observed that mTBI on a background of repeated trauma exposure resulted in an augmentation of axonal injury and inflammatory markers, neurofilament L and ICAM-1 respectively. Our observations thus far suggest that this novel stress-trauma-related paradigm may be a useful model for investigating further the overlapping and distinct spatio-temporal and behavioral/biochemical relationship between mTBI and PTSD experienced by combat

  14. Effects of Malnutrition as a Co-Morbid Factor on Neurocognitive ...

    African Journals Online (AJOL)

    Objectives: To investigate the effects of malnutrition as a co-morbid factor on neurocognitive functioning in HIV positive adults in Lusaka. Design: A cross- sectional study consisting of 263 participants. The sample comprised of 109 (40.2 %) males and 162 (59.8%) females with an age range of between 20 and 65 years.

  15. The Influence of Co-Morbidity and Other Health Measures on Dental and Medical Care Use among Medicare beneficiaries 2002

    Science.gov (United States)

    Chen, Haiyan; Moeller, John; Manski, Richard J.

    2011-01-01

    Objective To assess the impact of co-morbidity and other health measures on the use of dental and medical care services among the community-based Medicare population with data from the 2002 Medicare Current Beneficiary Survey. Methods A co-morbidity index is the main independent variable of our study. It includes oral cancer as a co-morbidity condition and was developed from Medicare claims data. The two outcome variables indicate whether a beneficiary had a dental visit during the year and whether the beneficiary had an inpatient hospital stay during the year. Logistic regressions estimated the relationship between the outcome variables and co-morbidity after controlling for other explanatory variables. Results High scores on the co-morbidity index, high numbers of self-reported physical limitations, and fair or poor self-reported health status were correlated with higher hospital use and lower dental care utilization. Similar results were found for other types of medical care including medical provider visits, outpatient care, and prescription drugs. A multiple imputation technique was used for the approximate 20% of the sample with missing claims, but the resulting co-morbidity index performed no differently than the index constructed without imputation. Conclusions Co-morbidities and other health status measures are theorized to play either a predisposing or need role in determining health care utilization. The study’s findings confirm the dominant role of these measures as predisposing factors limiting access to dental care for Medicare beneficiaries and as need factors producing higher levels of inpatient hospital and other medical care for Medicare beneficiaries. PMID:21972460

  16. Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Mayer, Jutta S; Hees, Katharina; Medda, Juliane; Grimm, Oliver; Asherson, Philip; Bellina, Mariano; Colla, Michael; Ibáñez, Pol; Koch, Elena; Martinez-Nicolas, Antonio; Muntaner-Mas, Adrià; Rommel, Anna; Rommelse, Nanda; de Ruiter, Saskia; Ebner-Priemer, Ulrich W; Kieser, Meinhard; Ortega, Francisco B; Thome, Johannes; Buitelaar, Jan K; Kuntsi, Jonna; Ramos-Quiroga, J Antoni; Reif, Andreas; Freitag, Christine M

    2018-02-26

    The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently needed. Bright light therapy (BLT) improves day-night rhythm and is an emerging therapy for major depression. Exercise intervention (EI) reduces obesity and improves depressive symptoms. To date, no randomized controlled trial (RCT) has been performed to establish feasibility and efficacy of these interventions targeting the prevention of co-morbid depression and obesity in ADHD. We hypothesize that the two manualized interventions in combination with mobile health-based monitoring and reinforcement will result in less depressive symptoms and obesity compared to treatment as usual in adolescents and young adults with ADHD. This trial is a prospective, pilot phase-IIa, parallel-group RCT with three arms (two add-on treatment groups [BLT, EI] and one treatment as usual [TAU] control group). The primary outcome variable is change in the Inventory of Depressive Symptomatology total score (observer-blinded assessment) between baseline and ten weeks of intervention. This variable is analyzed with a mixed model for repeated measures approach investigating the treatment effect with respect to all three groups. A total of 330 participants with ADHD, aged 14 - obesity, ADHD symptoms, general psychopathology, health-related quality of life, neurocognitive function, chronotype, and physical fitness are explored after the end of the intervention and at the 12-week follow-up. This is the first pilot RCT on the use of BLT and EI in combination with mobile health-based monitoring and reinforcement targeting the prevention of co-morbid depression and obesity in adolescents and young adults with ADHD. If at least medium effects can be established with regard to the prevention of depressive symptoms and

  17. The Coraline Effect: The Misdiagnosis of Personality Disorders in College Students Who Grew up with a Personality Disordered Parent

    Science.gov (United States)

    Donatone, Brooke

    2016-01-01

    College students may be misdiagnosed as personality disordered when in fact their problems are better explained by their upbringing. Growing up with a personality disordered parent may cause them to initially present with what appear to be personality disordered traits due to issues such as not learning adequate coping skills. Accurate diagnosis…

  18. Pattern of comorbidity among anxious and odd personality disorders: the case of obsessive-compulsive personality disorder.

    Science.gov (United States)

    Rossi, A; Marinangeli, M G; Butti, G; Kalyvoka, A; Petruzzi, C

    2000-09-01

    The aim of this study was to examine the pattern of comorbidity among obsessive-compulsive personality disorder (OCPD) and other personality disorders (PDs) in a sample of 400 psychiatric inpatients. PDs were assessed using the Semistructured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Odds ratios (ORs) were calculated to determine significant comorbidity among OCPD and other axis II disorders. The most elevated odds ratios were found for the cooccurrence of OCPD with cluster A PDs (the "odd" PDs, or paranoid and schizoid PDs). These results are consistent with those of previous studies showing a higher cooccurrence of OCPD with cluster A than with cluster C ("anxious") PDs. In light of these observations, issues associated with the nosologic status of OCPD within the Diagnostic and Statistical Manual of Mental Disorders clustering system remain unsettled.

  19. Mental health in Dutch adolescents: a TRAILS report on prevalence, severity, age of onset, continuity and co-morbidity of DSM disorders.

    Science.gov (United States)

    Ormel, J; Raven, D; van Oort, F; Hartman, C A; Reijneveld, S A; Veenstra, R; Vollebergh, W A M; Buitelaar, J; Verhulst, F C; Oldehinkel, A J

    2015-01-01

    With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders. We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents' Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization's Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths. Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects' risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5-10% of the sample, experiencing 34-55% of all severe lifetime disorders. At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5-10% of the adolescent population.

  20. A Descriptive Study on the Neonatal Morbidity Profile of Autism Spectrum Disorders, Including a Comparison with Other Neurodevelopmental Disorders

    Science.gov (United States)

    Atladóttir, H. Ó.; Schendel, D. E.; Parner, E. T.; Henriksen, T. B.

    2015-01-01

    The aim of this study was to describe the profile of specific neonatal morbidities in children later diagnosed with autism spectrum disorder (ASD), and to compare this profile with the profile of children with hyperkinetic disorder, cerebral palsy, epilepsy or intellectual disability. This is a Danish population based cohort study, including all…

  1. Neuroimaging in Antisocial Personality Disorder

    Directory of Open Access Journals (Sweden)

    Abdullah Yildirim

    2015-03-01

    Full Text Available Neuroimaging has been used in antisocial personality disorder since the invention of computed tomography and new modalities are introduced as technology advances. Magnetic resonance imaging, diffusion tensor imaging, functional magnetic resonance imaging and radionuclide imaging are such techniques that are currently used in neuroimaging. Although neuroimaging is an indispensible tool for psychiatric reseach, its clinical utility is questionable until new modalities become more accessible and regularly used in clinical practice. The aim of this paper is to provide clinicians with an introductory knowledge on neuroimaging in antisocial personality disorder including basic physics principles, current contributions to general understanding of pathophysiology in antisocial personality disorder and possible future applications of neuroimaging. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(1: 98-108

  2. Epilepsy and quality of life: socio-demographic and clinical aspects, and psychiatric co-morbidity

    Directory of Open Access Journals (Sweden)

    Gloria Maria de Almeida Souza Tedrus

    2013-06-01

    Full Text Available Objective To study socio-demographic and clinical aspects, as well as psychiatric co-morbidity that influence the quality of life of adult epileptic patients. Methods One hundred and thirty-two individuals diagnosed with epilepsy were evaluated from neurological/clinical and psychiatric points of view and by the Quality of Life in Epilepsy Inventory (QOLIE-31. Predictive factors for the QOLIE-31 scores were studied. Results The regression analyses indicated the existence of psychiatric co-morbidity (total score, seizure worry, emotional well-being, energy/fatigue, social function and cognitive function and a greater seizure frequency (total score, cognitive function and energy/fatigue as predictive factors for lower scores in the total QOLIE-31 score and in various dimensions. Abnormalities in the neurological exam and poly-therapy with anti-epileptic drugs were negative factors limited to one of the dimensions cognitive function and social function, respectively. Conclusion The presence of psychiatric co-morbidity and a greater seizure frequency were the main factors influencing the quality of life in epileptic patients as evaluated by QOLIE-31.

  3. Disease management for co-morbid depression and anxiety in diabetes mellitus

    DEFF Research Database (Denmark)

    Stoop, Corinne H; Spek, Viola R M; Pop, Victor J M

    2011-01-01

    BACKGROUND: Depression and anxiety are common co-morbid health problems in patients with type 2 diabetes. Both depression and anxiety are associated with poor glycaemic control and increased risk of poor vascular outcomes and higher mortality rates. Results of previous studies have shown that in ...

  4. A parallel process growth model of avoidant personality disorder symptoms and personality traits.

    Science.gov (United States)

    Wright, Aidan G C; Pincus, Aaron L; Lenzenweger, Mark F

    2013-07-01

    Avoidant personality disorder (AVPD), like other personality disorders, has historically been construed as a highly stable disorder. However, results from a number of longitudinal studies have found that the symptoms of AVPD demonstrate marked change over time. Little is known about which other psychological systems are related to this change. Although cross-sectional research suggests a strong relationship between AVPD and personality traits, no work has examined the relationship of their change trajectories. The current study sought to establish the longitudinal relationship between AVPD and basic personality traits using parallel process growth curve modeling. Parallel process growth curve modeling was applied to the trajectories of AVPD and basic personality traits from the Longitudinal Study of Personality Disorders (Lenzenweger, M. F., 2006, The longitudinal study of personality disorders: History, design considerations, and initial findings. Journal of Personality Disorders, 20, 645-670. doi:10.1521/pedi.2006.20.6.645), a naturalistic, prospective, multiwave, longitudinal study of personality disorder, temperament, and normal personality. The focus of these analyses is on the relationship between the rates of change in both AVPD symptoms and basic personality traits. AVPD symptom trajectories demonstrated significant negative relationships with the trajectories of interpersonal dominance and affiliation, and a significant positive relationship to rates of change in neuroticism. These results provide some of the first compelling evidence that trajectories of change in PD symptoms and personality traits are linked. These results have important implications for the ways in which temporal stability is conceptualized in AVPD specifically, and PD in general.

  5. Alcohol abuse, personality disorders, and aggression : The quest for a common underlying mechanism

    NARCIS (Netherlands)

    Garofalo, C.; Wright, Aidan G.C.

    2017-01-01

    Alcohol abuse and personality disorders are often comorbid, and their co-occurrence is associated with worse rognostic expectations, poor therapeutic outcomes, as well as deleterious behavioral and interpersonal consequences. The current review aims at untangling the association among alcohol abuse,

  6. Obsessive-compulsive personality disorder co-occurring with obsessive-compulsive disorder: Conceptual and clinical implications.

    Science.gov (United States)

    Starcevic, Vladan; Berle, David; Brakoulias, Vlasios; Sammut, Peter; Moses, Karen; Milicevic, Denise; Hannan, Anthony

    2013-01-01

    There are ongoing uncertainties in the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD). This study aimed to test the proposition that OCPD may be a marker of severity of OCD by comparing groups of OCD individuals with and without OCPD on a number of variables. A total of 148 adults with a principal diagnosis of OCD were administered the Mini International Neuropsychiatric Interview, Yale-Brown Obsessive-Compulsive Scale, Sheehan Disability Scale, Vancouver Obsessional Compulsive Inventory and Symptom Checklist 90-Revised. Participants with a DSM-IV diagnosis of OCPD were compared with those without OCPD. Some 70 (47.3%) participants were diagnosed with OCPD. The groups of participants with and without OCPD did not differ significantly with respect to any of the demographic variables, clinician-rated severity of OCD, levels of disability and mean age of onset of OCD. All self-rated OCD symptom dimensions except for contamination and checking were significantly more prominent in participants with OCPD, as were all self-rated dimensions of psychopathology. Participants with OCPD had significantly more frequent hoarding compulsions and obsessions involving a need to collect and keep objects. Of Axis I disorders, only panic disorder was significantly more frequent in participants with OCPD than in those without OCPD. A high frequency of OCPD among individuals with OCD suggests a strong, although not necessarily a unique, relationship between the two conditions. This finding may also be a consequence of the blurring of the boundary between OCD and OCPD by postulating that hoarding and hoarding-like behaviours characterise both disorders. Results of this study do not support the notion that OCD with OCPD is a marker of clinician-rated severity of OCD. However, individuals with OCPD had more prominent OCD symptoms, they were more distressed and exhibited various other psychopathological phenomena more intensely

  7. High prevalence of personality disorders among circadian rhythm sleep disorders (CRSD) patients.

    Science.gov (United States)

    Dagan, Y; Sela, H; Omer, H; Hallis, D; Dar, R

    1996-10-01

    The purpose of this study was to examine systematically our previous clinical impression regarding the prevalence of personality disorders in patients suffering from circadian rhythm sleep disorders (CRSD). We hypothesized that, in a group of patients suffering from CRSD, there would be a higher frequency of personality disorders than in a group of healthy controls. The experimental group consisted of CRSD patients diagnosed according to a clinical interview and actigraphic recordings. The control group consisted of healthy volunteers in whom CRSD had been ruled out by means of a self-administered questionnaire. Both groups were assessed for personality disorders using the MCMI, a diagnostic tool based on Millon's biopsychosocial theory of personality and the PRQ-R, a diagnostic tool based on the DMS-III-R. Both tests provided clear and significant support for the hypothesis that individuals suffering from CRSD are characterized to a greater extent by personality disorders than a control group. No specific characteristic pattern or profile of personality disorders was clearly detected. Correct early diagnosis and treatment of CRSD may improve afflicted individuals' adaptive capabilities and perhaps even prevent the development of a personality disorder. This suggests how important a greater awareness of CRSD on the part of the professional community may be.

  8. Personality disorders in adopted versus non-adopted adults.

    Science.gov (United States)

    Westermeyer, Joseph; Yoon, Gihyun; Amundson, Carla; Warwick, Marion; Kuskowski, Michael A

    2015-04-30

    The goal of this epidemiological study was to investigate lifetime history and odds ratios of personality disorders in adopted and non-adopted adults using a nationally representative sample. Data, drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), were compared in adopted (n=378) versus non-adopted (n=42,503) adults to estimate the odds of seven personality disorders using logistic regression analyses. The seven personality disorders were histrionic, antisocial, avoidant, paranoid, schizoid, obsessive-compulsive, and dependent personality disorder. Adoptees had a 1.81-fold increase in the odds of any personality disorder compared with non-adoptees. Adoptees had increased odds of histrionic, antisocial, avoidant, paranoid, schizoid, and obsessive-compulsive personality disorder compared with non-adoptees. Two risk factors associated with lifetime history of a personality disorder in adoptees compared to non-adoptees were (1) being in the age cohort 18-29 years (but no difference in the age 30-44 cohort), using the age 45 or older cohort as the reference and (2) having 12 years of education (but no difference in higher education groups), using the 0-11 years of education as the reference. These findings support the higher rates of personality disorders among adoptees compared to non-adoptees. Published by Elsevier Ireland Ltd.

  9. Psychotic experiences and suicide attempt risk in common mental disorders and borderline personality disorder.

    Science.gov (United States)

    Kelleher, I; Ramsay, H; DeVylder, J

    2017-03-01

    Recent research has demonstrated a strong relationship between psychotic experiences and suicidal behaviour. No research to date, however, has investigated the role of borderline personality disorder (BPD) in this relationship, despite the fact that BPD is highly comorbid with common mental disorders and is associated with both recurrent suicidal behaviour and psychotic experiences. This paper examined the relationship between psychotic experiences and suicide attempts, including interrelationships with BPD and common mental disorders. We used the 2007 Adult Psychiatric Morbidity Study, a stratified, multistage probability sample of households in England, which recruited a nationally representative sample aged 16 years and older. Participants were assessed for common mental disorders, BPD (clinical and subclinical), suicidal behaviour, and psychotic experiences. Approximately 4% of the total sample (n = 323) reported psychotic experiences. Psychotic experiences were associated with increased odds of suicide attempts in individuals with BPD (OR = 2.23, 95% CI = 1.03-4.85), individuals with a common mental disorder (OR = 2.47, 95% CI = 1.37-4.43), individuals without a common mental disorder (OR = 3.99, 95% CI = 2.47-6.43), and individuals with neither a common mental disorder nor BPD (OR = 3.20, 95% CI = 1.71-5.98). Psychotic experiences are associated with high odds of suicidal behaviour in individuals with and without psychopathology. This relationship is not explained by clinical or subclinical BPD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Borderline Personality Disorder and Narcissistic Personality Disorder Diagnoses From the Perspective of the DSM-5 Personality Traits: A Study on Italian Clinical Participants.

    Science.gov (United States)

    Fossati, Andrea; Somma, Antonella; Borroni, Serena; Maffei, Cesare; Markon, Kristian E; Krueger, Robert F

    2016-12-01

    To evaluate the associations between Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Alternative Model of Personality Disorder traits and domains and categorically diagnosed narcissistic personality disorder (NPD) and borderline personality disorder (BPD), respectively, 238 inpatient and outpatient participants who were consecutively admitted to the Clinical Psychology and Psychotherapy Unit of San Raffaele Hospital in Milan, Italy, were administered the Personality Inventory for DSM-5 (PID-5) and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Based on SCID-II, the participants were assigned to the following groups: a) NPD (n = 49), b) BPD (n = 32), c) any other PD (n = 91), and d) no PD (n = 63). Emotional lability, separation insecurity, depressivity, impulsivity, risk taking, and hostility were significantly associated with BPD diagnosis. Attention seeking significantly discriminated participants who received an SCID-II categorical NPD diagnosis. Separation insecurity, impulsivity, distractibility, and perceptual dysregulation were the DSM-5 traits that significantly discriminated BPD participants. Domain-level analyses confirmed and extended trait-level findings.

  11. Childhood maltreatment and the medical morbidity in bipolar disorder: a case-control study.

    Science.gov (United States)

    Hosang, Georgina M; Fisher, Helen L; Uher, Rudolf; Cohen-Woods, Sarah; Maughan, Barbara; McGuffin, Peter; Farmer, Anne E

    2017-09-07

    Childhood maltreatment (abuse and neglect) can have long-term deleterious consequences, including increased risk for medical and psychiatric illnesses, such as bipolar disorder in adulthood. Emerging evidence suggests that a history of childhood maltreatment is linked to the comorbidity between medical illnesses and mood disorders. However, existing studies on bipolar disorder have not yet explored the specific influence of child neglect and have not included comparisons with individuals without mood disorders (controls). This study aimed to extend the existing literature by examining the differential influence of child abuse and child neglect on medical morbidity in a sample of bipolar cases and controls. The study included 72 participants with bipolar disorder and 354 psychiatrically healthy controls (average age of both groups was 48 years), who completed the Childhood Trauma Questionnaire, and were interviewed regarding various medical disorders. A history of any type of childhood maltreatment was significantly associated with a diagnosis of any medical illness (adjusted OR = 6.28, 95% confidence intervals 1.70-23.12, p = 0.006) and an increased number of medical illnesses (adjusted OR = 3.77, 95% confidence intervals 1.34-10.57, p = 0.012) among adults with bipolar disorder. Exposure to child abuse was more strongly associated with medical disorders than child neglect. No association between childhood maltreatment and medical morbidity was detected among controls. To summarise, individuals with bipolar disorder who reported experiencing maltreatment during childhood, especially abuse, were at increased risk of suffering from medical illnesses and warrant greater clinical attention.

  12. Neurochemical alterations associated with borderline personality disorder.

    Science.gov (United States)

    Atmaca, Murad; Karakoc, Tevfik; Mermi, Osman; Gurkan Gurok, M; Yildirim, Hanefi

    2015-01-01

    In neuroimaging on borderline personality disorder, prior studies focused on the hippocampus and amygdala, as mentioned above. However, no study investigated whether there were neurochemical changes in the patients with borderline personality disorder. Therefore, in the present study, we aimed to investigate neurochemical change of patients diagnosed with borderline disorder and hypothesized that neurochemicals would change in the hippocampus region of these patients. Seventeen patients and the same number of healthy control subjects were analyzed by using a 1.5 Tesla GE Signa Imaging System. N-acetylaspartate (NAA), choline compounds (CHO), and creatine (CRE) values of hippocampal region were measured. The mean NAA/CRE ratio in the hippocampus region was significantly reduced in the patients with borderline personality disorder compared to that of healthy control subjects, In addition, NAA/CHO ratio of the patients with borderline personality disorder was also significantly reduced when compared to that of healthy subjects. There was no difference in the ratio of CHO/CRE. In summary, we present evidence for reduced NAA in the patients with borderline personality disorder. © 2015, The Author(s).

  13. A personality and impairment approach to examine the similarities and differences between avoidant personality disorder and social anxiety disorder.

    Science.gov (United States)

    Carmichael, Kieran L C; Sellbom, Martin; Liggett, Jacqueline; Smith, Alexander

    2016-11-01

    The current study examined whether avoidant personality disorder (AvPD) and social anxiety disorder (SAD) should be considered distinct disorder constructs, which is a persistent and controversial issue in the clinical literature. We examined whether relative scores on SAD and AvPD were associated with the same personality profile and severity of impairment. The current research used a cross-sectional design and self-report inventories, including multiple measures of personality, impairment and psychopathology. Results from a mixed sample of 402 university and community participants found that scores on AvPD and SAD were similarly associated with personality traits and impairment indices. Moreover, a latent construct accounting for the shared variance for AvPD and SAD was associated with personality traits and impairment, whereas the residuals representing the uniquenesses of these disorder constructs were not. These findings support the view that AvPD and SAD are similar disorders from a phenotypic personality trait and impairment perspective. These findings are contrary to a prevalent view in the literature, known as severity continuum hypothesis, because the two disorders could not be meaningfully differentiated based on severity of impairment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Can DSM-IV borderline personality disorder be diagnosed via dimensional personality traits? Implications for the DSM-5 personality disorder proposal.

    Science.gov (United States)

    Miller, Joshua D; Morse, Jennifer Q; Nolf, Kimberly; Stepp, Stephanie D; Pilkonis, Paul A

    2012-11-01

    The proposal for the diagnosis of personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5;American Psychiatric Association, in preparation) involves, in part, the use of elevated scores on dimensional personality traits. For instance, the diagnosis of borderline personality disorder (BPD) in the DSM-5 will require evidence of self- and interpersonal impairment as well as elevated scores on traits of emotional lability, anxiousness, separation insecurity, depressivity, impulsivity, risk taking, and hostility. Using a sample of individuals from the community (N = 134), half of whom were receiving psychiatric treatment, we tested whether the summation of relevant personality trait scores, using data derived from a measure of the Five-Factor Model of personality (FFM), would result in a construct that corresponds to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV, American Psychiatric Association, 2000) BPD construct as scored by expert consensus ratings. The DSM-IV and FFM BPD scores were significantly correlated (r = .60) and generated highly similar patterns of relations (ricc = .84) with key constructs from BPD's nomological network. These data should serve to allay concerns that the DSM-5's new diagnostic approach will be detrimental to the identification of BPD. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  15. Antisocial Personality disorder | Chinasa | Abia State University ...

    African Journals Online (AJOL)

    Personality disorders are mental disorders that are characterized by persistent maladaptive patterns of behavior, cognition and inner experience. These patterns develop early in life, are inflexible and associated with significant distress or disability. Antisocial personality disorder (ASPD) is a psychiatric condition ...

  16. Early-onset obsessive-compulsive disorder and personality disorders in adulthood.

    Science.gov (United States)

    Maina, Giuseppe; Albert, Umberto; Salvi, Virginio; Pessina, Enrico; Bogetto, Filippo

    2008-03-15

    Obsessive-compulsive disorder (OCD) often emerges in childhood or adolescence. The aim of the present study was to evaluate whether adult patients with prepuberal onset differ from subjects with later onset in terms of personality disorder comorbidity. The Structured Clinical Interview for DSM-IV Axis II Disorders was used to assess 148 patients with a principal diagnosis of OCD according to the Structured Clinical Interview for DSM-IV Axis I Disorders. The following two subgroups of subjects were selected according to the age at onset of symptomatology: patients with an early-onset ( or =17 years). Of the 148 patients screened for the present study, 33 (22.3%) had an early onset and 1369 (46.6%) had a later onset. With regard to personality disorders, early-onset patients showed more OC personality disorders (OCPD) than later onset patients. Our finding suggests that OCD in childhood increases the risk for developing OCPD in adulthood, or that early-onset OCD and OCPD share a common pathogenesis.

  17. Personality disorders are important risk factors for disability pensioning.

    Science.gov (United States)

    Østby, Kristian Amundsen; Czajkowski, Nikolai; Knudsen, Gun Peggy; Ystrom, Eivind; Gjerde, Line C; Kendler, Kenneth S; Ørstavik, Ragnhild E; Reichborn-Kjennerud, Ted

    2014-12-01

    To determine whether personality disorders (PDs) are associated with increased risk of disability pensioning in young adults, independent of other common mental disorders. 2,770 young adults from the general population were assessed for PDs by the Structured Interview for DSM-IV Personality, and for common mental disorders by the Composite of International Diagnostic Interview. These data were linked to the Norwegian National Insurance Administration's recordings of disability benefits for a 10-year period. Logistic regression analyses were applied to investigate the association between PDs and disability pensioning. The analyses were conducted for three types of PD measures: categorical diagnoses (any PD), dimensional scores of individual PDs and higher order components retrieved by principal component analyses. Having any PD was strongly associated with disability pensioning, regardless of disability diagnosis. The estimated odds ratio (OR) was substantially higher for PDs [OR 4.69 (95% confidence interval (CI) 2.6-8.5)] than for mood disorders [OR 1.3 (CI 0.7-2.3)] and anxiety disorders [OR 2.3 (CI 1.3-4.3)]. Measured dimensionally, all PD traits except antisocial traits were significantly associated with disability pensioning. After adjusting for co-occurring traits of other PDs, only schizoid, dependent and borderline PD traits showed a significant positive association with disability pension, while antisocial traits showed a significant negative association. The principal component analyses showed that negative affectivity, psychoticism, and detachment was associated with an increased risk of disability pensioning, while antagonism/disinhibition and obsessivity were not. PDs are strongly associated with disability pensioning in young adults, and might be more important predictors of work disability than anxiety and depressive disorders. Certain aspects of pathologic personalities are particularly important predictors of disability.

  18. Personality disorder types proposed for DSM-5

    NARCIS (Netherlands)

    Skodol, A.E.; Bender, D.S.; Morey, L.C.; Clark, L.A.; Oldham, J.M.; Alarcon, R.D.; Krueger, R.F.; Verheul, R.; Bell, C.C.; Siever, L.J.

    2011-01-01

    The Personality and Personality Disorders Work Group has proposed five specific personality disorder (PD) types for DSM-5, to be rated on a dimension of fit: antisocial/psychopathic, avoidant, borderline, obsessive-compulsive, and schizotypal. Each type is identified by core impairments in

  19. Personality Disorders and the 3-Year Course of Alcohol, Drug, and Nicotine Use Disorders

    Science.gov (United States)

    Hasin, Deborah; Fenton, Miriam C.; Skodol, Andrew; Krueger, Robert; Keyes, Katherine; Geier, Timothy; Greenstein, Eliana; Blanco, Carlos; Grant, Bridget

    2012-01-01

    Context Little is known about the role of a broad range of personality disorders in the course of substance use disorder (SUD), and whether these differ by substance. The existing literature focuses mostly on antisocial personality disorder and does not come to clear conclusions. Objective To determine the association between the ten DSM-IV personality disorders and the persistence of common SUDs in a 3-year prospective study of a national sample. Design Data were drawn from participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who had alcohol dependence (N=1,172), cannabis use disorder (N=454) or nicotine dependence (N=4,017) at baseline and who were re-interviewed three years later. Control variables included demographic characteristics, family history of substance disorders, baseline Axis I disorders and treatment status, and prior SUD duration. Main outcome measure Persistent SUD, defined as meeting full criteria for the relevant SUD throughout the 3-year follow-up period. Results Persistent SUD was found among 30.1% of participants with alcohol dependence, 30.8% with cannabis use disorder, and 56.6% with nicotine dependence at baseline. Axis I disorders did not have strong or consistent associations with persistent SUD. In contrast, antisocial personality disorder was significantly associated with persistent alcohol, cannabis and nicotine use disorders (adjusted odds ratios: 2.46-3.51), as was borderline personality disorder (adjusted odds ratios: 2.04-2.78) and schizotypal personality disorder (adjusted odds ratios: 1.65-5.90). Narcissistic, schizoid, and obsessive-compulsive personality disorders were less consistently associated with SUD persistence. Conclusions The consistent findings on the association of antisocial, borderline and schizotypal personality disorders with persistent SUD indicates the importance of these personality disorders in understanding the course of SUD. Future studies should examine dimensional

  20. Borderline personality disorder and emotional intelligence

    NARCIS (Netherlands)

    Peter, M.; Schuurmans, H.; Vingerhoets, A.J.J.M.; Smeets, G.; Verkoeijen, P.; Arntz, A.

    2013-01-01

    The present study investigated emotional intelligence (EI) in borderline personality disorder (BPD). It was hypothesized that patients with BPD (n = 61) compared with patients with other personality disorders (PDs; n = 69) and nonpatients (n = 248) would show higher scores on the ability to perceive

  1. Clinical Components of Borderline Personality Disorder and Personality Functioning.

    Science.gov (United States)

    Ferrer, Marc; Andión, Óscar; Calvo, Natalia; Hörz, Susanne; Fischer-Kern, Melitta; Kapusta, Nestor D; Schneider, Gudrun; Clarkin, John F; Doering, Stephan

    2018-01-01

    Impairment in personality functioning (PF) represents a salient criterion of the DSM-5 alternative diagnostic model for personality disorders (AMPD). The main goal of this study is to analyze the relationship of the borderline personality disorder (BPD) clinical components derived from the DSM-5 categorical diagnostic model (affective dysregulation, behavioral dysregulation, and disturbed relatedness) with personality organization (PO), i.e., PF, assessed by the Structured Interview of Personality Organization (STIPO). STIPO and the Structured Clinical Interviews for DSM-IV (SCID-I and -II) were administered to 206 BPD patients. The relationship between PO and BPD components were studied using Spearman correlations and independent linear regression analyses. Significant positive correlations were observed between STIPO scores and several DSM-5 BPD criteria and comorbid psychiatric disorders. STIPO dimensions mainly correlated with disturbed relatedness and, to a lesser extent, affective dysregulation components. Each BPD clinical component was associated with specific STIPO dimensions. Both diagnostic models, DSM-5 BPD criteria and PO, are not only related but complementary concepts. The results of this study particularly recommend STIPO for the assessment of relational functioning, which is a major domain of the Personality Functioning Scale Levels of the DSM-5 AMPD. © 2018 S. Karger AG, Basel.

  2. [Panic disorder--psychobiological aspects of personality dimensions].

    Science.gov (United States)

    Draganić-Rajić, Saveta; Lecić-Tosevski, Dusica; Paunović, Vladimir R; Cvejić, Vesna; Svrakić, Dragan

    2005-01-01

    Attempts to understand the underlying mechanisms of association between psychological factors and panic disorder have been mostly based on psychodynamic description. Evidence of the importance of serotonergic (5-HT) system in panic disorder (PD), however, has substanti ally increased in recent years. The objective of our study was to determine whether there was a specific personality profile of panic disorder patients and how it was related to possible neurobiological mechanisms underlying personality dimensions. Sample consisted of 14 inpatients with ICD-X diagnosis of panic disorder and 34 healthy control subjects. Personality dimensions were assessed by Minnesota Multiphasic Personality Inventory (MMPI-201) and Tridimensional Personality Questionnaire (TPQ). To assess central 5-HT function, platelet monoamine-oxidase (MAO) activity was measured. In panic disorder group, higher scores of histrionic, depressive and hypochondriac subscales and significant increase of harm avoidance (HA) scale as well as low MAO activity were found. Negative correlation was established between MAO activity and psychopathic deviance MMPI scale. The obtained results might indicate a specific personality profile of patients with panic disorder, which is characterized by high neuroticism, fearfulness, inhibition, shyness and apprehensive worry. Low MAO activity and high HA scores possibly indicate underlying hyperserotonergic state. The observed correlation between personality traits and MAO activity provide additional support for the hypothesized functional relationship between underlying central monoaminergic activity and temperament traits associated with anxiety, depression and impulsivity.

  3. Personality Pathology of Adults with Autism Spectrum Disorder without Accompanying Intellectual Impairment in Comparison to Adults with Personality Disorders

    Science.gov (United States)

    Strunz, Sandra; Westphal, Linda; Ritter, Kathrin; Heuser, Isabella; Dziobek, Isabel; Roepke, Stefan

    2015-01-01

    Differentiating autism spectrum disorders (ASDs) without accompanying intellectual impairment from personality disorders is often challenging. Identifying personality traits and personality pathology specific to ASD might facilitate diagnostic procedure. We recruited a sample of 59 adults with ASD without accompanying intellectual impairment, 62…

  4. Vulnerability, Borderline Personality Disorders. Clinical and ...

    African Journals Online (AJOL)

    Borderline personality disorder and vulnerability are difficult to assess and are rather elusive to define. A case study material is presented from a cognitive analytical model. An attempt of the dominant features of cognitive analytical therapy and discussion of vulnerability in relation to personality disorder is provided.

  5. Prognostic information in administrative co-morbidity data following coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Hvelplund, Anders; Rasmussen, Søren

    2010-01-01

    Objectives: The aim of this study was to evaluate the prognostic information obtainable from administrative data with respect to 30-day mortality following coronary artery bypass grafting (CABG) and to compare it with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) recorded ...... was equal to that of the EuroSCORE (c-statistic 0.79). Conclusions: A standard co-morbidity index based on administrative data as well as on clinical data has proven equally useful for prediction of mortality amongst CABG patients.......Objectives: The aim of this study was to evaluate the prognostic information obtainable from administrative data with respect to 30-day mortality following coronary artery bypass grafting (CABG) and to compare it with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) recorded...... in a clinical database. Methods: We used a co-morbidity index calculated from administrative data in the Danish National Patient Register by means of all admissions 1 year prior to CABG. In addition, each CABG was categorised as being isolated or not, and acute or not. The prognostic power of the co...

  6. Morbidity pattern and personal hygiene in children among private primary school in urban area: are the trends changing?

    Science.gov (United States)

    Mhaske, Mayavati S; Khismatrao, Deepak S; Kevin, Fernandez; Pandve, Harshal T; Kundap, Ritesh P

    2013-07-01

    School health is an important intervention as a great deal of research tells us that schools can have a major effect on children's health, by teaching them about health and promoting healthy behaviors. The aim of this study is to determine common health problems and assess personal hygiene status among primary school children. A cross-sectional study was conducted in academic years 2009-2010 and 2010-2011, with three health check-up camps organized in private primary school of Pune city. A total of 450 students were assessed for health problems and composite score of personal hygiene status was calculated ranging from 0 to 5 by examination of hairs, nails, skin and clothes. Proportions calculated with application of Chi-square test and Pearson co-efficient applied to observe the relation between two quantitative variables. Out of 450 students examined, 56.2% were boys and 43.8% were girls with age ranging from 5 to 10 years. The major morbidities observed were dental caries (65.1%), upper respiratory tract infections (38.2%), ear wax (29.9%) and myopia (10.0%). Mean hygiene score was significantly higher in girls (4.32) than boys (3.95) and poor hygiene observed in older boys. Increasing myopia and poor dental hygiene denotes a changing morbidity pattern in private primary school of the urban area. The hygiene status of the girls is significantly better than boys.

  7. Personality and psychotic disorders

    NARCIS (Netherlands)

    Boyette, L.L.N.J.

    2014-01-01

    The subject of the current thesis is the contribution of normal personality traits as conceptualized by the Five-Factor Model of personality (FFM) to the manifestation of illness in patients with psychotic disorders. These studies were part of the Dutch national Genetic Risk and Outcome of Psychosis

  8. Taking It One Day at a Time: African American Women Aging with HIV and Co-Morbidities

    OpenAIRE

    Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

    2014-01-01

    Self-managing HIV/AIDS presents challenges for anyone infected. These challenges may be further complicated for older HIV-infected African American women who acquired the disease at younger ages and now have co-morbidities. Little is known regarding how women's age identity, social responsibilities, co-morbidities, and romantic relationship status influence their HIV self-management. Five focus groups were conducted in Washington DC, with HIV-positive African American women aged 52–65. Topics...

  9. A 4q35.2 subtelomeric deletion identified in a screen of patients with co-morbid psychiatric illness and mental retardation.

    Science.gov (United States)

    Pickard, Ben S; Hollox, Edward J; Malloy, M Pat; Porteous, David J; Blackwood, Douglas H R; Armour, John A L; Muir, Walter J

    2004-08-13

    Cryptic structural abnormalities within the subtelomeric regions of chromosomes have been the focus of much recent research because of their discovery in a percentage of people with mental retardation (UK terminology: learning disability). These studies focused on subjects (largely children) with various severities of intellectual impairment with or without additional physical clinical features such as dysmorphisms. However it is well established that prevalence of schizophrenia is around three times greater in those with mild mental retardation. The rates of bipolar disorder and major depressive disorder have also been reported as increased in people with mental retardation. We describe here a screen for telomeric abnormalities in a cohort of 69 patients in which mental retardation co-exists with severe psychiatric illness. We have applied two techniques, subtelomeric fluorescence in situ hybridisation (FISH) and multiplex amplifiable probe hybridisation (MAPH) to detect abnormalities in the patient group. A subtelomeric deletion was discovered involving loss of 4q in a patient with co-morbid schizoaffective disorder and mental retardation. The precise region of loss has been defined allowing us to identify genes that may contribute to the clinical phenotype through hemizygosity. Interestingly, the region of 4q loss exactly matches that linked to bipolar affective disorder in a large multiply affected Australian kindred.

  10. Features of borderline personality disorder as a mediator of the relation between childhood traumatic experiences and psychosis-like experiences in patients with mood disorder.

    Science.gov (United States)

    Baryshnikov, Ilya; Aaltonen, Kari; Suvisaari, Jaana; Koivisto, Maaria; Heikkinen, Martti; Joffe, Grigori; Isometsä, Erkki

    2018-03-01

    Psychosis-like experiences (PEs) are common in patients with non-psychotic disorders. Several factors predict reporting of PEs in mood disorders, including mood-associated cognitive biases, anxiety and features of borderline personality disorder (BPD). Childhood traumatic experiences (CEs), often reported by patients with BPD, are an important risk factor for mental disorders. We hypothesized that features of BPD may mediate the relationship between CEs and PEs. In this study, we investigated the relationships between self-reported PEs, CEs and features of BPD in patients with mood disorders. As part of the Helsinki University Psychiatric Consortium study, McLean Screening Instrument (MSI), Community Assessment of Psychic Experiences (CAPE-42) and Trauma and Distress Scale (TADS) were filled in by patients with mood disorders (n = 282) in psychiatric care. Correlation coefficients between total scores of scales and their dimensions were estimated, multiple regression and mediation analyses were conducted. Total scores of MSI correlated strongly with scores of the CAPE-42 dimension "frequency of positive symptoms" (rho = 0.56; p ≤ 0.001) and moderately with scores of TADS (rho = 0.4; p ≤ 0.001). Total score of MSI and its dimension "cognitive symptoms", including identity disturbance, distrustfulness and dissociative symptoms, fully mediated the relation between TADS and CAPE-42. Each cognitive symptom showed a partial mediating role (dissociative symptoms 43% (CI = 25-74%); identity disturbance 40% (CI = 30-73%); distrustfulness 18% (CI = 12-50%)). Self-reported cognitive-perceptual symptoms of BPD fully mediate, while affective, behavioural and interpersonal symptoms only partially mediate the relationships between CEs and PEs. Recognition of co-morbid features of BPD in patients with mood disorders reporting PEs is essential. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Understanding recovery in the context of lived experience of personality disorders: a collaborative, qualitative research study.

    Science.gov (United States)

    Gillard, Steve; Turner, Kati; Neffgen, Marion

    2015-07-31

    Concepts of recovery increasingly inform the development and delivery of mental health services internationally. In the UK recent policy advocates the application of recovery concepts to the treatment of personality disorders. However diagnosis and understanding of personality disorders remains contested, challenging any assumption that mainstream recovery thinking can be directly translated into personality disorders services. In a qualitative interview-based study understandings of recovery were explored in extended, in-depth interviews with six people purposively sampled from a specialist personality disorders' service in the UK. An interpretive, collaborative approach to research was adopted in which university-, clinical- and service user (consumer) researchers were jointly involved in carrying out interviews and analysing interview data. Findings suggested that recovery cannot be conceptualised separately from an understanding of the lived experience of personality disorders. This experience was characterised by a complexity of ambiguous, interrelating and conflicting feelings, thoughts and actions as individuals tried to cope with tensions between internally and externally experienced worlds. Our analysis was suggestive of a process of recovering or, for some, discovering a sense of self that can safely coexist in both worlds. We conclude that key facilitators of recovery - positive personal relationships and wider social interaction - are also where the core vulnerabilities of individuals with lived experience of personaility disorders can lie. There is a role for personality disorders services in providing a safe space in which to develop positive relationships. Through discursive practice within the research team understandings of recovery were co-produced that responded to the lived experience of personality disorders and were of applied relevance to practitioners.

  12. [Personality disorders in the elderly].

    Science.gov (United States)

    Saarela, Tuula; Stenberg, Jan-Henry

    2011-01-01

    The diagnostic assessment of old age personality disorders is challenging. Medical illnesses and cognitive impairment may influence the clinical symptoms. Common elements of effective approaches such as building a collaborative relationship and maintaining consistency as well as structured framework of treatment can be tailored to the problems of a patient. Pharmacological treatment guidelines of personality disorders need to be individually applied to elderly persons. Comorbid depression is often the primary symptom seen and needs to be treated. Psychiatry should take steps to promote effective treatments and provide support and clinical supervision to health staff treating these individuals.

  13. Neurocognitive dysfunction in problem gamblers with co-occurring antisocial personality disorder.

    Science.gov (United States)

    Blum, Austin W; Leppink, Eric W; Grant, Jon E

    2017-07-01

    Problem gamblers with symptoms of antisocial personality disorder (ASPD) may represent a distinct problem gambling subtype, but the neurocognitive profile of individuals affected by both disorders is poorly characterized. Non-treatment-seeking young adults (18-29years) who gambled ≥5 times in the preceding year were recruited from the general community. Problem gamblers (defined as those meeting ≥1 DSM-5 diagnostic criteria for gambling disorder) with a lifetime history of ASPD (N=26) were identified using the Mini International Neuropsychiatric Interview (MINI) and compared with controls (N=266) using questionnaire-based impulsivity scales and objective computerized neuropsychological tasks. Findings were uncorrected for multiple comparisons. Effect sizes were calculated using Cohen's d. Problem gambling with ASPD was associated with significantly elevated gambling disorder symptoms, lower quality of life, greater psychiatric comorbidity, higher impulsivity questionnaire scores on the Barratt Impulsiveness Scale (d=0.4) and Eysenck Impulsivity Questionnaire (d=0.5), and impaired cognitive flexibility (d=0.4), executive planning (d=0.4), and an aspect of decision-making (d=0.6). Performance on measures of response inhibition, risk adjustment, and quality of decision making did not differ significantly between groups. These preliminary findings, though in need of replication, support the characterization of problem gambling with ASPD as a subtype of problem gambling associated with higher rates of impulsivity and executive function deficits. Taken together, these results may have treatment implications. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. [Differential diagnosis between borderline personality disorder and bipolar disorder].

    Science.gov (United States)

    Herbst, Luis

    2010-01-01

    The relationship between bipolar disorder and borderline personality disorder remains controversial since in both conditions there are overlapping and similar symptomatic dimensions. Symptomatic dimensions suitable to subserve differential diagnosis are: mood, mood variability mode, and personal and family history. Characteristics of psychotic symptoms may also be useful in the differentiation. On the other hand, anxiety symptoms, neuropsychological profiles, neuro-imaging procedures and biomarkers seem not to contribute to differentiate between both diseases. The presentation of nonsuicidal self mutilation behavior can offer some differences between bipolar and borderline personality disorders, but both can coexist in clinical comorbid forms and do not significantly contribute to the differential diagnosis. Differential diagnosis is complicated by the fact that a low percentage of patients can experience comorbidity of both conditions. In this work we review all these issues, and particularly emphasize the importance of sitematically take into account the patient background, the course that follows his or her disorder, together with the outcome in response to medical decisions.

  15. Neuropsychological findings in personality disorders: A.R. Luria’s Approach.

    Directory of Open Access Journals (Sweden)

    Pluzhnikov I.V.

    2015-06-01

    Full Text Available There is a lack of information concerning the features of cognitive processes in personality disorders, as well as the brain mechanisms of the pathogenesis of these diseases. Luria’s neuropsychological approach demonstrated its heuristicity in estimating the cognitive status of patients with mental disorders and can be employed to identify the brain bases of non-psychotic mental disorders (including personality disorders. The objective of this research is to study the features of neurocognitive functioning in patients with schizoid personality disorder and schizotypal personality disorder (against the norm, employing Luria’s neuropsychological methodology. Hypotheses: 1 While both types of personality disorders are related to schizophrenia spectrum disorders, the specificity of the neurocognitive functioning of each personality disorder will be observed in addition to general neuropsychological signs. Specific neuropsychological symptoms point to different brain deficits, which allows conclusion to be drawn regarding differences in the pathogenesis of each personality disorder; and 2 Luria’s methodology neuropsychology is adequate for the study of neurocognitive functioning in personality disorders. The study was conducted using qualitative and quantitative analyses (according to Luria of neuropsychological testing data in a group of fifty male patients aged 19,2±3,7 years with pathocharacteristic domain disorders. The group consisted of 30 schizoid personality disorder patients and 20 schizotypal personality disorder patients. Statistically significant differences (p <0,005 in neurocognitive function (regulatory processes, memory, spatial function between the healthy controls and patients with personality disorders were observed. Specific cognitive disorders pointing to the dysfunction of front-thalamoparietal connections were characteristic of both groups. Lateral differences were discovered for both patient groups. The

  16. Dangerous and severe personality disorder: an ethical concept?

    Science.gov (United States)

    Glen, Sally

    2005-04-01

    Most clinicians and mental health practitioners are reluctant to work with people with dangerous and severe personality disorders because they believe there is nothing that mental health services can offer. Dangerous and severe personality disorder also signals a diagnosis which is problematic morally. Moral philosophy has not found an adequate way of dealing with personality disorders. This paper explores the question: What makes a person morally responsible for his actions and what is a legitimate mitigating factor? How do psychiatric nurses working with this client group understand the awful things some clients do? What concepts do they need, if they are to know how to explain and how to react? It is suggested that dangerous and severe personality disorder is best regarded as a moral category, framed in terms of goodness, badness, obligation and other ethical concepts. It seems plausible that in important ways the dangerous and severe personality disordered client does not understand morality or understands it differently. The peculiar position of the dangerous and severe personality disordered individual in our system of moral responsibility stems from his apparent inability to see the importance of the interests of others. It might be more helpful to regard personality disordered clients as we do children: partially but not fully reasonable for their actions. We might regard the dangerous and severe personality disordered client responsible for those actions which he most clearly understands, such as causing others physical pain, but not for those with which he is only superficially engaged, such as causing emotional pain. The paper concludes by suggesting that the dangerous and severe personality disordered individual does not fit easily into any conventional moral category, be it criminal, patient, animal or child, and thus an assessment of his moral accountability must take into consideration his special circumstances.

  17. Personality risk profile for conduct disorder and substance use disorders in youth.

    Science.gov (United States)

    Anderson, Kristen G; Tapert, Susan F; Moadab, Ida; Crowley, Thomas J; Brown, Sandra A

    2007-10-01

    The five factor model of personality is a useful metric to describe personality profiles associated with maladaptive functioning. Using the NEO-Five Factor Inventory (NEO-FFI), we examined a conceptually based profile of high neuroticism, low agreeableness and low conscientiousness among 243 youth (aged 13-18 years) with varying degrees of conduct disorder (CD) and substance use disorders (SUD). Comparisons of the NEO-FFI personality dimensions between CD/SUD youth and adolescent siblings (N=173), and relations between the personality dimensions and behavioral indicators of conduct disorder and substance involvement were examined. Youth with CD and SUD had greater neuroticism, lower agreeableness, and lower conscientiousness than siblings of a similar age. The NEO-FFI scales predicted aggression and substance involvement for both probands and siblings in this cross-sectional investigation. These findings support the role for personality in models of the etiology and persistence of conduct disorder and substance use disorders.

  18. [Antisocial personality disorder].

    Science.gov (United States)

    Repo-Tiihonen, Eila; Hallikainen, Tero

    2016-01-01

    Antisocial personality disorder (ASP), especially psychopathy as its extreme form, has provoked fear and excitement over thousands of years. Ruthless violence involved in the disorder has inspired scientists, too.The abundance of research results concerning epidemiology, physiology, neuroanatomy, heritability, and treatment interventions has made ASP one of the best documented disorders in psychiatry. Numerous interventions have been tested, but there is no current treatment algorithm. Biological and sociological parameters indicate the importance of early targeted interventions among the high risk children. Otherwise, as adults they cause the greatest harm. The use of medications or psychotherapy for adults needs careful consideration.

  19. Three-Pronged Assessment and Diagnosis of Personality Disorder and its Consequences: Personality Functioning, Pathological Traits, and Psychosocial Disability

    Science.gov (United States)

    Clark, Lee Anna; Ro, Eunyoe

    2014-01-01

    The alternative dimensional model of personality disorder (PD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013), Section III, has two main criteria: Impairment in personality functioning and one or more pathological personality traits. The former is defined as disturbances in self functioning (viz., identity, self-direction), and/or interpersonal functioning (viz., empathy, intimacy). Distinguishing personality functioning and traits is important conceptually, because simply having extreme traits is not necessarily pathological. However, adding personality functioning to PD diagnosis represents an empirical challenge, because the constructs overlap conceptually. Further, there is debate regarding whether diagnosis of mental disorder requires either distress or disability, concepts that also overlap with maladaptive-range personality traits and personality dysfunction. We investigated interrelations among these constructs using multiple self-report measures of each domain in a mixed community-patient sample (N = 402). We examined the structures of functioning (psychosocial disability and personality), and personality traits, first independently, then jointly. The disability/functioning measures yielded the three dimensions we have found previously (Ro & Clark, 2013). Trait measures had a hierarchical structure which, at the five-factor level, reflected neuroticism/negative affectivity (N/NA), (low) sociability, disinhibition, (dis)agreeableness, and rigid goal engagement. When all measures were co-factored, a hierarchical structure again emerged which, at the five-factor level, included (1) internalizing (N/NA and self-pathology vs. quality-of-life/satisfaction), (2) externalizing (social/interpersonal dysfunction, low sociability, and disagreeableness), (3) disinhibition, (4) poor basic functioning, and (5) rigid goal engagement. Results are discussed in terms of developing an integrated PD

  20. Does diagnosis affect the predictive accuracy of risk assessment tools for juvenile offenders: Conduct Disorder and Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Khanna, Dinesh; Shaw, Jenny; Dolan, Mairead; Lennox, Charlotte

    2014-10-01

    Studies have suggested an increased risk of criminality in juveniles if they suffer from co-morbid Attention Deficit Hyperactivity Disorder (ADHD) along with Conduct Disorder. The Structured Assessment of Violence Risk in Youth (SAVRY), the Psychopathy Checklist Youth Version (PCL:YV), and Youth Level of Service/Case Management Inventory (YLS/CMI) have been shown to be good predictors of violent and non-violent re-offending. The aim was to compare the accuracy of these tools to predict violent and non-violent re-offending in young people with co-morbid ADHD and Conduct Disorder and Conduct Disorder only. The sample included 109 White-British adolescent males in secure settings. Results revealed no significant differences between the groups for re-offending. SAVRY factors had better predictive values than PCL:YV or YLS/CMI. Tools generally had better predictive values for the Conduct Disorder only group than the co-morbid group. Possible reasons for these findings have been discussed along with limitations of the study. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  1. Schizoid personality disorder

    Directory of Open Access Journals (Sweden)

    Gerhard Dammann

    2017-11-01

    Full Text Available The schizoid personality disorder is characterized by a lack of interest in close relationships, both in the family and in other interpersonal relationships, including intimate/sexual interactions, a superiority of introverted activities, emotional coldness, estrangement and flattened affect (DSM-5. This video lecture is devoted to the review of the prevalence, diagnosis, and treatment of this disorder. In addition, the lecture examines clinical cases and an example of managing such patients.

  2. Elevated ACE activity is not associated with asthma, COPD, and COPD co-morbidity

    DEFF Research Database (Denmark)

    Lee, Julie; Nordestgaard, Børge G; Dahl, Morten

    2009-01-01

    The angiotensin-converting enzyme (ACE) gene is a potential candidate gene for risk of asthma, COPD, and COPD co-morbidity. In 9034 Danish adults, we determined whether individuals homozygous or heterozygous for the ACE D allele are at greater risk of asthma, COPD, or COPD co-morbidity compared...... with ACE II homozygous individuals. In the general population, serum ACE activity increased with the number of D alleles (Kruskal-Wallis ANOVA: II vs. ID, p....4-1.2). The results were similar upon adjustment for sex, age, smoking status, body mass index, total cholesterol, and ACE inhibitor/angiotensin II type 1 receptor blocker use. These data suggest that lifelong genetically elevated ACE activity is not a major risk factor for asthma or COPD, or for ischemic heart...

  3. Panic disorder: Psychobiological aspects of personality dimensions

    Directory of Open Access Journals (Sweden)

    Draganić-Gajić Saveta

    2005-01-01

    Full Text Available Attempts to understand the underlying mechanisms of association between psychological factors and panic disorder have been mostly based on psychodynamic description. Evidence of the importance of serotonergic (5-HT system in panic disorder (PD, however, has substanti ally increased in recent years. OBJECTIVE The objective of our study was to determine whether there was a specific personality profile of panic disorder patients and how it was related to possible neurobiological mechanisms underlying personality dimensions. PATIENTS AND METHODS Sample consisted of 14 inpatients with ICD-X diagnosis of panic disorder and 34 healthy control subjects. Personality dimensions were assessed by Minnesota Multiphasic Personality Inventory (MMPI-201 and Tridimensional Personality Questionnaire (TPQ. To assess central 5-HT function, platelet monoamine-oxidase (MAO activity was measured. RESULTS In panic disorder group, higher scores of histrionic, depressive and hypochondriac subscales and significant increase of harm avoidance (HA scale as well as low MAO activity were found. Negative correlation was established between MAO activity and psychopathic deviance MMPI scale. CONCLUSION The obtained results might indicate a specific personality profile of patients with panic disorder, which is characterized by high neuroticism, fearfulness, inhibition, shyness and apprehensive worry. Low MAO activity and high HA scores possibly indicate underlying hyperserotonergic state. The observed correlation between personality traits and MAO activity provide additional support for the hypothesized functional relationship between underlying central monoaminergic activity and temperament traits associated with anxiety, depression and impulsivity.

  4. Using the SAPAS to identify risk for personality disorders among psychiatric outpatients in India: A feasibility study.

    Science.gov (United States)

    Innocent, Simeon; Podder, Priyanka; Ram, Jai Ranjan; Barnicot, Kirsten; Sen, Piyal

    2018-02-01

    Personality disorders (PDs) are common among psychiatric outpatients and are associated with increased morbidity and worse treatment outcomes. Epidemiological research conducted among this population in Asian countries is limited, reflecting a significant gap in the current literature. One barrier to this research is the lack of appropriate screening tools. The current research assessed the feasibility of using the SAPAS (Standardized Assessment of Personality-Abbreviated Scale) screening tool to identify individuals at high risk of PD in an Indian psychiatric outpatient population and provides an initial estimate of PD prevalence by using a validated diagnostic interview, the ICD-10 International Personality Disorder Examination. The findings suggest that whilst use of the SAPAS was feasible, acceptable to patients and led to clinically useful findings, when using the recommended cut-off score of 4, the SAPAS largely overdiagnoses the risk for PD in psychiatric outpatients in India (positive predictive value = 26.3%). The estimated prevalence of personality disorder in the sample was 11.1%, based on administering the International Personality Disorder Examination diagnostic interview to high-risk patients scoring 4 and above on the SAPAS, which is higher than previous estimates for this population and still likely to be an underestimation. Future studies should translate the measure into Bengali and evaluate its sensitivity and specificity at different cut-off points in order to optimize its use in Indian populations. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Personality functioning in patients with avoidant personality disorder and social phobia

    NARCIS (Netherlands)

    Eikenaes, I.; Hummelen, B.; Abrahamsen, G.; Andrea, H.; Wilberg, T.

    2013-01-01

    Avoidant personality disorder (APD) and social phobia (SP) are closely related, such that they are suggested to represent different severity levels of one social anxiety disorder. This cross-sectional study aimed to compare patients with APD to patients with SP, with particular focus on personality

  6. The relationship of the Severe Personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders

    Directory of Open Access Journals (Sweden)

    Setareh Jani

    2016-12-01

    Full Text Available Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present descriptive-correlational study recruited patients with paranoid, borderline and schizotypal personality disorders presenting to psychiatry clinics in Ardabil using convenient sampling method. A total of 30 paranoid patients, 30 borderline patients and 20 schizotypal patients were selected by a psychiatrist through psychiatric examination, clinical interview and completing Millon Clinical Multiaxial Inventory (MCMI-III. The following instruments were used: MCMI- III and behavioral activation-inhibition system scale (BIS-BAS. The data were analyzed with Pearson’s correlation coefficient and stepwise regression. Results: BIS and BAS systems were both significant for predicting borderline and paranoid personality disorders, but only BIS was significant for predicting schizotypal personality disorder. Conclusion: These findings can help experts to have a better and more accurate understanding of personality disorders and use proper methods to predict the probability of these disorders and develop treatments.

  7. Normal personality, personality disorder and psychosis: current views and future perspectives.

    Science.gov (United States)

    Balaratnasingam, Sivasankaran; Janca, Aleksandar

    2015-01-01

    The purpose of this article is to review recent literature examining the occurrence of psychotic experiences in normal population and those with personality disorders. Up to 15% of individuals in the general population report some type or degree of psychotic experience. Most of these individuals function adequately, do not require psychiatric treatment and do not receive diagnosis of a psychotic illness. A significant number of individuals diagnosed with borderline personality disorder (25-50%) also report psychotic symptoms. These are not easily differentiated from the psychotic symptoms reported by individuals with schizophrenia, nor are they always transient. However, emerging research has confirmed that individuals with schizotypal personality disorder are dimensionally related to those with schizophrenia and are at an increased risk of transition to psychosis. Psychotic symptoms are best considered as 'trans-diagnostic' entities on a continuum from normal to pathological. There is a large body of evidence for a dimensional relationship between schizotypal personality disorder and schizophrenia. There is also a significant amount of research showing that psychotic symptoms in borderline personality disorder are frequent, nontransient and represent a marker of illness severity. This review highlights the need to move beyond traditional assumptions and categorical boundaries when evaluating psychotic experiences and psychopathological phenomena.

  8. Relationship of personality disorders to the course of major depressive disorder in a nationally representative sample.

    Science.gov (United States)

    Skodol, Andrew E; Grilo, Carlos M; Keyes, Katherine M; Geier, Timothy; Grant, Bridget F; Hasin, Deborah S

    2011-03-01

    The purpose of this study was to examine the effects of specific personality disorder comorbidity on the course of major depressive disorder in a nationally representative sample. Data were drawn from 1,996 participants in a national survey. Participants who met criteria for major depressive disorder at baseline in face-to-face interviews (in 2001-2002) were reinterviewed 3 years later (in 2004-2005) to determine persistence and recurrence. Predictors included all DSM-IV personality disorders. Control variables included demographic characteristics, other axis I disorders, family and treatment histories, and previously established predictors of the course of major depressive disorder. A total of 15.1% of participants had persistent major depressive disorder, and 7.3% of those who remitted had a recurrence. Univariate analyses indicated that avoidant, borderline, histrionic, paranoid, schizoid, and schizotypal personality disorders all elevated the risk for persistence. With axis I comorbidity controlled, all personality disorders except histrionic personality disorder remained significant. With all other personality disorders controlled, borderline and schizotypal disorders remained significant predictors. In final, multivariate analyses that controlled for age at onset of major depressive disorder, the number of previous episodes, duration of the current episode, family history, and treatment, borderline personality disorder remained a robust predictor of major depressive disorder persistence. Neither personality disorders nor other clinical variables predicted recurrence. In this nationally representative sample of adults with major depressive disorder, borderline personality disorder robustly predicted persistence, a finding that converges with recent clinical studies. Personality psychopathology, particularly borderline personality disorder, should be assessed in all patients with major depressive disorder, considered in prognosis, and addressed in treatment.

  9. Historical Roots of Histrionic Personality Disorder

    Directory of Open Access Journals (Sweden)

    Filipa eNovais

    2015-09-01

    Full Text Available Histrionic Personality Disorder is one of the most ambiguous diagnostic categories in psychiatry. Hysteria is a classical term that includes a wide variety of psychopathological states.Ancient Egyptians and Greeks blamed a displaced womb, for many women’s afflictions. Several researchers from the 18th and 19th centuries studied this theme, namely, Charcot who defined hysteria as a neurosis with an organic basis and Sigmund Freud who redefined neurosis as a re-experience of past psychological trauma. Histerical personality disorder (HPD made its first official appearance in the Diagnostic and Statistical Manual of Mental Disorders II (DSM-II and since the DSM-III, histrionic personality disorder is the only disorder that kept the term derived from the old concept of hysteria.The subject of hysteria has reflected positions about health, religion and relationships between the sexes in the last 4000 years, and the discussion is likely to continue.

  10. Borderline Personality Disorder

    Science.gov (United States)

    ... of a mood disorder—not borderline personality disorder Self-harming behavior, such as cutting Recurring thoughts of suicidal ... symptoms and reduce the number of suicidal or self-harming behaviors. Read more on NIMH’s Psychotherapies health topic ...

  11. Integrating Early Intervention for Borderline Personality Disorder and Mood Disorders.

    Science.gov (United States)

    Chanen, Andrew M; Berk, Michael; Thompson, Katherine

    2016-01-01

    Borderline personality disorder (BPD) has been demonstrated to be a reliable and valid construct in young people (adolescents and young adults). Both borderline- and mood-related psychopathology become clinically apparent from puberty through to young adulthood, frequently co-occur, can reinforce one another, and can be difficult to differentiate clinically. This Gordian knot of overlapping clinical features, common risk factors, and precursors to both BPD and mood disorders complicates clinical assessment, prevention, and treatment. Regardless of whether an individual crosses an arbitrary diagnostic threshold, a considerable proportion of young people with borderline- and mood-related psychopathology will develop significant and persistent functional, vocational, and interpersonal impairment and disability during this critical risk and developmental period. There is a clear need for early intervention, but spurious diagnostic certainty risks stigma, misapplication of diagnostic labels, inappropriate treatment, and unfavorable outcomes. This article aims to integrate early intervention for BPD and mood disorders in the clinical context of developmental and phenomenological change and evolution. "Clinical staging," similar to disease staging in general medicine, is presented as a pragmatic, heuristic, and trans-diagnostic framework to guide prevention and intervention. It acknowledges that the early stages of these disorders cannot be disentangled sufficiently to allow for disorder-specific preventive measures and early interventions. Clinical staging defines an individual's location along the continuum of the evolving temporal course of a disorder. Such staging aids differentiation of early or milder clinical phenomena from those that accompany illness progression and chronicity, and suggests the application of appropriate and proportionate intervention strategies.

  12. [Impulse control disorders in borderline and antisocial personality disorder].

    Science.gov (United States)

    Herpertz, S

    2007-01-18

    A borderline personality disorder is associated with highly impulsive acts that cannot be controlled by cognitive inhibition. In a psychopathic/antisocial personality disorder emotional inhibition of hostile acts is lacking. The patient has a high proclivity for risk-seeking, and is incapable of responding appropriately to punishment. In both disorders, the result is (auto)aggressive behavior. The family doctor must refer such patients to a specialist, when there is an acute danger of self-harm or when a grave functional limitation in the areas of work or interpersonal relationship has persisted over a long period of time.

  13. A Parallel Process Growth Model of Avoidant Personality Disorder Symptoms and Personality Traits

    Science.gov (United States)

    Wright, Aidan G. C.; Pincus, Aaron L.; Lenzenweger, Mark F.

    2012-01-01

    Background Avoidant personality disorder (AVPD), like other personality disorders, has historically been construed as a highly stable disorder. However, results from a number of longitudinal studies have found that the symptoms of AVPD demonstrate marked change over time. Little is known about which other psychological systems are related to this change. Although cross-sectional research suggests a strong relationship between AVPD and personality traits, no work has examined the relationship of their change trajectories. The current study sought to establish the longitudinal relationship between AVPD and basic personality traits using parallel process growth curve modeling. Methods Parallel process growth curve modeling was applied to the trajectories of AVPD and basic personality traits from the Longitudinal Study of Personality Disorders (Lenzenweger, 2006), a naturalistic, prospective, multiwave, longitudinal study of personality disorder, temperament, and normal personality. The focus of these analyses is on the relationship between the rates of change in both AVPD symptoms and basic personality traits. Results AVPD symptom trajectories demonstrated significant negative relationships with the trajectories of interpersonal dominance and affiliation, and a significant positive relationship to rates of change in neuroticism. Conclusions These results provide some of the first compelling evidence that trajectories of change in PD symptoms and personality traits are linked. These results have important implications for the ways in which temporal stability is conceptualized in AVPD specifically, and PD in general. PMID:22506627

  14. Sodium pentothal hypnosis: a procedure for evaluating medical patients with suspected psychiatric co-morbidity.

    Science.gov (United States)

    Russo, M B; Brooks, F R; Fontenot, J P; Dopler, B M; Neely, E T; Halliday, A W

    1997-03-01

    The cases presented here were patients referred for neurologic disability evaluations. They met the three selection criteria presented and underwent the four-phase pentothal hypnosis procedure described and at the conclusion were diagnosed as having psychiatric morbidity. We recommend that the sodium pentothal hypnosis procedure be considered for use whenever there is concern for psychiatric co-morbidity in a patient with presumed physiologic disease.

  15. Personality dimensions and disorders in pathological gambling

    DEFF Research Database (Denmark)

    Odlaug, Brian Lawrence; Schreiber, Liana R N; Grant, Jon E

    2013-01-01

    This review presents the most current research in personality dimensions and disorders with respect to pathological gambling.......This review presents the most current research in personality dimensions and disorders with respect to pathological gambling....

  16. Could the improvement of obesity-related co-morbidities depend on modified gut hormones secretion?

    Science.gov (United States)

    Finelli, Carmine; Padula, Maria Carmela; Martelli, Giuseppe; Tarantino, Giovanni

    2014-01-01

    Obesity and its associated diseases are a worldwide epidemic disease. Usual weight loss cures - as diets, physical activity, behavior therapy and pharmacotherapy - have been continuously implemented but still have relatively poor long-term success and mainly scarce adherence. Bariatric surgery is to date the most effective long term treatment for morbid obesity and it has been proven to reduce obesity-related co-morbidities, among them nonalcoholic fatty liver disease, and mortality. This article summarizes such variations in gut hormones following the current metabolic surgery procedures. The profile of gut hormonal changes after bariatric surgery represents a strategy for the individuation of the most performing surgical procedures to achieve clinical results. About this topic, experts suggest that the individuation of the crosslink among the gut hormones, microbiome, the obesity and the bariatric surgery could lead to new and more specific therapeutic interventions for severe obesity and its co-morbidities, also non surgical. PMID:25469034

  17. Antisocial personality disorder with and without antecedent childhood conduct disorder: does it make a difference?

    Science.gov (United States)

    Walters, Glenn D; Knight, Raymond A

    2010-04-01

    The purpose of this study was to test whether prior conduct disorder increased deviance in persons diagnosed with antisocial personality disorder. One hundred and three male inmates satisfying adult antisocial and conduct disorder criteria for antisocial personality disorder achieved significantly higher scores on self-report measures of criminal thinking and antisocial attitudes than 137 male inmates satisfying only the adult criteria for antisocial personality disorder and 87 male nonantisocial inmates. Inmates satisfying adult antisocial and conduct disorder criteria for antisocial personality disorder were also more likely to receive disciplinary infractions for misconduct than inmates in the other two conditions. The theoretical, diagnostic, and practical implications of these results are discussed.

  18. Impact of severity of personality disorder on the outcome of depression.

    Science.gov (United States)

    Kelly, Brendan D; Nur, Ula A; Tyrer, Peter; Casey, Patricia

    2009-06-01

    The influence of severity of personality disorder on outcome of depression is unclear. Four hundred and ten patients with depression in 9 urban and rural communities in Finland, Ireland, Norway, Spain and the United Kingdom, were randomised to individual problem-solving treatment (n=121), group sessions on depression prevention (n=106) or treatment as usual (n=183). Depressive symptoms were recorded at baseline, 6 and 12 months. Personality assessment was performed using the Personality Assessment Schedule and analysed by severity (no personality disorder, personality difficulty, simple personality disorder, complex personality disorder). Complete personality assessments were performed on 301 individuals of whom 49.8% had no personality disorder; 19.3% had personality difficulties; 13.0% had simple personality disorder; and 17.9% had complex personality disorder. Severity of personality disorder was correlated with Beck Depression Inventory (BDI) scores at baseline (Spearman's r=0.21; ppersonality disorder and treatment type for depression. While multi-variable analyses indicate that depressive symptoms at baseline are the strongest predictor of depressive symptoms at 6 and 12 months, the strong correlations between severity of personality disorder and depressive symptoms make it difficult to establish the independent effect of personality disorder on outcome of depression.

  19. Culture and personality disorder: a focus on Indigenous Australians.

    Science.gov (United States)

    Balaratnasingam, Sivasankaran; Janca, Aleksandar

    2017-01-01

    To examine the validity of concept and diagnosis of personality disorder in transcultural settings using Indigenous Australian people as an example. There are significant deficits in comparative research on personality disorders across cultures. There is also a dearth of information regarding Indigenous Australians, and cultural applicability and clinical utility of the diagnosis of personality disorder in this group. The concept of culture is generally ignored when making a diagnosis of personality disorder. A valid diagnosis should incorporate what would be considered understandable and adaptive behavior in a person's culture. In Indigenous Australian culture, making diagnosis of a personality disorder is complicated by historical trauma from colonization, disruption of kinship networks, and ongoing effects of poverty and social marginalization.

  20. Specific features of suicidal behavior in patients with narcissistic personality disorder.

    Science.gov (United States)

    Blasco-Fontecilla, Hilario; Baca-Garcia, Enrique; Dervic, Kanita; Perez-Rodriguez, M Mercedes; Lopez-Castroman, Jorge; Saiz-Ruiz, Jeronimo; Oquendo, Maria A

    2009-11-01

    Suicidal behavior is a clinically significant but underestimated cause of mortality in narcissistic personality disorder. Currently, there are no reliable estimates of suicidal behavior for this population. The main objective of this study was to test whether or not suicide attempters diagnosed with narcissistic personality disorder are different in terms of impulsivity and expected lethality from suicide attempters with other cluster B personality disorders. In a sample of 446 suicide attempters, patients with cluster B personality disorder diagnoses (n = 254) as assessed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), version of the International Personality Disorder Examination-Screening Questionnaire (IPDE-SQ) were compared in terms of expected lethality and impulsivity (measured by the Beck Suicidal Intent Scale and the Barratt Impulsiveness Scale, respectively). The subjects were admitted to the emergency departments of the Ramón y Cajal Hospital and the Fundación Jiménez Diaz University Hospital in Madrid, Spain, between January 1999 and January 2003. Suicide attempts of subjects diagnosed with narcissistic personality disorder had higher expected lethality than those of subjects without narcissistic personality disorder (t = -4.24, df = 439, P personality disorder (t = 0.28, df = 439, P = .795), antisocial personality disorder (t = 0.66, df = 439, P = .504), and borderline personality disorder (t = 1.13, df = 439, P = .256), respectively. Suicide attempters diagnosed with narcissistic personality disorder did not significantly differ from suicide attempters without narcissistic personality disorder in terms of impulsivity measures (t = -0.33, df = 442, P = .738), while suicide attempters diagnosed with antisocial personality disorder, histrionic personality disorder, and borderline personality disorder were significantly more impulsive than suicide attempters without these diagnoses (t = -3.96, df = 442, P

  1. Integrative Treatment of Personality Disorder. Part I: Psychotherapy.

    Science.gov (United States)

    Jovanovic, Mirjana Divac; Svrakic, Dragan

    2017-03-01

    In this paper, we outline the concept of integrative therapy of borderline personality, also referred to as fragmented personality, which we consider to be the core psychopathology underlying all clinical subtypes of personality disorder. Hence, the terms borderline personality, borderline disorder, fragmented personality, and personality disorder are used interchangeably, as synonyms. Our integrative approach combines pharmacotherapy and psychotherapy, each specifically tailored to accomplish a positive feedback modulation of their respective effects. We argue that pharmacotherapy and psychotherapy of personality disorder complement each other. Pharmacological control of disruptive affects clears the stage, in some cases builds the stage, for the psychotherapeutic process to take place. In turn, psychotherapy promotes integration of personality fragments into more cohesive structures of self and identity, ultimately establishing self-regulation of mood and anxiety. We introduce our original method of psychotherapy, called reconstructive interpersonal therapy (RIT). The RIT integrates humanistic-existential and psychodynamic paradigms, and is thereby designed to accomplish a deep reconstruction of core psychopathology within the setting of high structure. We review and comment the current literature on the strategies, goals, therapy process, priorities, and phases of psychotherapy of borderline disorders, and describe in detail the fundamental principles of RIT.

  2. A miRNA Signature for Cognitive Deficits and Alcohol Use Disorder in Persons Living with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Dorota Wyczechowska

    2017-11-01

    Full Text Available HIV-associated neurocognitive disorders (HAND affects more than half of persons living with HIV-1/AIDS (PLWHA. Identification of biomarkers representing the cognitive status of PLWHA is a critical step for implementation of successful cognitive, behavioral and pharmacological strategies to prevent onset and progression of HAND. However, the presence of co-morbidity factors in PLWHA, the most common being substance abuse, can prevent the identification of such biomarkers. We have optimized a protocol to profile plasma miRNAs using quantitative RT-qPCR and found a miRNA signature with very good discriminatory ability to distinguish PLWHA with cognitive impairment from those without cognitive impairment. Here, we have evaluated this miRNA signature in PLWHA with alcohol use disorder (AUD at LSU Health Sciences Center (LSUHSC. The results show that AUD is a potential confounding factor for the miRNAs associated with cognitive impairment in PLWHA. Furthermore, we have investigated the miRNA signature associated with cognitive impairment in an independent cohort of PLWHA using plasma samples from the CNS HIV Antiretroviral Therapy Effects Research (CHARTER program. Despite differences between the two cohorts in socioeconomic status, AUD, and likely misuse of illicit or prescription drugs, we validated a miRNA signature for cognitive deficits found at LSUHSC in the CHARTER samples.

  3. Psychiatric disorders among a sample of internally displaced persons in South Darfur.

    Science.gov (United States)

    Elhabiby, Mahmoud M; Radwan, Doaa N; Okasha, Tarek A; El-Desouky, Eman D

    2015-06-01

    The violent armed conflict in Darfur has been ongoing for years getting the attention of human rights activists and mental health professionals. The aim of this study was to assess psychiatric disorders in a sample of internally displaced persons (IDPs) in South Darfur. A cross-sectional observational study, as a part of the 'Darfur Campaign' organized by Arab Federation of Psychiatrists, assessing psychiatric disorders in a sample of internally displaced women using the Structured Clinical Interview for DSM-IV (SCID-I) (clinical version). Up to 25.7% of participants had lost a close family member or more in the violent clashes. Psychiatric diagnoses were found in 62.2% of the participants. The most frequently reported was post-traumatic stress disorder (PTSD) reaching 14.9%, followed by depression 13.5% (among which 2.7% with psychotic features), while comorbid PTSD and depression reached 8.1% of participants. Patients with psychiatric diagnoses had an older age (36.6 years) (p = .024). Suffering from a psychiatric disorder was found to be associated with losing a family member in the conflict (p = .015), being 35.6% in patients with psychiatric diagnoses compared to 10.3% in those without losing a family member in the conflict (odds ratio (OR) =  .7, 95% confidence interval (CI) = 1.25-18.28). This study used a standardized tool for diagnosing psychiatric morbidity among refugees in Darfur to give as much as possible an actual description of the problems and psychiatric morbidity caused by human-made disasters. This study can help to lead to a more detailed and specific mental health service program much needed by this population. © The Author(s) 2014.

  4. Preliminary study of relationships between hypnotic susceptibility and personality disorder functioning styles in healthy volunteers and personality disorder patients

    Directory of Open Access Journals (Sweden)

    He Wei

    2011-07-01

    Full Text Available Abstract Background Hypnotic susceptibility is one of the stable characteristics of individuals, but not closely related to the personality traits such as those measured by the five-factor model in the general population. Whether it is related to the personality disorder functioning styles remains unanswered. Methods In 77 patients with personality disorders and 154 healthy volunteers, we administered the Stanford Hypnotic Susceptibility Scale: Form C (SHSSC and the Parker Personality Measure (PERM tests. Results Patients with personality disorders showed higher passing rates on SHSSC Dream and Posthypnotic Amnesia items. No significant correlation was found in healthy volunteers. In the patients however, SHSSC Taste hallucination (β = 0.26 and Anosmia to Ammonia (β = -0.23 were significantly correlated with the PERM Borderline style; SHSSC Posthypnotic Amnesia was correlated with the PERM Schizoid style (β = 0.25 but negatively the PERM Narcissistic style (β = -0.23. Conclusions Our results provide limited evidence that could help to understand the abnormal cognitions in personality disorders, such as their hallucination and memory distortions.

  5. Relationship between Comorbidity of Cluster Personality Disorders with Major Depression Disorder and Depression Relapse

    Directory of Open Access Journals (Sweden)

    Shima Tamanaei-Far

    2008-12-01

    Full Text Available Objective: this research studied the relation between cluster B personality disorders and major depression disorder with relapse. Materials & Methods: In this analytical and comparative study, samples consisted of the major depressive disorders patients that had experienced major depression through 5 years ago and were experiencing partial remission in research time. Samples were selected by non probability sampling in outpatient centers. The patients with more than two relapses were assigned as case group and the patients without any relapse were assigned as control group (two groups on the base of demographic in formations were matched. They completed BDI_II and SCID_II to assess cluster B personality disorders, and a questionnaire made by researcher to gather information’s. Results: Comorbidity of borderline personality disorder (P<0.001 and narcissitic personality disorder (P=0.016 with depression in patient with relapse of the depression is more significantly than patients with first episode of depression, but comorbidity of exhibitive personality disorder with depression and relapse had no significant difference between two groups (P=0.401. Conclusion: according to the relationship between narcissistic and borderline personality disorders and the role of them in relapse of depression, for making an effective psychotherapy for depression, it is necessary to consider personality beside special symptoms.

  6. The relationship of the Severe Personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders

    OpenAIRE

    Setareh Jani; Mehri Molaee

    2016-01-01

    Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present...

  7. Clinical aspects of personality disorder diagnosis in the DSM-5

    Directory of Open Access Journals (Sweden)

    Francesco Modica

    2015-05-01

    Full Text Available Abstract: Personality disorders represent psychopathological conditions hard to be diagnosed. The Author highlights the clinical aspects of personality disorder diagnosis according to the criteria of the DSM-5. In this study, some of the numerous definitions of personality are mentioned; afterwards, some of the theories on the development of personality shall be. Later on, concepts of temperament, character and personality get analysed. Then, the current approach to personality disorders according to the two models of DSM-5 is reported. The first model is included in the Section II of DSM-5; while in the Section III there exists a proposal for a so-called alternate model. The first one suggests a qualitative or categorical kind of approach to personality disorders, whereas the alternate model proposes a dimensional or quantitative kind of approach and aims to formulate, as well as a diagnosis for general alterations of the personological functioning, even a trait-based personality disorder diagnosis, which can be formulated when a personality disorder is there but doesn't fit criteria for a specific disorder. Ultimately, it can be so claimed: 1 diagnostic criteria of the first model are similar to those of DSM-IV with its respective strenghts and weaknesses, and namely high probability in diagnosis, where  there, of personality disorder, yet insufficient sensitivity in the specification of the disorder; 2 the alternate model, despite criticism, thanks to the possibility of delivering a trait-based personality disorder diagnosis, seems to be more equipped both in the identification of the personality disorder and further specifications.

  8. From Narcissistic Personality Disorder to Frontotemporal Dementia: A Case Report

    OpenAIRE

    Michele Poletti; Ubaldo Bonuccelli

    2011-01-01

    Premorbid personality characteristics could have a pathoplastic effect on behavioral symptoms and personality changes related to neurodegenerative diseases. Patients with personality disorders, in particular of the dramatic cluster, may present functional frontolimbic abnormalities. May these neurobiological vulnerabilities linked to a premorbid personality disorder predispose or represent a risk factor to subsequently develop a neurodegenerative disorder? Are subjects with personality disord...

  9. Gene-environment interplay in alcoholism and other substance abuse disorders: expressions of heritability and factors influencing vulnerability.

    Science.gov (United States)

    Palomo, Tomas; Kostrzewa, R M; Beninger, R J; Archer, T

    2004-01-01

    Factors that confer predisposition and vulnerability for alcoholism and other substance abuse disorders may be described usefully within the gene-environment interplay framework. Thus, it is postulated that heritability provides a major contribution not only to alcohol but also to other substances of abuse. Studies of evoked potential amplitude reduction have provided a highly suitable and testable method for the assessment of both environmentally-determined and heritable characteristics pertaining to substance use and dependence. The different personal attributes that may co-exist with parental influence or exist in a shared, monozygotic relationship contribute to the final expression of addiction. In this connection, it appears that personality disorders are highly prevalent co-morbid conditions among addicted individuals, and, this co-morbidity is likely to be accounted for by multiple complex etiological relationships, not least in adolescent individuals. Co-morbidity associated with deficient executive functioning may be observed too in alcohol-related aggressiveness and crimes of violence. The successful intervention into alcohol dependence and craving brought about by baclofen in both human and animal studies elucidates glutamatergic mechanisms in alcoholism whereas the role of the dopamine transporter, in conjunction with both the noradrenergic and serotonergic transporters, are implicated in cocaine dependence and craving. The role of the cannabinoids in ontogeny through an influence upon the expression of key genes for the development of neurotransmitter systems must be considered. Finally, the particular form of behaviour/characteristic outcome due to childhood circumstance may lie with biological, gene-based determinants, for example individual characteristics of monoamine oxidase (MAO) activity levels, thereby rendering simple predictive measures both redundant and misguiding.

  10. Personality disorder features as predictors of symptoms 5 years post-treatment

    DEFF Research Database (Denmark)

    Jansson, Irene; Hesse, Morten; Fridell, Mats

    2008-01-01

    disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms......Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality...... disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered...

  11. Metacognition moderates the relationship of disturbances in attachment with severity of borderline personality disorder among persons in treatment of substance use disorders.

    Science.gov (United States)

    Outcalt, Jared; Dimaggio, Giancarlo; Popolo, Raffaele; Buck, Kelly; Chaudoin-Patzoldt, Kelly A; Kukla, Marina; Olesek, Kyle L; Lysaker, Paul H

    2016-01-01

    Borderline personality disorder traits have been observed to be linked with both insecure attachment styles as well as deficits in mentalizing and metacognition. Less is known, however, about how attachment style does or does not interact with deficits in mentalizing and metacognition to create, sustain, or influence levels of borderline personality disorder traits. In this study, we examined the hypothesis that metacognitive mastery, which is the ability to use knowledge about mental states of self and others to cope with distress and solve social problems, moderates the relationship of anxious attachment style with the severity of borderline personality disorder traits. Concurrent assessments were gathered of metacognitive mastery using the Metacognitive Assessment Scale Abbreviated, anxious attachment style using the Experiences of in Close Relationships Scale, and borderline personality disorder traits using the Structured Clinical Interview for DSM-IV Axis II Disorders. Participants were 59 adults in an early phase of recovery from substance use disorders in a residential setting. Multiple regression revealed that metacognitive mastery moderated the relationship of anxious attachment style with the number of borderline personality disorder traits. A median split of the anxious attachment and metacognitive mastery scores was performed yielding 4 groups. An analysis of covariance revealed that participants with higher levels of anxious attachment and poorer metacognitive mastery had more borderline personality disorder traits did than the other groups after controlling for levels of psychopathology. Insecure attachment may be associated with higher number of borderline personality disorder traits in the presence of deficits in metacognitive mastery. Patients with substance use and borderline personality disorder traits may benefit from treatment which addresses metacognitive mastery. Published by Elsevier Inc.

  12. Proteolytic receptor cleavage in the pathogenesis of blood rheology and co-morbidities in metabolic syndrome. Early forms of autodigestion.

    Science.gov (United States)

    Mazor, Rafi; Schmid-Schönbein, Geert W

    2015-01-01

    Abnormal blood rheological properties seldom occur in isolation and instead are accompanied by other complications, often designated as co-morbidities. In the metabolic syndrome with complications like hypertension, diabetes and lack of normal microvascular blood flow, the underlying molecular mechanisms that simultaneously lead to elevated blood pressure and diabetes as well as abnormal microvascular rheology and other cell dysfunctions have remained largely unknown. In this review, we propose a new hypothesis for the origin of abnormal cell functions as well as multiple co-morbidities. Utilizing experimental models for the metabolic disease with diverse co-morbidities we summarize evidence for the presence of an uncontrolled extracellular proteolytic activity that causes ectodomain receptor cleavage and loss of their associated cell function. We summarize evidence for unchecked degrading proteinase activity, e.g. due to matrix metalloproteases, in patients with hypertension, Type II diabetes and obesity, in addition to evidence for receptor cleavage in the form of receptor fragments and decreased extracellular membrane expression levels. The evidence suggest that a shift in blood rheological properties and other co-morbidities may in fact be derived from a common mechanism that is due to uncontrolled proteolytic activity, i.e. an early form of autodigestion. Identification of the particular proteases involved and the mechanisms of their activation may open the door to treatment that simultaneously targets multiple co-morbidities in the metabolic syndrome.

  13. Conscientiousness and obsessive-compulsive personality disorder.

    Science.gov (United States)

    Samuel, Douglas B; Widiger, Thomas A

    2011-07-01

    A dimensional perspective on personality disorder hypothesizes that the current diagnostic categories represent maladaptive variants of general personality traits. However, a fundamental foundation of this viewpoint is that dimensional models can adequately account for the pathology currently described by these categories. While most of the personality disorders have well established links to dimensional models that buttress this hypothesis, obsessive-compulsive personality disorder (OCPD) has obtained only inconsistent support. The current study administered multiple measures of 1) conscientiousness-related personality traits, 2) DSM-IV OCPD, and 3) specific components of OCPD (e.g., compulsivity and perfectionism) to a sample of 536 undergraduates who were oversampled for elevated OCPD scores. Six existing measures of conscientiousness-related personality traits converged strongly with each other supporting their assessment of a common trait. These measures of conscientiousness correlated highly with scales assessing specific components of OCPD, but obtained variable relationships with measures of DSM-IV OCPD. More specifically, there were differences within the conscientiousness instruments such that those designed to assess general personality functioning had small to medium relationships with OCPD, but those assessing more maladaptive variants obtained large effect sizes. These findings support the view that OCPD does represent a maladaptive variant of normal-range conscientiousness.

  14. Dependent personality features in a complex case of borderline personality disorder.

    Science.gov (United States)

    Nirestean, Tudor; Lukacs, Emese; Nirestean, Aurel; Gabos Grecu, Iosif

    2016-11-01

    Borderline personality disorder is a complex disease model as it encompasses a diversity of pathological personality traits and psychopathological symptoms. It is not surprising, therefore, that it is often manifested by personality disorders across all three clusters and accompanied by other mental (Axis I) disorders. This melange makes both psychological treatment and pharmacotherapy especially challenging, and this paper describes the case of a particularly complex case of a 33-year-old Romanian patient, who has a history of severe deprivation in childhood, mood and substance use disorder in association with borderline pathology. In the course of treatment from many sources and interventions, it has become clear that dependence is a key component of the pathology and has been rewarded with a degree of success in management. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  15. [Psychiatric co-morbidity, body image problems and psychotherapeutic interventions for burn survivors: a review].

    Science.gov (United States)

    Jasper, Stefanie; Rennekampff, Hans-Oliver; de Zwaan, Martina

    2013-11-01

    Due to progress in burn treatment, more patients even with severe burn injuries survive. Despite this positive development, however, there are still negative somatic and mental consequences. These include the life-long care of scars and pain. In addition, posttraumatic-stress disorder and depression are common consequences. Also distress due to disfigurement and body image problems have to be considered, since this is likely to result in social withdrawal, low self-esteem, and reduction of quality of life. Overall, the impact of mental strain on burn victims is quite high. Therefore, psychotherapeutic treatment approaches should be integrated into the care of patients with burns. This might be helpful for both coping and compliance with long-term treatment. This paper provides a review of the mental co-morbidity of burn victims and of psychotherapeutic treatment approaches focusing on changes in body image and the respective social consequences. © Georg Thieme Verlag KG Stuttgart · New York.

  16. The influence of specific chronic somatic conditions on the care for co-morbid depression in general practice

    NARCIS (Netherlands)

    Nuyen, J.; Spreeuwenberg, P.M.; Dijk, L. van; Bos, G.A.M. van den; Groenewegen, P.P.; Schellevis, F.G.

    Background. Limited information exists on the relationship between specific chronic somatic conditions and care for co-morbid depression in primary care settings. Therefore, the present prospective, general practice-based study examined this relationship. Method. Longitudinal data on morbidity,

  17. Long term complications of diabetes and co-morbidities contributing to atherosclerosis in diabetic population of Mirpur, Azad Kashmir

    International Nuclear Information System (INIS)

    Tariq, C.; Afzal, W.

    2013-01-01

    Objective: To ascertain the prevalence of diabetes mellitus and its chronic complications along with co-morbidities contributing to atherosclerosis in the diabetic population of Mirpur, Azad Kashmir. Methods: The cross-sectional study and was carried out at the Divisional Headquarter Hospital, Mirpur, Azad Kashmir, between January and August 2012. The patients selected were established diabetics. Data was collected through special questionnaire. SPSS version 14 was used to analyse the data. Results: A total 3602 patients were interviewed initially. Of them 318 were diabetics; the prevalence rate being 8.83%. Of the 318 study subjects, 24 (7.3%) had a history of stroke; 4 (1.3%) had history of transient ischaemic attack; 17 (5.3%) had history of myocardial infarction; 27 (8.5%) and had a history of angina. Foot ulcers were present in 22 (6.9%) and 3 (0.9%) had an amputation. Diabetic retinopathy was found in 95 (29.9%), diabetic nephropathy in 25 (7.9%) and diabetic neuropathy in 126 (39.6%). Co-morbid hypertension was found in 153 (48.1%) of cases whereas co-morbid hypercholesterolaemia was found in 66 (20.8%) and 56.9% had family history of diabetes mellitus. Overall, 34 (10.7%) were smokers. Conclusion: Diabetes is responsible for significant morbidity and mortality. Co-morbidities like hypertension and hypercholesterolaemia must be aggressively treated to prevent coronary heart disease. (author)

  18. Personality disorder features as predictors of symptoms five years post-treatment.

    Science.gov (United States)

    Jansson, Irene; Hesse, Morten; Fridell, Mats

    2008-01-01

    Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms.

  19. [A case of major depressive disorder barely distinguishable from narcissistic personality disorder].

    Science.gov (United States)

    Saito, Shinnosuke; Kobayashi, Toshiyuki; Kato, Satoshi

    2013-01-01

    The recent increase in cases of depression with a narcissistic tendency, especially among young individuals, has been pointed out. When the narcissistic tendency is conspicuous, patients may be treated for a personality disorder or pervasive developmental disorder, and not for a mood disorder. A case is described of a man in his late twenties who developed depression due to his failure in research work and job hunting, and, after a time, due to the break off of his engagement with his fiancée, manifested with narcissistic symptoms including an exaggerated opinion of himself, a sense of entitlement, interpersonal exploitation, lack of empathy, strong feelings of envy, and an extrapunitive tendency. He was regarded at the start of treatment as having narcissistic personality disorder. However, persevering treatment, mainly with supportive psychotherapy and pharmacotherapy including antidepressants (high dose of maprotiline combined with low dose of mirtazapine), sodium valprote and aripiprazole, finally improved not only his depressive symptoms, but also the symptoms regarded as a deriving from a personality disorder. He presented fierce anger and aggression regarded as a mixed state, and showed the rapid improvement in his depressive state after hospitalization, which we considered to show potential bipolarity. We diagnosed the patient with narcissistic depression, emphasizing the aspect which suggested a mood disorder, such as the episodic presence of narcissistic symptoms as long as a depressive state resided, his circular, recursive discourse, and his potential bipolarity. To accurately evaluate the aspect of mood disorders which patients appearing to show personality disorders have, it is considered useful to grasp a patient's condition from the viewpoint of a personality structure and viable dynamics. From a therapeutic standpoint, we suggest the importance of simple but persevering psychotherapy and a sufficient quantity of antidepressant medication for

  20. Personality disorders in women with severe premenstrual syndrome.

    Science.gov (United States)

    Sassoon, Stephanie A; Colrain, Ian M; Baker, Fiona C

    2011-06-01

    Premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder, affect up to 18% of women. Both are commonly associated with other mood-related disorders such as major depression, and cause significant life impairment, but their relationship with personality disorders is less clear. After completing the Structured Clinical Interview for DSM-IV-TR disorders, 33 women with severe PMS and 26 asymptomatic women, counterbalanced for menstrual cycle phase, were administered the Structured Interview for DSM-IV Personality Disorders, a diagnostic interview with low transparency, strong inter-rater reliability, and good diagnostic clarity. Women with severe PMS had a higher prevalence of personality disorders (p = 0.003) than asymptomatic women (27% versus 0%), and were more likely to have odd-eccentric, dramatic-erratic, and anxious-fearful personality disorder traits (p OCPD) was the most common character pathology in the PMS group (n = 6, 18%). OCPD, although not necessarily associated with greater severity of premenstrual symptoms, was related to poorer life functioning in women with PMS. The comorbidity of a personality disorder and severe PMS places an additive burden on general life functioning and may have implications for psychiatric treatment or medication given to those with severe premenstrual symptoms.

  1. A 4q35.2 subtelomeric deletion identified in a screen of patients with co-morbid psychiatric illness and mental retardation

    Directory of Open Access Journals (Sweden)

    Blackwood Douglas HR

    2004-08-01

    Full Text Available Abstract Background Cryptic structural abnormalities within the subtelomeric regions of chromosomes have been the focus of much recent research because of their discovery in a percentage of people with mental retardation (UK terminology: learning disability. These studies focused on subjects (largely children with various severities of intellectual impairment with or without additional physical clinical features such as dysmorphisms. However it is well established that prevalence of schizophrenia is around three times greater in those with mild mental retardation. The rates of bipolar disorder and major depressive disorder have also been reported as increased in people with mental retardation. We describe here a screen for telomeric abnormalities in a cohort of 69 patients in which mental retardation co-exists with severe psychiatric illness. Methods We have applied two techniques, subtelomeric fluorescence in situ hybridisation (FISH and multiplex amplifiable probe hybridisation (MAPH to detect abnormalities in the patient group. Results A subtelomeric deletion was discovered involving loss of 4q in a patient with co-morbid schizoaffective disorder and mental retardation. Conclusion The precise region of loss has been defined allowing us to identify genes that may contribute to the clinical phenotype through hemizygosity. Interestingly, the region of 4q loss exactly matches that linked to bipolar affective disorder in a large multiply affected Australian kindred.

  2. Personality Disorders in Obsessive-Compulsive Disorder: A Comparative Study versus Other Anxiety Disorders

    Directory of Open Access Journals (Sweden)

    Josep Pena-Garijo

    2013-01-01

    Full Text Available Objective. The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs, obsessive compulsive disorder (OCD, and other anxiety disorders different from OCD (non-OCD symptomatology. Method. The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. Results. Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. Conclusions. Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed.

  3. Personality Disorders in Obsessive-Compulsive Disorder: A Comparative Study versus Other Anxiety Disorders

    Science.gov (United States)

    Pena-Garijo, Josep; Edo Villamón, Silvia; Ruipérez, M. Ángeles

    2013-01-01

    Objective. The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs), obsessive compulsive disorder (OCD), and other anxiety disorders different from OCD (non-OCD) symptomatology. Method. The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls) matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. Results. Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. Conclusions. Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD) is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed. PMID:24453917

  4. Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder: Attrition and Change During Long-term Treatment.

    Science.gov (United States)

    Gift, Thomas E; Reimherr, Frederick W; Marchant, Barrie K; Steans, Tammy A; Wender, Paul H

    2016-05-01

    Personality disorders (PDs) are commonly found in adults with attention-deficit/hyperactivity disorder (ADHD) and are associated with increased ADHD symptoms and psychosocial impairment. To assess the impact of PDs or personality traits on retention rates in ADHD trials and whether treating ADHD affects the expression of PD, data were analyzed from 2 methylphenidate trials. Assessment of PDs and personality traits included using the Wisconsin Personality Disorders Inventory IV and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Personality Disorders. Attention-deficit/hyperactivity disorder symptoms were evaluated using the Wender-Reimherr Adult Attention Deficit Disorder Scale. Major findings were that subjects with cluster A, cluster B, passive-aggressive, or more than 1 PD showed more attrition. Subjects dropping out also had more schizoid and narcissistic traits. Attention-deficit/hyperactivity disorder symptoms (p Disorders Inventory IV items that improved most, 8 resembled ADHD or oppositional defiant disorder symptoms.

  5. Association of personal hygiene with common morbidities among upper primary school children in rural Odisha

    Directory of Open Access Journals (Sweden)

    Kalyan Kumar Paul

    2017-01-01

    Full Text Available Context: In India, children of upper primary school receive less attention from health-care providers. The majority of their health problems are preventable through hygienic practices. Aims: The aim of this study was to find out the association of personal hygiene with common morbidities among upper primary school children. Settings and Design: A cross-sectional study conducted in a rural upper primary school of Odisha. Subjects and Methods: A semi-structured schedule based on the Global School Health Survey Questionnaire and necessary instruments for clinical examination were used. Statistical Analysis Used: Data were entered in Microsoft Excel 2007 and analyzed by SPSS version 20 software. Results: Of 90 participants, 58 (64.4% were girls. The mean age was 11.8 (±1.01 years. The mean body mass index of females was significantly higher than males (16.95 vs. 14.72; P = 0.001. More than 90% of children maintained good personal hygiene such as clean tongue, clean hair, handwashing, and using footwear. The most common morbidities found were dental caries (38.9%, history of worms in stool and lethargy (20%. A mean score of 6.14 ± 0.11 (out of 8 was seen for personal hygiene and not associated with any particular morbidity or gender. Brushing daily was significantly associated with reduced dental caries (χ2 = 8.7; P < 0.005 and foul-smelling breath (χ2 = 4.93; P < 0.05. Fungal infections were significantly less in children who bathed daily (χ2 = 28.7; <0.005 and wore clean clothes (χ2 = 5.06; P < 0.05. Conclusion: Dental caries, foul-smelling breath, and fungal infections were significantly associated with poor personal hygiene. School health services should also focus on upper primary school children for improvement of personal hygiene.

  6. New diagnostic perspectives on obsessive-compulsive personality disorder and its links with other conditions.

    Science.gov (United States)

    Starcevic, Vladan; Brakoulias, Vlasios

    2014-01-01

    This review examines the conceptualization of obsessive-compulsive personality disorder (OCPD), its epidemiology and efforts to better understand the relationships between OCPD and other conditions. The alternative Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders conceptualization of OCPD is radically different in that it combines categorical and dimensional diagnostic approaches and introduces a hierarchy of diagnostic criteria. OCPD is one of the most common personality disorders in the general population. The relationship between OCPD and obsessive-compulsive disorder (OCD) is important, but to a large extent obfuscated by the overlap between their diagnostic criteria. Frequent changes in the OCPD diagnostic criteria make it difficult to ascertain the 'true' relationship between OCPD and OCD. It is not uncommon for OCPD to occur with anorexia nervosa, depression, hypochondriasis, certain other personality disorders and Parkinson's disease, but further research is necessary to understand the implications of these links. OCPD is yet to be conceptualized consistently and in the manner that would make a clear and well supported distinction between its core and peripheral features. Future studies need to separate a genuine from overlap-driven co-occurrence of OCPD and other conditions, as that would give a better insight into the way in which OCPD relates to other disorders.

  7. Personality Disorder Features and Insomnia Status amongst Hypnotic-Dependent Adults

    Science.gov (United States)

    Ruiter, Megan E.; Lichstein, Kenneth L.; Nau, Sidney D.; Geyer, James

    2012-01-01

    Objective To determine the prevalence of personality disorders and their relation to insomnia parameters among persons with chronic insomnia with hypnotic dependence. Methods Eighty-four adults with chronic insomnia with hypnotic dependence completed the SCID-II personality questionnaire, two-weeks of sleep diaries, polysomnography, and measures of insomnia severity, impact, fatigue severity, depression, anxiety, and quality of life. Frequencies, between-subjects t-tests and hierarchical regression models were conducted. Results Cluster C personality disorders were most prevalent (50%). Obsessive-compulsive personality disorder (OCPD) was most common (n=39). These individuals compared to participants with no personality disorders did not differ in objective and subjective sleep parameters. Yet, they had poorer insomnia-related daytime functioning. OCPD and Avoidant personality disorders features were associated with poorer daytime functioning. OCPD features were related to greater fatigue severity, and overestimation of time awake was trending. Schizotypal and Schizoid features were positively associated with insomnia severity. Dependent personality disorder features were related to underestimating time awake. Conclusions Cluster C personality disorders were highly prevalent in patients with chronic insomnia with hypnotic dependence. Features of Cluster C and A personality disorders were variously associated with poorer insomnia-related daytime functioning, fatigue, and estimation of nightly wake-time. Future interventions may need to address these personality features. PMID:22938862

  8. Personality disorder features and insomnia status amongst hypnotic-dependent adults.

    Science.gov (United States)

    Ruiter, Megan E; Lichstein, Kenneth L; Nau, Sidney D; Geyer, James D

    2012-10-01

    To determine the prevalence of personality disorders and their relation to insomnia parameters among persons with chronic insomnia with hypnotic dependence. Eighty-four adults with chronic insomnia with hypnotic dependence completed the SCID-II personality questionnaire, two-weeks of sleep diaries, polysomnography, and measures of insomnia severity, impact, fatigue severity, depression, anxiety, and quality of life. Frequencies, between-subjects t-tests and hierarchical regression models were conducted. Cluster C personality disorders were most prevalent (50%). Obsessive-Compulsive personality disorder (OCPD) was most common (n=39). These individuals compared to participants with no personality disorders did not differ in objective and subjective sleep parameters. Yet, they had poorer insomnia-related daytime functioning. OCPD and Avoidant personality disorders features were associated with poorer daytime functioning. OCPD features were related to greater fatigue severity, and overestimation of time awake was trending. Schizotypal and Schizoid features were positively associated with insomnia severity. Dependent personality disorder features were related to underestimating time awake. Cluster C personality disorders were highly prevalent in patients with chronic insomnia with hypnotic dependence. Features of Cluster C and A personality disorders were variously associated with poorer insomnia-related daytime functioning, fatigue, and estimation of nightly wake-time. Future interventions may need to address these personality features. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Characteristics associated with family money management for persons with psychiatric disorders.

    Science.gov (United States)

    Labrum, Travis

    2018-05-11

    Persons with psychiatric disorders (PD) commonly have their money officially or unofficially managed by others, with money managers most commonly being family members. (i) Identify characteristics of persons with PD, adult family members, and interactions with each other significantly associated with family money management (FMM). (ii) Identify significant differences in aforementioned characteristics between official versus unofficial FMM. Five hundred and seventy-three adults residing in USA with an adult relative with PD completed a survey. Among persons with PD, FMM was positively associated with lower income, diagnosis of schizophrenia/schizoaffective or bipolar disorder, psychiatric hospitalization, and arrest history. FMM was negatively associated with family members having a mental health diagnosis. FMM was positively associated with interaction characteristics of co-residence, financial assistance, caregiving, and use of limit-setting practices. Compared to official FMM, when unofficial FMM was present, persons with PD were less likely to have been psychiatrically hospitalized or to have regularly attended mental health treatment. When unofficial FMM was present, adult family members were less likely to be a parent of the person with PD. Practitioners should assess the level of burden experienced by family money managers and assess and address with family money managers the use of limit-setting practices.

  10. Comorbidity of Personality Disorders and Adult Attention Deficit Hyperactivity Disorder (ADHD)--Review of Recent Findings.

    Science.gov (United States)

    Matthies, Swantje; Philipsen, Alexandra

    2016-04-01

    Children suffering from attention deficit hyperactivity disorder (ADHD) may remit until adulthood. But, more than 60-80% have persisting ADHD symptoms. ADHD as an early manifesting neurodevelopmental disorder is considered a major risk factor for the development of comorbid psychiatric disorders in later life. Particularly, personality disorders are oftentimes observed in adult patients suffering from ADHD. If ADHD and personality disorders share common etiological mechanisms and/or if ADHD as a severely impairing condition influences psychological functioning and learning and leads to unfavorable learning histories is unclear. The development of inflexible and dysfunctional beliefs on the basis of real and perceived impairments or otherness due to the core symptoms of ADHD is intuitively plausible. Such beliefs are a known cause for the development of personality disorders. But, why some personality disorders are more frequently found in ADHD patients as for example antisocial and borderline personality disorder remains subject of debate. Because of the high prevalence of ADHD and the high impact of personality disorders on daily functioning, it is important to take them into account when treating patients with ADHD. Research on the developmental trajectories leading to personality disorders in adult ADHD patients might open the door for targeted interventions to prevent impairing comorbid clinical pictures.

  11. Personality Trait Differences in Boys and Girls with Clinical or Sub-Clinical Diagnoses of Conduct Disorder versus Antisocial Personality Disorder

    Science.gov (United States)

    Taylor, Jeanette; Iacono, William G.

    2007-01-01

    This study tested differences in personality traits measured by the Multidimensional Personality Questionnaire (MPQ) in a community sample of adolescents with definite or probable conduct disorder (CD) diagnoses that