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Sample records for psychiatrically impaired persons

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

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    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

  2. Survey of methods for the rating of psychiatric impairment in Australia.

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    Mendelson, George

    2004-05-01

    One of the enduring clinical issues in the assessment of plaintiffs in personal injury and workers' compensation claims, as well as applicants for social security and disablement benefits, is that of the evaluation of impairment and work incapacity. Many writers on this topic confuse the concepts of impairment and disability, and similar confusion is reflected in a number of the rating methods that purport to evaluate impairment but in reality assess disability. In Australia there are 20 distinct statutory schemes for workers' compensation, motor accident compensation, and social security and other benefits, which utilise a variety of methods for the rating of psychiatric impairment. Recent legislative changes designed to restrict access to personal injury compensation at common law, which in two Australian State jurisdictions require the use of impairment rating scales, also specify the rating methods to be used in the assessment of psychiatric impairment. This article discusses the concepts of impairment and disability as defined by the World Health Organisation, and reviews the various methods for the rating of psychiatric impairment that are specified by statute in the federal and State jurisdictions in Australia.

  3. Incremental Validity of the DSM-5 Section III Personality Disorder Traits With Respect to Psychosocial Impairment.

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    Simms, Leonard J; Calabrese, William R

    2016-02-01

    Traditional personality disorders (PDs) are associated with significant psychosocial impairment. DSM-5 Section III includes an alternative hybrid personality disorder (PD) classification approach, with both type and trait elements, but relatively little is known about the impairments associated with Section III traits. Our objective was to study the incremental validity of Section III traits--compared to normal-range traits, traditional PD criterion counts, and common psychiatric symptomatology--in predicting psychosocial impairment. To that end, 628 current/recent psychiatric patients completed measures of PD traits, normal-range traits, traditional PD criteria, psychiatric symptomatology, and psychosocial impairments. Hierarchical regressions revealed that Section III PD traits incrementally predicted psychosocial impairment over normal-range personality traits, PD criterion counts, and common psychiatric symptomatology. In contrast, the incremental effects for normal-range traits, PD symptom counts, and common psychiatric symptomatology were substantially smaller than for PD traits. These findings have implications for PD classification and the impairment literature more generally.

  4. Psychiatric impairment and disability assessment — proposals to ...

    African Journals Online (AJOL)

    Impairment and disability assessment on psychiatric grounds has always been subjective, controversial and at best, a difficult task. The South African Society of Psychiatrists (SASOP) needs to be congratulated, firstly on being instrumental in the publication of the first 'Guidelines to the Management of Disability Claims on ...

  5. The detrimental impact of maladaptive personality on public mental health: a challenge for psychiatric practice

    Directory of Open Access Journals (Sweden)

    Michael Pascal Hengartner

    2015-06-01

    Full Text Available Experts in personality psychology and personality disorders have long emphasised the pervasive and persistent detrimental impact of maladaptive personality traits on mental health and functioning. However, in routine psychiatric practice maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challenges common psychiatric practice. A comprehensive search and synthesis of the scientific literature demonstrates that maladaptive personality traits and personality disorders, in particular high neuroticism and negative affectivity, first, are risk factors for divorce, unemployment and disability pensioning; second, relate to the prevalence, incidence and co-occurrence of common mental disorders; third, impair functioning, symptom remission and recovery in co-occurring common mental disorders; and fourth, predispose to treatment resistance, non-response and poor treatment outcome. In conclusion, maladaptive personality is not only involved in the development and course of mental disorders, but also predisposes to chronicity and re-occurrence of psychopathology and reduces the efficacy of psychiatric treatments. The pernicious impact of maladaptive personality on mental health and functioning demands that careful assessment and thorough consideration of personality should be compulsory in psychiatric practice.

  6. Narcissistic personality disorder: relations with distress and functional impairment.

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    Miller, Joshua D; Campbell, W Keith; Pilkonis, Paul A

    2007-01-01

    This study examined the construct validity of narcissistic personality disorder (NPD) by examining the relations between NPD and measures of psychologic distress and functional impairment both concurrently and prospectively across 2 samples. In particular, the goal was to address whether NPD typically "meets" criterion C of the DSM-IV definition of Personality Disorder, which requires that the symptoms lead to clinically significant distress or impairment in functioning. Sample 1 (n = 152) was composed of individuals receiving psychiatric treatment, whereas sample 2 (n = 151) was composed of both psychiatric patients (46%) and individuals from the community. Narcissistic personality disorder was linked to ratings of depression, anxiety, and several measures of impairment both concurrently and at 6-month follow-up. However, the relations between NPD and psychologic distress were (a) small, especially in concurrent measurements, and (b) largely mediated by impaired functioning. Narcissistic personality disorder was most strongly related to causing pain and suffering to others, and this relationship was significant even when other Cluster B personality disorders were controlled. These findings suggest that NPD is a maladaptive personality style which primarily causes dysfunction and distress in interpersonal domains. The behavior of narcissistic individuals ultimately leads to problems and distress for the narcissistic individuals and for those with whom they interact.

  7. PSYCHIATRIC MORBIDITY AND PERSONALITY PROFILE IN DIVORCE SEEKING COUPLES

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    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

  8. Personality traits and psychiatric comorbidities in alcohol dependence

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    M.F. Donadon; F.L. Osório

    2016-01-01

    Non-adaptive personality traits may constitute risk factors for development of psychiatric disorders such as depression and anxiety. We aim to evaluate associations and the predictive value of personality traits among alcohol-dependent individuals, with or without psychiatric comorbidities. The convenience sample comprised two groups of males over 18 years of age: one with subjects who had an alcohol dependence diagnosis (AG, n=110), and a control group without abuse and/or alcohol dependence...

  9. [Being personal: the development of community psychiatric mental health nursing].

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    Shiau, Shu-Jen; Lee, Shu-Hong

    2009-08-01

    Community psychiatric mental health nursing care emphasizes humanistic values and focuses on serving patient and family needs. In Taiwan, such care is delivered largely as part of patient discharge care plans and hospital / community based service models. Issues involved underscore the importance of operating an effective and integrated transfer system, the role and function of nurses and training in relevant competencies (Shiau, Huang & Lin, 2005). This article again emphasizes the importance of 'being personal' in the development of community psychiatric mental health nursing in Taiwan. Critical issues to consider include humanization, empowerment, nursing competencies, regulations, relating on a personal level, and facilitating empowerment and enlightenment on the healing process.

  10. The relationship between quality of life and psychiatric impairment for a Taiwanese community post-earthquake.

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    Choul, F H-C; Chou, P; Lin, C; Su, Tom T-P; Ou-Yang, W-C; Chien, I C; Su, C-Y; Lui, M-K; Chen, M-C

    2004-08-01

    This purpose of this study was to investigate the relationship between quality of life and psychiatric impairment in a Taiwanese community located near the epicenter of the 1999 earthquake, as assessed four to six months after the natural catastrophe. Trained assistants interviewed the 4223 respondents using the disaster-related psychological screening test (DRPST), an instrument specifically designed and validated by senior psychiatrists for assessment of psychiatric impairment after natural catastrophe. Additionally, the 36-Item Short-Form Health Survey (SF-36) was used to evaluate quality of life. The collected results were analyzed using Windows SPSS 10.0 software. Psychiatric impairment rated moderate to severe was assessed for 1448 (34.3%) of the responding residents. The 4223 respondents were divided into 4 psychiatric-impairment groups based on DPRST score: healthy (n = 952); mild impairment (n = 1823); moderate impairment (n = 1126); and, severe impairment (n = 322). The four groups were compared for a number of salient factors, including gender, age, current marital status and psychiatric-impairment score, to determine impact on quality of life. Respondents assessed as psychiatrically impaired tended to be older, female, divorced/widowed, and less educated, and they were more likely to have experienced major familial financial loss as an immediate consequence of the earthquake. Further, the greater the severity of the psychiatric impairment, the lower the scores for quality of life, for both the physical and mental aspects of this important general indicator.

  11. Plasma oxytocin and personality traits in psychiatric outpatients.

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    Bendix, Marie; Uvnäs-Moberg, Kerstin; Petersson, Maria; Gustavsson, Petter; Svanborg, Pär; Åsberg, Marie; Jokinen, Jussi

    2015-07-01

    The oxytocin system is regarded as being of relevance for social interaction. In spite of this, very few studies have investigated the relationship between oxytocin and personality traits in clinical psychiatric populations. We assessed the relationship between personality traits and plasma oxytocin levels in a population of 101 medication-free psychiatric outpatients (men = 37, women = 64). We used the Karolinska Scale of Personality (KSP) and diagnostic and symptomatic testing. Plasma oxytocin levels were analysed with a specific radioimmunoassay at inclusion and after one month for testing of stability. Plasma oxytocin levels were stable over time and did not differ between patients with or without personality disorders, nor were they related to severity of depressive or anxiety symptoms. The KSP factors Impulsiveness and Negative Emotionality were significant independent predictors of plasma oxytocin. A subscale analysis of these personality factors showed significant positive correlations between baseline plasma oxytocin and the KSP subscales monotony avoidance and psychic anxiety. The significant association between the KSP factor Impulsiveness and oxytocin levels observed at baseline was observed also one month later in men. These findings suggest that personality traits such as Impulsiveness and Negative emotionality which are linked to social functioning in several psychiatric disorders seem to be associated with endogenous plasma oxytocin levels. These variations in oxytocin levels might have an impact on social sensitivity or social motivation with possible gender differences. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Hazardous alcohol users during pregnancy: psychiatric health and personality traits.

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    Magnusson, Asa; Göransson, Mona; Heilig, Markus

    2007-07-10

    We examined alcohol use disorders, psychiatric symptoms and personality traits in women reporting alcohol use during pregnancy. In a pilot cohort (n=139), subjects were screened for alcohol use disorders, and assessed for psychopathology, personality traits, and alcohol use during the first trimester. Those reporting consumption exceeding a conservative threshold for harmful use were offered a diagnostic psychiatric interview. The main findings of the pilot study were replicated using a large sample of women in the third trimester (n=715), who were screened for alcohol use disorders, had their consumption during pregnancy assessed, and were assessed for personality traits. In the pilot cohort, only a minority of women who consumed significant amounts of alcohol during pregnancy fulfilled alcohol dependence criteria, or had scores on the Alcohol Use Disorder Identification Test typically associated with such a diagnosis. Psychiatric morbidity was also unremarkable as assessed by self-reported symptom intensity. The distinguishing feature was high novelty seeking. The results were robustly confirmed in the replication study. Most women with significant alcohol consumption during pregnancy do not seem to be alcohol dependent. Instead, use during pregnancy may reflect impulsive personality traits, and be correlated with additional risk behaviors.

  13. Pain in cognitively impaired older persons.

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    Parmelee, P A

    1996-08-01

    To summarize, there has been shamefully little empirical research directly examining the prevalence and correlates of pain among cognitively impaired older people. Even less is known about techniques for assessing and managing pain in this group. Existing evidence suggests that cognitively impaired older persons may voice fewer complaints about pain, but there is no reason to believe that they are in fact at less risk of pain than their cognitively intact age-mates. Rather, for whatever reason, persons with cognitively deficits appear to be less inclined to report pain than are intact elders of similar health status. This reporting difference may account at least in part for the fact that pain is less likely to be treated aggressively among cognitively impaired individuals. Unfortunately, knowing the reason for this state of affairs does not mitigate its implication: cognitive deficits place frail older persons at risk of unnecessary pain simply because it is not properly identified. Data reviewed in this chapter suggest that accurate assessment of pain in cognitively impaired older persons, far from being impossible, may actually be only slightly more demanding than it is in intact individuals. Even among markedly impaired elders, self-reports should certainly be taken as valid indicators; early evidence suggests promising avenues for developing reliable, clear-cut guidelines for the nonverbal assessment of pain in very severely demented individuals. As the nation grows older and medical care advances, a growing proportion of individuals can expect to live well into their eighth and even ninth decades. Unfortunately, with this extended life span comes increased likelihood of both cognitive impairment and pain. Thus, expansion of our repertoire of techniques for assessing and managing pain among cognitively impaired older persons must be a central priority for research on pain in late life.

  14. Psychiatric symptomatology in persons with organic solvent exposure.

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    Morrow, L A; Kamis, H; Hodgson, M J

    1993-02-01

    This study investigated psychiatric symptomatology, self-concept, locus of control, and daily events in persons with a history of exposure to mixtures of organic solvents. Exposed subjects were more likely than controls to report depression, anxiety, fatigue, confusion, and somatic concerns, which in turn were associated with certain exposure-related variables (e.g., cacosmia). There were no differences between the groups in self-concept, locus of control, or ratings of daily hassles and uplifts. Exposed persons may be able to accurately identify what they perceive as changes that are due to the exposure (e.g., anxiety) without attributing these specific adverse outcomes to dispositional variables.

  15. Personality traits and psychiatric comorbidities in alcohol dependence

    Directory of Open Access Journals (Sweden)

    M.F. Donadon

    2016-01-01

    Full Text Available Non-adaptive personality traits may constitute risk factors for development of psychiatric disorders such as depression and anxiety. We aim to evaluate associations and the predictive value of personality traits among alcohol-dependent individuals, with or without psychiatric comorbidities. The convenience sample comprised two groups of males over 18 years of age: one with subjects who had an alcohol dependence diagnosis (AG, n=110, and a control group without abuse and/or alcohol dependence diagnosis (CG, n=110. The groups were assessed by means of the Structured Clinical Interview DSM-IV (SCID-IV. AG participants were recruited among outpatients from the university hospital, whereas CG participants were recruited from a primary healthcare program. Data collection was done individually with self-assessment instruments. Parametric statistics were performed, and a significance level of P=0.05 was adopted. A positive correlation was observed between openness and the length of time that alcohol has been consumed, as were significant and negative correlations between conscientiousness and both the length of time alcohol has been consumed and the number of doses. For alcoholics, extraversion emerged as a protective factor against depression development (P=0.008 and tobacco abuse (P=0.007, whereas openness worked as a protective factor against anxiety (P=0.02. The findings point to specific deficits presented by alcoholics in relation to personality traits with or without psychiatric comorbidities and to the understanding that therapeutic approaches should favor procedures and/or preventive measures that allow more refined awareness about the disorder.

  16. Personality traits and psychiatric comorbidities in alcohol dependence.

    Science.gov (United States)

    Donadon, M F; Osório, F L

    2016-01-01

    Non-adaptive personality traits may constitute risk factors for development of psychiatric disorders such as depression and anxiety. We aim to evaluate associations and the predictive value of personality traits among alcohol-dependent individuals, with or without psychiatric comorbidities. The convenience sample comprised two groups of males over 18 years of age: one with subjects who had an alcohol dependence diagnosis (AG, n=110), and a control group without abuse and/or alcohol dependence diagnosis (CG, n=110). The groups were assessed by means of the Structured Clinical Interview DSM-IV (SCID-IV). AG participants were recruited among outpatients from the university hospital, whereas CG participants were recruited from a primary healthcare program. Data collection was done individually with self-assessment instruments. Parametric statistics were performed, and a significance level of P=0.05 was adopted. A positive correlation was observed between openness and the length of time that alcohol has been consumed, as were significant and negative correlations between conscientiousness and both the length of time alcohol has been consumed and the number of doses. For alcoholics, extraversion emerged as a protective factor against depression development (P=0.008) and tobacco abuse (P=0.007), whereas openness worked as a protective factor against anxiety (P=0.02). The findings point to specific deficits presented by alcoholics in relation to personality traits with or without psychiatric comorbidities and to the understanding that therapeutic approaches should favor procedures and/or preventive measures that allow more refined awareness about the disorder.

  17. Body image and borderline personality disorder among psychiatric inpatients.

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    Sansone, Randy A; Chu, Jamie W; Wiederman, Michael W

    2010-01-01

    With the exclusion of studies in individuals with eating disorders, few investigators have examined body image issues in patients with borderline personality disorder (BPD). In this study, we examined among psychiatric inpatients relationships between body image and BPD. In a cross-sectional sample of convenience, we surveyed 126 women in an inpatient psychiatric unit using 5 measures for body image and 2 measures for BPD. Using standardized cutoffs for BPD diagnosis, participants with BPD demonstrated a number of differentiating features with regard to body image issues. Explicitly, BPD did not seem to be related to being self-conscious about one's appearance, although BPD was related to being more self-conscious, in general. Individuals with BPD were not more invested in their appearance as a source of self-definition but evaluated their own appearance more negatively and were more likely to believe that attractiveness is an important factor for happiness and acceptance. Although BPD was not related to perceptions about the strength and competence of one's own body, those with BPD indicated less comfort and trust in their own bodies. In general, it appeared that body image measures that were more perceptually grounded were more likely to be similar to non-BPD participants, whereas body image measures that were more cognitively grounded were more likely to be statistically significantly different in comparison with non-BPD participants. Psychiatric inpatients with BPD demonstrate a number of disturbances in body image. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. Clinical characteristics of older psychiatric inpatients with borderline personality disorder.

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    Trappler, B; Backfield, J

    2001-01-01

    This case study investigation considers typical and potentially unique characteristics of older (> 50 years) Borderline Personality Disorder (BPD) patients and describes their impact on an inpatient psychiatric unit encompassing a therapeutic milieu setting and multidisciplinary treatment teams. The somatization of symptoms, in particular, and the associated therapeutic, medical, and psychopharmacological interventions, result in prolonged and elaborate treatments that undermine clinical and personal boundaries, clash with managed care directives, and engender frustrating and elusive transferential and countertransferential reactions. Moreover, the guilt-inducing nature of somatization and physical frailty in older individuals, combined with the well-documented ability of BPD patients, regardless of age, to incite stormy and 'split' relationships, are linked characteristics that may describe a diagnostic subtype of BPD. Rather than suggesting a diminution of psychopathology as BPD patients age, the results of this investigation indicate that their persistent difficulties may only be altering in content and in pathological adaptation to changing needs.

  19. Significance of personality disorders in the face of drop-outs from psychiatric hospitalizations. The case of selected psychiatric units.

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    Biała, Maja; Kiejna, Andrzej

    2017-06-18

    The World Health Organization's estimations indicate that about 50% of patients in well-developed countries may not adhere to long-term therapies. In the field of psychiatry, drop-outs from psychiatric treatment are particularly important. Personality disorders are a significant part of this sphere. The aim of this research was to empirically verify the hypothesis regarding the relation between comorbid personality disorders and drop-outs from treatment among patients of psychiatric wards. This study was a prospective cohort study. 110 patients, hospitalized in 3 different psychiatric wards, were included. Personality disorders were assessed with the Structured Clinical Interview For DSM-IV Personality Disorders (SCID-II). The research was financed by the Polish National Science Center (DEC-2011/01/N/NZ5/05364). The response rate was 89.1%. 72.56% of patients suffered from personality disorders (SCID-II) (among them the most prevalent were: personality disorder - not otherwise specified - 40.7% and borderline personality disorder - 12.38%; 22.95% of patients dropped out from treatment). However, occurrence of personality disorders was not relevant for those drop-outs. On the other hand, relationships at the level of certain criteria of borderline personality disorders and passive-aggressive personality have been revealed. These relationships became stronger when considered from the perspective of differences in the organization of treatment at individual wards. Some personality disorders may play an important role in drop-outs from psychiatric treatment. Presented results require further research.

  20. [Forensic Psychiatric Assessment for Organic Personality Disorders after Craniocerebral Trauma].

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    Li, C H; Huang, L N; Zhang, M C; He, M

    2017-04-01

    To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma. According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI). The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients (18.7%) of mild craniocerebral trauma ( P personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences ( P personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences ( P >0.05) in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma. The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment. Copyright© by the Editorial Department of Journal of Forensic Medicine

  1. Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

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    Tunde-Ayinmode Mosunmola

    2012-07-01

    Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score  In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p  Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of

  2. Factors associated with family violence by persons with psychiatric disorders.

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    Labrum, Travis; Solomon, Phyllis L

    2016-10-30

    Family violence by persons with psychiatric disorders (PD) is a highly under-researched area. The primary objective of the present analysis was to identify perpetrator, victim, and interaction/relationship factors associated with this phenomenon. The secondary objective was to examine the extent to which the relationship between caregiving and family violence was mediated by limit-setting practices used towards relatives with PD. 573 adults across the U.S. with an adult relative with PD completed an online survey. Multivariate logistic regression was performed examining the association of factors with the occurrence of family violence. Mediation was assessed with Sobel testing. Family violence was significantly associated with the following factors: perpetrator-income, illegal drug use, psychiatric hospitalization, treatment attendance, and use of medications; victim-age, employment status, income, and mental health status; interaction/relationship-parental relationship, co-residence, use of limit-setting practices, representative payeeship, and unofficial money management. Mediation was statistically significant. Increasing access to mental health and/or substance abuse treatment may decrease the risk of family violence. Interventions may benefit from attempting to decrease/modify the use of limit-setting practices. Where family representative payeeship or unofficial money management exists, it is advisable for practitioners to assess and address financial coercion and promote greater collaboration in financial decision-making. Published by Elsevier Ireland Ltd.

  3. Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness.

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    Lahmann, Claas; Henningsen, Peter; Brandt, Thomas; Strupp, Michael; Jahn, Klaus; Dieterich, Marianne; Eckhardt-Henn, Annegret; Feuerecker, Regina; Dinkel, Andreas; Schmid, Gabriele

    2015-03-01

    Vertigo and dizziness are often not fully explained by an organic illness, but instead are related to psychiatric disorders. This study aimed to evaluate psychiatric comorbidity and assess psychosocial impairment in a large sample of patients with a wide range of unselected organic and non-organic (ie, medically unexplained) vertigo/dizziness syndromes. This cross-sectional study involved a sample of 547 patients recruited from a specialised interdisciplinary treatment centre for vertigo/dizziness. Diagnostic evaluation included standardised neurological examinations, structured clinical interview for major mental disorders (SCID-I) and self-report questionnaires regarding dizziness, depression, anxiety, somatisation and quality of life. Neurological diagnostic workup revealed organic and non-organic vertigo/dizziness in 80.8% and 19.2% of patients, respectively. In 48.8% of patients, SCID-I led to the diagnosis of a current psychiatric disorder, most frequently anxiety/phobic, somatoform and affective disorders. In the organic vertigo/dizziness group, 42.5% of patients, particularly those with vestibular paroxysmia or vestibular migraine, had a current psychiatric comorbidity. Patients with psychiatric comorbidity reported more vertigo-related handicaps, more depressive, anxiety and somatisation symptoms, and lower psychological quality of life compared with patients without psychiatric comorbidity. Almost half of patients with vertigo/dizziness suffer from a psychiatric comorbidity. These patients show more severe psychosocial impairment compared with patients without psychiatric disorders. The worst combination, in terms of vertigo-related handicaps, is having non-organic vertigo/dizziness and psychiatric comorbidity. This phenomenon should be considered when diagnosing and treating vertigo/dizziness in the early stages of the disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  4. Psychiatric Disorder or Impairing Psychology in Children Who Have Been Excluded from School: A Systematic Review

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    Whear, Rebecca; Marlow, Ruth; Boddy, Kate; Ukoumunne, Obioha C.; Parker, Claire; Ford, Tamsin; Thompson-Coon, Jo; Stein, Ken

    2014-01-01

    When children with special educational needs are excluded from school, it should raise the concern that these children are not receiving adequate help and support. This systematic review aims to identify the prevalence of psychiatric disorder or impairing psychopathology among children who are excluded from school compared to children who are not…

  5. The detrimental impact of maladaptive personality on public mental health : a challenge for psychiatric practice

    OpenAIRE

    Hengartner, Michael Pascal

    2015-01-01

    Experts in personality psychology and personality disorders have long emphasized the pervasive and persistent detrimental impact of maladaptive personality traits on mental health and functioning. However, in routine psychiatric practice, maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challen...

  6. Antisocial personality disorder in incarcerated offenders: Psychiatric comorbidity and quality of life.

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    Black, Donald W; Gunter, Tracy; Loveless, Peggy; Allen, Jeff; Sieleni, Bruce

    2010-05-01

    We determined the frequency of antisocial personality disorder (ASPD) in offenders. We examined demographic characteristics, psychiatric comorbidity, and quality of life in those with and without ASPD. We also looked at the subset with attention-deficit/hyperactivity disorder (ADHD). A random sample of 320 newly incarcerated offenders was assessed using the Mini International Neuropsychiatric Interview (MINI), the 36-item Short Form Health Survey (SF-36), and the Level of Service Inventory-Revised (LSI-R). ASPD was present in 113 subjects (35.3%). There was no gender-based prevalence difference. Offenders with ASPD were younger, had a higher suicide risk, and had higher rates of mood, anxiety, substance use, psychotic, somatoform disorders, borderline personality disorder, and ADHD. Quality of life was worse, and their LSI-R scores were higher, indicating a greater risk for recidivism. A subanalysis showed that offenders with ASPD who also had ADHD had a higher suicide risk, higher rates of comorbid disorders, and worse mental health functioning. ASPD is relatively common among both male and female inmates and is associated with comorbid disorders, high suicide risk, and impaired quality of life. Those with comorbid ADHD were more impaired than those without ADHD. ASPD occurs frequently in prison populations and is nearly as common in women as in men. These study findings should contribute to discussions of appropriate and innovative treatment of ASPD in correctional settings.

  7. Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey.

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    Bigelow, Robin T; Semenov, Yevgeniy R; du Lac, Sascha; Hoffman, Howard J; Agrawal, Yuri

    2016-04-01

    Patients with vestibular disease have been observed to have concomitant cognitive and psychiatric dysfunction. We evaluated the association between vestibular vertigo, cognitive impairment and psychiatric conditions in a nationally representative sample of US adults. We performed a cross-sectional analysis using the 2008 National Health Interview Survey (NHIS), which included a Balance and Dizziness Supplement, and questions about cognitive function and psychiatric comorbidity. We evaluated the association between vestibular vertigo, cognitive impairment (memory loss, difficulty concentrating, confusion) and psychiatric diagnoses (depression, anxiety and panic disorder). We observed an 8.4% 1-year prevalence of vestibular vertigo among US adults. In adjusted analyses, individuals with vestibular vertigo had an eightfold increased odds of 'serious difficulty concentrating or remembering' (OR 8.3, 95% CI 4.8 to 14.6) and a fourfold increased odds of activity limitation due to difficulty remembering or confusion (OR 3.9, 95% CI 3.1 to 5.0) relative to the rest of the US adults. Individuals with vestibular vertigo also had a threefold increased odds of depression (OR 3.4, 95% CI 2.9 to 3.9), anxiety (OR 3.2, 95% CI 2.8 to 3.6) and panic disorder (OR 3.4, 95% CI 2.9 to 4.0). Our findings indicate that vestibular impairment is associated with increased risk of cognitive and psychiatric comorbidity. The vestibular system is anatomically connected with widespread regions of the cerebral cortex, hippocampus and amygdala. Loss of vestibular inputs may lead to impairment of these cognitive and affective circuits. Further longitudinal research is required to determine if these associations are causal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. [Issues in psychiatric evaluation of children and adolescents with visual impairment].

    Science.gov (United States)

    Saisky, Yaniv; Hasid, Soli; Ebert, Tanya; Kosov, Irene

    2014-02-01

    Approximately 8% from those who are defined as blind in Israel are children and adolescents. Visual impairment is correlated with a high rate of psychopathology. However, some of these children and adolescents do not receive appropriate diagnosis and treatment. Often, the clinicians and those who treat the children/adolescents lack the proper professional knowledge related to the unique diagnosis and treatment of children/ adolescents who are visually impaired. Visual impairment might influence different aspects of the psychiatric diagnosis. These aspects include the influence of the impairment on different developmental axes; the reciprocal relationship between the child and his/her environment; the clinical presentation of different psychopathologies; and the different treatment modalities. In this review we discuss these issues. Moreover, we raise the question as to whether there is a need to adapt the psychiatric evaluation and the treatment specifically to the visually impaired child. The review is based on the existing literature in addition to our clinical experience, which stems from our work with children and adolescents who are at the "Jewish Institute for the Blind", an institute for children and adolescents with visual impairment in Israel.

  9. [Voting by cognitively impaired persons: legal and ethical issues].

    Science.gov (United States)

    Bosquet, Antoine; Medjkane, Amar; Vinceneux, Philippe; Mahé, Isabelle

    2010-03-01

    In democratic countries, cognitively impaired persons are a substantial and growing group of citizens. Most of them are citizens with dementia. In dementia, cognitive impairment induces a loss of some capacities, resulting in vulnerability and increased need for assistance. Voting by cognitively impaired persons raises any questions about the integrity of the electoral process, the risk of fraud and the respect of their citizenship. In France, the law is not definite about the voting of cognitively impaired persons. An objective assessment for voting capacity may be useful both for professionals in charge of voting organisation and for guardianship judge in order to help him in his decision to remove or keep the voting right of persons placed under guardianship. Assessing the reality of voting by cognitively impaired citizens is necessary to advance respect for their right to vote.

  10. Managing psychiatric emergencies in persons with mental health ...

    African Journals Online (AJOL)

    Background: Psychiatric emergencies are commonly encountered by the emergency room team where non-mental health specialists are often the first care providers. Materials and Methods: The study took place at the University of Ibadan Health Service, it was a descriptive cross-sectional study and participants were ...

  11. Autonomic Impairment in Borderline Personality Disorder: A Laboratory Investigation

    Science.gov (United States)

    Weinberg, Anna; Klonsky, E. David; Hajcak, Greg

    2009-01-01

    Recent research suggests that emotional dysfunction in psychiatric disorders can be reflected in autonomic abnormalities. The present study examines sympathetic and parasympathetic autonomic nervous system activity in individuals with Borderline Personality Disorder (BPD) before, during, and following a social stressor task. Data were obtained…

  12. Resource Guide for Persons with Learning Impairments.

    Science.gov (United States)

    IBM, Atlanta, GA. National Support Center for Persons with Disabilities.

    The resource guide identifies products which assist learning disabled and mentally retarded individuals in accessing IBM (International Business Machine) Personal Computers or the IBM Personal System/2 family of products. An introduction provides a general overview of ways computers can help learning disabled or retarded persons. The document then…

  13. Can personality traits predict the future development of heart disease in hospitalized psychiatric veterans?

    Science.gov (United States)

    Williams, Wright; Kunik, Mark E; Springer, Justin; Graham, David P

    2013-11-01

    To examine which personality traits are associated with the new onset of chronic coronary heart disease (CHD) in psychiatric inpatients within 16 years after their initial evaluation. We theorized that personality measures of depression, anxiety, hostility, social isolation, and substance abuse would predict CHD development in psychiatric inpatients. We used a longitudinal database of psychological test data from 349 Veterans first admitted to a psychiatric unit between October 1, 1983, and September 30, 1987. Veterans Affairs and national databases were assessed to determine the development of new-onset chronic CHD over the intervening 16-year period. New-onset CHD developed in 154 of the 349 (44.1%) subjects. Thirty-one psychometric variables from five personality tests significantly predicted the development of CHD. We performed a factor analysis of these variables because they overlapped and four factors emerged, with positive adaptive functioning the only significant factor (OR=0.798, p=0.038). These results support previous research linking personality traits to the development of CHD, extending this association to a population of psychiatric inpatients. Compilation of these personality measures showed that 31 overlapping psychometric variables predicted those Veterans who developed a diagnosis of heart disease within 16 years after their initial psychiatric hospitalization. Our results suggest that personality variables measuring positive adaptive functioning are associated with a reduced risk of developing chronic CHD.

  14. Neuropsychological Impairment and Its Association with Violence Risk in Japanese Forensic Psychiatric Patients: A Case-Control Study.

    Science.gov (United States)

    Nishinaka, Hirofumi; Nakane, Jun; Nagata, Takako; Imai, Atsushi; Kuroki, Noriomi; Sakikawa, Noriko; Omori, Mayu; Kuroda, Osamu; Hirabayashi, Naotsugu; Igarashi, Yoshito; Hashimoto, Kenji

    2016-01-01

    In Japan, the legislation directing treatment of offenders with psychiatric disorders was enacted in 2005. Neuropsychological impairment is highly related to functional outcomes in patients with psychiatric disorders, and several studies have suggested an association between neuropsychological impairment and violent behaviors. However, there have been no studies of neuropsychological impairment in forensic patients covered by the Japanese legislation. This study is designed to examine the neuropsychological characteristics of forensic patients in comparison to healthy controls and to assess the relationship between neuropsychological impairment and violence risk. Seventy-one forensic patients with psychiatric disorders and 54 healthy controls (matched by age, gender, and education) were enrolled. The CogState Battery (CSB) consisting of eight cognitive domains, the Iowa Gambling Task (IGT) to test emotion-based decision making, and psychological measures of violence risk including psychopathy were used. Forensic patients exhibited poorer performances on all CSB subtests and the IGT than controls. For each group, partial correlational analyses indicated that poor IGT performance was related to psychopathy, especially antisocial behavior. In forensic patients, the CSB composite score was associated with risk factors for future violent behavior, including stress and noncompliance with remediation attempts. Forensic patients with psychiatric disorders exhibit a wide range of neuropsychological impairments, and these findings suggest that neuropsychological impairment may increase the risk of violent behavior. Therefore, the treatment of neuropsychological impairment in forensic patients with psychiatric disorders is necessary to improve functional outcomes as well as to prevent violence.

  15. Neuropsychological Impairment and Its Association with Violence Risk in Japanese Forensic Psychiatric Patients: A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Hirofumi Nishinaka

    Full Text Available In Japan, the legislation directing treatment of offenders with psychiatric disorders was enacted in 2005. Neuropsychological impairment is highly related to functional outcomes in patients with psychiatric disorders, and several studies have suggested an association between neuropsychological impairment and violent behaviors. However, there have been no studies of neuropsychological impairment in forensic patients covered by the Japanese legislation. This study is designed to examine the neuropsychological characteristics of forensic patients in comparison to healthy controls and to assess the relationship between neuropsychological impairment and violence risk.Seventy-one forensic patients with psychiatric disorders and 54 healthy controls (matched by age, gender, and education were enrolled. The CogState Battery (CSB consisting of eight cognitive domains, the Iowa Gambling Task (IGT to test emotion-based decision making, and psychological measures of violence risk including psychopathy were used.Forensic patients exhibited poorer performances on all CSB subtests and the IGT than controls. For each group, partial correlational analyses indicated that poor IGT performance was related to psychopathy, especially antisocial behavior. In forensic patients, the CSB composite score was associated with risk factors for future violent behavior, including stress and noncompliance with remediation attempts.Forensic patients with psychiatric disorders exhibit a wide range of neuropsychological impairments, and these findings suggest that neuropsychological impairment may increase the risk of violent behavior. Therefore, the treatment of neuropsychological impairment in forensic patients with psychiatric disorders is necessary to improve functional outcomes as well as to prevent violence.

  16. Personality traits and suicide attempts with and without psychiatric disorders: analysis of impulsivity and neuroticism.

    Science.gov (United States)

    Bi, Bo; Liu, Wei; Zhou, Die; Fu, Xu; Qin, Xiaoxia; Wu, Jiali

    2017-08-15

    There is a critical need for empirical data concerning the association of personality traits and attempted suicide with and without psychiatric disorders in mainland China. The objective of the present study is to provide such data by determining the prevalence of psychiatric disorders and analyzing the levels of impulsivity and neuroticism among people who have attempted suicide, and to examine the association between these personality traits and suicide attempt in people with or without psychiatric disorders. We administered self-reported tests and clinical interviews to 196 people who have attempted suicide who were admitted to a hospital emergency room or our psychiatric settings after a suicide attempt. One hundred and fifty-six subjects (79.6%) met the criteria for Axis I disorders and eleven (6.6%) met the criteria Axis II personality disorders. Those who have attempted suicide who did not have psychiatric disorders exhibited a greater degree of background characteristics (e.g., high lethality, more interpersonal conflicts and more alcohol use), lower levels of suicidality (suicide risk, depressive symptoms) and differences of personality traits (e.g., more impulsive and less neuroticism) as compared to those who do have psychiatric disorders. Profile differences existed even after control for the stressful life event. Our findings suggest that some personality traits differ between people who have attempted suicide depending on whether or not they have psychiatric disorders. Based on these findings, investigating the impact of personality traits on suicidal behavior in therapeutic settings would provide critical data to improve patient treatment and outcomes.

  17. Promoting Healthful Exercise for Visually Impaired Persons with Diabetes.

    Science.gov (United States)

    Weitzman, D. M.

    1993-01-01

    This article discusses the importance of exercise for many people with visual impairments and diabetes. It lists precautions for the person with visual impairments and diabetes and specifies who should not exercise, explains "diabetes-specific" benefits of exercise, suggests a format for a safe workout, and includes an example of a successful…

  18. Childhood Maltreatment as Predictor of Pathological Personality Traits Using PSY-5 in an Adult Psychiatric Sample.

    Science.gov (United States)

    Choi, Ji Young; Park, Soo Hyun

    2018-02-01

    Extant literature indicates that childhood maltreatment is significantly associated with personality disorders. With the recent call for a more dimensional approach to understanding personality and pathological personality traits, the aim of the present study was to examine whether the experience of childhood maltreatment is associated with pathological personality traits as measured by the Personality Psychopathology Five (PSY-5). We analyzed data from 557 adult psychiatric patients with diverse psychiatric diagnoses, including mood disorders, schizophrenia spectrum disorders, and anxiety disorders. Hierarchical multiple regression analyses were conducted to determine the degree to which childhood maltreatment explained the five trait dimensions after controlling for demographic variables, presence of psychotic symptoms, and degree of depressive symptoms. Childhood maltreatment significantly predicted all of the five trait dimensions of the PSY-5. This suggests that childhood maltreatment may negatively affect the development of an adaptive adjustment system, thereby potentially contributing to the emergence of pathological personality traits.

  19. Evaluating the role of functional impairment in personality psychopathology.

    Science.gov (United States)

    Boland, Jennifer K; Damnjanovic, Tatjana; Anderson, Jaime L

    2018-03-22

    DSM-5's Section III Alternative Model for Personality Disorder (AMPD) model states that an individual must show impairment in self and interpersonal functioning for PD diagnosis. The current study investigated dimensional personality trait associations with impairment, including differential patterns of impairment across specific PDs, and whether traits have improved our assessment of functional impairment in PDs. Two-hundred and seventy-seven participants were administered measures of Antisocial PD, Avoidant PD, Borderline PD, Narcissistic PD, Obsessive-Compulsive PD, and Schizotypal PD from the perspectives of Section II (PDQ-4) and Section III (PID-5) PD models, as well as measures of functional impairment in interpersonal and intrapersonal domains. Pearson correlations showed associations between ratings of impairment and most Section II and Section III PDs and trait facets, with the exception of narcissistic PD. Hierarchical regression analyses revealed that Section III PDs added predictive validity beyond Section II PDs in predicting impairment, except narcissistic PD. These findings provide support both for the impairment criterion in the AMPD and for the association between trait-based PDs and impairment, and suggest that this trait-based measurement adds uniquely to the understanding of functional impairment. Copyright © 2018. Published by Elsevier B.V.

  20. 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.

  1. Korsakoff Syndrome in Non-alcoholic Psychiatric Patients. Variable Cognitive Presentation and Impaired Frontotemporal Connectivity

    Directory of Open Access Journals (Sweden)

    Georgios Nikolakaros

    2018-05-01

    Full Text Available Background: Non-alcoholic Wernicke's encephalopathy and Korsakoff syndrome are greatly underdiagnosed. There are very few reported cases of neuropsychologically documented non-alcoholic Korsakoff syndrome, and diffusion tensor imaging (DTI data are scarce.Methods: We report clinical characteristics and neuropsychological as well as radiological findings from three psychiatric patients (one woman and two men with a history of probable undiagnosed non-alcoholic Wernicke's encephalopathy and subsequent chronic memory problems.Results: All patients had abnormal neuropsychological test results, predominantly in memory. Thus, the neuropsychological findings were compatible with Korsakoff syndrome. However, the neuropsychological findings were not uniform. The impairment of delayed verbal memory of the first patient was evident only when the results of the memory tests were compared to her general cognitive level. In addition, the logical memory test and the verbal working memory test were abnormal, but the word list memory test was normal. The second patient had impaired attention and psychomotor speed in addition to impaired memory. In the third patient, the word list memory test was abnormal, but the logical memory test was normal. All patients had intrusions in the neuropsychological examination. Executive functions were preserved, except for planning and foresight, which were impaired in two patients. Conventional MRI examination was normal. DTI showed reduced fractional anisotropy values in the uncinate fasciculus in two patients, and in the corpus callosum and in the subgenual cingulum in one patient.Conclusions: Non-alcoholic Korsakoff syndrome can have diverse neuropsychological findings. This may partly explain its marked underdiagnosis. Therefore, a strong index of suspicion is needed. The presence of intrusions in the neuropsychological examination supports the diagnosis. Damage in frontotemporal white matter tracts, particularly in the

  2. Korsakoff Syndrome in Non-alcoholic Psychiatric Patients. Variable Cognitive Presentation and Impaired Frontotemporal Connectivity.

    Science.gov (United States)

    Nikolakaros, Georgios; Kurki, Timo; Paju, Janina; Papageorgiou, Sokratis G; Vataja, Risto; Ilonen, Tuula

    2018-01-01

    Background: Non-alcoholic Wernicke's encephalopathy and Korsakoff syndrome are greatly underdiagnosed. There are very few reported cases of neuropsychologically documented non-alcoholic Korsakoff syndrome, and diffusion tensor imaging (DTI) data are scarce. Methods: We report clinical characteristics and neuropsychological as well as radiological findings from three psychiatric patients (one woman and two men) with a history of probable undiagnosed non-alcoholic Wernicke's encephalopathy and subsequent chronic memory problems. Results: All patients had abnormal neuropsychological test results, predominantly in memory. Thus, the neuropsychological findings were compatible with Korsakoff syndrome. However, the neuropsychological findings were not uniform. The impairment of delayed verbal memory of the first patient was evident only when the results of the memory tests were compared to her general cognitive level. In addition, the logical memory test and the verbal working memory test were abnormal, but the word list memory test was normal. The second patient had impaired attention and psychomotor speed in addition to impaired memory. In the third patient, the word list memory test was abnormal, but the logical memory test was normal. All patients had intrusions in the neuropsychological examination. Executive functions were preserved, except for planning and foresight, which were impaired in two patients. Conventional MRI examination was normal. DTI showed reduced fractional anisotropy values in the uncinate fasciculus in two patients, and in the corpus callosum and in the subgenual cingulum in one patient. Conclusions: Non-alcoholic Korsakoff syndrome can have diverse neuropsychological findings. This may partly explain its marked underdiagnosis. Therefore, a strong index of suspicion is needed. The presence of intrusions in the neuropsychological examination supports the diagnosis. Damage in frontotemporal white matter tracts, particularly in the uncinate

  3. Psychiatric Severity and HIV-Risk Sexual Behaviors among Persons with Substance Use Disorders

    Science.gov (United States)

    Majer, John M.; Komer, Anne C.; Jason, and Leonard A.

    2014-01-01

    Objective The relationship between mental illness and human-immunodeficiency virus (HIV)-risk sexual behavior among persons with substance use disorders is not well established because of differences in assessing psychiatric factors (types, symptoms, severity), substance use (diagnosis, survey responses, past substance use) and HIV-risk sexual behaviors (individual measures, combination of sex/drug use risk behaviors) across studies. This study utilized a more global and dimensional aspect of psychiatric issues (problem severity), to examine the relationship with HIV-risk sexual behaviors and substance use among persons with substance use disorders. Methods Participants included 224 men and 46 women, with a mean age of 40.4 years (SD = 9.5). The most common substances were heroin/opiates, with 41.4% reporting use of these substances (n = 110, 110/266), while 27.8% reported using cocaine (n = 74, 74/266) and 12.8% reported using alcohol (n = 34, 34/266). Of all participants, 39 (14.4%) were identified as having high psychiatric severity (defined using the psychiatric severity score from the Addiction Severity Index), which was used as an indication of probable comorbid psychiatric and substance use disorders. Among these participants likely to have comorbid disorders, hierarchical linear regression was conducted to examine HIV-risk sexual behaviors (number of partners and unprotected sexual behaviors in the past 30 days) in relation to psychiatric severity, substance use, and gender. Results Gender (women) and psychiatric severity (higher) were significantly related to greater HIV-risk sexual behaviors. After entering gender and substance use into the regression model, psychiatric severity accounted for another 21.9% of the variance in number of partners and 14.1% of the variance in unprotected sexual behaviors. Overall, the models accounted for 55.5% and 15.6% of the variance, respectively. A significant interaction was found for number of partners (but not

  4. The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients.

    Science.gov (United States)

    Karadayi, Husna; Arisoy, Ozden; Altunrende, Burcu; Boztas, Mehmet Hamid; Sercan, Mustafa

    2014-01-01

    Cognitive impairment (CI) in multiple sclerosis (MS) can develop any time. CI is associated with the degree of neuronal loss, but disease duration, fatigue, comorbid affective disorder, and drug dose may also affect cognition. Our aim was to assess which cognitive domain was disturbed primarily in mild MS patients and to see whether CI was related with clinical and psychiatric features. Neurological and psychiatric evaluation of 31 MS patients and 31 age, sex, and education-matched healthy controls were made with Structured Clinical Interview for Axis I Disorders (SCID-I). Depression, anxiety, functionality, fatigue, and disability scoring were determined with Hamilton Depression-Anxiety scales, Global Assessment of Functionality, Fatigue Severity and Expanded Disability Status Scales. Cognitive functions were assessed using Mini Mental, Serial Digit Learning, Verbal and Nonverbal Cancellation, Stroop and Rey Auditory Verbal Learning tests. Retrieval from long-term memory and psychomotor speed were significantly worse in MS group. CI was correlated with disease duration, number of attacks, and physical disability but not with depression and anxiety severity. Disease duration predicted disturbances in recall and psychomotor speed, whereas fatigue and disability predicted depression. Psychomotor speed and memory were primarily impaired in MS patients, and CI was closely associated with clinical aspects of MS rather than with depression and anxiety.

  5. Adolescents with personality disorders suffer from severe psychiatric stigma: evidence from a sample of 131 patients

    Directory of Open Access Journals (Sweden)

    Catthoor K

    2015-05-01

    Full Text Available Kirsten Catthoor,1,3 Dine J Feenstra,2 Joost Hutsebaut,2 Didier Schrijvers,3 Bernard Sabbe3 1Department of Psychiatry, Psychiatrisch Ziekenhuis Stuivenberg, ZNA Antwerpen, Antwerp, Belgium; 2Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands; 3Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Wilrijk, Belgium Background: The aim of the study is to assess the severity of psychiatric stigma in a sample of personality disordered adolescents in order to evaluate whether differences in stigma can be found in adolescents with different types and severity of personality disorders (PDs. Not only adults but children and adolescents with mental health problems suffer from psychiatric stigma. In contrast to the abundance of research in adult psychiatric samples, stigma in children and adolescents has hardly been investigated. Personality disordered adolescents with fragile identities and self-esteem might be especially prone to feeling stigmatized, an experience which might further shape their identity throughout this critical developmental phase. Materials and methods: One hundred thirty-one adolescent patients underwent a standard assessment with Axis I and Axis II diagnostic interviews and two stigma instruments, Stigma Consciousness Questionnaire (SCQ and Perceived Devaluation–Discrimination Questionnaire (PDDQ. Independent sample t-tests were used to investigate differences in the mean SCQ and PDDQ total scores for patients with and without a PD. Multiple regression main effect analyses were conducted to explore the impact of the different PDs on level of stigma, as well as comorbid Axis I disorders. Age and sex were also entered in the regression models. Results and conclusions: Adolescents with severe mental health problems experience a burden of stigma. Personality disordered patients experience more stigma than adolescents with other severe psychiatric Axis I disorders. Borderline PD

  6. Preventive Psychiatric Admission for Patients With Borderline Personality Disorder: A Pilot Study

    NARCIS (Netherlands)

    Koekkoek, B.W.; Snoek, R. van der; Oosterwijk, K.; Meijel, B.K.G. van

    2010-01-01

    PURPOSE. The purpose of this study was to establish the preliminary effects of preventive psychiatric admission of patients with severe borderline personality disorder (BPD) on the rate of agreement over treatment, patient service use, and patient views on the intervention. DESIGN AND METHODS. A

  7. [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.

  8. CAPs-IDD: Characteristics of Assessment Instruments for Psychiatric Disorders in Persons with Intellectual Developmental Disorders

    Science.gov (United States)

    Zeilinger, E. L.; Nader, I. W.; Brehmer-Rinderer, B.; Koller, I.; Weber, G.

    2013-01-01

    Background: Assessment of psychiatric disorders in persons with an intellectual developmental disorder (IDD) can be performed with a variety of greatly differing instruments. This makes the choice of an instrument best suited for the intended purpose challenging. In this study, we developed a comprehensive set of characteristics for the evaluation…

  9. Association of psychiatric history and type D personality with symptoms of anxiety, depression, and health status prior to ICD implantation

    DEFF Research Database (Denmark)

    Starrenburg, Annemieke H; Kraaier, Karin; Pedersen, Susanne S.

    2013-01-01

    Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD).......Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD)....

  10. 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.

  11. Championing person-first language: a call to psychiatric mental health nurses.

    Science.gov (United States)

    Jensen, Mary E; Pease, Elizabeth A; Lambert, Kris; Hickman, Diane R; Robinson, Ora; McCoy, Kathleen T; Barut, Jennifer K; Musker, Kathleen M; Olive, Dana; Noll, Connie; Ramirez, Jeffery; Cogliser, Dawn; King, Joan Kenerson

    2013-01-01

    At the heart of recovery-oriented psychiatric mental health care are the dignity and respect of each person and the ways in which helping professionals convey a person's uniqueness, strengths, abilities, and needs. "Person-first language" is a form of linguistic expression relying on words that reflect awareness, a sense of dignity, and positive attitudes about people with disabilities. As such, person-first language places emphasis on the person first rather than the disability (e.g., "person with schizophrenia" rather than "a schizophrenic"). This article champions the use of person-first language as a foundation for recovery-oriented practice and enhanced collaborative treatment environments that foster respect, human dignity, and hope.

  12. A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder.

    Science.gov (United States)

    McMain, Shelley F; Links, Paul S; Gnam, William H; Guimond, Tim; Cardish, Robert J; Korman, Lorne; Streiner, David L

    2009-12-01

    The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management, including a combination of psychodynamically informed therapy and symptom-targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder. This was a single-blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self-injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. The primary outcome measures, assessed at baseline and every 4 months over the treatment period, were frequency and severity of suicidal and nonsuicidal self-harm episodes. Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment, including significant reductions in the frequency and severity of suicidal and nonsuicidal self-injurious episodes and significant improvements in most secondary clinical outcomes. Both groups had a reduction in general health care utilization, including emergency visits and psychiatric hospital days, as well as significant improvements in borderline personality disorder symptoms, symptom distress, depression, anger, and interpersonal functioning. No significant differences across any outcomes were found between groups. These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well-specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder.

  13. 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.

  14. Personal Experiences of Hearing-impaired People in Higher ...

    African Journals Online (AJOL)

    This qualitative paper analyses the personal experiences of hearing-impaired people in accessing, participating and completing higher education in Zimbabwe, and the authors' experiences in the education of students with disabilities. A 6As' framework is informed by the 4As framework of Tomaševski (2001), namely ...

  15. Familiar Sports and Activities Adapted for Multiply Impaired Persons.

    Science.gov (United States)

    Schilling, Mary Lou, Ed.

    1984-01-01

    Means of adapting some familiar and popular physical activities for multiply impaired persons are described. Games reviewed are dice baseball, one base baseball, in-house bowling, wheelchair bowling, ramp bowling, swing-ball bowling, table tennis, shuffleboard, beanbag bingo and tic-tac-toe, balloon basketball, circle football, and wheelchair…

  16. PERSONALITY TRAITS, ANGER AND PSYCHIATRIC SYMPTOMS RELATED TO QUALITY OF LIFE IN PATIENTS WITH NEWLY DIAGNOSED DIGESTIVE SYSTEM CANCER

    Directory of Open Access Journals (Sweden)

    Noemi Peres HONORATO

    2017-03-01

    Full Text Available ABSTRACT BACKGROUND The presence of psychiatric symptoms, anger, and personality characteristics are factors that affect the quality of life of newly diagnosed digestive system cancer patients. OBJECTIVE This study aims to identify which stable characteristics of the individual’s personality interfere with quality of life, even when reactive emotional characteristics of falling ill are controlled. METHODS A cross-sectional study was performed at the Oncology Clinic ( Hospital das Clínicas , Marília/SP, Brazil, in which 50 adult patients with digestive system cancer and diagnosed less than 6 months answered the State-Trait Anger Expression Inventory, Temperament and Character Inventory, Hospital Anxiety and Depression Scale and WHOQOL-BREF. Multiple regression was performed to verify if quality of life was related to stable characteristics of the subject’s personality (anger trait, temperament and character after controlling to the transient emotional aspects (anger state, psychiatric symptoms. RESULTS The quality of life psychological health score was higher in presence of self-directedness character and reward dependence temperament and quality of life environment score was higher in presence of self-directedness character and lower in presence of harm avoidance temperament. CONCLUSION The psychological well-being and the adaptive needs to the environment that favoring a better quality of life were reinforced mainly by the self-directedness character; which means that patients more autonomous cope better with the disease. On the other hand, the harm avoidance temperament (meaning the patient has fear of aversive situations impaired the adaptive capacity to deal with the changes of the day-to-day imposed by the disease. Understanding these personality traits is important to the health professionals drive the patient to more successful treatment.

  17. Psychiatric stigma in treatment seeking adults with personality problems: evidence from a sample of 214 patients.

    Directory of Open Access Journals (Sweden)

    Kirsten eCatthoor

    2015-07-01

    Full Text Available Stigmatization is a major hindrance in adult psychiatric patients with Axis-I diagnoses, as shown consistently in most studies. Significantly fewer studies on the emergence of psychiatric stigma in adult patients with personality disorders exist, although the resulting evidence is conclusive. Some authors consider patients with personality disorders at risk for severe stigmatization because of intense difficulties during interpersonal contact, even in a psychotherapeutic relationship. The aim of this study was primarily the assessment of pre-existing stigma in patients referred for intensive treatment for personality disorders. The study enrolled 214 patients admitted to the adult department of a highly specialized mental health care institute offering psychotherapy for patients with severe and complex personality pathology. All patients underwent a standard assessment with self-report questionnaires and a semi-structured interview to measure Axis II personality disorders. The Stigma Consciousness Questionnaire (SCQ and the Perceived Devaluation-Discrimination Questionnaire (DDQ, both validated instruments, were used to measure perceived and actual experiences of stigma. Independent sample t-tests were used to investigate differences in the mean total stigma scores for patients both with and without a personality disorder. One-way ANOVA’s were performed to assess the differences between having a borderline personality disorder, another personality disorder, or no personality disorder diagnosis.Multiple regression main effect analyses were conducted in order to explore the impact of the different personality disorder diagnosis on the level of stigma. The mean scores across all patient groups were consistent with rather low stigma. No differences were found for patients with or without a personality disorder diagnosis. Level of stigma in general was not associated with an accumulating number of personality disorders.

  18. Attachment, affective temperament, and personality disorders: a study of their relationships in psychiatric outpatients.

    Science.gov (United States)

    MacDonald, Kai; Berlow, Rustin; Thomas, Michael L

    2013-12-01

    As the result of extensive translational and cross-disciplinary research, attachment theory is now a construct with significant neuropsychiatric traction. The correlation of attachment with other influential conceptual models (i.e. temperament and personality) is therefore of interest. Consequently, we explored how two attachment dimensions (attachment anxiety and attachment avoidance) correlated with measures of temperament and personality in 357 psychiatric outpatients. We performed a retrospective review of four questionnaires (the Experiences in Close Relationship scale (ECR-R), Temperament and Character inventory (TCI), Temperament Evaluation of the Memphis, Pisa, Paris and San Diego questionnaire (TEMPS-A), and Personality Self-Portrait Questionnaire (PSQ)). Frequency measures and correlations were examined, as was the predictive value of attachment security for a personality disorder (PD). Significant, robust correlations were found between attachment anxiety and (1) several negative affective temperaments (dysthymic and cyclothymic); (2) several indices of personality pathology (low self-directedness (TCI), DSM-IV paranoid, borderline, histrionic, avoidant and dependent personality traits). Attachment avoidance had fewer large correlations. In an exploratory model, the negative predictive value of attachment security for a PD was 86%. Subjects were a relatively homogeneous subset of ambulatory psychiatric outpatients. PD diagnoses were via self-report. Clinically, these findings highlight the significant overlap between attachment, affective temperament, and personality and support the value of attachment as a screen for PDs. More broadly, given our growing understanding of the neurobiology of attachment (i.e. links with the oxytocin system), these results raise interesting questions about underlying biological systems and psychiatric treatment. © 2013 Elsevier B.V. All rights reserved.

  19. [Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization].

    Science.gov (United States)

    Domingos, Thiago da Silva; Braga, Eliana Mara

    2015-06-01

    To investigate the effectiveness of aromatherapy massage using the essential oils (0.5%) of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate) were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State) was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. There was a statistically significant decrease (p Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  20. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Thiago da Silva Domingos

    Full Text Available OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5% of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001 of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  1. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Thiago da Silva Domingos

    2015-06-01

    Full Text Available OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5% of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001 of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  2. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

    OpenAIRE

    Domingos, Thiago da Silva; Braga, Eliana Mara

    2015-01-01

    OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5%) of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate) were collected before and afte...

  3. Personality traits and risk of cognitive impairment and dementia.

    Science.gov (United States)

    Terracciano, Antonio; Stephan, Yannick; Luchetti, Martina; Albanese, Emiliano; Sutin, Angelina R

    2017-06-01

    We investigated the association between five factor model personality traits (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and risk of dementia, cognitive impairment not dementia (CIND), and conversion from CIND to dementia in a large national cohort. Participants from the Health and Retirement Study (N > 10,000) completed a personality scale in 2006-2008 and their cognitive status was tracked for up to 8 years using the modified Telephone Interview for Cognitive Status (TICSm). Adjusting for age, sex, education, race, and ethnicity, lower conscientiousness and agreeableness and higher neuroticism were independently associated with increased risk of dementia. These associations remained significant after adjusting for other risk factors for dementia, including income, wealth, smoking, physical inactivity, obesity, diabetes, hypertension, and blood biomarkers. These associations were not modified by age, sex, race, ethnicity, and education, suggesting that the associations of personality with risk of dementia were similar across demographic groups. Neuroticism and conscientiousness were also associated with risk of CIND. Low conscientiousness predicted conversion from CIND to dementia. Using brief assessments of personality and cognition, we found robust evidence that personality is associated with risk of cognitive impairment and dementia in a large national sample. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Persons with major psychiatric illness in prisons--a three years study.

    Science.gov (United States)

    Banerjee, Arnab; Sengupta, Prativa; Ray, Tapas Kumar

    2009-01-01

    A research project entitled 'operation oasis' was implemented in West Bengal prisons by SEVAC, supported by the National Human Rights Commission of India for identification of the persons suffering from major psychiatric illnesses (ie, schizophrenia, psychosis not otherwise specified, mood disorder not otherwise specified) in prisons, making arrangements for their psychiatric treatment and rehabilitation and assessing the changes in them after intervention. Dum Dum Central Jail, Presidency Jail (female section), and Berhampore Central Jail were selected as the project fields. The prison inmates were screened through clinical examination and mental state examination. Among them who were found suffering from mental illness were brought under psychiatric and psychological treatment, rehabilitation and restoration. Their sociodemographical data were also collected on the basis of a structured information schedule developed by the SEVAC team. The patients were followed-up for three consecutive years (2001 to 2004). The global assessment of functioning scores of the patients recorded at the time of initiation and completion of project were compared. During the project implementation period, 3871 prison inmates (male 3527 + female 344) were screened and 10% (n = 401) were identified as suffering from major psychiatric illnesses, of which 64% (n = 258) were housed in the prisons for minor offences/stray cases and 90% (n = 363) were undertrials. The findings concluded with a global assessment of functioning score improvement with a statistical significance of p treatment and rehabilitation.

  5. Psychiatric symptomatology and personality in a population of primary care patients

    Directory of Open Access Journals (Sweden)

    Maja Biała

    2014-06-01

    Full Text Available introduction and objective. Psychiatric disorders (and their high rates of prevalence in primary care have been widely analyzed, but the problem of underdiagnosis remains unresolved. This becomes increasingly more important in rural health centres in the face of lack of epidemiological data from these centres. The aim of this study is focused on the relationship between general health, psychiatric symptomatology and personality characteristics in the context of an adequate diagnosis. materials and methods. 518 primary care patients in 6 Polish urban clinical centres were studied using (in order of administration: a sociodemographic questionnaire, the General Health Questionnaire (GHQ-28 and Eysenck Personality Questionnaire (EPQ-R. results. The investigated sample was representative for urban primary care patients. The findings confirmed a significant association between neuroticism and general health. The strongest relation with current functioning and mental distress of the patients (GHQ general score was observed in case of symptoms of anxiety and insomnia. The symptoms of depression may be the most difficult to identify (psychiatric symptoms assessed using GHQ sub-scales. conclusions. According to the GHQ assumptions and confirmed by the presented study, sub-threshold psychiatric symptomatology affects the functioning of primary care patients and their general health. This correlates with personality factors. Improving adequacy of diagnosis becomes extremely important, as it may often be the only chance for appropriate therapy of mental problems for people living in rural areas due to lower availability of specialistic mental services. Further epidemiological studies concerning rural primary care and prevalence of the spectrum of mental disorders need to be conducted.

  6. Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment.

    Science.gov (United States)

    Cooperman, Nina A; Lu, Shou-En; Richter, Kimber P; Bernstein, Steven L; Williams, Jill M

    2016-01-01

    We aimed to evaluate how psychiatric and personality disorders influence smoking cessation goals and attempts among people with opiate dependence who smoke. This information could aid the development of more effective cessation interventions for these individuals. Participants (N = 116) were recruited from two methadone clinics, completed the Millon Clinical Multiaxial Inventory-III, and were asked about their smoking behavior and quitting goals. We used the Least Absolute Shrinkage and Selection Operator (LASSO) method, a technique commonly used for studies with small sample sizes and large number of predictors, to develop models predicting having a smoking cessation goal, among those currently smoking daily, and ever making a quit attempt, among those who ever smoked. Almost all participants reported ever smoking (n = 115, 99%); 70% (n = 80) had made a serious quit attempt in the past; 89% (n = 103) reported current daily smoking; and 59% (n = 61) had a goal of quitting smoking and staying off cigarettes. Almost all (n = 112, 97%) had clinically significant characteristics of a psychiatric or personality disorder. White race, anxiety, and a negativistic personality facet (expressively resentful) were negative predictors of having a cessation goal. Overall, narcissistic personality pattern and a dependent personality facet (interpersonally submissive) were positive predictors of having a cessation goal. Somatoform disorder, overall borderline personality pattern, and a depressive personality facet (cognitively fatalistic) were negative predictors of ever making a quit attempt. Individual histrionic (gregarious self-image), antisocial (acting out mechanism), paranoid (expressively defensive), and sadistic (pernicious representations) personality disorder facets were positive predictors of ever making a quit attempt. Each model provided good discrimination for having a smoking cessation goal or not (C-statistic of .76, 95% CI [0.66, 0.85]) and ever making a quit

  7. Influence of Psychiatric and Personality Disorders on Smoking Cessation among Individuals in Opiate Dependence Treatment

    Science.gov (United States)

    Cooperman, Nina A.; Lu, Shou-En; Richter, Kimber P.; Bernstein, Steven L.; Williams, Jill M.

    2016-01-01

    Objective We aimed to evaluate how psychiatric and personality disorders influence smoking cessation goals and attempts among people with opiate dependence who smoke. This information could aid the development of more effective cessation interventions for these individuals. Methods Participants (N=116) were recruited from two methadone clinics, completed the Millon Clinical Multiaxial Inventory–III, and were asked about their smoking behavior and quitting goals. We used the Least Absolute Shrinkage and Selection Operator (LASSO) method, a technique commonly used for studies with small sample sizes and large number of predictors, to develop models predicting having a smoking cessation goal, among those currently smoking daily, and ever making a quit attempt, among those who ever smoked. Results Almost all participants reported ever smoking (n = 115, 99%); 70% (n = 80) had made a serious quit attempt in the past; 89% (n = 103) reported current daily smoking; and, 59% (n = 61) had a goal of quitting smoking and staying off cigarettes. Almost all (n = 112, 97%) had clinically significant characteristics of a psychiatric or personality disorder. White race, anxiety, and a negativistic personality facet (expressively resentful) were negative predictors of having a cessation goal. Overall narcissistic personality pattern and a dependent personality facet (interpersonally submissive) were positive predictors of having a cessation goal. Somatoform disorder, overall borderline personality pattern, and a depressive personality facet (cognitively fatalistic) were negative predictors of ever making a quit attempt. Individual histrionic (gregarious self-image), antisocial (acting out mechanism), paranoid (expressively defensive), and sadistic (pernicious representations) personality disorder facets were positive predictors of ever making a quit attempt. Each model provided good discrimination for having a smoking cessation goal or not (C-statistic of .76, 95% CI[0.66, 0

  8. Patient factors predicting early dropout from psychiatric outpatient care for borderline personality disorder.

    Science.gov (United States)

    De Panfilis, Chiara; Marchesi, Carlo; Cabrino, Chiara; Monici, Alberto; Politi, Virginia; Rossi, Matteo; Maggini, Carlo

    2012-12-30

    Despite obvious clinical need, factors underlying early treatment discontinuation among 'real world' borderline personality disorder (BPD) patients are still unknown. This study investigates individual characteristics that can predict early (Disorders, fourth edition (DSM-IV) Personality. Sociodemographic, clinical and personality variables potentially relevant for dropout were assessed for all participants at baseline. Early dropouts (n=54) were compared to continuers (n=108) on all measures. Logistic regression was then used to identify independent predictors of early dropout. A history of suicide attempts predicted early discontinuation, whereas the presence of an eating disorder and of avoidant personality features protected from early dropout. If confirmed, these findings may help clinicians operating in general psychiatric settings with estimating the risk of premature treatment discontinuation, and stress the need to specifically address suicidal behaviours in order to improve treatment retention among borderline outpatients. In this regard, implementing general psychiatric care with specialised, evidence-based psychotherapeutic interventions may be deemed necessary. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Psychiatric evaluation of civil capacity with the new Brazilian Statute of the Person with Disabilities

    Directory of Open Access Journals (Sweden)

    Elias Abdalla-Filho

    2017-05-01

    Full Text Available The objective of this paper is to provide an update to psychiatrists regarding the new Brazilian Law for the Inclusion of People with Disabilities (BLI, Law 13,146 of 2015, and, specifically, to discuss potential implications of situations in which examination by a forensic psychiatrist points toward civil incompetence, while the above-mentioned law mandates full civil capacity for disabled persons. A study of Law 13,146/2015 was conducted, including a comparative analysis of legal and psychiatric approaches on the subject. This analysis revealed that the BLI has generated differences of opinion among legislators. However, the greatest difference seems to arise between the justice system and psychiatric expertise in relation to the difference of criteria adopted in the two approaches. The BLI is very recent; it should be revised in response to debates among psychiatrists and the criminal justice system, and especially as jurisprudence is formed over time.

  10. 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.

  11. 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…

  12. High prevalence of seasonal affective disorder among persons with severe visual impairment

    DEFF Research Database (Denmark)

    Madsen, Helle Østergaard; Dam, Henrik; Hageman, Ida

    2016-01-01

    BACKGROUND: Light severely affects the occurrence of seasonal affective disorder (SAD). AIMS: To compare the prevalence of SAD in persons with severe visual impairment and persons with full sight, and in persons with severe visual impairment with or without light perception. METHOD: This cross......-sectional study assessed the Global Seasonality Score (GSS) and the prevalence of SAD among 2781 persons with visual impairment and 4099 persons with full sight using the Seasonal Pattern Assessment Questionnaire (SPAQ). RESULTS: Respondents with visual impairment had significantly higher GSS and prevalence...... of SAD compared with full sight controls, Pvisual impairment and SPAQ-defined SAD parameters...

  13. Everyday life experiences among relatives of persons with mental disabilities represented in basic documents governing the Swedish psychiatric reform

    OpenAIRE

    Wilhelmsson, Anna-Britta; Berge, Britt-Marie

    2012-01-01

    Mental disability is one of the most serious health problems facing Europe today. The reform of psychiatric care inSweden has passed much of the rehabilitation and daily care of these people on to their families/relatives. The aim of this article is to analyze how the psychiatric reform in Sweden has affected everyday life experiences among close relatives of persons with mental disabilities. It is an explorative and descriptive study using inductive qualitative content analysis of 18 individ...

  14. Quality of life and psychiatric work impairment in compulsive buying: increased symptom severity as a function of acquisition behaviors.

    Science.gov (United States)

    Williams, Alishia D

    2012-08-01

    The aims of the current study were to determine if compulsive acquisition behaviors are meaningfully related to quality of life and psychiatric work impairment and to determine if compulsive buyers who engage in 2 forms of acquisition (buying and excessive acquisition of free items) are more impaired than individuals who only engage in 1 form of acquisition. In a community-recruited sample, analysis of covariance conducted between groups identified as noncompulsive buyers (NCB) (n = 30), compulsive buyers who did not acquire free items (CBB) (n = 30), and compulsive buyers who also acquired free items (CBF) (n = 35) revealed that both acquisition groups reported higher levels of depression and stress and lower quality of psychological well-being than the NCB group, despite a comparable number of individuals self-reporting a current mental health disorder in each group. The CBF group reported higher levels of anxiety and general distress as well as greater work inefficiency days compared with the NCB and CBB groups. Furthermore, regression analyses supported the unique contribution of acquisition of free items to the prediction of psychiatric work impairment. Taken together, the findings highlight the serious impact of compulsive buying on work functioning, general quality of life, and psychological well-being and provide avenues for future research to investigate the role of acquisition of free items in symptom severity. Limitations and future directions are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Personality and psychiatric disorders in women affected by polycystic ovary syndrome.

    Science.gov (United States)

    Scaruffi, Elisabetta; Gambineri, Alessandra; Cattaneo, Stefania; Turra, Jenni; Vettor, Roberto; Mioni, Roberto

    2014-01-01

    Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder among fertile women. Studies show reduced quality of life, anxiety, depression, body dissatisfaction, eating disorder, and sexual dysfunction, but the etiology of these disturbs remains still debated. The aim of our study is to verify whether this hyperandrogenic syndrome characterizes a strong psycho(patho)logical personality. Sixty PCOS subjects (mean age 25.8 ± 4.7 years) were evaluated by anthropometric, metabolic, hormonal, clinical, and psychological parameters. After the certainty of the diagnosis of PCOS, the Rorschach test, according to Exner's comprehensive system (CS) and the Millon Clinical Multiaxial Inventory-III (MCMI-III) were administered to each patient. The control group, on which the comparison was carried out, was composed by 40 healthy and aged compared women who were exclusively administered the Rorschach test according to CS. MCMI-III evidenced axis II DSM-IV personality disorders [4.1% schizoid, depressive, sadistic, negativistic (passive-aggressive), and masochistic, 6.1% avoiding, 12.2% dependent, 20.4% histrionic, 16.3% narcissistic, 2.0% obsessive-compulsive], and axis I DSM-IV psychiatric disorders: 10.2% anxiety, 2.0% somatoform disorder and bipolar disorder, 16.3% major depressive disorder. Finally, we found 44.9% delusional disorder and 4.1% thought disorder. Rorschach test's results show 53.1% reduced coping abilities and social skills, 55.1% depression, 30.6% perceptual distortion and cognitive slippage, 24.5% constantly alert and worry, 8.1% at risk for suicide, and finally about 50% of our patients had chronic stress. PCOS women have relevant personality and psychiatric disorders, when compared with normal subjects.

  16. PERSONALITY AND PSYCHIATRIC DISORDERS IN WOMEN AFFECTED BY POLYCYSTIC OVARY SYNDROME (PCOS

    Directory of Open Access Journals (Sweden)

    Elisabetta eScaruffi

    2014-11-01

    Full Text Available AbstractBackground: Polycystic ovary syndrome (PCOS is the most prevalent endocrine disorder among fertile women. Studies show reduced quality of life, anxiety, depression, body dissatisfaction, eating disorder and sexual dysfunction, but the etiology of these disturbs remains still debated. The aim of our study is to verify whether this hyperandrogenic syndrome characterizes a strong psycho(pathological personality. Method: Sixty PCOS subjects (mean age 25.8 ± 4.7 yrs were evaluated by antropometric, metabolic, hormonal, clinical and psychological parameters. After the certainty of the diagnosis of PCOS, the Rorschach test, according to Exner's Comprehensive System (CS and the Millon Clinical Multiaxial Inventory-III (MCMI-III were administered to each patient. The control group, on which the comparison was carried out, was composed by 40 healthy and aged compared women who were exclusively administered the Rorschach test according to C.S. Results: MCMI-III evidenced axis II DSM-IV personality disorders (4.1% schizoid, depressive, sadistic, negativistic (passive-aggressive and masochistic, 6.1% avoiding, 12.2% dependent, 20.4% histrionic, 16.3% narcissistic, 2.0% obsessive-compulsive and axis I DSM-IV psychiatric disorders: 10.2% anxiety, 2.0%, somatoform disorder and bipolar disorder, 16.3% major depressive disorder. Finally we found 44.9% delusional disorder and 4.1% thought disorder. Rorschach test’s results show 53.1% reduced coping abilities and social skills, 55.1% depression, 30.6% perceptual distortion and cognitive slippage, 24.5% constantly alert and worry, 8.1% at risk for suicide and finally about 50% of our patients had chronic stress.Conclusion: PCOS women have relevant personality and psychiatric disorders, when compared with normal subjects.

  17. A behavioral weight-loss intervention for persons with serious mental illness in psychiatric rehabilitation centers.

    Science.gov (United States)

    Daumit, G L; Dalcin, A T; Jerome, G J; Young, D R; Charleston, J; Crum, R M; Anthony, C; Hayes, J H; McCarron, P B; Khaykin, E; Appel, L J

    2011-08-01

    Overweight and obesity are epidemic in populations with serious mental illnesses. We developed and pilot-tested a behavioral weight-loss intervention appropriately tailored for persons with serious mental disorders. We conducted a single-arm pilot study in two psychiatric rehabilitation day programs in Maryland, and enrolled 63 overweight or obese adults. The 6-month intervention provided group and individual weight management and group physical activity classes. The primary outcome was weight change from baseline to 6 months. A total of 64% of those potentially eligible enrolled at the centers. The mean age was 43.7 years; 56% were women; 49% were white; and over half had schizophrenia or a schizoaffective disorder. One-third had hypertension and one-fifth had diabetes. In total, 52 (82%) completed the study; others were discharged from psychiatric centers before completion of the study. Average attendance across all weight management sessions was 70% (87% on days participants attended the center) and 59% for physical activity classes (74% on days participants attended the center). From a baseline mean of 210.9 lbs (s.d. 43.9), average weight loss for 52 participants was 4.5 lb (s.d. 12.8) (P<0.014). On average, participants lost 1.9% of body weight. Mean waist circumference change was 3.1 cm (s.d. 5.6). Participants on average increased the distance on the 6-minute walk test by 8%. This pilot study documents the feasibility and preliminary efficacy of a behavioral weight-loss intervention in adults with serious mental illness who were attendees at psychiatric rehabilitation centers. The results may have implications for developing weight-loss interventions in other institutional settings such as schools or nursing homes.

  18. Personality disorders in heart failure patients requiring psychiatric management: comorbidity detections from a routine depression and anxiety screening protocol.

    Science.gov (United States)

    Tully, Phillip J; Selkow, Terina

    2014-12-30

    Several international guidelines recommend routine depression screening in cardiac disease populations. No previous study has determined the prevalence and comorbidities of personality disorders in patients presenting for psychiatric treatment after these screening initiatives. In the first stage 404 heart failure (HF) patients were routinely screened and 73 underwent structured interview when either of the following criteria were met: (a) Patient Health Questionnaire ≥10; (b) Generalized Anxiety Disorder Questionnaire ≥7); (c) Response to one item panic-screener. Or (d) Suicidality. Patients with personality disorders were compared to the positive-screen patients on psychiatric comorbidities. The most common personality disorders were avoidant (8.2%), borderline (6.8%) and obsessive compulsive (4.1%), other personality disorders were prevalent in less than patients. Personality disorder patients had significantly greater risk of major depression (risk ratio (RR) 1.2; 95% confidence interval (CI) 1.2-13.3), generalized anxiety disorder (RR 3.2; 95% CI 1.0-10.0), social phobia (RR 3.8; 95% CI 1.3-11.5) and alcohol abuse/dependence (RR 3.2; 95% 1.0-9.5). The findings that HF patients with personality disorders presented with complex psychiatric comorbidity suggest that pathways facilitating the integration of psychiatric services into cardiology settings are warranted when routine depression screening is in place. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

  19. The Biographical Personality Interview (BPI)--a new approach to the assessment of premorbid personality in psychiatric research. Part I: Development of the instrument.

    Science.gov (United States)

    von Zerssen, D; Pössl, J; Hecht, H; Black, C; Garczynski, E; Barthelmes, H

    1998-01-01

    The Biographical Personality Interview (BPI) is a research instrument for the retrospective assessment of premorbid personality traits of psychiatric patients. Its construction is based on results of a series of investigations in which biographical data from psychiatric case notes were analysed with respect to premorbid personality traits. In order to avoid methodological shortcomings of the utilisation of clinical records, an interview technique was developed. It is applied by two independent, specially trained investigators who are kept "blind" regarding any clinical data of the subject under study. One of them has to conduct the interview of a clinically remitted patient and to provide an interview protocol, the other one has to rate personality traits from that protocol along a large series of purely descriptive items. Sum scores for six personality structures ("types") are calculated and the case is then assigned to the intra-individually dominating personality type according to the highest of these scores.

  20. Visual perception and appraisal of persons with impairments: a randomised controlled field experiment using photo elicitation.

    Science.gov (United States)

    Reinhardt, Jan Dietrich; Ballert, Carolina Saskia; Fellinghauer, Bernd; Lötscher, Alexander; Gradinger, Felix; Hilfiker, Roger; Graf, Sibylle; Stucki, Gerold

    2011-01-01

    Visual cues from persons with impairments may trigger stereotypical generalisations that lead to prejudice and discrimination. The main objective of this pilot study is to examine whether visual stimuli of impairment activate latent prejudice against disability and whether this connection can be counteracted with priming strategies. In a field experiment, participants were asked to rate photographs showing models with mental impairments, wheelchair users with paraplegia, and persons without any visible impairment. Participants should appraise the models with regard to several features (e.g. communicativeness, intelligence). One hundred participants rated 12 photo models yielding a total of 1183 observations. One group of participants was primed with a cover story introducing visual perception of impairment as the study's gist, while controls received neutral information. Photo models with mental impairments were rated lowest and models without visible impairment highest. In participants who did not have prior contacts with persons with impairments, priming led to a levelling of scores of models with and without impairment. Prior contacts with persons with impairments created similar effects as the priming. Unexpectedly, a pattern of converse double discrimination to the disadvantage of men with mental impairments was revealed. Signs of stereotypical processing of visual cues of impairment have been found in participants of the Swiss general population. Personal contact with persons with impairments as well as priming participants seems to reduce stereotyping.

  1. Concomitant psychiatric symptoms and impaired quality of life in women with cervical cancer: a critical review

    Directory of Open Access Journals (Sweden)

    Klügel S

    2017-10-01

    Full Text Available Stephanie Klügel,1 Caroline Lücke,1 Aurora Meta,1 Meike Schild-Suhren,2 Eduard Malik,2 Alexandra Philipsen,1 Helge HO Müller1,3 1Department of Psychiatry and Psychotherapy, Carl von Ossietzky University Oldenburg, Bad Zwischenahn, 2Department of Gynecology and Obstetrics, Carl von Ossietzky University Oldenburg, Oldenburg, 3Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany Abstract: Our aim was to summarize the current relevant literature on concomitant psychiatric symptoms with a focus on anxiety/depression in a population with gynecologic cancer; to identify the predictors, associated factors, and prevention strategies of psychiatric disorders; to examine psychiatric disorders in a population with recurrent gynecologic cancer; and to describe the limitations of the literature and future research areas. Little is known about attending psychiatric disorders in patients with gynecologic and other malignant diseases like cervical or breast cancer. However, patients suffering from other types of gynecologic cancer (eg, genital/cervical cancer may also have an increased risk of psychiatric symptoms. In this review, we identify the potential information deficits in this field. A two-rater independent literature search was conducted using the PubMed/Google Scholar search engines to systematically evaluate the literature on the research objectives, followed by a critical reflection on the results. Of the 77 screened studies, 15 met the criteria for inclusion in this review. Patients with gynecologic malignancies, especially cervical cancer, had a very high prevalence of psychiatric symptoms including depression (33%–52%. Additionally, the risk groups facing higher rates of concomitant reduced quality of life and increased psychiatric symptoms such as depression were identified. Specifically, low socioeconomic status, sexual inactivity, absence of a partner, and physical symptoms were correlated with an increased risk. Patients

  2. 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.

  3. Exploring registered Psychiatric Nurses' responses towards Service Users with a diagnosis of borderline personality disorder.

    LENUS (Irish Health Repository)

    McGrath, Bridget

    2012-01-01

    This study explored registered psychiatric nurses\\' (RPNs\\') interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD). A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the "staff-patient interaction response scale" (SPIRS). Four themes emerged following data analysis: "challenging and difficult," "manipulative, destructive and threatening behaviour," "preying on the vulnerable resulting in splitting staff and other service users," and "boundaries and structure." Additionally, low levels of empathy were evident in the majority of participants\\' responses to the SPIRS. The findings provide further insight on nurses\\' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.

  4. Exploring Registered Psychiatric Nurses' Responses towards Service Users with a Diagnosis of Borderline Personality Disorder

    Directory of Open Access Journals (Sweden)

    Bridget McGrath

    2012-01-01

    Full Text Available This study explored registered psychiatric nurses' (RPNs' interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD. A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the “staff-patient interaction response scale” (SPIRS. Four themes emerged following data analysis: “challenging and difficult,” “manipulative, destructive and threatening behaviour,” “preying on the vulnerable resulting in splitting staff and other service users,” and “boundaries and structure.” Additionally, low levels of empathy were evident in the majority of participants' responses to the SPIRS. The findings provide further insight on nurses' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.

  5. Childhood emotional support and borderline personality features in a sample of Canadian psychiatric outpatients.

    Science.gov (United States)

    Kealy, David; Sierra-Hernandez, Carlos A; Ogrodniczuk, John S

    2016-08-01

    Despite links between early relational experiences and psychopathology, data regarding childhood emotional neglect among Canadian mental health services users are scarce. To explore the absence of emotional support experiences reported by Canadian psychiatric outpatients, and to examine the relationship between childhood emotional support and borderline personality disorder (BPD) features. A survey regarding childhood emotional support was completed by consecutively admitted adult outpatients, along with self-report assessments of symptom distress and BPD features. A substantial proportion of outpatients reported absent emotional support experiences. After controlling for the effects of age and symptom distress, childhood emotional support was found to be significantly negatively associated with BPD features. The findings add further support to the need for clinical attention to the early relational experiences of mental health service users. © The Author(s) 2016.

  6. Animal-assisted therapy with farm animals for persons with psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Bente Berget

    Full Text Available Animal-assisted therapy (AAT with farm animals for humans with psychiatric disorders may reduce depression and state anxiety, and increase self-efficacy, in many participants. Social support by the farmer appears to be important. Positive effects are best documented for persons with affective disorders or clinical depression. Effects may sometimes take a long time to be detectable, but may occur earlier if the participants are encouraged to perform more complex working skills. Progress must however be individually adapted allowing for flexibility, also between days. Therapists involved with mental health show a pronounced belief in the effects of AAT with farm animals, variation being related to type of disorder, therapist's sex and his/her experience with AAT. Research is still scarce and further research is required to optimize and individually adapt the design of farm animal-assisted interventions.

  7. Animal-assisted therapy with farm animals for persons with psychiatric disorders.

    Science.gov (United States)

    Berget, Bente; Braastad, Bjarne O

    2011-01-01

    Animal-assisted therapy (AAT) with farm animals for humans with psychiatric disorders may reduce depression and state anxiety, and increase self-efficacy, in many participants. Social support by the farmer appears to be important. Positive effects are best documented for persons with affective disorders or clinical depression. Effects may sometimes take a long time to be detectable, but may occur earlier if the participants are encouraged to perform more complex working skills. Progress must however be individually adapted allowing for flexibility, also between days. Therapists involved with mental health show a pronounced belief in the effects of AAT with farm animals, variation being related to type of disorder, therapist's sex and his/her experience with AAT. Research is still scarce and further research is required to optimize and individually adapt the design of farm animal-assisted interventions.

  8. Gender differences in the clinical characteristics and psychiatric comorbidity in patients with antisocial personality disorder.

    Science.gov (United States)

    Sher, Leo; Siever, Larry J; Goodman, Marianne; McNamara, Margaret; Hazlett, Erin A; Koenigsberg, Harold W; New, Antonia S

    2015-10-30

    Gender is an important variable in the study of mental health because of the actual and perceived differences between men and women. Relatively little is known how males and females differ in their manifestations of antisocial personality disorder (ASPD). Demographic and clinical features of 323 participants with ASPD were assessed and recorded. Women had fewer episodes of antisocial behavior involving or not involving police, higher scores on the Childhood Trauma Questionnaire (CTQ) and on Emotional Abuse and Sexual Abuse subscales of the CTQ compared to men. CTQ scores positively correlated with the number of episodes of antisocial behavior involving police in men but not in women. The percentage of patients with comorbid borderline and histrionic personality disorders was higher and the percentage of participants with cocaine use disorder was lower among women compared to men. Comorbid alcohol use disorder was frequent in both groups, while a higher percentage of women had comorbid mood disorders compared to men. Logistic regression analysis demonstrates that CTQ scores, histrionic personality disorder, and antisocial behavior involving the police drive the difference between the groups. Our findings indicate that treatment of individuals with ASPD should focus on the management of comorbid psychiatric disorders. Published by Elsevier Ireland Ltd.

  9. Standardising antisocial personality disorder: the social shaping of a psychiatric technology.

    Science.gov (United States)

    Pickersgill, Martyn

    2012-05-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM) is one of the most influential and controversial terminological standards ever produced. As such, it continues to provide a valuable case study for sociologists of health and illness. In this article I take as my focus one particular DSM category: antisocial personality disorder (ASPD). The analysis charts the shifting understandings of personality disorders associated with antisocial behaviour in the DSM and in US psychiatry more broadly from 1950 to the present day. Memos, letters and minutes produced by the DSM-III committee and held in the American Psychiatric Association (APA) archives ground the discussion. Finally, the article explores more recent constructions of antisocial personality disorder and examines the anticipatory discourse pertaining to the rewriting of this category expected in the forthcoming DSM-5. In presenting an in-depth socio-historical narrative of the development - and potential future - of standards for pathological antisociality, this analysis casts new light on the ASPD construct. In particular, by considering it as a technology, I elaborate how processes of path dependency constrain innovation and how imaginaries of users and publics are implicated in the APA debates constitutive of this. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  10. 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.

  11. School Exclusion in Children with Psychiatric Disorder or Impairing Psychopathology: A Systematic Review

    Science.gov (United States)

    Parker, Claire; Whear, Rebecca; Ukoumunne, Obioha C.; Bethel, Alison; Thompson-Coon, Jo; Stein, Ken; Ford, Tamsin

    2015-01-01

    Childhood psychiatric disorders are associated with a wide range of adverse outcomes including poor academic attainment. For some children these difficulties are recognised through school Special Educational Need procedures (SEN) but many others may remain unidentified and/or unsupported. In Britain, government data suggests disproportionate…

  12. Offenders With Antisocial Personality Disorder Display More Impairments in Mentalizing.

    Science.gov (United States)

    Newbury-Helps, John; Feigenbaum, Janet; Fonagy, Peter

    2017-04-01

    This study was designed to test the hypothesis that individuals with antisocial, particularly violent, histories of offending behavior have specific problems in social cognition, notably in relation to accurately envisioning mental states. Eighty-three male offenders on community license, 65% of whom met the threshold for antisocial personality disorder (ASPD), completed a battery of computerized mentalizing tests requiring perspective taking (Perspectives Taking Test), mental state recognition from facial expression (Reading the Mind in the Eyes Test), and identification of mental states in the context of social interaction (Movie for the Assessment of Social Cognition). The results were compared with a partially matched sample of 42 nonoffending controls. The offender group showed impaired mentalizing on all of the tasks when compared with the control group for this study when controlling for demographic and clinical variables, and the offending group performed poorly in comparisons with participants in published studies, suggesting that limited capacity to mentalize may be part of the picture presented by individuals with histories of offending behavior. Offenders with ASPD demonstrated greater difficulty with mentalizing than non-ASPD offenders. Mentalization subscales were able to predict offender status and those with ASPD, indicating that specific impairments in perspective taking, social cognition, and social sensitivity, as well as tendencies toward hypomentalizing and nonmentalizing, are more marked in individuals who meet criteria for a diagnosis of ASPD. Awareness of these deficits may be helpful to professionals working with offenders, and specifically addressing these deficits may be a productive aspect of therapy for this "hard to reach" clinical group.

  13. Newly identified psychiatric illness in one general practice: 12-month outcome and the influence of patients' personality.

    Science.gov (United States)

    Wright, A F; Anderson, A J

    1995-01-01

    BACKGROUND. Relatively little is known about the natural history and outcome of psychological problems in patients who present to general practitioners. Only a small proportion of such patients are seen by specialists. Clinical experience suggests that patient personality is one of the factors influencing outcome in patients diagnosed as having psychiatric illness. AIM. This study set out to examine prospectively the progress and 12-month outcome of patients with newly identified psychiatric illness, and the association of patients' personality with outcome. METHOD. One hundred and seventy one patients with clinically significant psychiatric illness attending one practice in a Scottish new town were followed up prospectively (96 presented with psychological symptoms and 75 with somatic symptoms), and were compared with a group of 127 patients with chronic physical illness. Patients were assessed in terms of psychiatric state, social problems and personality using both computer-based and pencil and paper tests in addition to clinical assessments at each consultation during the follow-up year and structured interview one year after recruitment. RESULTS. Most of the improvement in psychiatric state scores on the 28-item general health questionnaire occurred in the first six months of the illness. Of the 171 patients with psychiatric illness 34% improved quickly and remained well, 54% had an intermittent course but had improved at 12-month follow up while 12% pursued a chronic course without improvement. The mean number of consultations in the follow-up year was 8.4 for patients presenting with psychological symptoms, 7.2 for those presenting with somatic symptoms and 6.6 for patients with chronic physical illness. The Eysenck N score proved a strong predictor of the outcome of new psychiatric illness. CONCLUSION. Only one in three patients with newly identified psychiatric illness improved quickly and and remained well, reflecting the importance of continuing care of

  14. Development of the Observation Scale for Aggressive Behavior (OSAB) for Dutch forensic psychiatric inpatients with an antisocial personality disorder.

    NARCIS (Netherlands)

    Hornsveld, R.H.J.; Nijman, H.L.I.; Hollin, C.R.; Kraaimaat, F.W.

    2007-01-01

    The Observation Scale for Aggressive Behavior (OSAB) has been developed to evaluate inpatient treatment programs designed to reduce aggressive behavior in Dutch forensic psychiatric patients with an antisocial personality disorder, who are "placed at the disposal of the government". The scale should

  15. Psychiatric symptoms and response quality to self-rated personality tests: Evidence from the PsyCoLaus study.

    Science.gov (United States)

    Dupuis, Marc; Meier, Emanuele; Rudaz, Dominique; Strippoli, Marie-Pierre F; Castelao, Enrique; Preisig, Martin; Capel, Roland; Vandeleur, Caroline L

    2017-06-01

    Despite the fact that research has demonstrated consistent associations between self-rated measures of personality dimensions and mental disorders, little has been undertaken to investigate the relation between psychiatric symptoms and response patterns to self-rated tests. The aim of this study was to investigate the association between psychiatric symptoms and response quality using indices from our functional method. A sample of 1,784 participants from a Swiss population-based cohort completed a personality inventory (NEO-FFI) and a symptom checklist of 90 items (SCL-90-R). Different indices of response quality were calculated based on the responses given to the NEO-FFI. Associations among the responses to indices of response quality, sociodemographic characteristics and the SCL-90-R dimensions were then established. Psychiatric symptoms were associated with several important differences in response quality, questioning subjects' ability to provide valid information using self-rated instruments. As suggested by authors, psychiatric symptoms seem associated with differences in personality scores. Nonetheless, our study shows that symptoms are also related to differences in terms of response patterns as sources of differences in personality scores. This could constitute a bias for clinical assessment. Future studies could still determine whether certain subpopulations of subjects are more unable to provide valid information to self-rated questionnaires than others. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  16. Clinician perceptions of personal safety and confidence to manage inpatient aggression in a forensic psychiatric setting.

    Science.gov (United States)

    Martin, T; Daffern, M

    2006-02-01

    Inpatient mental health clinicians need to feel safe in the workplace. They also require confidence in their ability to work with aggressive patients, allowing the provision of therapeutic care while protecting themselves and other patients from psychological and physical harm. The authors initiated this study with the predetermined belief that a comprehensive and integrated organizational approach to inpatient aggression was required to support clinicians and that this approach increased confidence and staff perceptions of personal safety. To assess perceptions of personal safety and confidence, clinicians in a forensic psychiatric hospital were surveyed using an adapted version of the Confidence in Coping With Patient Aggression Instrument. In this study clinicians reported the hospital as safe. They reported confidence in their work with aggressive patients. The factors that most impacted on clinicians' confidence to manage aggression were colleagues' knowledge, experience and skill, management of aggression training, use of prevention and intervention strategies, teamwork and the staff profile. These results are considered with reference to an expanding literature on inpatient aggression. It is concluded that organizational resources, policies and frameworks support clinician perceptions of safety and confidence to manage inpatient aggression. However, how these are valued by clinicians and translated into practice at unit level needs ongoing attention.

  17. Mental disorders and personality traits as determinants of impaired work functioning

    NARCIS (Netherlands)

    Michon, H. W. C.; ten Have, M.; Kroon, H.; van Weeghel, J.; de Graaf, R.; Schene, A. H.

    2008-01-01

    Background. Both mental disorders and personality characteristics are associated with impaired work functioning, but these determinants have not yet been studied together. The aim of this paper is to examine the impairing effects that mental disorders and personality characteristics (i.e.

  18. [Guideline-adherent inpatient psychiatric psychotherapeutic treatment of borderline personality disorder : Normative definition of personnel requirements].

    Science.gov (United States)

    Bohus, M; Schmahl, C; Herpertz, S C; Lieb, K; Berger, M; Roepke, S; Heinz, A; Gallinat, J; Lyssenko, L

    2016-07-01

    Borderline personality disorders (BPD) are severe mental diseases which place high pressure on the psychiatric healthcare system. Nowadays, well-tested, disorder-specific treatment concepts are available also for inpatient treatment in Germany. These show very good and long-term improvements in the psychopathology as well as posttreatment social participation; however, prerequisites for the implementation of these evidence-based inpatient psychotherapy programs are well-trained treatment teams and appropriate financing of resource expenditure. The aim was to formulate a definition of normative needs for treatment duration and intensity for a guideline-conform, empirically proven and effective inpatient treatment of borderline personality disorder as well as the derived personnel requirements in comparison to the currently available resources within the framework of the Psychiatry Personnel Act (Psych-PV). The resource requirements were established based on evaluated hospital ward models, the recommendations of the S2 guidelines and the criteria of specialist societies and compared with the personnel stipulations according to the Psych-PV. The results for a normatively established treatment program showed a pronounced deficit in the financing of the evaluated resource requirements, even when the stipulations laid down in the Psych-PV were implemented to 100 %. Disorder-specific inpatient treatment programs for borderline personality disorder have been scientifically proven to be highly effective; however, resource analyses show that the personnel requirements necessary for effective implementation of these programs are much higher than those allocated by the funding according to the Pysch-PV. The current underfunding leads to inadequate treatment outcomes with high readmission rates and as a result high direct and indirect costs of illness.

  19. The impact of avoidant personality disorder on psychosocial impairment is substantial.

    Science.gov (United States)

    Wilberg, Theresa; Karterud, Sigmund; Pedersen, Geir; Urnes, Øyvind

    2009-01-01

    Few studies have compared the psychosocial problems associated with different types of personality disorders (PDs). The aim of this study was to investigate the functional impairment and symptomatic distress associated with six PD diagnoses coded in DSM-IV: paranoid, borderline, avoidant, dependent, obsessive-compulsive PD and PD not otherwise specified, as well as a condition of non-psychotic symptom disorders with no PD. The study included 1023 patients from eight day treatment units specialized in the treatment of PDs. Eighty-one per cent had one or more PD diagnoses. At admission to day treatment, the patients were evaluated with respect to global functioning, symptomatic and interpersonal distress, education, quality of life, social support, legal problems and previous psychotic episodes and psychiatric hospitalizations. There were few differences in global functioning or symptomatic and interpersonal distress between patients with a single PD diagnosis. Avoidant PD and borderline PD was the diagnoses that contributed most to dysfunction in most variables when taking into account the presences of several co-occurrent PD diagnoses and axis I disorders. The psychosocial problems associated with avoidant and borderline PD were partly domain specific. The study indicates that avoidant PD is associated with severe dysfunction and subjective distress, at a level comparable to that of borderline PD. Avoidant PD deserves more attention, both with respect to the specific psychopathology and dynamics underlying the disorder and the development of treatment approaches.

  20. 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.

  1. 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.

  2. Dysfunctional personality disorder beliefs and lifetime suicide attempts among psychiatrically hospitalized military personnel.

    Science.gov (United States)

    Ghahramanlou-Holloway, Marjan; Lee-Tauler, Su Yeon; LaCroix, Jessica M; Kauten, Rebecca; Perera, Kanchana; Chen, Rusan; Weaver, Jennifer; Soumoff, Alyssa

    2018-04-01

    Personality disorders (PDs) are associated with an increased risk for suicide. However, the association between PDs and suicide risk has not been examined among military personnel. This study evaluated whether endorsement of different PD dysfunctional beliefs was associated with lifetime suicide attempt status. Cross-sectional data were collected during the baseline phase of a randomized controlled trial, evaluating the efficacy of an inpatient cognitive behavior therapy protocol for the prevention of suicide. Participants (N = 185) were military service members admitted for inpatient psychiatric care following a suicide-related event. MANOVA and Poisson regression evaluated the association between each type of PD dysfunctional belief and the number of suicide attempts. Service members' PBQ subscale scores for borderline (p = 0.049) and histrionic PD dysfunctional beliefs (p = 0.034) significantly differed across those with suicide ideation only, single attempt, and multiple attempts. Upon further analysis, histrionic PD dysfunctional beliefs scores were significantly higher among those with multiple suicide attempts than those with single attempts. One point increase of dependent (Incidence Risk Ratio = 1.04, p = 0.009), narcissistic (IRR = 1.07, p histrionic beliefs as part of a psychosocial intervention will be useful. Copyright © 2018. Published by Elsevier Inc.

  3. Predicting dropout in outpatient dialectical behavior therapy with patients with borderline personality disorder receiving psychiatric disability.

    Science.gov (United States)

    Landes, Sara J; Chalker, Samantha A; Comtois, Katherine Anne

    2016-01-01

    Rates of treatment dropout in outpatient Dialectical Behavior Therapy (DBT) in the community can be as high as 24 % to 58 %, making dropout a great concern. The primary purpose of this article was to examine predictors of dropout from DBT in a community mental health setting. Participants were 56 consumers with borderline personality disorder (BPD) who were psychiatrically disabled participating in a larger feasibility trial of Dialectical Behavior Therapy- Accepting the Challenges of Exiting the System. The following variables were examined to see whether they predicted dropout in DBT: age, education level, baseline level of distress, baseline level of non-acceptance of emotional responses, and skills module in which a consumer started DBT skills group. These variables were chosen based on known predictors of dropout in consumers with BPD and in DBT, as well as an interest in what naturally occurring variables might impact dropout. The dropout rate in this sample was 51.8 %. Results of the logistic regression show that younger age, higher levels of baseline distress, and a higher level of baseline non-acceptance of emotional responses were significantly associated with dropout. The DBT skills module in which an individual started group did not predict dropout. The implications of these findings are that knowledge of consumer age and pretreatment levels of distress and non-acceptance of emotional responses can impact providers' choice of commitment and treatment strategies to reduce dropout. Future research should examine these strategies, as well as the impact of predictor variables on outcome and reasons for dropout.

  4. Prevalence of psychiatric disorders and functional impairment after loss of a family member: a longitudinal study after the 2004 Tsunami.

    Science.gov (United States)

    Kristensen, Pål; Weisaeth, Lars; Hussain, Ajmal; Heir, Trond

    2015-01-01

    Bereavement following disasters is a devastating experience for family members. The aim of this study was to examine the long-term mental health effects of losing a loved one in a natural disaster. Ninety-four Norwegians aged 18-80 years who lost close family members in the 2004 Southeast Asian tsunami were evaluated 2 and 6 years after the disaster. The participants were either staying in an affected area at the time of the disaster (i.e., directly exposed) or not (i.e., not directly exposed). The prevalence of psychiatric disorders was assessed by the MINI International Neuropsychiatric Interview (M.I.N.I). Prolonged grief disorder (PGD) was self-reported using the Inventory of Complicated Grief (ICG), and functional impairment was self-reported using the Work and Social Adjustment Scale (WSAS). We did not identify a significant decrease in the prevalence of PGD, posttraumatic stress disorder (PTSD), or major depressive disorder (MDD) from 2 to 6 years. Approximately, one-third of the bereaved (36%) had a psychiatric disorder 6 years after the tsunami. The most common disorder was PGD (12%) followed by general anxiety disorder (GAD, 11%), agoraphobia (11%), and MDD (10%). The prevalence of PTSD and MDD was higher among family members who were directly exposed to the disaster compared to those who were not (21 vs. 0%, and 25 vs. 3%). PGD was associated with functional impairment independent of other disorders. Loss of a close family member in a natural disaster can have a substantial adverse long-term effect on mental health and everyday functioning. © 2014 Wiley Periodicals, Inc.

  5. Comparative functional study of 2 psychiatric pathologies by means of brainspect TC99 HMPO: major depression and borderline personality disorder

    International Nuclear Information System (INIS)

    Mena G, Ismael; Prado Matte, Cristian; Correa P S, Maria del Pilar

    2001-01-01

    In the D.S.M. IV, classification system of the American Psychiatric Association (1), which is the most used document in investigation and communication in psychiatry, it is stated that the Depressive Disorder affects between 5 and 9% in women and 2 per cent and 3 per cent of men, while border line personality disorder, correspond to 2% of the general population. Both pathological disorders share dimensions of regulation of affection and control of impulses (2). In these pathologies there are important impaired functions in at least three common systems of neurotransmission with behavioral features such as the cholinergic system, noradrenergic system and serotoninergic systems (3). In this paper an intracomparisson of brain blood flow is reported of a group of patients with Mayor Depression and Borderline Personality, in basal conditions versus activation conditions with the Wisconsin Test, as well an intercomparisson between the results of both pathologies are reported. In this work brain blood flow is quantified by SPECT Tc99m HMPAO evaluating the compromise in areas of the brain cortex, which are part of the three brain separate circuits (4) such as the frontal orbit circuit, the anterior cyngulate and the dorsolateral prefrontal circuit, with its afferences and efferences (5). In the analysis of results we can see a compromise shared in structures linked to motivation, where the anterior cyngulate stands out, while the hipofuncionality induced by the Wisconsin test in borderline patients (P< 0.00005 to the right and< 0.0003 to the left) is more marked than in depressive patients ( P< 0.002 to the right and < 0.003 to the left). The same happens in the area 32 of Brodmann (part of the limbic system), and the area 25 mentioned by Damasio (6) as the area of the 'anhedonia' where the compromise exists in both pathologies. There is only in borderline patients a significative compromise of the dorsolateral prefrontal area or executive area induced by the stress of the

  6. [The triad configuration, humanist-existential-personal: a theoretical and methodological approach to psychiatric and mental health nursing].

    Science.gov (United States)

    Vietta, E P

    1995-01-01

    The author establishes a research line based on a theoretical-methodological referential for the qualitative investigation of psychiatric nursing and mental health. Aspects of humanist and existential philosophies and personalism were evaluated integrating them in a unique perspective. In order to maintain the scientific method of research in this referential the categorization process which will be adopted in this kind of investigation was explained.

  7. "Balancing on Skates on the Icy Surface of Work": a metasynthesis of work participation for persons with psychiatric disabilities.

    Science.gov (United States)

    Kinn, Liv Grethe; Holgersen, Helge; Aas, Randi W; Davidson, Larry

    2014-03-01

    To explore how persons with psychiatric disabilities experience facilitators of and barriers to participation in paid work in transitional, supported, and open employment settings, in order to provide guidance for efforts to attract and retain these persons in gainful employment as a key dimension of recovery and community life. A metasynthesis was conducted using 16 qualitative studies published between 1990 and 2011. Ten themes, two phases, and an overarching metaphor were identified. The first five themes describe facilitators of and impediments to getting a job (getting off the bench): (1) fighting inertia; (2) taking control; (3) encouraging peers; (4) disruptions related to the illness; (5) lack of opportunities and supports. The next five themes represent facilitators of and impediments to working (skating on the ice); (6) going mainstream; (7) social cohesion; (8) clarity in role and responsibilities; (9) environmental factors; (10) managing self-disclosure. We chose as our overarching metaphor "Balancing on Skates on the Icy Surface of Work," as we view both iceskaters and workers with psychiatric disabilities as needing to achieve and maintain their balance while being "on the edge" between various extremities. We have shown that, for persons with psychiatric disabilities to "get off the bench" and "onto the ice" of employment, they may need to be supported in finding and maintaining their balance in new situations through a combination of learning new skills and competencies (learning how to skate) while receiving in vivo assistance from empathic and knowledgeable supporters (being coached while on the ice).

  8. Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up.

    Science.gov (United States)

    McMain, Shelley F; Guimond, Tim; Streiner, David L; Cardish, Robert J; Links, Paul S

    2012-06-01

    The authors conducted a 2-year prospective naturalistic follow-up study to evaluate posttreatment clinical outcomes in outpatients who were randomly selected to receive 1 year of either dialectical behavior therapy or general psychiatric management for borderline personality disorder. Patients were assessed by blind raters 6, 12, 18, and 24 months after treatment. The clinical effectiveness of treatment was assessed on measures of suicidal and nonsuicidal self-injurious behaviors, health care utilization, general symptom distress, depression, anger, quality of life, social adjustment, borderline psychopathology, and diagnostic status. The authors conducted between-group comparisons using generalized estimating equation, mixed-effects models, or chi-square statistics, depending on the distribution and nature of the data. Both treatment groups showed similar and statistically significant improvements on the majority of outcomes 2 years after discharge. The original effects of treatment did not diminish for any outcome domain, including suicidal and nonsuicidal self-injurious behaviors. Further improvements were seen on measures of depression, interpersonal functioning, and anger. However, even though two-thirds of the participants achieved diagnostic remission and significant increases in quality of life, 53% were neither employed nor in school, and 39% were receiving psychiatric disability support after 36 months. One year of either dialectical behavior therapy or general psychiatric management was associated with long-lasting positive effects across a broad range of outcomes. Despite the benefits of these specific treatments, one important finding that replicates previous research is that participants continued to exhibit high levels of functional impairment. The effectiveness of adjunctive rehabilitation strategies to improve general functioning deserves additional study.

  9. A Prototype: Reading of Documents Web for Visually Impaired Persons

    National Research Council Canada - National Science Library

    Santiago, S

    2001-01-01

    .... The system uses a multimedia speech synthesizer, into windows environment, The users could be normal persons searching filtered information without paying his whole attention, display-disable readers...

  10. 75 FR 28331 - Meaningful Access to United States Currency for Blind and Visually Impaired Persons

    Science.gov (United States)

    2010-05-20

    ... feature is used in some foreign currency, and the Study's data indicated that this feature was more... Currency for Blind and Visually Impaired Persons AGENCY: Bureau of Engraving and Printing, Department of... meaningful access to U.S. currency to people who are blind and visually impaired pursuant to section 504 of...

  11. Accessibility of shared space for visually impaired persons : A comparative field study

    NARCIS (Netherlands)

    Havik, Else; Steyvers, Franciscus J.J.M.; Kooijman, Aart; Melis, Bart

    Shared Space is a concept that comprises the design and planning process of a public space. There are concerns about the accessibility of Shared Spaces for people who are visually impaired. In a comparative field study, the wayfinding performance of 25 visually impaired persons (VIPs) was observed

  12. Computers, Automation, and the Employment of Persons Who Are Blind or Visually Impaired.

    Science.gov (United States)

    Mather, J.

    1994-01-01

    This article discusses the impact of technology on the formation of skills and the career advancement of persons who are blind or visually impaired. It concludes that dependence on technology (computerization and automation) and the mechanistic aspects of jobs may trap blind and visually impaired workers in occupations with narrow career paths…

  13. Antiretroviral therapy, immune suppression and renal impairment in HIV-positive persons

    DEFF Research Database (Denmark)

    Nielsen, Lene Ryom; Mocroft, Amanda; Lundgren, Jens D

    2014-01-01

    The purpose of this article is to review recent literature on antiretroviral treatment (ART) and immune suppression as risk factors for renal impairment in HIV-positive persons, and to discuss pending research questions within this field.......The purpose of this article is to review recent literature on antiretroviral treatment (ART) and immune suppression as risk factors for renal impairment in HIV-positive persons, and to discuss pending research questions within this field....

  14. Psychiatric, behavioral, and attitudinal correlates of avoidant and obsessive-compulsive personality pathology in patients with binge-eating disorder.

    Science.gov (United States)

    Becker, Daniel F; Masheb, Robin M; White, Marney A; Grilo, Carlos M

    2010-01-01

    We examined correlates of avoidant and obsessive-compulsive personality pathology--with respect to psychiatric comorbidity, eating disorder psychopathology, and associated psychologic factors--in patients with binge-eating disorder (BED). Three hundred forty-seven treatment-seeking patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), research criteria for BED were reliably assessed with semistructured interviews to evaluate DSM-IV Axis I disorders, personality disorders, and behavioral and attitudinal features of eating disorder psychopathology. Fifteen percent of subjects had avoidant personality disorder features, 12% had obsessive-compulsive personality disorder features, 8% had features of both disorders, and 66% had features of neither. These groups differed significantly in the frequencies of depressive and anxiety disorders, as well as on measures of psychologic functioning (negative/depressive affect and self-esteem) and eating disorder attitudes (shape and weight concerns). There were no group differences on measures of eating behaviors. The avoidant and obsessive-compulsive groups had more psychiatric comorbidity than the group without these personality features but less than the combined group. The group without these features scored significantly lower than all other groups on negative/depressive affect and significantly higher than the avoidant and combined groups on self-esteem. The combined group had the greatest severity on shape and weight concerns. Avoidant and obsessive-compulsive personality features are common in patients with BED. Among BED patients, these forms of personality psychopathology--separately and in combination--are associated with clinically meaningful diagnostic, psychologic, and attitudinal differences. These findings have implications for the psychopathologic relationship between BED and personality psychopathology and may also have implications for assessment and treatment. Copyright

  15. Psychiatric disorders in students in six French universities: 12-month prevalence, comorbidity, impairment and help-seeking.

    Science.gov (United States)

    Verger, Pierre; Guagliardo, Valérie; Gilbert, Fabien; Rouillon, Frédéric; Kovess-Masfety, Viviane

    2010-02-01

    Few studies have explored the prevalence of psychiatric disorders (PD) among university students. This article aims to study 12-month prevalence of PD in university students, their socio-economic correlates, impairment in daily life and help-seeking behaviours. Cross-sectional study of randomly selected first-year students aged 18-24 years, enrolled in one of the six universities in south-eastern France in 2005-2006. We used the WHO CIDI-Short Form to derive DSM-IV diagnoses and the Sheehan disability scale to evaluate impairment. We studied their correlates with multiple logistic regressions. The 12-month prevalence of major depressive disorder (MDD), anxiety disorders (AD) and substance use disorders (SUD) were 8.9% (95% CI: 7.2-10.9), 15.7% (95% CI: 13.5-18.2) and 8.1% (95% CI: 6.7-9.8), respectively. MDD was associated with precarious economic situation (OR = 1.83; 95% CI: 1.03-3.23), AD with a precarious job or unemployment of the father (OR = 2.08; 95% CI: 1.04-4.14) and SUD with higher educational level of father (OR = 2.17; 95% CI: 1.28-3.67) or having a paid job (OR = 1.82; 95% CI: 1.06-3.13). "Marked" or "extreme" impairment (score > or =7 for at least one of the domains in the Sheehan scale) was noted for 51.7% of students presenting a PD and was even more frequent in the presence of MDD/AD comorbidity. Only 30.5% of the students with a PD had sought professional help in the past 12 months. This study provides new results regarding university students suggesting a link between precarious economic situations and MDD. The frequent impairment arising from PD alongside low rates of help-seeking suggests that PD could be one of the factors in academic failure in first year of university. These results should be used to improve prevention and care of PD in university students in France.

  16. Getting to know the person behind the illness - the significance of interacting with patients hospitalised in forensic psychiatric settings.

    Science.gov (United States)

    Salzmann-Erikson, Martin; Rydlo, Cecilia; Wiklund Gustin, Lena

    2016-05-01

    To describe what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings. Relationships between staff and patients in forensic psychiatric settings should be grounded in trust and confidence, and the patients need opportunities for emotional reconciliation. However, relationships can be challenging for nurses, who sometimes distance themselves from patients' expressions of suffering. The role of forensic mental health nurses is nebulous, as are the prescriptives and the implementation of nursing practices. Qualitative descriptive design. In-depth interviews with five nurses who all work in forensic psychiatric settings. We present a descriptive analysis of what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings. The results are presented in two main categories: (1) getting to know the person behind the illness and (2) making a difference. Care in forensic psychiatry needs to shift towards a more long-term view of the role of nursing, focusing less on the traditional and stereotypical identity of the productive nurse and more on the care given when nurses slow down and take the time to see the patients as individuals. Establishing trusting relationships with patients in forensic psychiatric settings is viewed as a less oppressive way to control patients and guide them in directions that are preferable for the nurses and for the society. Nurses may use simple strategies in their daily practice such as sitting on the sofa with patients to establish trust. We stress that nurses should abandon policing roles and custodial activities in favour of guiding principles that promote individual recovery, treatment and health-promoting care. © 2016 John Wiley & Sons Ltd.

  17. Individual difficulties faced by persons with mobility impairments

    CSIR Research Space (South Africa)

    Greeff, M

    2007-07-01

    Full Text Available Disabled persons are experiencing additional difficulties when interacting with systems, applications or devices and also have their own unique requirements that enable them to use a system. If the design of the system does not support...

  18. Substance abuse treatment and psychiatric comorbidity: do benefits spill over? analysis of data from a prospective trial among cocaine-dependent homeless persons

    Directory of Open Access Journals (Sweden)

    Kertesz Stefan G

    2006-09-01

    Full Text Available Abstract Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998 were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression and anxiety-related disorders (e.g. post-traumatic stress disorder. Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32% and anxiety-related disorders (-20% (p = 0.12. Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.

  19. Design and evaluation of a kitchen for persons with visual impairments.

    Science.gov (United States)

    Kutintara, Benjamas; Somboon, Pornpun; Buasri, Virajada; Srettananurak, Metinee; Jedeeyod, Piyanooch; Pornpratoom, Kittikan; Iam-cham, Veraya

    2013-03-01

    Visually impaired people need skills on daily living, such as cooking, and Ratchasuda College offers independent living training for them. In order to fulfill their needs, a suitable kitchen should be designed with the consideration of their limitations. The objective of this study was to design and evaluate a kitchen for persons with visual impairments. Before designing the kitchen, interviews and an observation were carried out to obtain information on the needs of blind and low vision persons. Consequently, a kitchen model was developed, and it was evaluated by 10 persons with visual impairments. After the design improvement, the kitchen was built and has been routinely used for training persons with visual impairments to prepare meals. Finally, a post-occupancy evaluation of the kitchen was conducted by observing and interviewing both trainers and those with visual impairments during the food preparation training. The results of the study indicated that kitchens for persons with visual impairments should have safety and usability features. The results of the post-occupancy evaluation showed that those who attended cooking courses were able to cook safely in the kitchen. However, the kitchen still had limitations in some features.

  20. Smoking and cognitive impairment among older persons in Malaysia.

    Science.gov (United States)

    Momtaz, Yadollah Abolfathi; Ibrahim, Rahimah; Hamid, Tengku Aizan; Chai, Sen Tyng

    2015-06-01

    Previous studies have shown conflicting results on the association between smoking and cognitive function. This study aims to examine the relationship of smoking with cognitive function. Data for the study, consisting of 2553 older adults aged 60 years and older, were drawn from a nationwide household survey entitled "Determinants of Wellness among Older Malaysians: A Health Promotion Perspective" conducted in 2010. Current smokers had lower rates of cognitive impairment compared to never smokers (17.4% vs 25.9%), while cognitive function in former or ex-smokers was almost similar to that of the never smokers. Findings from multiple logistic regression analysis showed that current smokers were 37% less likely to be cognitively impaired, compared to the never smokers (odds ratio [OR] = .63; 95% confidence interval [CI]: .46-.86) while controlling for potential confounders. No difference in cognitive function was observed between former smokers and never smokers (OR = .94; 95% CI: .71-1.25). Although the findings indicated a negative association between cigarette smoking and cognitive impairment, we are unable to conclude whether this relationship is causal or affected by other unmeasured confounding factors, especially survival bias. © The Author(s) 2014.

  1. Associations between DSM-5 section III personality traits and the Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scales in a psychiatric patient sample.

    Science.gov (United States)

    Anderson, Jaime L; Sellbom, Martin; Ayearst, Lindsay; Quilty, Lena C; Chmielewski, Michael; Bagby, R Michael

    2015-09-01

    Our aim in the current study was to evaluate the convergence between Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) Section III dimensional personality traits, as operationalized via the Personality Inventory for DSM-5 (PID-5), and Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scale scores in a psychiatric patient sample. We used a sample of 346 (171 men, 175 women) patients who were recruited through a university-affiliated psychiatric facility in Toronto, Canada. We estimated zero-order correlations between the PID-5 and MMPI-2-RF substantive scale scores, as well as a series of exploratory structural equation modeling (ESEM) analyses to examine how these scales converged in multivariate latent space. Results generally showed empirical convergence between the scales of these two measures that were thematically meaningful and in accordance with conceptual expectations. Correlation analyses showed significant associations between conceptually expected scales, and the highest associations tended to be between scales that were theoretically related. ESEM analyses generated evidence for distinct internalizing, externalizing, and psychoticism factors across all analyses. These findings indicate convergence between these two measures and help further elucidate the associations between dysfunctional personality traits and general psychopathology. (c) 2015 APA, all rights reserved.

  2. Hypersexual behavior in an online sample of males: associations with personal distress and functional impairment.

    Science.gov (United States)

    Spenhoff, Miriam; Kruger, Tillmann H C; Hartmann, Uwe; Kobs, Julia

    2013-12-01

    The population of individuals reporting hypersexual behavior is heterogeneous. Prior research has implicated the importance of personal distress and functional impairment, as both may serve as indicators of problem severity and relevance. Still, little is known about associations with distress and impairment following hypersexuality. The purpose of this study was to investigate personal distress and functional impairment in a community sample of male self-identified "sex addicts" and to explore the associations with related variables. Three hundred forty-nine men completed an online survey that included questions about personal distress, functional impairment, motivation for behavior change, type of hypersexual behaviors, time spent on sexual behavior, and progression of sexual urges. The survey included the Sexual Addiction Screening Test-Revised (SAST-R) core. Specific survey questions about personal distress and functional impairment in six life areas were used to assess these variables. Chi-square and P-values were calculated to explore the interrelations among them. There were 75.3% (N = 253) who reported feeling distressed due to hypersexual behavior. Functional impairment in at least one life area was specified by 77.4% (N = 270), and most participants (56.2%) reported impairment regarding partner relationships. Personal distress and functional impairment in three areas were associated with a strong motivation for behavior change. Distress was associated with online pornography use, masturbation, and/or sexual contact with changing partners. The progression of sexual urges was related to distress, while time spent on sexual behavior was not. There were 92.9% of the distressed participants who scored above the SAST-R core scale cut-off, but also 59.0% of the participants with little or no distress scored in this range. Results underline the particular role of problems in social or intimate relationships in association with hypersexuality. Clustering

  3. Continuity Between Interview-Rated Personality Disorders and Self-Reported DSM-5 Traits in a Danish Psychiatric Sample

    DEFF Research Database (Denmark)

    Bach, Bo; Anderson, Jaime; Simonsen, Erik

    2017-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Section III offers an alternative model for the diagnosis of personality disorders (PDs), including 25 pathological personality trait facets organized into 5 trait domains. To maintain continuity with the categorical PD...... diagnoses found in DSM-5 Section II, specified sets of facets are configured into familiar PD types. The current study aimed to evaluate the continuity across the Section II and III models of PDs. A sample of 142 psychiatric outpatients were administered the Personality Inventory for DSM-5 and rated...... showed that, overall, the interview-rated DSM-5 Section II disorders were most strongly associated with expected self-reported Section III traits. Results also supported the addition of facets not included in the proposed Section III PD criteria. These findings partly underscore the continuity between...

  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. Who Am I? A Life Story Intervention for Persons With Intellectual Disability and Psychiatric Problems

    NARCIS (Netherlands)

    Westerhof, Gerben Johan; Beernink, Janny; Sools, Anna Maria

    2016-01-01

    This article describes an innovative intervention based on narrative and life review therapy that is tailored to people with intellectual disability (ID) and psychiatric problems. The current study provides a first evaluation of the intervention. A symptom checklist (SCL-90) was used in a pre- and

  6. Who Am I? A Life Story Intervention for Persons with Intellectual Disability and Psychiatric Problems

    Science.gov (United States)

    Westerhof, Gerben J.; Beernink, Janny; Sools, Anneke

    2016-01-01

    This article describes an innovative intervention based on narrative and life review therapy that is tailored to people with intellectual disability (ID) and psychiatric problems. The current study provides a first evaluation of the intervention. A symptom checklist (SCL-90) was used in a pre- and post-follow-up design, and a qualitative…

  7. Current psychiatric morbidity, aggression/impulsivity, and personality dimensions in child and adolescent suicide: a case-control study.

    Science.gov (United States)

    Renaud, Johanne; Berlim, Marcelo T; McGirr, Alexander; Tousignant, Michel; Turecki, Gustavo

    2008-01-01

    The present study was designed to evaluate psychiatric risk factors for child and adolescent suicide, and to determine the association between impulsive-aggressive and other personality traits, and suicide completion in this population. Psychiatric diagnoses, impulsive-aggressive and other personality traits were assessed in 55 child and adolescent suicide victims and 55 community controls using semi-structured proxy-based interviews and questionnaires. The most significant psychiatric risk factors associated with child and adolescent suicide were depressive disorders (OR=48.414, 95% CI 6.247-375.185), substance/alcohol abuse disorder (OR=5.365, 95% CI 1.434-20.076), and disruptive disorders (OR=13.643, 95% CI 2.292-23.16). Additionally, suicide victims showed higher scores on lifetime aggression/impulsivity, and harm avoidance. However, after logistic regression, the only independent significant predictors of suicide in this age group were the presence of depressive disorders (Adjusted OR (AOR)=39.652, 95% CI 4.501-349.345), substance/alcohol abuse disorders (AOR=7.325, 95% CI 1.127-47.62), and disruptive disorders (AOR=6.464, 95% CI 1.422-29.38). Relatively small sample size, and cross-sectional design. Our findings confirm the existence of a particular clinical profile of children and adolescents at high risk for suicide. Additionally, our results reinforce the need for improved understanding of the interrelationships between stressors, depression, substance/alcohol abuse disorders, disruptive disorders and personality traits/dimensions in youth suicidal behavior.

  8. Type D personality, cardiac events, and impaired quality of life

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Denollet, Johan

    2003-01-01

    Psychological distress has been associated with the pathogenesis and progression of coronary heart disease (CHD) but little is known about the determinants of distress as a coronary risk factor. Although it has become unfashionable to focus on personality factors since research on Type A behaviour...

  9. The impact of familial expressed emotion on clinical and personal recovery among patients with psychiatric disorders: The mediating roles of self-stigma content and process.

    Science.gov (United States)

    Chan, Kevin Ka Shing; Lam, Chun Bun

    2018-05-24

    The present study examined the associations of familial expressed emotion (EE) with clinical and personal recovery among patients with psychiatric disorders, as well as the potential mechanisms underlying these associations. Guided by the content-process theory of self-stigma, we hypothesized that EE would be negatively associated with clinical and personal recovery and that these associations would be mediated by self-stigma content and process. A total of 311 patients with psychiatric disorders completed questionnaires on their perceptions of EE, self-stigma, and recovery. Structural equation modeling demonstrated that EE was positively associated with self-stigma content and process, which were in turn negatively associated with clinical and personal recovery. The indirect effects of EE on clinical and personal recovery, via self-stigma content and process, were also significant. Multigroup analyses further demonstrated that the impact of EE on self-stigma and recovery was generalizable across patients with psychotic and nonpsychotic disorders. Theoretically, our findings revealed the potential pathways through which EE may adversely affect psychiatric recovery. Practically, our findings highlighted the importance of designing multipronged intervention programs to reduce familial EE and its potential harmful impact on psychiatric patients. In addition to helping family members improve their knowledge about psychiatric disorders and adjust their communication styles, practitioners should help psychiatric patients develop resilience against EE, mitigate self-stigma, and achieve recovery. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Mental health/psychiatric issues in elder abuse and neglect.

    Science.gov (United States)

    Cooper, Claudia; Livingston, Gill

    2014-11-01

    Elder abuse may be defined as a violation of a vulnerable older person's human and civil rights. Psychiatric illness is an important cause of vulnerability to abuse, especially when it is comorbid with other risk factors, such as physical frailty, sensory impairment, social isolation, and physical dependency. Health care providers are likely to encounter elder abuse regularly, and therefore have an important role in its detection and management, and in the treatment of subsequent psychiatric illness. This article reviews the relationships between psychiatric illnesses and elder abuse and neglect, examines the psychiatric consequences, and discusses how these may be treated. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    Directory of Open Access Journals (Sweden)

    M. I. Razumovsky

    2014-07-01

    Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.

  12. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    Directory of Open Access Journals (Sweden)

    M. I. Razumovsky

    2014-01-01

    Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.

  13. Within-person variability in response speed as an indicator of cognitive impairment in older adults.

    Science.gov (United States)

    Strauss, Esther; Bielak, Allison A M; Bunce, David; Hunter, Michael A; Hultsch, David F

    2007-11-01

    Within-person variability may be an important indicator of central nervous system compromise. In this study, within-person variability in response speed was examined in community-dwelling older adults, ages 64-92 years, using a new framework that takes into account both the extent (single versus multiple domains affected) and nature (amnestic versus non-amnestic) of the cognitive impairment. Those with multiple domains of impairment were more variable than those who showed an isolated area of impairment, regardless of whether memory was one of the domains affected. Further, for those with difficulties in two or more non-memory domains, increased variability was most evident in more cognitively demanding situations, when individuals had to manipulate information held briefly in mind, switch cognitive set or inhibit an automatic response. Finally, group differentiation was better achieved when within-person variability as opposed to mean speed of performance was considered.

  14. The Effect of Attending Good Psychiatric Management (GPM) Workshops on Attitudes Toward Patients With Borderline Personality Disorder.

    Science.gov (United States)

    Keuroghlian, Alex S; Palmer, Brian A; Choi-Kain, Lois W; Borba, Christina P C; Links, Paul S; Gunderson, John G

    2016-08-01

    The effect that attending a 1-day workshop on Good Psychiatric Management (GPM) had on attitudes about borderline personality disorder (BPD) was assessed among 297 clinicians. Change was recorded by comparing before and after scores on a 9-item survey previously developed to assess the effects of workshops on Systems Training for Emotional Predictability and Problem Solving (STEPPS). Participants reported decreased inclination to avoid borderline patients, dislike of borderline patients, and belief that BPD's prognosis is hopeless, as well as increased feeling of competence, belief that borderline patients have low self-esteem, feeling of being able to make a positive difference, and belief that effective psychotherapies exist. Less clinical experience was related to an increased feeling of competence and belief that borderline patients have low self-esteem. These findings were compared to those from the STEPPS workshop. This assessment demonstrates GPM's potential for training clinicians to meet population-wide needs related to borderline personality disorder.

  15. Personality traits of nurses and organizational climate in relation to the use of coercion in psychiatric wards.

    Science.gov (United States)

    Pawlowski, Tomasz; Baranowski, Piotr

    2018-04-01

    The aim of this study was to analyze the personality traits of nurses and the organizational climate in psychiatric wards affecting the frequency of the use of coercion. The study applied a descriptive, longitudinal design based on a 1-year prospective observation. The best predictor for the initiation of coercion by nursing personnel was a low score on the Creative Personality Factor Scale in Adjective Check List and the low score in the area of Leadership in Kolb's Organizing Climate Questionnaire (KOQC). The best predictor for decisions to use coercion was the low score in the area Requirements in the KOQC, whereas the best predictors for the participation in coercion were a high value for Leadership area and a low value for Requirements area in KOQC. The nursing personnel should be given frequent practical and theoretical training regarding the use of coercion. © 2017 Wiley Periodicals, Inc.

  16. The Biographical Personality Interview (BPI)--a new approach to the assessment of premorbid personality in psychiatric research. Part II: Psychometric properties.

    Science.gov (United States)

    von Zerssen, D; Barthelmes, H; Pössl, J; Black, C; Garzynski, E; Wessel, E; Hecht, H

    1998-01-01

    The Biographical Personality Interview (BPI) was applied to 179 subjects (158 psychiatric patients and 21 probands from the general population); 100 patients and 20 healthy controls served as a validation sample; the others had been interviewed during the training period or did not meet the inclusion criteria for the validation of the BPI. The acceptance of the interview was high, the inter-rater reliability of the ratings of premorbid personality structures ("types") varied between 0.81 and 0.88 per type. Concurrent validity of the typological constructs as assessed by means of the BPI was inferred from the intercorrelations of type scores and correlations of these scores with questionnaire data and proved to be adequate. Clinical validity of the assessment was indicated by statistically significant differences between diagnostic groups. Problems and further developments of the instrument and its application are discussed.

  17. Influence of a lifestyle intervention among persons with a psychiatric disability: a cluster randomised controlled trail on symptoms, quality of life and sense of coherence.

    Science.gov (United States)

    Forsberg, Karl A; Björkman, Tommy; Sandman, Per O; Sandlund, Mikael

    2010-06-01

    The aim of this study was to investigate how a lifestyle intervention programme influences psychiatric and psychosocial factors among persons with psychiatric disabilities. Persons with psychiatric disabilities often suffer from a simultaneous physical health problem, where circulatory disorder, hyperlipideamia, digestive disease, diabetes mellitus and obesity are prevalent. Studies have also shown a relationship between physical activity and mental health. But few randomised controlled trails have been aimed specifically at lifestyle interventions and their effect on psychiatric health and quality of life among persons with psychiatric disabilities. A cluster randomised controlled trail. Forty-one persons with a DSM-IV diagnosis in eight supported housing facilities and two housing support programmes and their carers were on cluster level randomly assigned to a 12-month health intervention programme in the form of study circles with diet sessions and physical activities or a control programme. The changes in the mean of quality of life, level of functioning, psychiatric symptoms and sense of coherence was investigated and its relationship to physical health and attendance. A significant increase in the sense of coherence was seen in both programmes but also significant improvements in the intervention group compared to controls at the follow-up. Structured activities in the form of lifestyle intervention programmes with a sufficient level of challenge that encourage persons with psychiatric disabilities to participate in activities in a social context may contribute to a significant increase in the sense of coherence. Improving physical health with lifestyle programmes in the form of study circles and when involving their cares will in addition to increased physical health end in improved sense of coherence.

  18. Increasing Suicide Rates Among Middle-age Persons and Interventions to Manage Patients with Psychiatric Complaints

    Directory of Open Access Journals (Sweden)

    Bharath Chakravarthy

    2014-02-01

    Full Text Available The Centers for Disease Control and Prevention (CDC has published significant data and trends related to suicide rates in the United States (U.S.. Suicide is the 10th leading cause of death in U.S. adults, and rates are increasing across all geographic regions. There is a significant increase in the suicide rate among adults in the 35-64 age range. We present findings from the CDC’s Morbidity and Mortality Weekly Report (MMWR with commentary on current resources and barriers to psychiatric care. [West J Emerg Med. 2014;15(1:11–13.

  19. Personality and perception of stigma in psychiatric patients with depressive disorders

    OpenAIRE

    Borecki, L; Gozdzik-Zelazny, A; Pokorski, M

    2010-01-01

    Objective The study seeks to determine the relationships between neuroticism and extroversion, on the one side, and the perception of various dimensions of social stigma, on the other, in psychiatric in-patients with depressive disorders, such as depressive episodes, or mood and anxiety disorders with the presence of depressive symptoms. Material and methods A total of 72 patients were examined in the study. Twenty four of them (F/M - 12/12; age range 42-65 years) were used for assessing the ...

  20. Personalized neuromusculoskeletal modeling to improve treatment of mobility impairments: a perspective from European research sites

    Directory of Open Access Journals (Sweden)

    Fregly Benjamin J

    2012-03-01

    Full Text Available Abstract Mobility impairments due to injury or disease have a significant impact on quality of life. Consequently, development of effective treatments to restore or replace lost function is an important societal challenge. In current clinical practice, a treatment plan is often selected from a standard menu of options rather than customized to the unique characteristics of the patient. Furthermore, the treatment selection process is normally based on subjective clinical experience rather than objective prediction of post-treatment function. The net result is treatment methods that are less effective than desired at restoring lost function. This paper discusses the possible use of personalized neuromusculoskeletal computer models to improve customization, objectivity, and ultimately effectiveness of treatments for mobility impairments. The discussion is based on information gathered from academic and industrial research sites throughout Europe, and both clinical and technical aspects of personalized neuromusculoskeletal modeling are explored. On the clinical front, we discuss the purpose and process of personalized neuromusculoskeletal modeling, the application of personalized models to clinical problems, and gaps in clinical application. On the technical front, we discuss current capabilities of personalized neuromusculoskeletal models along with technical gaps that limit future clinical application. We conclude by summarizing recommendations for future research efforts that would allow personalized neuromusculoskeletal models to make the greatest impact possible on treatment design for mobility impairments.

  1. Influence of single peer interventions on the recovery attitude of persons with a psychiatric disability.

    Science.gov (United States)

    Rabenschlag, Franziska; Schusterschitz, Claudia; Conca, Antoinette; Knuf, Andreas; Needham, Ian; Hoffmann, Holger

    2012-12-01

    This study examined the influence of single peer to peer interventions on participants' recovery attitudes. Following a 40-hour training, pairs of individuals with a psychiatric disability offered a session (2.5 hour) in outpatient and residential psychiatric institutions. These peer to peer interventions aimed at inspiring and contributing to participants' recovery process, by introducing them to constituent parts of the concept Recovery. Thirteen of the peer interventions were evaluated by measuring participants' recovery attitudes before (N = 145), just after (N = 115) and at 6 months postintervention (N = 53) using the Recovery Attitudes Questionnaire (RAQ7) and the Recovery Process Inventory (RPI). Wilcoxon tests demonstrated that individuals participating in a peer intervention felt significantly more certain that Recovery is possible (factor 'Recovery is possible') just after the intervention (p = 0.004), but not 6 months later; likewise, the perception of the difficulty of recovery in spite of a mental illness (factor 'Recovery is difficult and differs') was significantly lower 6 months later (p = 0.016), but not from pre to just after. The statistically significant effect of a single recovery-oriented peer intervention on participants' attitude that recovery is possible was not sustainable. These results suggest a possible higher sustainability of repeated or longer-lasting peer interventions. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  2. Reading interest and information needs of persons with visual impairment in Nigeria

    Directory of Open Access Journals (Sweden)

    ’Niran Adetoro

    2010-01-01

    Full Text Available Information materials can only become usable to persons with visual impairment when they are transcribed into alternative formats. Over time, the transcription and provision of alternative formats in Nigeria by libraries has not been based on users’ reading interest and information needs. This study delves into the reading interests and information needs of persons with visual impairment in Nigeria. Survey research design was adopted and the study purposively focused on southwestern Nigeria. Using stratified proportionate random sampling techniques, data was gathered by questionnaires namely the Visually Impaired Adult Questionnaire VIAQ (= 0.75 and Visually Impaired Student Questionnaire VISQ (= 0.78 from fourteen selected libraries stratified into non-governmental, public, tertiary institutions and secondary schools. Of the 563 copies of the questionnaire that were administered, 401 (71.3% were successfully completed and used for the study. The study found that adults with visual impairment had high reading interests in religious, business, and entertainment materials, among others. Secondary school respondents had high reading interest in art subjects, reference materials, manuals and animal story materials. Both respondents showed high information needs in expected and relevant areas. Braille materials (58.3% are the most preferred source of information generally. Adult respondents preferred Braille (72.4%, while the secondary school respondents preferred Talking books/audio recordings (55%. Transcription and provision of information materials for the visually impaired through libraries should be based on knowledge of their reading interest and information needs.

  3. Ethical Issues Relative to Autonomy and Personal Control in Independent and Cognitively Impaired Elders.

    Science.gov (United States)

    Rice, Virginia Hill; And Others

    1997-01-01

    Discusses ethical issues surrounding health care for independent elders, those in long-term care, and those with cognitive impairments, as well as death, dying, euthanasia, and assisted suicide. Suggests that nurses should focus on older adults' choice, autonomy, and personal control. (SK)

  4. Eye disorder differentiates seasonality outcomes in persons with severe visual impairment

    DEFF Research Database (Denmark)

    Madsen, Heller; Dam, Henrik; Hageman, Ida

    2017-01-01

    Background Light plays a crucial role in both the pathogenesis and treatment of seasonal affective disorder (SAD). Consequently decreased retinal sensitivity to light has been suggested to be a risk factor for SAD. In a population of persons with severe visual impairment we recently found a highly...

  5. Impaired Mood in Headache Clinic Patients : Associations With the Perceived Hindrance and Attainability of Personal Goals

    NARCIS (Netherlands)

    Ciere, Yvette; Visser, Annemieke; Lebbink, John; Sanderman, Robbert; Fleer, Joke

    BackgroundHeadache disorders are often accompanied by impaired mood, especially in the headache clinic population. There is a large body of literature demonstrating that an illness or disability may affect the way in which patients perceive their personal goals and that the perception that the

  6. Impaired Mood in Headache Clinic Patients: Associations With the Perceived Hindrance and Attainability of Personal Goals

    NARCIS (Netherlands)

    Ciere, Yvette; Visser, Annemieke; Lebbink, John; Sanderman, Robbert; Fleer, Joke

    2016-01-01

    Background Headache disorders are often accompanied by impaired mood, especially in the headache clinic population. There is a large body of literature demonstrating that an illness or disability may affect the way in which patients perceive their personal goals and that the perception that the

  7. A Note on Some Problems in the Testing of Personality Characteristics in Children with Visual Impairment

    Science.gov (United States)

    Tobin, Michael; Hill, Eileen

    2010-01-01

    An examination is made of the value of using published personality tests with young blind and partially sighted children. Based on data gathered during a longitudinal investigation into the educational and psychological development of a group of 120 visually impaired learners, the authors conclude that their own selection of a test instrument…

  8. Vibrotactile Feedbacks System for Assisting the Physically Impaired Persons for Easy Navigation

    Science.gov (United States)

    Safa, M.; Geetha, G.; Elakkiya, U.; Saranya, D.

    2018-04-01

    NAYAN architecture is for a visually impaired person to help for navigation. As well known, all visually impaired people desperately requires special requirements even to access services like the public transportation. This prototype system is a portable device; it is so easy to carry in any conduction to travel through a familiar and unfamiliar environment. The system consists of GPS receiver and it can get NEMA data through the satellite and it is provided to user's Smartphone through Arduino board. This application uses two vibrotactile feedbacks that will be placed in the left and right shoulder for vibration feedback, which gives information about the current location. The ultrasonic sensor is used for obstacle detection which is found in front of the visually impaired person. The Bluetooth modules connected with Arduino board is to send information to the user's mobile phone which it receives from GPS.

  9. Depressive Symptoms and Their Interactions With Emotions and Personality Traits Over Time: Interaction Networks in a Psychiatric Clinic.

    Science.gov (United States)

    Semino, Laura N; Marksteiner, Josef; Brauchle, Gernot; Danay, Erik

    2017-04-13

    Associations between depression, personality traits, and emotions are complex and reciprocal. The aim of this study is to explore these interactions in dynamical networks and in a linear way over time depending on the severity of depression. Participants included 110 patients with depressive symptoms (DSM-5 criteria) who were recruited between October 2015 and February 2016 during their inpatient stay in a general psychiatric hospital in Hall in Tyrol, Austria. The patients filled out the Beck Depression Inventory-II, a German emotional competence questionnaire (Emotionale Kompetenz Fragebogen), Positive and Negative Affect Schedule, and the German versions of the Big Five Inventory-short form and State-Trait-Anxiety-Depression Inventory regarding symptoms, emotions, and personality during their inpatient stay and at a 3-month follow-up by mail. Network and regression analyses were performed to explore interactions both in a linear and a dynamical way at baseline and 3 months later. Regression analyses showed that emotions and personality traits gain importance for the prediction of depressive symptoms with decreasing symptomatology at follow-up (personality: baseline, adjusted R2 = 0.24, P personality traits is significantly denser and more interconnected (network comparison test: P = .03) at follow-up than at baseline, meaning that with decreased symptoms interconnections get stronger. During depression, personality traits and emotions are walled off and not strongly interconnected with depressive symptoms in networks. With decreasing depressive symptomatology, interfusing of these areas begins and interconnections become stronger. This finding has practical implications for interventions in an acute depressive state and with decreased symptoms. The network approach offers a new perspective on interactions and is a way to make the complexity of these interactions more tangible. © Copyright 2017 Physicians Postgraduate Press, Inc.

  10. Elucidating the association between the self-harm inventory and several borderline personality measures in an inpatient psychiatric sample.

    Science.gov (United States)

    Sellbom, Martin; Sansone, Randy A; Songer, Douglas A

    2017-09-01

    The current study evaluated the utility of the self-harm inventory (SHI) as a proxy for and screening measure of borderline personality disorder (BPD) using several diagnostic and statistical manual of mental disorders (DSM)-based BPD measures as criteria. We used a sample of 145 psychiatric inpatients, who completed the SHI and a series of well-validated, DSM-based self-report measures of BPD. Using a series of latent trait and latent class analyses, we found that the SHI was substantially associated with a latent construct representing BPD, as well as differentiated latent classes of 'high' vs. 'low' BPD, with good accuracy. The SHI can serve as proxy for and a good screening measure for BPD, but future research needs to replicate these findings using structured interview-based measurement of BPD.

  11. Brief Report: Using the Internet to Identify Persons with Cognitive Impairment for Participation in Clinical Trials

    Directory of Open Access Journals (Sweden)

    Lindsay F. Morra

    2017-04-01

    Full Text Available Identifying, recruiting, and enrolling persons in clinical trials of dementia treatments is extremely difficult. One approach to first-wave screening of potential participants is the use of online assessment tools. Initial studies using the Dementia Risk Assessment (DRA—which includes a previously validated recognition memory test—support the use of this self-administered assessment to identify individuals with “suspected MCI” or “suspected dementia.” In this study, we identified between 71 and 622 persons with suspected dementia and between 128 and 1653 persons with suspected mild cognitive impairment (depending on specific criteria over the course of 22 months. Assessment tools that can inexpensively and easily identify individuals with higher than average risk for cognitive impairment can facilitate recruitment for large-scale clinical trials for dementia treatments.

  12. Relationships of personality and psychiatric disorders to multiple domains of smoking motives and dependence in middle-aged adults.

    Science.gov (United States)

    Kahler, Christopher W; Leventhal, Adam M; Daughters, Stacey B; Clark, Melissa A; Colby, Suzanne M; Ramsey, Susan E; Boergers, Julie; Abrams, David B; Niaura, Raymond; Buka, Stephen L

    2010-04-01

    Individual differences in psychopathology and personality may associate with dependence on smoking for specific motivational reasons. However, the associations among psychopathology, personality, and smoking dependence and motives have not been examined simultaneously in studies to date, leaving it unclear whether specific patterns of affective and behavioral functioning are associated with specific aspects of smoking dependence. The present study examined these associations in 296 current smokers aged 35-43 years. Smoking dependence and motives were assessed with structured interview, the Fagerström Test for Nicotine Dependence, and the Wisconsin Inventory of Smoking Dependence Motives. Regardless of the measure of smoking dependence tested, a lifetime history of major depression and high levels of trait stress reaction were consistently related to greater current smoking dependence severity. Substance dependence showed significant associations with some measures of smoking dependence but had relatively few effects when entered in models along with depression history and trait stress reaction. In multivariate models, alcohol dependence and conduct disorder history did not show unique significant associations with smoking dependence nor did trait aggression, alienation, control, or harm avoidance. Results indicate little specificity in the associations of particular psychiatric diagnoses or personality traits with specific self-reported facets of smoking dependence. It appears that a general vulnerability to depression and negative emotions is the most robust indicator of vulnerability to high levels of self-reported smoking dependence, regardless of which dimensions of smoking dependence are analyzed.

  13. Exploring the hierarchical structure of the MMPI-2-RF Personality Psychopathology Five in psychiatric patient and university student samples.

    Science.gov (United States)

    Bagby, R Michael; Sellbom, Martin; Ayearst, Lindsay E; Chmielewski, Michael S; Anderson, Jaime L; Quilty, Lena C

    2014-01-01

    In this study our goal was to examine the hierarchical structure of personality pathology as conceptualized by Harkness and McNulty's (1994) Personality Psychopathology Five (PSY-5) model, as recently operationalized by the MMPI-2-RF (Ben-Porath & Tellegen, 2011) PSY-5r scales. We used Goldberg's (2006) "bass-ackwards" method to obtain factor structure using PSY-5r item data, successively extracting from 1 to 5 factors in a sample of psychiatric patients (n = 1,000) and a sample of university undergraduate students (n = 1,331). Participants from these samples had completed either the MMPI-2 or the MMPI-2-RF. The results were mostly consistent across the 2 samples, with some differences at the 3-factor level. In the patient sample a factor structure representing 3 broad psychopathology domains (internalizing, externalizing, and psychoticism) emerged; in the student sample the 3-factor level represented what is more commonly observed in "normal-range" personality models (negative emotionality, introversion, and disconstraint). At the 5-factor level the basic structure was similar across the 2 samples and represented well the PSY-5r domains.

  14. Association of impairments of older persons with caregiver burden among family caregivers: Findings from rural South India.

    Science.gov (United States)

    Ajay, Shweta; Kasthuri, Arvind; Kiran, Pretesh; Malhotra, Rahul

    In India, owing to cultural norms and a lack of formal long-term care facilities, responsibility for care of the older person falls primarily on the family. Based on the stress process model, we assessed the association of type and number of impairments of older persons (∼primary stressors) with caregiver burden among their family caregivers in rural South India. All impaired older persons (aged ≥60, with impairment in activities of daily living (ADL) or cognition or vision or hearing) residing in 8 villages in Bangalore district, Karnataka, India, and their primary informal caregivers were interviewed. Caregiver burden was measured using the Zarit Burden Interview (ZBI; higher score indicating greater perceived burden). Linear regression models, adjusting for background characteristics of older persons and caregivers, assessed the association of type of impairment (physical [Yes/No], cognitive [Yes/No], vision [Yes/No] and hearing [Yes/No]) and number (1 or 2 or 3 or 4) of older person impairments with caregiver burden. A total of 140 caregivers, caring for 149 older persons, were interviewed. The mean (standard deviation) ZBI score was 21.2 (12.9). Of the various older person impairments, ZBI score was associated only with physical impairment (β=6.6; 95% CI: 2.1-11.1). Relative to caregivers of older person with one impairment, those caring for an older person with all 4 impairments had significantly higher ZBI score (β=13.9; CI: 2.5-25.4). Caregivers of older persons with multiple impairments, especially physical impairment, are vulnerable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Psychiatric Disorders and Personality Profiles of Middle-Aged Suicide Attempters with no Evidence of Specific Psychopathological Profiles Referring to an Emergency Department

    Directory of Open Access Journals (Sweden)

    Serge Brand

    2017-10-01

    Full Text Available Objective: The aim of the present study was to assess socio-demographic and psychiatric characteristics of 40-65 years old suicide attempters referred to an emergency department within four hours of making their attempt.Method: We assessed a total of 93 suicide attempters (Mage=46.59 years referred to an emergency department. Patients completed questionnaires covering socio-demographic data, personality traits, mood, and impulsivity; experts rated patients’ psychiatric status.Results: Experts rated 85 (92.4% of the suicide attempters as having a psychiatric disorder. Based on self-ratings and compared to normative data, 42 (46.6% were psychopathologically ill. Suicide attempts were not related to impulsive personality traits, mood disorders, socio-demographic patterns or gender (gender-ratio: 1:1.58;f:m.Conclusions: The pattern of results suggests that further unknown factors were involved in pushing people to attempt suicide.

  16. Psychiatric Disorders and Personality Profiles of Middle-Aged Suicide Attempters with No Evidence of Specific Psychopathological Profiles Referred to an Emergency Department

    Science.gov (United States)

    Brand, Serge; Nejat, Mehri; Haghighi, Mohammad; Rahimi, Alireza; Jahangard, Leila; Sadeghi Bahmani, Dena; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Ahmadpanah, Mohammad

    2017-01-01

    Objective: The present study aimed at assessing the sociodemographic and psychiatric characteristics of 40 to 65 year- old suicide attempters, who were referred to an emergency department within 4 hours of the attempt. Method: A total of 93 suicide attempters (Mean age=46.59 years) who were referred to an emergency department, were assessed in this study. Patients completed questionnaires covering sociodemographic data, personality traits, mood, and impulsivity. Psychiatric status of the patients was rated by experts. Results: Experts rated 85 (92.4%) of the suicide attempters as having a psychiatric disorder. Based on self-ratings and compared to normative data, 42 (46.6%) patients were psychopathologically ill. It was found that suicide attempts were not related to impulsive personality traits, mood disorders, sociodemographic patterns, or gender (gender-ratio: 1:1.58; f: m). Conclusion: The pattern of results suggests that further unknown factors were involved in pushing people to attempt suicide. PMID:29472951

  17. Psychiatric Disorders and Personality Profiles of Middle-Aged Suicide Attempters with No Evidence of Specific Psychopathological Profiles Referred to an Emergency Department.

    Science.gov (United States)

    Brand, Serge; Nejat, Mehri; Haghighi, Mohammad; Rahimi, Alireza; Jahangard, Leila; Sadeghi Bahmani, Dena; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Ahmadpanah, Mohammad

    2017-10-01

    Objective: The present study aimed at assessing the sociodemographic and psychiatric characteristics of 40 to 65 year- old suicide attempters, who were referred to an emergency department within 4 hours of the attempt. Method: A total of 93 suicide attempters (Mean age=46.59 years) who were referred to an emergency department, were assessed in this study. Patients completed questionnaires covering sociodemographic data, personality traits, mood, and impulsivity. Psychiatric status of the patients was rated by experts. Results: Experts rated 85 (92.4%) of the suicide attempters as having a psychiatric disorder. Based on self-ratings and compared to normative data, 42 (46.6%) patients were psychopathologically ill. It was found that suicide attempts were not related to impulsive personality traits, mood disorders, sociodemographic patterns, or gender (gender-ratio: 1:1.58; f: m). Conclusion: The pattern of results suggests that further unknown factors were involved in pushing people to attempt suicide.

  18. The effectiveness of anticonvulsants in psychiatric disorders

    Science.gov (United States)

    Grunze, Heinz C. R.

    2008-01-01

    Anticonvulsant drugs are widely used in psychiatric indications. These include mainly alcohol and benzodiazepine withdrawal syndromes, panic and anxiety disorders, dementia, schizophrenia, affective disorders, bipolar affective disorders in particular, and, to some extent, personality disorders, A further area in which neurology and psychiatry overlap is pain conditions, in which some anticonvulsants, and also typical psychiatric medications such as antidepressants, are helpful. From the beginning of their psychiatric use, anticonvulsants have also been used to ameliorate specific symptoms of psychiatric disorders independently of their causality and underlying illness, eg, aggression, and, more recently, cognitive impairment, as seen in affective disorders and schizophrenia. With new anticonvulsants currently under development, it is likely that their use in psychiatry will further increase, and that psychiatrists need to learn about their differential efficacy and safety profiles to the same extent as do neurologists. PMID:18472486

  19. Oregon's Gun Relief Program for Adjudicated Mentally Ill Persons: The Psychiatric Security Review Board.

    Science.gov (United States)

    Britton, Juliet; Bloom, Joseph D

    2015-06-01

    This article describes the State of Oregon's implementation of two programs designed to comply with federal gun laws regarding reporting individuals who have received mental health adjudications in criminal and civil courts. One mandate requires that states submit names of adjudicated individuals to the National Instant Criminal Background Check System (NICS) while the second requires that the state establish a qualifying gun restoration program for those disqualified from gun ownership. In 2009, Oregon's Legislature developed an administrative approach to gun restoration and assigned the responsibility for conducting these hearing to the Oregon Psychiatric Security Review Board (PSRB). The PSRB is a state administrative board that has existed since 1977 and has been primarily focused on the supervision and treatment of adult and juvenile insanity acquittees. The gun restoration program began in 2010, but to date has only received three completed petitions requesting restoration of firearm rights. The article concludes with a discussion that surmises why very few of the Oregonians who are listed in NICS have submitted petitions for relief. Copyright © 2015 John Wiley & Sons, Ltd.

  20. 流浪精神病人共病人格障碍调查%Personality Disorder of Homelessness Psychiatric Disorder

    Institute of Scientific and Technical Information of China (English)

    蔡燕玉; 钟远惠; 付美华; 张玉珊

    2016-01-01

    Objective:To survey on the comorbidity of personality disorder(PD)with psychiatric disorder on home‐lessness .Methods:A total of 864 patients with homelessness psychiatric disorder were consecutively examined in the Third People's Hospital of Meizhou City and Mental hospital of Guangzhou Civil Administration .All subjects inclu‐ding troublemaking group(n=380)and non-troublemaking group(n=484)were investigated with self -made ques‐tionnaire ,SCID- Ⅱ .Results:The comorbidity rate of personality disorder with homelessness psychiatric disorder was 69 3.% .Compared with the non -troublemaking group ,the troublemaking group had significant difference in the avoidant(χ2 =154 7. ,P<0 0.1) ,depressive(χ2 =28 5.9 ,P<0 0.1) ,passive-aggressive(χ2 =65 4.0 ,P<0 0.1) ,obsess‐ive-compulsive(χ2 =75 3.1 ,P<0 .01) ,paranoid(χ2 =79 .24 ,P<0 0.1) ,schizoid(χ2 =8 .43 ,P<0 0.1) ,schizotypal (χ2 =11 1.1 ,P<0 0.1) ,borderline(χ2 =27 9.7 ,P<0 0.1) ,antisocial personality disorder(χ2 =16 9.9 ,P<0 0.5) .There were significant differences in the avoidant(χ2 =30 8.5 ,P<0 0.1) ,dependent personality disorder(χ2 =9 .279 ,P<0 0.1)in the schizophrenia and non -schizophrenia group .Conclusion:The personality disorder rate of homelessness psychiatric disorder is very high ,and we should consider the influence of personality disorder in the treatment of homeless psychiatric disorder .%目的:探讨流浪精神病人人格障碍的共病情况。方法:将来自梅州市第三人民医院和广州市民政局精神病院流浪精神病人864例连续入组,分为肇事肇祸组( n=380例)和非肇事肇祸组( n=484例),采用自制调查表、人格障碍访谈问卷第2版(SCID-II)对其进行横断面评估。结果:流浪精神病人精神疾病与人格障碍共病率为693.%,在回避型(χ2=1547.,P<00.1)、强迫型(χ2=753.1,P<00.1)、被动攻击型(χ2=654.0,P<00.1)、抑郁型(χ2=285.9

  1. Are there gender differences in wellbeing related to work status among persons with severe impairments?

    Science.gov (United States)

    Reine, Ieva; Palmer, Edward; Sonnander, Karin

    2016-12-01

    The aim of this study was to analyse gender differences in wellbeing, as related to work status, among working-age people with severe impairments. This study is based on register and survey data for a sample of 7298 persons, drawn from the entire Swedish population of 15,515 working-age people 16-64 years old who, at the end of 2010, received Sweden's unique personal assistance allowance, an allowance paid from the Swedish Social Insurance Agency (SSIA) to persons with severe impairments, enabling them to pay for assistants to support them in the functions of daily life. Logistic regression models were used to estimate the strength of relations between six measures of wellbeing, work status (not working, irregular work and regular work) and gender, together with key confounders. Of the persons surveyed, 21% responded that they had regular work. Gender differences were found for all confounders, except for age. They were mostly in favour of men, which could reflect the general pattern in the labour market at large. Our results indicated there are substantial differences between non-working, irregularly working and working persons for several wellbeing aspects. This study analyses the contributions to wellbeing of work participation among working-age people with severe impairments, with a focus on gender differences. The analysis shows that work is an important determinant of the six measures of wellbeing examined, where the relationship between work participation and wellbeing is especially strong for peoples' perceived standard of living. This major finding holds for both genders; however, the data show gender imbalance, in that compared with women, there was a larger percentage of men with severe impairments who have regular work. Future research should focus on finer distinctions between the types of work and the value added of personal assistants in the work context. Measures of general health not available for this study are needed to filter out a clearer

  2. The prevalence and structure of obsessive-compulsive personality disorder in Hispanic psychiatric outpatients

    OpenAIRE

    Ansell, Emily B.; Pinto, Anthony; Crosby, Ross D.; Becker, Daniel F.; Añez, Luis M.; Paris, Manuel; Grilo, Carlos M.

    2010-01-01

    This study sought to confirm a multi-factor model of Obsessive-compulsive personality disorder (OCPD) in a Hispanic outpatient sample and to explore associations of the OCPD factors with aggression, depression, and suicidal thoughts. One hundred and thirty monolingual, Spanish-speaking participants were recruited from a community mental health center and were assessed by bilingual doctoral level clinicians. OCPD was highly prevalent (26%) in this sample. Multi-factor models of OCPD were teste...

  3. Thyroid hormones, interpersonal violence and personality traits : clinical studies in high-risk psychiatric cohorts

    OpenAIRE

    Sinai, Cave

    2015-01-01

    Suicidal and violent behaviors as well as early life adversity are prevalent in clinical high-risk populations. Early life adversity is related to developmental dysregulation of behavioral and emotional traits. The neuroendocrine systems involved in the development of dysfunctional behavior and impulsive aggressive traits are not fully known. The overall aim of this thesis was to investigate the relationship between thyroid hormones and personality traits, as well as to exposur...

  4. Prevalence of Physical Impairment Among the Elderlly Persons of the Tehran City in 1385

    Directory of Open Access Journals (Sweden)

    Afsoon Nodehi Moghadam

    2007-01-01

    Full Text Available Objectives: Musculoskeletal pain is common in elderly people with prevalence range from 10% to 71%. Musculoskeletal pain is found to be a strong risk factor for disability in elderly woman. The purpose of this study is to examine the prevalence of physical impairment of elderly people. Methods & Materials: A physiotherapist has evaluated elderly persons files in four physiotherapy centers during 1384-85. Results: Knee osteoarthritis and low back pain respectively were the most common causes of physical impairment in elderly women. Prevalence of knee osteoarthritis is increasing. This increase is likely due to several factors: advancing age of population, increasing injuries and rapidly advancing rates of obesity. Age–related change of intervertebral disks, decreased back muscle strength and decreased bone mineral density may lead to low back pain. Conclusion: Knee osteoarthritis and low back pain are the most commom causes of physical impairment.

  5. Training in Good Psychiatric Management for Borderline Personality Disorder in Residency: An Aide to Learning Supportive Psychotherapy for Challenging-to-Treat Patients.

    Science.gov (United States)

    Bernanke, Joel; McCommon, Benjamin

    2018-01-01

    Given many competing demands, psychotherapy training to competency is difficult during psychiatric residency. Good Psychiatric Management for borderline personality disorder (GPM) offers an evidence-based, simplified, psychodynamically informed framework for the outpatient management of patients with borderline personality disorder, one of the most challenging disorders psychiatric residents must learn to treat. In this article, we provide an overview of GPM, and show that training in GPM meets a requirement for training in supportive psychotherapy; builds on psychodynamic psychotherapy training; and applies to other severe personality disorders, especially narcissistic personality disorder. We describe the interpersonal hypersensitivity model used in GPM as a straightforward way for clinicians to collaborate with patients in organizing approaches to psychoeducation, treatment goals, case management, use of multiple treatment modalities, and safety. A modification of the interpersonal hypersensitivity model that includes intra-personal hypersensitivity can be used to address narcissistic problems often present in borderline personality disorder. We argue that these features make GPM ideally suited for psychiatry residents in treating their most challenging patients, provide clinical examples to illustrate these points, and report the key lessons learned by a psychiatry resident after a year of GPM supervision.

  6. Structure and correlating variables of attitudes of students, future helping professionals, towards persons with hearing impairments

    Directory of Open Access Journals (Sweden)

    Glintić Milica

    2014-01-01

    Full Text Available The aim of this study was to explore the structure and the correlates of students attitudes towards persons with hearing impairments. The sample consisted of 103 first year students of The Faculty of Special Education and Rehabilitation (F-93; M-10, divisions Prevention and treatment of conduct disorders and Speech therapy. These attitudes were assessed by The revised version of Multidimensional Attitudes Scale Toward Persons With Disabilities, Empathy by Empathy Quotient, dimensions of personality by The Big Five Inventory, the attachment by Experiences in Close Relationships Scale, the motivation for studying the Faculty of Special Education and Rehabilitation by the scale assembled for this research. It was found that in the domain of basic dimensions of personality only tendency to collaborate with others negatively correlates with absence of pro-social thoughts (-0.204, scale of anxiety in close relationships, in attachment domain, positively correlates with inhibiting thoughts and feelings (0.220, while the empathy quotient negatively correlates with the absence of pro-social thoughts (-0.226. The motivation for studying Faculty of Special Education and Rehabilitation was not associated with components of the attitude towards people with hearing impairment. Future researches should try to identify predictors of negative emotional and behavioral which lead to ignoring and rejecting of persons with disability.

  7. The use of the Psychiatric Electroencephalography Evaluation Registry (PEER to personalize pharmacotherapy

    Directory of Open Access Journals (Sweden)

    Iosifescu DV

    2016-08-01

    Full Text Available Dan V Iosifescu,1 Robert J Neborsky,2–4 Robert J Valuck5–7 1Adult Psychopharmacology Program, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 2School of Medicine, University of California, San Diego, CA, USA; 3University of California, Los Angeles, CA, USA; 4Medical Corps, US Navy, USA; 5Pharmacy, Epidemiology, and Family Medicine, University of Colorado, Denver, CO, USA; 6Center for Pharmaceutical Outcomes Research, University of Colorado, Denver, CO, USA; 7Colorado Consortium for Prescription Drug Abuse Prevention, Denver, CO, USA Purpose: This study aims to determine whether Psychiatric Electroencephalography Evaluation Registry (PEER Interactive (an objective, adjunctive tool based on a comparison of a quantitative electroencephalogram to an existing registry of patient outcomes is more effective than the current standard of care in treatment of subjects suffering from depression. Patients and methods: This is an interim report of an ongoing, 2-year prospective, randomized, double blind, controlled study to evaluate PEER Interactive in guiding medication selection in subjects with a primary diagnosis of depression vs standard treatment. Subjects in treatment at two military hospitals were blinded as to study group assignment and their self-report symptom ratings were also blinded. Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16 depression scores were the primary efficacy endpoint. One hundred and fifty subjects received a quantitative electroencephalography exam and were randomized to either treatment as usual or PEER-informed pharmacotherapy. Subjects in the control group were treated according to Veterans Administration/Department of Defense Guidelines, the current standard of care. In the experimental group, the attending physician received a PEER report ranking the subject’s likely clinical response to on-label medications. Results: In this post hoc interim analysis

  8. Augmented Reality: Sustaining Autonomous Way-Finding in the Community for Older Persons with Cognitive Impairment.

    Science.gov (United States)

    Sejunaite, K; Lanza, C; Ganders, S; Iljaitsch, A; Riepe, M W

    2017-01-01

    Impairment of autonomous way-finding subsequent to a multitude of neurodegenerative and other diseases impedes independence of older persons and their everyday activities. It was the goal to use augmented reality to aid autonomous way-finding in a community setting. A spatial map and directional information were shown via head-up display to guide patients from the start zone on the hospital campus to a bakery in the nearby community. Hospital campus and nearby community. Patients with mild cognitive impairment (age 63 to 89). A head-up display was used to help patients find their way. Time needed to reach goal and number of assists needed. With use of augmented reality device, patients preceded along the correct path in 113 out of 120 intersections. Intermittent reassurance was needed for most patients. Patients affirmed willingness to use such an augmented reality device in everyday life if needed or even pay for it. Augmented reality guided navigation is a promising means to sustain autonomous way-finding as a prerequisite for autonomy of older persons in everyday activities. Thus, this study lays ground for a field trial in the community using assistive technology for older persons with cognitive impairment.

  9. Facial emotion perception impairments in schizophrenia patients with comorbid antisocial personality disorder.

    Science.gov (United States)

    Tang, Dorothy Y Y; Liu, Amy C Y; Lui, Simon S Y; Lam, Bess Y H; Siu, Bonnie W M; Lee, Tatia M C; Cheung, Eric F C

    2016-02-28

    Impairment in facial emotion perception is believed to be associated with aggression. Schizophrenia patients with antisocial features are more impaired in facial emotion perception than their counterparts without these features. However, previous studies did not define the comorbidity of antisocial personality disorder (ASPD) using stringent criteria. We recruited 30 participants with dual diagnoses of ASPD and schizophrenia, 30 participants with schizophrenia and 30 controls. We employed the Facial Emotional Recognition paradigm to measure facial emotion perception, and administered a battery of neurocognitive tests. The Life History of Aggression scale was used. ANOVAs and ANCOVAs were conducted to examine group differences in facial emotion perception, and control for the effect of other neurocognitive dysfunctions on facial emotion perception. Correlational analyses were conducted to examine the association between facial emotion perception and aggression. Patients with dual diagnoses performed worst in facial emotion perception among the three groups. The group differences in facial emotion perception remained significant, even after other neurocognitive impairments were controlled for. Severity of aggression was correlated with impairment in perceiving negative-valenced facial emotions in patients with dual diagnoses. Our findings support the presence of facial emotion perception impairment and its association with aggression in schizophrenia patients with comorbid ASPD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Assessment of Sexual Fantasies in Psychiatric Inpatients With Mood and Psychotic Disorders and Comorbid Personality Disorder Traits.

    Science.gov (United States)

    Colón Vilar, Giancarlo; Concepción, Erika; Galynker, Igor; Tanis, Thachell; Ardalan, Firouz; Yaseen, Zimri; Cohen, Lisa J

    2016-02-01

    Sexuality is an important aspect of quality of life and sexual fantasies comprise a normal part of human sexuality. However, the nature of sexuality and sexual fantasies of patients with mental illness remains an understudied area. To investigate the nature and frequency of sexual fantasies in psychiatric patients, the present study compared the frequency of four types of sexual fantasies across four different mood and psychotic diagnoses and three personality disorder clusters. Study participants included 133 psychiatric inpatients recruited from an urban hospital. Sexual fantasies were compared across patients with schizophrenia, bipolar disorder, schizoaffective disorder, major depressive disorder and three nonclinical samples from the literature and then correlated with personality cluster scores. Subjects were administered the Structured Clinical Interview for DSM-IV for Axis I and for Axis II Disorders. Sexual fantasies were assessed by the Wilson Sexual Fantasies Questionnaire, which measures four types of sexual fantasies (exploratory, intimate, impersonal, and sadomasochistic). Within the entire sample, there were significant differences across sexual fantasy types, with subjects scoring highest on intimate sexual fantasies and then exploratory, impersonal, and sadomasochistic. There were no significant differences across mood and psychotic diagnostic groups for any of the sexual fantasy scales and the scores were within the normative range of nonclinical samples. Patients with high cluster B scores scored significantly higher on all four fantasy scales than those without. Patients with high cluster A scores scored lower on intimate fantasies, but there was no association between cluster C scores and sexual fantasies. The association between cluster B and sexual fantasies remained consistent across Structured Clinical Interview for DSM-IV for Axis I diagnoses (no interaction effect). Patients with severe mental illness report sexual fantasies that are

  11. The prevalence and structure of obsessive-compulsive personality disorder in Hispanic psychiatric outpatients.

    Science.gov (United States)

    Ansell, Emily B; Pinto, Anthony; Crosby, Ross D; Becker, Daniel F; Añez, Luis M; Paris, Manuel; Grilo, Carlos M

    2010-09-01

    This study sought to confirm a multi-factor model of Obsessive-compulsive personality disorder (OCPD) in a Hispanic outpatient sample and to explore associations of the OCPD factors with aggression, depression, and suicidal thoughts. One hundred and thirty monolingual, Spanish-speaking participants were recruited from a community mental health center and were assessed by bilingual doctoral-level clinicians. OCPD was highly prevalent (26%) in this sample. Multi-factor models of OCPD were tested and the two factors - perfectionism and interpersonal rigidity - provided the best model fit. Interpersonal rigidity was associated with aggression and anger while perfectionism was associated with depression and suicidal thoughts. (c) 2010 Elsevier Ltd. All rights reserved.

  12. Correlation among personal, social performance and cognitive impairment in male schizophrenic patient

    Science.gov (United States)

    Damanik, R.; Effendy, E.; Camellia, V.

    2018-03-01

    Schizophrenia is a dramatic mental illness with tragic manifestation. The consequences of the illness are for the individual, affected his or her family and society. Schizophrenia is one of the twenty illness that causes Years Lost due to Disability. Treating only the symptom is insufficient. The aim of treatment must include the quality of life of aschizophrenic person. This study aims to examine the relationship between cognitive impairment and performance of the person with schizophrenia. Cognitive test is scaled with Indonesian version of Montreal Cognitive Assessment (MoCA-Ina), while personal and social performance isscaled with Personal and Social Performance scale. There are many studies that search the relationship between cognitive impairment and social functioning of schizophrenic patients, but this is the first study that uses PSP and MoCA-Ina. Both PSP and MoCA-Ina are easy to use but still have high sensitivity and specificity, and perhaps can build people’s interest to use it in clinical practice. Twenty-five male schizophrenic patients were assessed in Prof. M. Ildrem Mental Hospital of North Sumatera Province of Indonesia. Positive correlations between MoCA-Ina and PSP score were identified. Clinicians should pay attention to cognitive and might give some early intervention to it.

  13. Changes in psychiatric symptoms among persons with methamphetamine dependence predicts changes in severity of drug problems but not frequency of use.

    Science.gov (United States)

    Polcin, Douglas L; Korcha, Rachael; Bond, Jason; Galloway, Gantt; Nayak, Madhabika

    2016-01-01

    Few studies have examined how changes in psychiatric symptoms over time are associated with changes in drug use and severity of drug problems. No studies have examined these relationships among methamphetamine (MA)-dependent persons receiving motivational interviewing within the context of standard outpatient treatment. Two hundred seventeen individuals with MA dependence were randomly assigned to a standard single session of motivational interviewing (MI) or an intensive 9-session model of MI. Both groups received standard outpatient group treatment. The Addiction Severity Index (ASI) and timeline follow-back (TLFB) for MA use were administered at treatment entry and 2-, 4-, and 6-month follow-ups. Changes in ASI psychiatric severity between baseline and 2 months predicted changes in ASI drug severity during the same time period, but not changes on measures of MA use. Item analysis of the ASI drug scale showed that psychiatric severity predicted how troubled or bothered participants were by their drug us, how important they felt it was for them to get treatment, and the number of days they experienced drug problems. However, it did not predict the number days they used drugs in the past 30 days. These associations did not differ between study conditions, and they persisted when psychiatric severity and outcomes were compared across 4- and 6-month time periods. Results are among the first to track how changes in psychiatric severity over time are associated with changes in MA use and severity of drug problems. Treatment efforts targeting reduction of psychiatric symptoms among MA-dependent persons might be helpful in reducing the level of distress and problems associated with MA use but not how often it is used. There is a need for additional research describing the circumstances under which the experiences and perceptions of drug-related problems diverge from frequency of consumption.

  14. On the potential for iatrogenic effects of psychiatric crisis services: The example of dialectical behavior therapy for adult women with borderline personality disorder.

    Science.gov (United States)

    Coyle, Trevor N; Shaver, Jennifer A; Linehan, Marsha M

    2018-02-01

    Although previous research has suggested that people with a history of using psychiatric crisis services are at higher risk for suicide, it is unclear whether this link is attributable to individual risk factors or iatrogenic effects of service utilization. We examined this question by analyzing data from a randomized controlled trial of dialectical behavior therapy (DBT), a treatment for highly suicidal individuals in which patients took advantage of crisis services less than those in the comparison condition. We hypothesized that crisis-service utilization during a treatment year, rather than pretreatment indicators of suicide risk, would be associated with higher suicide risk after treatment, and that DBT's treatment effects would be partially attributable to this association. Participants were 101 women (Mage = 29.3, 87% Caucasian) with recent suicidal and self-injurious behaviors meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association [APA], 1994) criteria for borderline personality disorder. We examined relationships between suicidal ideation (using the Suicide Behaviors Questionnaire; Linehan, 1981), number of suicide attempts (using the Suicide Attempt Self-Injury Interview; Linehan, Comtois, Brown, Heard, & Wagner, 2006), and number of psychiatric inpatient admissions and psychiatric emergency-room (ER) visits (using the Treatment History Interview; Linehan & Heard, 1987) from the years prior to, during, and following treatment. Treatment-year psychiatric ER visits were the sole predictor of the number of follow-up year suicide attempts. Treatment condition and pretreatment inpatient admissions predicted treatment-year psychiatric ER visits. Finally, there was evidence that DBT resulted in fewer suicide attempts at follow-up, in part because getting DBT led to fewer psychiatric ER visits. In this population and context, data suggest that crisis-service utilization conveys risk for suicide. DBT may

  15. Forensic and non-forensic psychiatric nursing skills and competencies for psychopathic and personality disordered patients.

    Science.gov (United States)

    Bowen, Matt; Mason, Tom

    2012-12-01

    To understand better the skills and competencies for forensic and non-forensic nursing of psychopathic and personality disordered patients. In the UK, there has been growing interest in service provision for this client group, but with little research to support the nursing skills required. A non-experimental design, using a postal survey to 990 forensic and 500 non-forensic nurses. An information gathering schedule was used to generate data about the most desirable skills and competencies and least desirable weaknesses and nursing attributes to nurse this group. The results for the forensic nurses. Main strengths and skills: being firm, setting limits and defining boundaries. Main weaknesses: inability to engage, inability to resolve conflict and impatience. Main skills and competencies: being non-threatening, non-judgemental and able to expect anything. Least desirable qualities: over-reacting, being judgemental and over-confrontational. The results for the non-forensic nurses. Main strengths and skills: being non-judgemental, listening skills and good risk assessment. Main weaknesses: frustration with the system, a fear of aggression and no skills to engage. Main skills and competencies: being open-minded, non-judgemental and forming relationships. Least desirable qualities: a supercilious attitude, cynicism and being judgemental. The results highlight the importance of forming therapeutic relationships as the bedrock of both forensic and non-forensic nursing, and they also highlight the important differences with regard to the significance of therapeutic action and therapeutic verbal interaction. The provision of better care for this client group will rely on appropriate training for nurses. This research highlights the need for training that supports the development of engagement skills, communication skills and an ability to use reflection in action as a means of providing therapeutic care. It also highlights the different emphasis on the use of these skills

  16. Mediation analysis of critical time intervention for persons living with serious mental illnesses: assessing the role of family relations in reducing psychiatric rehospitalization.

    Science.gov (United States)

    Tomita, Andrew; Lukens, Ellen P; Herman, Daniel B

    2014-03-01

    Critical Time Intervention (CTI) is a time-limited care coordination intervention designed to reduce homelessness and other adverse outcomes for persons living with serious mental illness during the transition period between institutions and community living. This study assesses whether CTI improves the quality of family relationships between family members and individuals living with serious mental illness, and examines whether changes in quality of family relationship mediated the association between the intervention and psychiatric rehospitalization outcomes. This study utilizes data from a randomized controlled trial that assessed the effect of CTI in preventing homelessness. Following discharge from inpatient psychiatric treatment in New York City, 150 previously homeless persons living with serious mental illness were randomly assigned to receive usual services only or 9 months of CTI in addition to usual services. Findings from mixed-effects regression models indicated that those assigned to the CTI group reported greater frequency of family contact and greater improvement in satisfaction with family relations than the comparison group during the 18-month follow-up period. Mediation analysis revealed that greater improvement in satisfaction with family relations mediated the effect of CTI on psychiatric rehospitalization outcome, but only at a modest level. These findings suggest that a relatively brief but targeted intervention delivered at the point of hospital discharge may contribute to strengthening family relations and that improvement in perceived family relationship quality can contribute to a reduction in psychiatric rehospitalization.

  17. An assistive technology for hearing-impaired persons: analysis, requirements and architecture.

    Science.gov (United States)

    Mielke, Matthias; Grunewald, Armin; Bruck, Rainer

    2013-01-01

    In this contribution, a concept of an assistive technology for hearing-impaired and deaf persons is presented. The concept applies pattern recognition algorithms and makes use of modern communication technology to analyze the acoustic environment around a user, identify critical acoustic signatures and give an alert to the user when an event of interest happened. A detailed analysis of the needs of deaf and hearing-impaired people has been performed. Requirements for an adequate assisting device have been derived from the results of the analysis, and have been turned into an architecture for its implementation that will be presented in this article. The presented concept is the basis for an assistive system which is now under development at the Institute of Microsystem Engineering at the University of Siegen.

  18. Therapeutic doll play in the treatment of a severely impaired psychiatric inpatient: dramatic clinical improvements with a nontraditional nursing intervention.

    Science.gov (United States)

    Birnbaum, Shira; Hanchuk, Hilary; Nelson, Marjorie

    2015-05-01

    Interest has grown in the use of doll therapy, particularly in geropsychiatric and dementia care settings. In a long-term state psychiatric hospital, a dollhouse-play activity was implemented in an effort to engage an acutely disturbed, middle-aged woman undergoing medication trials and whose symptoms had been refractory to conventional treatments. A schedule of nondirective dollhouse-play activities was implemented over an 8-week period. Measures of behavioral change were tracked. Dramatic clinical improvements were seen, including significant reductions in verbal and physical aggression, use of as-needed medications, and need for close one-to-one monitoring. Improvements were seen prior to achievement of therapeutic drug levels. The patient was successfully discharged from the hospital. Doll play has recently been associated with clinical benefits in the care of patients with dementia and has long been deployed in childhood mental health treatment. The current findings suggest doll play may have applications as a time-limited intervention in the treatment of major psychiatric disorders in adults and warrants consideration when achieving therapeutic alliance has proven particularly challenging. Copyright 2015, SLACK Incorporated.

  19. [Pilot study to investigate sleep disorders in the blind and persons with relevant visual impairment].

    Science.gov (United States)

    Dirks, C; Grünewald, D; Young, P; Heidbreder, A

    2018-05-22

    Sleep disorders are associated with serious health problems in blind and visually impaired persons. Loss of light perception may result in a shift of sleep-wake pattern, which may lead to significant impairments in daily life--the so-called non-24-hour sleep-wake disorder. To date, epidemiologic data on non-24 only exist for the USA. This pilot study was conducted to provide first epidemiologic data for the prevalence of non-24 and other sleep disorders among blind and visually impaired persons in Germany. Recruited were 111 blind and visually impaired subjects (36 subjects without light perception; male [m] = 56, 27-85 years, average [Mx] = 59.53, standard deviation [SD] = 14.69) and 111 sighted controls (m = 41, 27-88 years, Mx = 58.32, SD = 14.21), who answered a set of validated questionnaires referring to general health status (SF-36), sleep characteristics (PSQI), and daytime sleepiness (ESS). In addition, a questionnaire to predict non-24-hour sleep-wake disorder, which is not yet validated in German, was provided. The prevalence of 72.2% for the non-24-hour sleep-wake disorder in blind people is in accordance with results from the USA. In contrast, our results indicated non-24 in only 21.3% of the subjects with residual light perception. Furthermore, other sleep disorders like problems falling asleep (100% vs. 79.9%), maintaining sleep (90% vs. 88.1%), sleep-disordered breathing (19.4% vs. 32%), or sleep-related movement disorders (28.1% vs. 32.9%) were also common in the group of blind or visually impaired persons. The non-24-hour sleep-wake disorder is a frequent problem among people with no light perception, associated with problems falling asleep, maintaining sleep, and daytime sleepiness. The perception of light as an external cue for our circadian rhythm plays a key role. However, sleep disruption is not fully explained by non-24, making a detailed sleep history essential.

  20. Severe MUPS in a sick-listed population: a cross-sectional study on prevalence, recognition, psychiatric co-morbidity and impairment

    Directory of Open Access Journals (Sweden)

    Koopmans Petra C

    2009-12-01

    Full Text Available Abstract Background Medically unexplained physical symptoms (MUPS have a high prevalence in the general population and are associated with psychiatric morbidity. There are indications that MUPS are an important determinant of frequent and long-term disability. The primary objective was to assess the prevalence of MUPS in sick-listed-employees and its associations with depressive disorders, anxiety disorders, health anxiety, distress and functional impairment. Secondary objectives were to investigate the classification of the occupational health physicians (OHPs, their opinions about the causes as well as the attributions of the employee. Methods In a cross-sectional study of 489 sick-listed employees from 5 OHP group practices, MUPS, depressive disorders, anxiety disorders, health anxiety, distress and functional impairment were assessed with the Patient Health Questionnaire (PHQ, the Whitely Index (WI, the Four- Dimensional Symptom Questionnaire (4DSQ and the Short-Form 36 Health Survey (SF-36. We used a cut off score of 15 on the PHQ for the categorisation of severe MUPS. The opinions of the OHPs were evaluated by means of a separate questionnaire with regard to the presence of employees physical symptoms, and the symptoms attributions, and the diagnoses of the OHPs. Results Severe MUPS had a prevalence of 15.1% in this population of sick-listed employees. These employees had 4-6 times more depressive and anxiety disorders, and were more impaired. Female gender and PHQ-9 scores were determinants of severe MUPS. Most of the time the OHPs diagnosed employees with severe MUPS as having a mental disorder. The employees attributed their physical symptoms in 66% to mental or to both mental and physical causes. Conclusion The prevalence of severe MUPS is higher in long-term sick-listed employees than in the non-sick- listed working population and at least equals the prevalence in the general practice population. Severe MUPS are associated with

  1. Comparing the Psychological Effects of Different Psychiatric Labels: Borderline, Paranoid, and Antisocial Personality Disorder; Major Depression; Anxiety Disorder; and Posttraumatic Stress Disorder

    OpenAIRE

    Celaire, Sarah; McDermott, Mark R.

    2015-01-01

    The psychological effects of six Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) psychiatric labels on respondents were evaluated, three of them being variants of "personality disorder" (PD). Self-selecting students from a university in London, United Kingdom, were invited to take part in a repeated-measures questionnaire study delivered online. One hundred and seventy-three participants completed the questionnaire, responding to 16 items for each of the six mental heal...

  2. Mutational spectrum of the WFS1 gene in Wolfram syndrome, nonsyndromic hearing impairment, diabetes mellitus, and psychiatric disease

    NARCIS (Netherlands)

    Cryns, K; Sivakumaran, TA; Van den Ouweland, JMW; Pennings, RJE; Cremers, CWRJ; Flothmann, K; Young, TL; Smith, RJH; Lesperance, MM; Van Camp, G

    2003-01-01

    WFS1 is a novel gene and encodes an 890 amino-acid glycoprotein (wolframin), predominantly localized in the endoplasmic reticulum. Mutations in WFS1 underlie autosomal recessive Wolfram syndrome and autosomal dominant low frequency sensorineural hearing impairment (LFSNHI) DFNA6/14. In addition,

  3. Mutational spectrum of the WFS1 gene in Wolfram syndrome, nonsyndromic hearing impairment, diabetes mellitus, and psychiatric disease.

    NARCIS (Netherlands)

    Cryns, K.; Sivakumaran, T.A.; Ouweland, J.M.W. van den; Pennings, R.J.E.; Cremers, C.W.R.J.; Flothmann, K.; Young, T.L.; Smith, R.J.H.; Lesperance, M.M.; Camp, G. van

    2003-01-01

    WFS1 is a novel gene and encodes an 890 amino-acid glycoprotein (wolframin), predominantly localized in the endoplasmic reticulum. Mutations in WFS1 underlie autosomal recessive Wolfram syndrome and autosomal dominant low frequency sensorineural hearing impairment (LFSNHI) DFNA6/14. In addition,

  4. Development and preliminary validation of the Level of Care Index (LOCI) from the Personality Assessment Inventory (PAI) in a psychiatric sample.

    Science.gov (United States)

    Sinclair, Samuel Justin; Slavin-Mulford, Jenelle; Antonius, Daniel; Stein, Michelle B; Siefert, Caleb J; Haggerty, Greg; Malone, Johanna C; O'Keefe, Sheila; Blais, Mark A

    2013-06-01

    Research over the last decade has been promising in terms of the incremental utility of psychometric tools in predicting important clinical outcomes, such as mental health service utilization and inpatient psychiatric hospitalization. The purpose of this study was to develop and validate a new Level of Care Index (LOCI) from the Personality Assessment Inventory (PAI). Logistic regression was initially used in a development sample (n = 253) of psychiatric patients to identify unique PAI indicators associated with inpatient (n = 75) as opposed to outpatient (n = 178) status. Five PAI variables were ultimately retained (Suicidal Ideation, Antisocial Personality-Stimulus Seeking, Paranoia-Persecution, Negative Impression Management, and Depression-Affective) and were then aggregated into a single LOCI and independently evaluated in a second validation sample (n = 252). Results indicated the LOCI effectively differentiated inpatients from outpatients after controlling for demographic variables and was significantly associated with both internalizing and externalizing risk factors for psychiatric admission (range of ds = 0.46 for history of arrests to 0.88 for history of suicidal ideation). The LOCI was additionally found to be meaningfully associated with measures of normal personality, performance-based tests of psychological functioning, and measures of neurocognitive (executive) functioning. The clinical implications of these findings and potential utility of the LOCI are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  5. The recognition of mental health disorders and its association with psychiatric scepticism, knowledge of psychiatry, and the Big Five personality factors: an investigation using the overclaiming technique.

    Science.gov (United States)

    Swami, Viren; Persaud, Raj; Furnham, Adrian

    2011-03-01

    The present study examined the general public's ability to recognise mental health disorders and this ability's association with psychiatric scepticism, knowledge of psychiatry, and the Big Five personality factors. A total of 477 members of the British general public completed an overclaiming scale, in which they were asked to rate the degree to which they believed 20 mental health disorders (of which five were foils designed to resemble real disorders) were real or fake. Participants also completed a novel scale measuring psychiatric scepticism, a single-item measure of knowledge of psychiatry, and a measure of the Big Five personality factors. Results showed that participants were significantly more likely to rate foils as fake disorders than real disorders. In addition, the difference between real and foil ratings was significantly predicted by knowledge of psychiatry, psychiatric scepticism, and the Big Five personality factors of agreeableness and openness to experience. These results are discussed in relation to the overclaiming technique as a novel method to study mental health literacy.

  6. Nature and Extent of Person Recognition Impairments Associated with Capgras Syndrome in Lewy Body Dementia

    Directory of Open Access Journals (Sweden)

    Chris M. Fiacconi

    2014-09-01

    Full Text Available Patients with Capgras Syndrome (CS adopt the delusional belief that persons well-known to them have been replaced by an imposter. Several current theoretical models of CS attribute such misidentification problems to deficits in covert recognition processes related to the generation of appropriate affective autonomic signals. These models assume intact overt recognition processes for the imposter and, more broadly, for other individuals. As such, it has been suggested that CS could reflect the ‘mirror image’ of prosopagnosia. The purpose of the current study was to determine whether overt person recognition abilities are indeed always spared in CS. Furthermore, we examined whether CS might be associated with any impairments in overt affective judgments of facial expressions. We pursued these goals by studying a patient with Lewy Body Dementia (DLB who showed clear signs of CS, and by comparing him to another patient with DLB who did not experience CS, as well as to a group of healthy control participants. We assessed overt person recognition with three fame recognition tasks, using faces, voices, and names as cues. We also included measures of confidence and probed pertinent semantic knowledge. In addition, participants rated the intensity of fearful facial expressions. We found that CS was associated with overt person recognition deficits when probed with faces and voices, but not with names. Critically, these deficits were not present in the DLB patient without CS. In addition, CS was associated with impairments in overt judgments of affect intensity. Taken together, our findings cast doubt on the traditional view that CS is the mirror-image of prosopagnosia and that it spares overt recognition abilities. These findings can still be accommodated by models of CS that emphasize deficits in autonomic responding, to the extent that the potential role of interoceptive awareness in overt judgments is taken into account.

  7. Validation of Self-Report Impairment Measures for Section III Obsessive-Compulsive and Avoidant Personality Disorders.

    Science.gov (United States)

    Liggett, Jacqueline; Carmichael, Kieran L C; Smith, Alexander; Sellbom, Martin

    2017-01-01

    This study examined the validity of newly developed disorder-specific impairment scales (IS), modeled on the Level of Personality Functioning Scale, for obsessive-compulsive (OCPD) and avoidant (AvPD) personality disorders. The IS focused on content validity (items directly reflected the disorder-specific impairments listed in DSM-5 Section III) and severity of impairment. A community sample of 313 adults completed personality inventories indexing the DSM-5 Sections II and III diagnostic criteria for OCPD and AvPD, as well as measures of impairment in the domains of self- and interpersonal functioning. Results indicated that both impairment measures (for AvPD in particular) showed promise in their ability to measure disorder-specific impairment, demonstrating convergent validity with their respective Section II counterparts and discriminant validity with their noncorresponding Section II disorder and with each other. The pattern of relationships between scores on the IS and scores on external measures of personality functioning, however, did not indicate that it is useful to maintain a distinction between impairment in the self- and interpersonal domains, at least for AvPD and OCPD.

  8. Differential Impairment as an Indicator of Sex Bias in DSM-IV Criteria for Four Personality Disorders

    Science.gov (United States)

    Boggs, Christina D.; Morey, Leslie C.; Skodol, Andrew E.; Shea, M. Tracie; Sanislow, Charles A.; Grilo, Carlos M.; McGlashan, Thomas H.; Zanarini, Mary C.; Gunderson, John G.

    2005-01-01

    The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were…

  9. Social Media as a Communication Support for Persons with Mild Acquired Cognitive Impairment: A Social Network Analysis Study.

    Science.gov (United States)

    Eghdam, Aboozar; Hamidi, Ulrika; Bartfai, Aniko; Koch, Sabine

    2017-01-01

    This study was conducted as a social network analysis of a Facebook group for Swedish speaking persons (1310 members) with perceived brain fatigue after an illness or injury to the brain to address the lack of research examining social media and the potential value of on-line support for persons with mild acquired cognitive impairment.

  10. Caregiver perception of apathy in persons with mild cognitive impairment or Alzheimer's disease: a longitudinal study.

    Science.gov (United States)

    Pfeifer, Livia; Horn, Andrea B; Maercker, Andreas; Forstmeier, Simon

    2017-05-01

    Discrepancy between self- and caregiver apathy ratings was examined longitudinally for persons with mild cognitive impairment or Alzheimer's disease. Particular focus was on the distinction between the positive and negative caregiver bias and its predictive value for a clinical diagnosis of apathy. Apathy rating discrepancy was based on the apathy evaluation scale. Dyads were categorized depending on whether the caregiver reported fewer deficits (positive caregiver bias) or more deficits (negative caregiver bias) than the cognitively impaired person did. Caregiver ratings and rating discrepancy showed a significant increase from baseline to follow-up. By contrast, self- and clinician ratings showed no change across the two time points. Ratings with a negative caregiver bias remained stable, while those with a positive caregiver bias showed a significant increase in the caregiver ratings but also a significant decrease in the self-ratings. A negative caregiver bias at baseline was significantly related to greater likelihood of having clinical apathy at follow-up, adjusted for an array of control variables. Positive and negative caregiver bias should be distinguished, as they seem to reflect distinct dyadic processes and are relevant for clinical outcome. Furthermore, negative rating discrepancies can be considered a risk factor for developing apathy.

  11. Personality traits as predictors of inpatient aggression in a high-security forensic psychiatric setting: prospective evaluation of the PCL-R and IPDE dimension ratings.

    Science.gov (United States)

    Langton, Calvin M; Hogue, Todd E; Daffern, Michael; Mannion, Aisling; Howells, Kevin

    2011-05-01

    The Dangerous and Severe Personality Disorder (DSPD) initiative in England and Wales provides specialized care to high-risk offenders with mental disorders. This study investigated the predictive utility of personality traits, assessed using the Psychopathy Checklist-Revised (PCL-R) and the International Personality Disorder Examination, with 44 consecutive admissions to the DSPD unit at a high-security forensic psychiatric hospital. Incidents of interpersonal physical aggression (IPA) were observed for 39% of the sample over an average 1.5-year period following admission. Histrionic personality disorder (PD) predicted IPA, and Histrionic, Borderline, and Antisocial PDs all predicted repetitive (2+ incidents of) IPA. PCL-R Factor 1 and Facets 1 and 2 were also significant predictors of IPA. PCL-R Factor 1 and Histrionic PD scores were significantly associated with imminence of IPA. Results were discussed in terms of the utility of personality traits in risk assessment and treatment of specially selected high-risk forensic psychiatric patients in secure settings.

  12. Getting to know the person behind the illness - the significance of interacting with patients hospitalised in forensic psychiatric settings

    OpenAIRE

    Salzmann-Erikson, Martin; Rydlo, Cecilia; Wiklund Gustin, Lena

    2016-01-01

    Source: http://onlinelibrary.wiley.com/doi/10.1111/jocn.13252/epdf AIMS AND OBJECTIVES: To describe what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings. BACKGROUND: Relationships between staff and patients in forensic psychiatric settings should be grounded in trust and confidence, and the patients need opportunities for emotional reconciliation. However, relationships can be challenging for nurses, who sometimes dist...

  13. Motivations of persons with psychiatric disabilities to work in mental health peer services: a qualitative study using self-determination theory.

    Science.gov (United States)

    Moran, Galia Sharon; Russinova, Zlatka; Yim, Jung Yeon; Sprague, Catherine

    2014-03-01

    Individuals with psychiatric disabilities have low rates of employment and occupational rehabilitation success. Mental health peer services are a new occupational modality that opened a promising occupational path: persons with serious mental illnesses employed to provide support to others with psychiatric conditions. However challenges to successful peer work exist. Work motivation is central to understanding and supporting peer workers, yet little is known about sources of motivation to work as mental health peer providers. The aim of this study was to identify what drives individuals to mental health peer work using self determination theory (SDT). Motivations of 31 mental health peer workers were explored as part of a larger study. A theory driven approach was employed to emerging qualitative data using SDT concepts: external motivation and internally regulated motivations derived from basic needs (autonomy, competence, relatedness). External motivations included generic occupational goals and getting away from negative work experiences. Internal motivations corresponded with SDT basic needs: autonomy met-needs was reflected in having freedom to disclose and finding that work accords with personal values; competence met-needs was reflected in using personal experience as a resource to help others; and relatedness met-needs were reflected in having opportunity to connect intimately and reciprocate with consumers. This study identified external and internal motivations of persons with psychiatric disabilities to work as peer providers-a novel occupation in mental health. Employing personal experience and enabling peer contact emerge as major motivational tenets of mental health peer work. According to SDT instrumental occupational goals are considered more external than satisfaction of basic psychological needs. The study demonstrates the applicability of SDT in the design of autonomy supported environments to promote work engagement and sustenance of mental

  14. Self-concept, self-esteem, personality traits and psychopathological symptoms in adolescents with and without visual impairment.

    Science.gov (United States)

    Garaigordobil, Maite; Bernarás, Elena

    2009-05-01

    The purpose of this study was to analyze self-concept, self-esteem, and other personality traits and psychopathological symptoms in subjects with and without visual impairment. The sample was made up of 90 participants aged 12 to 17: 61 with no impairment and 29 with visual impairment. The ANOVA showed that there were no significant differences in self-concept and self-esteem in the samples, but the visually impaired adolescents scored significantly higher in various psychopathological symptoms as well as in their capacity for kind behavior. The ANOVA revealed no gender differences in any variables in adolescents without visual impairment. However, women with visual impairment scored lower in self-esteem and higher in various psychopathological symptoms. Pearson coefficients revealed negative relations between self-concept/self-esteem and all the psychopathological symptoms, and neuroticism, as well as a positive relation with extraversion. Low psychoticism, high extraversion, and low hostility were identified as predictors of high self-concept.

  15. Validation of the Verbal and Social Interaction questionnaire: carers' focus in the carer-resident relationship in supported housing facilities for persons with psychiatric disabilities (VSI-SH).

    Science.gov (United States)

    Brunt, D; Rask, M

    2013-04-01

    A questionnaire to measure the verbal and social interactions between carers and residents in supported housing facilities for persons with psychiatric disabilities has been developed. It is an adaptation of a questionnaire originally used in a forensic psychiatric setting. The aim of the present study was thus to investigate the construct validity and the reliability of this new version of the Verbal and Social Interactions questionnaire for use in supported housing facilities (VSI-SH). Two hundred and twenty-three carers from municipal and privately run housing facilities completed the questionnaire. A factor analysis was performed, which resulted in six factors. The number of items was reduced from the original 47 to 30 in order to minimize factorial complexity and multiple loadings. The reliability was tested with Cronbach's alpha and good internal consistency for the questionnaire and five of the six factors was found. The resulting six factors and the items were compared to the conceptual model and four of the six factors corresponded well with the categories in this original theoretical model. The questionnaire can be a useful contribution to the study of interactions between carers and residents in supported housing facilities for persons with psychiatric disabilities. © 2012 Blackwell Publishing.

  16. Mild cognitive impairment is associated with poorer decision-making in community-based older persons.

    Science.gov (United States)

    Han, S Duke; Boyle, Patricia A; James, Bryan D; Yu, Lei; Bennett, David A

    2015-04-01

    To test the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and healthcare decision-making. Community-based epidemiological cohort study. Communities throughout northeastern Illinois. Older persons without dementia from the Rush Memory and Aging Project (N = 730). All participants underwent a detailed clinical evaluation and decision-making assessment using a measure that closely approximates materials used in real-world financial and healthcare settings. This allowed for measurement of total decision-making and financial and healthcare decision-making. Regression models were used to examine whether MCI was associated with a lower level of decision-making. In subsequent analyses, the relationship between specific cognitive systems (episodic memory, semantic memory, working memory, perceptual speed, visuospatial ability) and decision-making was explored in participants with MCI. MCI was associated with lower total, financial, and healthcare decision-making scores after accounting for the effects of age, education, and sex. The effect of MCI on total decision-making was equivalent to the effect of more than 10 additional years of age. Additional models showed that, when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision-making in participants with MCI. Persons with MCI may have poorer financial and healthcare decision-making in real-world situations, and perceptual speed may be an important contributor to poorer decision-making in persons with MCI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  17. Exposure to Violence, Posttraumatic Stress Symptoms, and Borderline Personality Pathology Among Adolescents in Residential Psychiatric Treatment: The Influence of Emotion Dysregulation.

    Science.gov (United States)

    Buckholdt, Kelly E; Weiss, Nicole H; Young, John; Gratz, Kim L

    2015-12-01

    Exposure to violence during adolescence is a highly prevalent phenomenon associated with a range of deleterious outcomes. Theoretical literature suggests that emotion dysregulation is one consequence of exposure to violence associated with the manifestation of posttraumatic stress symptoms (PTSS) and borderline personality (BP) pathology. Thus, the goal of the present study was to examine the mediating role of emotion dysregulation in the relation between exposure to violence and both PTSS and BP pathology in a sample of 144 adolescents (age 10- to 17-years; 51% male; 55% African American) admitted to a psychiatric residential treatment center. Exposure to violence was associated with greater emotion dysregulation, which, in turn, was associated with greater PTSS and BP pathology. Furthermore, emotion dysregulation mediated the associations between exposure to violence and both PTSS and BP pathology. Findings suggest the importance of assessing and treating emotion dysregulation among violence-exposed adolescents in psychiatric residential treatment.

  18. A six-month prospective evaluation of personality traits, psychiatric symptoms and quality of life in ayahuasca-naïve subjects.

    Science.gov (United States)

    Barbosa, Paulo Cesar Ribeiro; Cazorla, Irene Maurício; Giglio, Joel Sales; Strassman, Rick

    2009-09-01

    The authors assessed 23 subjects immediately before and six months (27.5 weeks) after their first ayahuasca experience in an urban Brazilian religious setting, either Santo Daime (N = 15) or União do Vegetal (N = 8). Measures included scores on instruments assessing psychiatric symptoms, personality variables and quality of life. Independent variables were the frequency of ayahuasca use throughout the period and the length of ayahuasca wash-out after six months. Santo Daime subjects had a significant reduction of minor psychiatric symptoms, improvement of mental health, and a change in attitude towards more confidence and optimism. The União do Vegetal group had a significant decrease in physical pain, and attitude change towards more independence. Independence was positively correlated with the frequency of ayahuasca use and negatively correlated with the wash-out period. We discuss possible mechanisms by which these changes may occur and suggest areas for future research.

  19. Association between dopaminergic polymorphisms and borderline personality traits among at-risk young adults and psychiatric inpatients

    Directory of Open Access Journals (Sweden)

    Faludi Gabor

    2010-01-01

    Full Text Available Abstract Background In the development of borderline personality disorder (BPD both genetic and environmental factors have important roles. The characteristic affective disturbance and impulsive aggression are linked to imbalances in the central serotonin system, and most of the genetic association studies focused on serotonergic candidate genes. However, the efficacy of dopamine D2 receptor (DRD2 blocking antipsychotic drugs in BPD treatment also suggests involvement of the dopamine system in the neurobiology of BPD. Methods In the present study we tested the dopamine dysfunction hypothesis of impulsive self- and other-damaging behaviors: borderline and antisocial traits were assessed by Structured Clinical Interview for Diagnosis (SCID for DSM-IV in a community-based US sample of 99 young adults from low-to-moderate income families. For the BPD trait analyses a second, independent group was used consisting of 136 Hungarian patients with bipolar or major depressive disorder filling out self-report SCID-II Screen questionnaire. In the genetic association analyses the previously indicated polymorphisms of the catechol-O-methyl-transferase (COMT Val158Met and dopamine transporter (DAT1 40 bp VNTR were studied. In addition, candidate polymorphisms of the DRD2 and DRD4 dopamine receptor genes were selected from the impulsive behavior literature. Results The DRD2 TaqI B1-allele and A1-allele were associated with borderline traits in the young adult sample (p = 0.001, and p = 0.005, respectively. Also, the DRD4 -616 CC genotype appeared as a risk factor (p = 0.02. With severity of abuse accounted for in the model, genetic effects of the DRD2 and DRD4 polymorphisms were still significant (DRD2 TaqIB: p = 0.001, DRD2 TaqIA: p = 0.008, DRD4 -616 C/G: p = 0.002. Only the DRD4 promoter finding was replicated in the independent sample of psychiatric inpatients (p = 0.007. No association was found with the COMT and DAT1 polymorphisms. Conclusions Our results

  20. Personal factors that contribute to or impair women's ability to achieve orgasm.

    Science.gov (United States)

    de Lucena, B B; Abdo, C H N

    2014-01-01

    This work aims to identify factors that contribute and those that impair the ability to experience orgasm during sexual activity. It compared women (n=96) aged 18-61 (M=38.5 years) in a stable relationship that, after a normal arousal phase, do not have an orgasm (OD) with those that do (OA) regarding sociodemographic data, sexual frequency, talking about sex with their physician, talking about sex with their partner, sexual education, masturbation, sexual desire, sexual satisfaction, depression and anxiety. We found differences between the OD and OA groups with regard to level of education (P=0.022), sex education during childhood and/or adolescence (Porgasm problems included the variables 'masturbation', 'high school', 'sexual desire' and 'anxiety'. Orgasm difficulties are influenced by personal factors, such as anxiety and low sexual desire. Increased levels of anxiety also increase orgasmic difficulties. Women who masturbate and/or have completed high school are considerably more likely to reach orgasm during sexual activity.

  1. Burden and depression in primary caregivers of persons with visual impairment

    Directory of Open Access Journals (Sweden)

    Shubhank Khare

    2016-01-01

    Full Text Available Context: Caregivers who assist persons with visual impairment often neglect their needs, resulting in burden and depression. Rehabilitation efforts, directed to the disabled, seldom target the caregiver. Aim: To assess burden and depression in persons caring for blind individuals. Settings and Design: This was a cross-sectional study carried out in the outpatient department of a tertiary-level teaching hospital in New Delhi. Materials and Methods : Institutional Ethical Board approval was obtained and written informed consent too was obtained from the participants involved in this study. Persons with best-corrected vision <20/200 in the better eye, and their primary caregivers, were recruited. We recorded demography, other illness/disability, household income, relationship with disabled person, and caregiver burden (Caregiver Burden Scale and depression (Centre for Epidemiologic Studies Depression Scale. Statistical Analysis: Statistical analysis was carried out using SPSS version 20 (Released 2011. Armonk, NY: IBM Corp.; range, average, and standard deviation were determined for age, burden, and depression. The association between burden and depression was determined using Pearson′s correlation; the relationship between degree of disability and caregiver burden and depression was determined using unpaired t-test; using multiple linear regression, factors were found to be statistically significant; significance was taken at P < 0.05. Results: Twenty-seven (53.0% men and 24 (47.0% women had visual impairment. Most caregivers (n = 40; 81.6% were first-degree relatives or a spouse; 32 (65% had schooling <5 years; and 29 (59% were unemployed. Depression ranged from 21 to 52 (average 43.2 ± 5.71; it correlated with degree of disability (P = 0.012, household income (r = −0.320; P = 0.025, and burden (r = 0.616; P < 0.001. Burden ranged from 30 to 73 (average 54.5 ± 6.73 and correlated with degree of disability (P = 0.006. On multiple linear

  2. Validation of a Modified Life-Space Assessment in Multimorbid Older Persons With Cognitive Impairment.

    Science.gov (United States)

    Ullrich, Phoebe; Werner, Christian; Bongartz, Martin; Kiss, Rainer; Bauer, Jürgen; Hauer, Klaus

    2018-01-31

    To investigate the validity, reliability, sensitivity to change, and feasibility of a modified University of Alabama at Birmingham Study of Aging Life-Space Assessment (UAB-LSA) in older persons with cognitive impairment (CI). The UAB-LSA was modified for use in persons with CI Life-Space Assessment for Persons with Cognitive Impairment (LSA-CI). Measurement properties of the LSA-CI were investigated using data of 118 multimorbid older participants with CI [mean age (SD): 82.3 (6.0) years, mean Mini-Mental State Examination score: 23.3 (2.4) points] from a randomized controlled trial (RCT) to improve motor performance and physical activity. Construct validity was asessed by Spearman's rank (rs) and point-biseral correlations (rpb) with age, gender, motor, and cognitive status, psychosocial factors, and sensor-derived (outdoor) physical activity variables. Test-retest reliability was analyzed using intra-class correlation coefficients (ICCs). Sensitivity to change was determined by standardized response means (SRMs) calculated for the RCT intervention group. The LSA-CI demonstrated moderate to high construct validity, with significant correlations of the LSA-CI scores with (outdoor) physical activity (rs = .23-.63), motor status (rs = .27-.56), fear of falling-related psychosocial variables (rs = |.24-.44|), and demographic characteristics (rpb = |.27-.32|). Test-retest reliability was good to excellent (ICC = .65-.91). Sensitivity to change was excellent for the LSA-CI composite score (SRM = .80) and small to moderate for the LSA-CI subscores (SRM = .35-.60). A completion rate of 100% and a mean completion time of 4.1 min) documented good feasibility. The LSA-CI represents a valid, reliable, sensitive, and feasible interview-based life-space assessment tool in multimorbid older persons with CI. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Speech intelligibility of normal listeners and persons with impaired hearing in traffic noise

    Science.gov (United States)

    Aniansson, G.; Peterson, Y.

    1983-10-01

    Speech intelligibility (PB words) in traffic-like noise was investigated in a laboratory situation simulating three common listening situations, indoors at 1 and 4 m and outdoors at 1 m. The maximum noise levels still permitting 75% intelligibility of PB words in these three listening situations were also defined. A total of 269 persons were examined. Forty-six had normal hearing, 90 a presbycusis-type hearing loss, 95 a noise-induced hearing loss and 38 a conductive hearing loss. In the indoor situation the majority of the groups with impaired hearing retained good speech intelligibility in 40 dB(A) masking noise. Lowering the noise level to less than 40 dB(A) resulted in a minor, usually insignificant, improvement in speech intelligibility. Listeners with normal hearing maintained good speech intelligibility in the outdoor listening situation at noise levels up to 60 dB(A), without lip-reading (i.e., using non-auditory information). For groups with impaired hearing due to age and/or noise, representing 8% of the population in Sweden, the noise level outdoors had to be lowered to less than 50 dB(A), in order to achieve good speech intelligibility at 1 m without lip-reading.

  4. Electrophysiological Repetition Effects in Persons with Mild Cognitive Impairment depend upon Working Memory Demand.

    Science.gov (United States)

    Broster, Lucas S; Jenkins, Shonna L; Holmes, Sarah D; Edwards, Matthew G; Jicha, Gregory A; Jiang, Yang

    2018-05-07

    Forms of implicit memory, including repetition effects, are preserved relative to explicit memory in clinical Alzheimer's disease. Consequently, cognitive interventions for persons with Alzheimer's disease have been developed that leverage this fact. However, despite the clinical robustness of behavioral repetition effects, altered neural mechanisms of repetition effects are studied as biomarkers of both clinical Alzheimer's disease and pre-morbid Alzheimer's changes in the brain. We hypothesized that the clinical preservation of behavioral repetition effects results in part from concurrent operation of discrete memory systems. We developed two experiments that included probes of emotional repetition effects differing in that one included an embedded working memory task. We found that neural repetition effects manifested in patients with amnestic mild cognitive impairment, the earliest form of clinical Alzheimer's disease, during emotional working memory tasks, but they did not manifest during the task that lacked the embedded working memory manipulation. Specifically, the working memory task evoked neural repetition effects in the P600 time-window, but the same neural mechanism was only minimally implicated in the task without a working memory component. We also found that group differences in behavioral repetition effects were smaller in the experiment with a working memory task. We suggest that cross-domain cognitive challenge can expose "defunct" neural capabilities of individuals with amnestic mild cognitive impairment. Copyright © 2018. Published by Elsevier Ltd.

  5. Conveying facial expressions to blind and visually impaired persons through a wearable vibrotactile device.

    Science.gov (United States)

    Buimer, Hendrik P; Bittner, Marian; Kostelijk, Tjerk; van der Geest, Thea M; Nemri, Abdellatif; van Wezel, Richard J A; Zhao, Yan

    2018-01-01

    In face-to-face social interactions, blind and visually impaired persons (VIPs) lack access to nonverbal cues like facial expressions, body posture, and gestures, which may lead to impaired interpersonal communication. In this study, a wearable sensory substitution device (SSD) consisting of a head mounted camera and a haptic belt was evaluated to determine whether vibrotactile cues around the waist could be used to convey facial expressions to users and whether such a device is desired by VIPs for use in daily living situations. Ten VIPs (mean age: 38.8, SD: 14.4) and 10 sighted persons (SPs) (mean age: 44.5, SD: 19.6) participated in the study, in which validated sets of pictures, silent videos, and videos with audio of facial expressions were presented to the participant. A control measurement was first performed to determine how accurately participants could identify facial expressions while relying on their functional senses. After a short training, participants were asked to determine facial expressions while wearing the emotion feedback system. VIPs using the device showed significant improvements in their ability to determine which facial expressions were shown. A significant increase in accuracy of 44.4% was found across all types of stimuli when comparing the scores of the control (mean±SEM: 35.0±2.5%) and supported (mean±SEM: 79.4±2.1%) phases. The greatest improvements achieved with the support of the SSD were found for silent stimuli (68.3% for pictures and 50.8% for silent videos). SPs also showed consistent, though not statistically significant, improvements while supported. Overall, our study shows that vibrotactile cues are well suited to convey facial expressions to VIPs in real-time. Participants became skilled with the device after a short training session. Further testing and development of the SSD is required to improve its accuracy and aesthetics for potential daily use.

  6. [Differences in psychiatric expertise of responsibility for schizophrenic persons accused of murder: Study with experts of the Court of Appeal of Aix-en-Provence].

    Science.gov (United States)

    Guivarch, J; Piercecchi-Marti, M-D; Glezer, D; Chabannes, J-M

    2016-08-01

    In France, forensic psychiatric assessment plays a central role in the relationship between psychiatry and justice. The psychiatric expert is commissioned to determine whether or not the accused has a mental disorder and to specify whether or not it affected discernment at the time of offense. Nowadays, psychiatric expertise is coming under more and more criticism, particularly regarding divergences between experts. Our objectives were to find points of divergence between experts, try to understand causes and suggest ways to try to reduce them. For this we conducted a study, between July 2012 and January 2013, with psychiatric experts of the Court of Appeal of Aix-en-Provence through semi-structured interviews. We focused on a limited context: psychiatric expertise of responsibility for schizophrenic persons accused of murder. We questioned the experts about the issue of criminal liability of a person with schizophrenia in general but also in clinical situations we thought particularly involved in disagreements. We recruited a population of 17 psychiatrists, mostly males of average age of 58 years, working mostly in the department of adult psychiatry of a hospital. We highlighted the differences between the experts, first with regards to the issue of liability in general. Experts divided seemed to keep in majority (52.9 %) the alternative between abolition and alteration of discernment when faced with a schizophrenic person accused of murder. The differences were even more pronounced in specific contexts. Thus, the fact that the person had suffered from delirium at the time of the offense led half of the experts (47.1 %) to conclude a systematic abolition of discernment, while the other half made such a conclusion when the delirium was directly linked to the facts. Discontinuation of neuroleptic treatment, drug abuse or existence of premeditation changed the conclusions of the experts in half the cases, more in the sense of an increased accountability in the

  7. Impact of novelty and type of material on recognition in healthy older adults and persons with mild cognitive impairment.

    Science.gov (United States)

    Belleville, Sylvie; Ménard, Marie-Claude; Lepage, Emilie

    2011-08-01

    The goal of this study was to assess the effect of novelty on correct recognition (hit minus false alarms) and on recollection and familiarity processes in normal aging and amnestic mild cognitive impairment (MCI). Recognition tasks compared well-known and novel stimuli in the verbal domain (words vs. pseudowords) and in the musical domain (well-known vs. novel melodies). Results indicated that novel materials associated with lower correct recognition and lower recollection, an effect that can be related to its lower amenability to elaborative encoding in comparison with well-known items. Results also indicated that normal aging impairs recognition of well-known items, whereas MCI impairs recognition of novel items only. Healthy older adults showed impaired recollection and familiarity relative to younger controls and individuals with MCI showed impaired recollection relative to healthy older adults. The recollection deficit in healthy older adults and persons with MCI and their impaired recognition of well-known items is compatible with the difficulty both groups have in encoding information in an elaborate manner. In turn, familiarity deficit could be related to impaired frontal functioning. Therefore, novelty of material has a differential impact on recognition in persons with age-related memory disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Assessment and treatment of violent forensic psychiatric patients with a conduct or an antisocial personality disorder in the Netherlands

    NARCIS (Netherlands)

    Hornsveld, R.H.J.

    2007-01-01

    Because a Dutch treatment program for so-called terbeschikkinggestelden or violent forensic psychiatric inpatients was lacking, we took to developing an Aggression Control Therapy (ACT) in 2000, which was based on Goldstein, Glick, and Gibbs' Aggression Replacement Training (ART). The ACT program

  9. Using a Five-Factor Lens to Explore the Relation Between Personality Traits and Violence in Psychiatric Patients

    Science.gov (United States)

    Skeem, Jennifer L.; Miller, Joshua D.; Mulvey, Edward; Tiemann, Jenny; Monahan, John

    2005-01-01

    Recent work suggests that predictors of violence are similar for individuals with and without mental illness. Although psychopathy is among the most potent of such predictors, the nature of its relation to violence is unclear. On the basis of a sample of 769 civil psychiatric patients, the authors explore the possibility that measures of…

  10. Community orientation of services for persons with a psychiatric disability. Comparison between Estonia, Hungary and the Netherlands

    NARCIS (Netherlands)

    Prof. dr. Jean Pierre Wilken; Zsolt Bugarszki; Karin Hanga; Dagmar Narusson; Koidu Saia; Marju Medar

    2017-01-01

    This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the

  11. Stress and burnout in psychiatric professionals when starting to use dialectical behavioural therapy in the work with young self-harming women showing borderline personality symptoms.

    Science.gov (United States)

    Perseius, K-I; Kåver, A; Ekdahl, S; Asberg, M; Samuelsson, M

    2007-10-01

    The aim of the study was to investigate how starting to use dialectical behavioural therapy (DBT) in the work with young self-harming women showing symptoms of borderline personality disorder affected the psychiatric professionals (n = 22) experience of occupational stress and levels of professional burnout. The study was carried out in relation to an 18-month clinical psychiatric development project, and used a mix of quantitative and qualitative research methods [a burnout inventory, the Maslach burnout inventory-General Survey (MBI-GS), free format questionnaires and group interviews]. The result confirms previous reports that psychiatric health professionals experience treatment of self-harming patients as very stressful. DBT was seen as stressful in terms of learning demands, but decreased the experience of stress in the actual treatment of the patients. The teamwork and supervision were felt to be supportive, as was one particular facet of DBT, namely mindfulness training which some therapists felt also improved their handling of other work stressors not related to DBT. The inventory for professional burnout, the MBI-GS, showed no significant changes over the 18-month period, although there was a tendency for increased burnout levels at the 6-month assessment, which had returned to baseline levels at 18 months.

  12. Ability to manage everyday technology : a comparison of persons with dementia or mild cognitive impairment and older adults without cognitive impairment.

    OpenAIRE

    Malinowsky, Camilla; Almkvist, Ove; Kottorp, Anders; Nygård, Louise

    2010-01-01

    Purpose: The ability to manage technology is important for performance and participation in everyday activities. This study compares the management of technology in everyday activities among people with mild-stage dementia or MCI with older adults without known cognitive impairment (OA). Method: Persons with mild-stage dementia (n=38), MCI (n=34) and OA (n=45) were observed and interviewed when managing their everyday technology at home by using the Management of Everyday Technology Ass...

  13. Parkinsonian motor impairment predicts personality domains related to genetic risk and treatment outcomes in schizophrenia.

    Science.gov (United States)

    Molina, Juan L; Calvó, María; Padilla, Eduardo; Balda, Mara; Alemán, Gabriela González; Florenzano, Néstor V; Guerrero, Gonzalo; Kamis, Danielle; Rangeon, Beatriz Molina; Bourdieu, Mercedes; Strejilevich, Sergio A; Conesa, Horacio A; Escobar, Javier I; Zwir, Igor; Cloninger, C Robert; de Erausquin, Gabriel A

    2017-01-01

    Identifying endophenotypes of schizophrenia is of critical importance and has profound implications on clinical practice. Here we propose an innovative approach to clarify the mechanims through which temperament and character deviance relates to risk for schizophrenia and predict long-term treatment outcomes. We recruited 61 antipsychotic naïve subjects with chronic schizophrenia, 99 unaffected relatives, and 68 healthy controls from rural communities in the Central Andes. Diagnosis was ascertained with the Schedules of Clinical Assessment in Neuropsychiatry; parkinsonian motor impairment was measured with the Unified Parkinson's Disease Rating Scale; mesencephalic parenchyma was evaluated with transcranial ultrasound; and personality traits were assessed using the Temperament and Character Inventory. Ten-year outcome data was available for ~40% of the index cases. Patients with schizophrenia had higher harm avoidance and self-transcendence (ST), and lower reward dependence (RD), cooperativeness (CO), and self-directedness (SD). Unaffected relatives had higher ST and lower CO and SD. Parkinsonism reliably predicted RD, CO, and SD after correcting for age and sex. The average duration of untreated psychosis (DUP) was over 5 years. Further, SD was anticorrelated with DUP and antipsychotic dosing at follow-up. Baseline DUP was related to antipsychotic dose-years. Further, 'explosive/borderline', 'methodical/obsessive', and 'disorganized/schizotypal' personality profiles were associated with increased risk of schizophrenia. Parkinsonism predicts core personality features and treatment outcomes in schizophrenia. Our study suggests that RD, CO, and SD are endophenotypes of the disease that may, in part, be mediated by dopaminergic function. Further, SD is an important determinant of treatment course and outcome.

  14. Mild Cognitive Impairment is Associated with PoorerDecision Making in Community-Based Older Persons

    Science.gov (United States)

    Duke Han, S.; Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Bennett, David A.

    2015-01-01

    Background/Objectives Financial and healthcare decision making are important for maintaining wellbeing and independence in old age. We tested the hypothesis that Mild Cognitive Impairment (MCI) is associated with poorer decision making in financial and healthcare matters. Design Community-based epidemiologic cohort study. Setting Communities throughout Northeastern Illinois. Participants Participants were 730 older nondemented persons from the Rush Memory and Aging Project. Measurements All participants underwent a detailed clinical evaluation and decision making assessment using a measure that closely approximates materials utilized in real world financial and healthcare settings. This allowed for measurement of total decision making, as well as financial and healthcare decision making. Regression models were used to examine whether the presence of MCI was associated with a lower level of decision making. In subsequent analyses, we explored the relation of specific cognitive systems (i.e., episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability) with decision making in those with MCI. Results Results showed that MCI was associated with lower decision making total scores as well as financial and healthcare scores, respectively, after accounting for the effects of age, education, and sex. The effect of MCI on total decision making was equivalent to the effect of more than 10 additional years of age. Additional models showed that when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision making among participants with MCI. Conclusion Results suggest that persons with MCI may exhibit poorer financial and healthcare decision making in real world situations, and that perceptual speed may be an important contributor to poorer decision making among persons with MCI. PMID:25850350

  15. A systematic review of medication non-adherence in persons with dementia or cognitive impairment.

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    Daisy Smith

    Full Text Available Adherence to medication is vital for disease management while simultaneously reducing healthcare expenditure. Older persons with cognitive impairment (CI are at risk for non-adherence as cognitive processes are needed to manage medications. This systematic review focuses on the relationship between medication non-adherence and specific cognitive domains in persons with CI, and explores determinants of medication non-adherence. When available, relationships and factors are compared with cognitively intact populations.A seven database systematic search of studies published between 1 January 1949-31 December 2015 examining medication non-adherence in community dwelling persons with CI or dementia was conducted. Articles reporting medication non-adherence in people with CI or dementia in the community, with or without caregiver supports were eligible for inclusion. Papers reporting adherence to treatments in cognitively intact populations, populations from hospital or institutional settings, for non-prescribed medication or those describing dementia as a factor predicting medication non-adherence were excluded. Data on study and population characteristics, research design, data sources and analysis, specific cognitive domains, non-adherence prevalence, measurement of adherence, salient findings, factors associated with adherence and strategies to improve medication adherence were extracted. Study limitations included inconsistencies between data sources and definitions, resulting in a loss of fidelity in the value and comprehensiveness of data, as well as exclusion of non-pharmacological treatments and regimens.Fifteen studies met inclusion criteria. Adherence among CI subjects ranged from 10.7%-38% with better rates of adherence in non-CI individuals. Medication non-adherence definitions varied considerably. New-learning, memory and executive functioning were associated with improved adherence and formed the focus of most studies. Multiple factors

  16. [Psychiatric assessment in civil law questions].

    Science.gov (United States)

    Nedopil, N

    2009-05-01

    Psychiatric reports in German civil law cases are required if questions are raised of legal capacity, capacity to express a testamentary will, ability to sue or be sued, capacity to marry, ability of mentally disordered patients to consent to treatment, and when custody or hospital orders of these patients is considered or compensation is due for mental disorders resulting from accidents. Many reports must decide whether the ability to decide using sound reason or motives is or was impaired by a mental disorder. This capability is attributed to every adult person; only if incapability is claimed must it be proven by psychiatric assessment. As in most psychiatric court reports, such assessments must be structured in several steps. First a clinical diagnosis has to be established which must then be translated into legal terminology. After this has been accomplished, the psychiatrist must describe the functional impairments caused by the disorder and define the probability with which these impairments might affect the legal act in question. Most reports are prepared in the context of custody law, which centers on helping those patients who, due to a mental disorder, cannot manage their own legal matters.

  17. [Selected problems in the forensic-psychiatric evaluation of persons posing a likelihood of repeating a criminal act].

    Science.gov (United States)

    Florkowski, Antoni; Zboralski, Krzysztof; Nowacka, Agata; Strójwas, Krzysztof; Flinik-Jankowska, Magdalena; Konopa, Aleksandra; Łacisz, Joanna; Wierzbiński, Piotr

    2014-09-01

    In the current penal code, compared to previous regulations, there have been alterations concerning medical security measures. These amendments have been prompted by socio-politic circumstances in Poland as well as implementation of Mental Health Act. According to the current law the court, on the request of expert psychiatrists, can pronounce a sentence of obligatory stay in psychiatric institution for perpetrator of criminal act who has been deemed not sane due to 31 subsection 1 of penal code and who is predictably able of recidivism. In legal-medical practice those less experienced expert psychiatrists may encounter difficulties producing expertise for the court, especially evaluating probability of recurrence of committing a criminal act and resulting request for psychiatric detention. In order to make this issue more acquainted we present a review of literature concerning it.

  18. The Effect of Psychological Distress and Personality Traits on Cognitive Performances and the Risk of Dementia in Patients with Mild Cognitive Impairment

    NARCIS (Netherlands)

    Ramakers, I.H.G.B.; Honings, S.T.H.; Ponds, R.W.; Aalten, P.; Kohler, S.; Verhey, F.R.J.; Visser, P.J.

    2015-01-01

    Background: The relation between psychological distress, personality traits, and cognitive decline in cognitively impaired patients remains unclear. Objective: To investigate the effect of psychological distress and personality traits on cognitive functioning in subjects with mild cognitive

  19. Reduced amygdala reactivity and impaired working memory during dissociation in borderline personality disorder.

    Science.gov (United States)

    Krause-Utz, Annegret; Winter, Dorina; Schriner, Friederike; Chiu, Chui-De; Lis, Stefanie; Spinhoven, Philip; Bohus, Martin; Schmahl, Christian; Elzinga, Bernet M

    2017-05-19

    Affective hyper-reactivity and impaired cognitive control of emotional material are core features of borderline personality disorder (BPD). A high percentage of individuals with BPD experience stress-related dissociation, including emotional numbing and memory disruptions. So far little is known about how dissociation influences the neural processing of emotional material in the context of a working memory task in BPD. We aimed to investigate whole-brain activity and amygdala functional connectivity (FC) during an Emotional Working Memory Task (EWMT) after dissociation induction in un-medicated BPD patients compared to healthy controls (HC). Using script-driven imagery, dissociation was induced in 17 patients ('BPD_D'), while 12 patients ('BPD_N') and 18 HC were exposed to neutral scripts during fMRI. Afterwards, participants performed the EWMT with neutral vs. negative IAPS pictures vs. no distractors. Main outcome measures were behavioral performance (reaction times, errors) and whole-brain activity during the EWMT. Psychophysiological interaction analysis was used to examine amygdala connectivity during emotional distraction. BPD patients after dissociation induction showed overall WM impairments, a deactivation in bilateral amygdala, and lower activity in left cuneus, lingual gyrus, and posterior cingulate than BPD_N, along with stronger left inferior frontal gyrus activity than HC. Furthermore, reduced amygdala FC with fusiform gyrus and stronger amygdala FC with right middle/superior temporal gyrus and left inferior parietal lobule was observed in BPD_D. Findings suggest that dissociation affects reactivity to emotionally salient material and WM. Altered activity in areas associated with emotion processing, memory, and self-referential processes may contribute to dissociative states in BPD.

  20. The School-to-Community Transition of Hearing-Impaired Persons with Developmental Disabilities: A Review of the Empirical Literature.

    Science.gov (United States)

    Davis, Cheryl; Bullis, Michael

    1990-01-01

    This article summarizes 43 empirical studies of school-to-community transition of hearing-impaired persons with developmental disabilities; discusses data collection and interpretation issues; and recommends future research, development, and evaluation. The studies deal with such areas as career/vocational preparation, independent living skills,…

  1. Epidemiology of Psychiatric Disorders in Iranian Children and Adolescents (IRCAP) and Its Relationship with Social Capital, Life Style and Parents' Personality Disorders: Study Protocol.

    Science.gov (United States)

    Mohammadi, Mohammad Reza; Ahmadi, Nastaran; Kamali, Koorosh; Khaleghi, Ali; Ahmadi, Ameneh

    2017-01-01

    Objective: We aimed at designing a cross sectional study to investigate the prevalence of psychiatric disorders in Iranian children and adolescents (IRCAP) and to determine its relationship with social capital, life style, and parents' personality disorders. Method: This cross sectional study was a national project implemented in all provinces of Iran. In this community-based study, using ‎multistage cluster sampling method, we selected 1000 children and adolescents aged 6 to 18 years in each province. The total sample size reached to 31 000. ‎We randomly collected 170 blocks. Then, of each cluster head, we selected 6 cases including 3 cases of each gender in ‎different age groups (6- 9 years, 10- 14 years, and 15- 18 years). The clinical psychologists instructed the participants to complete the Persian version of Kiddie-Sads-‎Present and Lifetime Version (K-SADS-PL). In addition, demographic data (gender, age, education, parent education, and economic situation) and information on lifestyle, social capital, and parents' personality disorders were obtained from the participants. Discussion: IRCAP study presents a protocol for an epidemiological survey on the first estimates for the prevalence of psychiatric disorders in children and adolescents across the country. This large body of data, on a range of individual behavioural and emotional items and scores, allows us to compare the rates and patterns of deviance between urban and rural places of residence in 31 provinces of Iran with non Iranian samples surveyed with the same measures.

  2. Epidemiology of Psychiatric Disorders in Iranian Children and Adolescents and Its Relationship with Social Capital, Life Style and Parents' Personality Disorders: Study Protocol

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Mohammadi

    2017-02-01

    Full Text Available Objective: We aimed at designing a cross sectional study to investigate the prevalence of psychiatric disorders in Iranian children and adolescents and to determine its relationship with social capital, life style, and parents' personality disorders.Method: This cross sectional study was a national project implemented in all provinces of Iran. In this community-based study, using ‎multistage cluster sampling method, we selected 1000 children and adolescents aged 6 to 18 years in each province. The total sample size reached to 31 000. ‎We randomly collected 170 blocks. Then, of each cluster head, we selected 6 cases including 3 cases of each gender in ‎different age groups (6- 9 years, 10- 14 years, and 15- 18 years. The clinical psychologists instructed the participants to complete the Persian version of Kiddie-Sads-‎Present and Lifetime Version (K-SADS-PL. In addition, demographic data (gender, age, education, parent education, and economic situation and information on lifestyle, social capital, and parents' personality disorders were obtained from the participants.Discussion: This study presents a protocol for an epidemiological survey on the first estimates for the prevalence of psychiatric disorders in children and adolescents across the country. This large body of data, on a range of individual behavioural and emotional items and scores, allows us to compare the rates and patterns of deviance between urban and rural places of residence in 31 provinces of Iran with non Iranian samples surveyed with the same measures.

  3. Reconciling concepts of space and person-centred care of the older person with cognitive impairment in the acute care setting.

    Science.gov (United States)

    Rushton, Carole; Edvardsson, David

    2017-07-01

    Although a large body of literature exists propounding the importance of space in aged care and care of the older person with dementia, there is, however, only limited exploration of the 'acute care space' as a particular type of space with archetypal constraints that maybe unfavourable to older people with cognitive impairment and nurses wanting to provide care that is person-centred. In this article, we explore concepts of space and examine the implications of these for the delivery of care to older people who are cognitively impaired. Our exploration is grounded in theorisations of space offered by key geographers and phenomenologists, but also draws on how space has been constructed within the nursing literature that refers specifically to acute care. We argue that space, once created, can be created and that nursing has a significant role to play in the process of its recreation in the pursuit of care that is person-centred. We conclude by introducing an alternative logic of space aimed at promoting the creation of more salutogenic spaces that invokes a sense of sanctuary, safeness, and inclusion, all of which are essential if the care provided to the older person with cognitive impairment is apposite to their needs. The concept of 'person-centred space' helps to crystallize the relationship between space and person-centred care and implies more intentional manipulation of space that is more conducive to caring and healing. Significantly, it marks a return to Nightingale's wisdom, that is, to put the person in the best possible conditions for nature to act upon them. © 2016 John Wiley & Sons Ltd.

  4. Different perception of cognitive impairment, behavioral disturbances, and functional disabilities between persons with mild cognitive impairment and mild Alzheimer's disease and their caregivers.

    Science.gov (United States)

    Onor, M L; Trevisiol, M; Negro, C; Aguglia, E

    2006-01-01

    Insight in dementia is a multifaceted concept and ability, which includes the persons' perception of their behavioral and cognitive symptoms and functional disability. This ability seems to deteriorate as dementia progresses. The aim of this study was to evaluate the level of insight in the cognitive, behavioral, and functional disorders in a group of persons with mild cognitive impairment (MCI) or mild AD (Alzheimer's disease) and to compare their perception of their illness with that of their caregivers. The study involved a group of 121 persons with MCI and mild AD and their caregivers. The persons with MCI and mild AD were administered the tests Mini-Mental State Examination, Instrumental Activities of Daily Living, Activities of Daily Living, Neuropsychiatric Inventory, Schedule for the Assessment of Insight, Clinical Insight Rating Scale, and a short interview. Major differences were identified between how the persons with MCI or mild AD and their caregivers perceived the persons' cognitive and behavioral disorders. The group with MCI or mild AD underestimated their deficits, which were considered serious and disabling by their caregivers.

  5. Neurological soft signs in persons with amnestic mild cognitive impairment and the relationships to neuropsychological functions

    Directory of Open Access Journals (Sweden)

    Li Hui-jie

    2012-06-01

    Full Text Available Abstract Background Neurological abnormalities have been reported in people with amnestic mild cognitive impairment (aMCI. The current study aimed to examine the prevalence of neurological soft signs (NSS in this clinical group and to examine the relationship of NSS to other neuropsychological performances. Methods Twenty-nine people with aMCI and 28 cognitively healthy elderly people were recruited for the present study. The NSS subscales (motor coordination, sensory integration, and disinhibition of the Cambridge Neurological Inventory and a set of neuropsychological tests were administered to all the participants. Results People with aMCI exhibited significantly more motor coordination signs, disinhibition signs, and total NSS than normal controls. Correlation analysis showed that the motor coordination subscale score and total score of NSS were significantly inversely correlated with the combined Z-score of neuropsychological tests in aMCI group. Conclusions These preliminary findings suggested that people with aMCI demonstrated a higher prevalence of NSS compared to healthy elderly people. Moreover, NSS was found to be inversely correlated with the neuropsychological performances in persons with aMCI. When taken together, these findings suggested that NSS may play a potential important role and serve as a tool to assist in the early detection of aMCI.

  6. Multi-Section Sensing and Vibrotactile Perception for Walking Guide of Visually Impaired Person

    Directory of Open Access Journals (Sweden)

    Gu-Young Jeong

    2016-07-01

    Full Text Available Electronic Travel Aids (ETAs improve the mobility of visually-impaired persons, but it is not easy to develop an ETA satisfying all the factors needed for reliable object detection, effective notification, and actual usability. In this study, the authors developed an easy-to-use ETA having the function of reliable object detection and its successful feedback to the user by tactile stimulation. Seven ultrasonic sensors facing in different directions detect obstacles in the walking path, while vibrators in the tactile display stimulate the hand according to the distribution of obstacles. The detection of ground drop-offs activates the electromagnetic brakes linked to the rear wheels. To verify the feasibility of the developed ETA in the outdoor environment, walking tests by blind participants were performed, and the evaluation of safety to ground drop-offs was carried out. From the experiment, the feasibility of the developed ETA was shown to be sufficient if the sensor ranges for hanging obstacle detection is improved and learning time is provided for the ETA. Finally, the light-weight and low cost ETA designed and assembled based on the evaluation of the developed ETA is introduced to show the improvement of portability and usability, and is compared with the previously developed ETAs.

  7. Multi-Section Sensing and Vibrotactile Perception for Walking Guide of Visually Impaired Person.

    Science.gov (United States)

    Jeong, Gu-Young; Yu, Kee-Ho

    2016-07-12

    Electronic Travel Aids (ETAs) improve the mobility of visually-impaired persons, but it is not easy to develop an ETA satisfying all the factors needed for reliable object detection, effective notification, and actual usability. In this study, the authors developed an easy-to-use ETA having the function of reliable object detection and its successful feedback to the user by tactile stimulation. Seven ultrasonic sensors facing in different directions detect obstacles in the walking path, while vibrators in the tactile display stimulate the hand according to the distribution of obstacles. The detection of ground drop-offs activates the electromagnetic brakes linked to the rear wheels. To verify the feasibility of the developed ETA in the outdoor environment, walking tests by blind participants were performed, and the evaluation of safety to ground drop-offs was carried out. From the experiment, the feasibility of the developed ETA was shown to be sufficient if the sensor ranges for hanging obstacle detection is improved and learning time is provided for the ETA. Finally, the light-weight and low cost ETA designed and assembled based on the evaluation of the developed ETA is introduced to show the improvement of portability and usability, and is compared with the previously developed ETAs.

  8. Quality Registries in Sweden, Healthcare Improvements and Elderly Persons with Cognitive Impairments.

    Science.gov (United States)

    Mattsson, Titti

    2016-12-01

    Policy-makers, the medical industry and researchers are demonstrating a keen interest in the potential of large registries of patient data, both nationally and internationally. The registries offer promising ways to measure and develop operational quality within health and medical care services. As a result of certain favourable patient data regulations and government funding, the development of quality registries is advanced in Sweden. The combination of increasing demand for more cost-efficient healthcare that can accommodate the demographic development of a rapidly ageing population, and the emergence of eHealth with an increasing digitalisation of patient data, calls attention to quality registries as a possible way for healthcare improvements. However, even if the use of registries has many advantages, there are some drawbacks from a patient privacy point of view. This article aims to analyse this growing interdependence of quality registries for the healthcare sector. It discusses some lessons from the Swedish case, with particular focus on the collection of data from elderly persons with cognitive impairments.

  9. Predicting progression to dementia in persons with mild cognitive impairment using cerebrospinal fluid markers.

    Science.gov (United States)

    Handels, Ron L H; Vos, Stephanie J B; Kramberger, Milica G; Jelic, Vesna; Blennow, Kaj; van Buchem, Mark; van der Flier, Wiesje; Freund-Levi, Yvonne; Hampel, Harald; Olde Rikkert, Marcel; Oleksik, Ania; Pirtosek, Zvezdan; Scheltens, Philip; Soininen, Hilkka; Teunissen, Charlotte; Tsolaki, Magda; Wallin, Asa K; Winblad, Bengt; Verhey, Frans R J; Visser, Pieter Jelle

    2017-08-01

    We aimed to determine the added value of cerebrospinal fluid (CSF) to clinical and imaging tests to predict progression from mild cognitive impairment (MCI) to any type of dementia. The risk of progression to dementia was estimated using two logistic regression models based on 250 MCI participants: the first included standard clinical measures (demographic, clinical, and imaging test information) without CSF biomarkers, and the second included standard clinical measures with CSF biomarkers. Adding CSF improved predictive accuracy with 0.11 (scale from 0-1). Of all participants, 136 (54%) had a change in risk score of 0.10 or higher (which was considered clinically relevant), of whom in 101, it was in agreement with their dementia status at follow-up. An individual person's risk of progression from MCI to dementia can be improved by relying on CSF biomarkers in addition to recommended clinical and imaging tests for usual care. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  10. Humor and laughter in persons with cognitive impairment and their caregivers.

    Science.gov (United States)

    Liptak, Amy; Tate, Judith; Flatt, Jason; Oakley, Mary Ann; Lingler, Jennifer

    2014-03-01

    The purpose of this study was to describe humor and laughter in persons with cognitive impairment (PWCI) and caregivers who were recalling a shared experience in a focus group. Twenty participants attended an Art Engagement Activity at the Andy Warhol Art Museum, which included a guided tour and an art project. All PWCI had medically diagnosed cognitive disorders and all caregiver participants did not. Four focus groups were conducted and transcripts of audio-recorded sessions were transferred to a qualitative software program. Words, phrases, and episodes of humor and laughter were used to construct codes, which were refined during group analysis using constant comparison. Humor and laughter were present in all four focus groups. Emerging themes of humor included silliness, sarcasm, and commenting about hardships of dementia. Laughter was identified in segments with and without humor. Some PWCI were unable to follow social cues. Humor and laughter played a role in creating a safe social environment. PWCI were able to engage in humor during social interactions, yet some had difficulty recognizing social cues. Further study may reveal roles of humor and laughter in adaptation to cognitive decline and holistic interventions for improved quality of life.

  11. Humor and laughter in persons with cognitive impairment and their caregivers

    Science.gov (United States)

    Liptak, Amy; Tate, Judith; Flatt, Jason; Oakley, Mary Ann; Lingler, Jennifer

    2014-01-01

    Purpose The purpose of this study was to describe humor and laughter in persons with cognitive impairment (PWCI) and caregivers who were recalling a shared experience in a focus group. Design Twenty participants attended an Art Engagement Activity at the Andy Warhol Art Museum, which included a guided tour and an art project. All PWCI had medically diagnosed cognitive disorders and all caregiver participants did not. Four focus groups were conducted and transcripts of audio-recorded sessions were transferred to a qualitative software program. Methods Words, phrases and episodes of humor and laughter were used to construct codes, which were refined during group analysis using constant comparison. Findings Humor and laughter were present in all four focus groups. Emerging themes of humor included silliness, sarcasm and commenting about hardships of dementia. Laughter was identified in segments with and without humor. Some PWCI were unable to follow social cues. Conclusions Humor and laughter played a role in creating a safe social environment. PWCI were able to engage in humor during social interactions, yet some had difficulty recognizing social cues. Further study may reveal roles of humor and laughter in adaptation to cognitive decline and holistic interventions for improved quality of life. PMID:23926217

  12. Borderline personality disorder associates with violent criminality in women: A population based follow-up study of adolescent psychiatric inpatients in Northern Finland.

    Science.gov (United States)

    Arola, Riikka; Antila, Henna; Riipinen, Pirkko; Hakko, Helinä; Riala, Kaisa; Kantojärvi, Liisa

    2016-09-01

    Various psychiatric problems in adolescence and early adulthood have been shown to associate with criminal behaviour. In this study the association of personality disorders (PDs) with criminal behaviour was examined in adolescents treated in psychiatric hospitals. The study sample consisted of 508 adolescents (age 13-17) admitted to acute psychiatric impatient care between April 2001 and March 2006. Crime data was obtained from the Finnish Legal Register Centre on September 2013. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) was used to assess psychiatric diagnoses in adolescence. The information on PDs in early adulthood was based on follow-up information on psychiatric treatments in either out- or inpatient settings until the end of 2012, and was extracted from the National Care Register for Health Care provided by the Finnish National Institute for Health and Welfare. A total of 22 (39%) of the 57 subjects with PD had committed a crime. In women, the likelihood for violent criminality was significantly increased in those with Borderline PD (OR 6.09, CI 1.24-29.84, p=0.009) and was also associated with conduct disorder (OR 4.26, CI 1.38-13.19, p=0.012), child welfare placement (OR 11.82, CI 3.61-38.76, pdisorder (OR 7.74, CI 2.30-26.10, p=0.001). In men, no association was observed between PD and any kind of criminal behaviour. Significant predictors for violent criminality in males were conduct disorder (OR 4.05, CI 1.75-9.38, p=0.001), substance use disorder (OR 2.51, CI 1.22-5.17, p=0.012) and special services at school (OR 2.58, CI 1.16-5.76, p=0.021). Females with Borderline PD showed an increased risk for violent offending. This suggests Borderline PD as a potential explanatory factor for violent assaults by females and highlights the importance of recognizing the risk for violence in young women with a Borderline PD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. HEALTH SELF-EVALUATION OF ELDERLY PERSONS WITH VISUAL IMPAIRMENTS IN RELATION TO GENDER AND STATE OF HEALTH

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    Amela Teskeredžić

    2017-09-01

    Full Text Available Health self-evaluation, as a subjective measure, is related to person’s well-being because it encapsulates physical and emotional health evaluation. It has been concluded that subjective health is, for most of people, number one trait of quality of living that is connected to health. Individual is to decide which aspects of objective situation are important for their satisfaction in life. In other words, way in which a person will perceive and react to an objective situation depends on their personal traits. Aim of this research was to examine the differences in relation to gender and health state of visually impaired older persons of that live in institutional accommodation, by self-evaluation. Respondents sample was comprised of 40 visually impaired older persons, both genders (13 male and 27 female that live in nursing home “Dom penzionera” in Tuzla. Research has been conducted by interview, using questionnaire “Quality of life of adult persons with motoric disabilities in territory of Vojvodina” (Susnjevic, 2015. Because of the structure of questions in questionnaire, it was possible to apply it on visually impaired persons as well. Data acquired had been processed with descriptive statistics, hi-squre and t – test, in order to determine if there were differences in relation to gender and selfevaluation of physical and social functioning. Results of the research have shown that although means have proven that there are differences in acquired results between respondents of male and female gender, results of t-test have shown that those differences are not statistically significant. Presence of any kind of damage, and visual impairment as well can influence person’s psychological and physical integrity.

  14. Oxytocin and Psychiatric Disorders

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    Gokce Nur Say

    2016-06-01

    Full Text Available Oxytocin is a neuropeptide that plays critical role in mother-infant bonding, pair bonding and prosocial behaviors. Several neuropsychiatric disorders such as autism, schizophrenia, affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, alcohol/substance addiction, aggression, suicide, eating disorders and personality disorders show abnormalities of oxytocin system. These findings have given rise to the studies searching therapeutic use of oxytocin for psychi-atric disorders. The studies of oxytocin interventions in psychiatric disorders yielded potentially promising findings. This paper reviews the role of oxytocin in emotions, behavior and its effects in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 102-113

  15. Exclusion-Proneness in Borderline Personality Disorder Inpatients Impairs Alliance in Mentalization-Based Group Therapy

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    Sebastian Euler

    2018-05-01

    Full Text Available Interpersonal sensitivity, particularly threat of potential exclusion, is a critical condition in borderline personality disorder (BPD which impairs patients’ social adjustment. Current evidence-based treatments include group components, such as mentalization-based group therapy (MBT-G, in order to improve interpersonal functioning. These treatments additionally focus on the therapeutic alliance since it was discovered to be a robust predictor of treatment outcome. However, alliance is a multidimensional factor of group therapy, which includes the fellow patients, and may thus be negatively affected by the exclusion-proneness of BPD patients. The aim of this pilot study was to examine the predictive value of threat of social exclusion for the therapeutic alliance in MBT-G. In the first part of the study, social exclusion was experimentally induced in 23 BPD inpatients and 28 healthy subjects using the Cyberball paradigm, a virtual ball tossing game. The evoked level of threat was measured with the Need-Threat Scale (NTS which captures four dimensions of fundamental human needs, i.e., the need for belongingness, for self-esteem, for control, and for a meaningful existence. In the second part of the study, therapeutic alliance was measured on three dimensions, the therapists, the fellow patients and the group as a whole, using the Group-Questionnaire (GQ-D. BPD patients scored higher in their level of threat according to the NTS in both, the inclusion and the exclusion condition. The level of threat after exclusion predicted impairments of the therapeutic alliance in MBT-G. It was associated with more negative relationships, lower positive bonding and a lower positive working alliance with the fellow patients and lower positive bonding to the group as a whole whilst no negative prediction of the alliance to the therapists was found. Consequently, our translational study design has shown that Cyberball is an appropriate tool to use as an approach

  16. Effects of Four-Month Exercise Program on Correction of Body Posture of Persons with Different Visual Impairment

    Directory of Open Access Journals (Sweden)

    Damira Vranesic-Hadzimehmedovic

    2018-04-01

    Full Text Available The aim of this study was to determine the effect of a four-month specific exercise program on correcting the posture of persons with different visual impairment. The sample consisted of 20 elementary students with visual impairment diagnosis, 11 boys and 9 girls aged 9-14 (12±0.6. The classification of the examinees was performed according to the established degree of visual impairment, 10 blind persons and 10 partially sighted persons. The pupils voluntarily participated in the exercise program. The exercise program was structured of two phases: exercise on dryland and exercise in water. A total of 36 exercise units were completed during four months period. Seven tests were used to evaluate the body posture, based on the determination of segmental dimensions and the visual projection of the marked points. The contents of the program were performed with the aim of preventing and correcting the observed irregularities of the body posture. The t-test scores indicated statistically significant differences between two measurements (p<0.05, p<0.01. It can be concluded that elementary movements, performed through dryland and especially water exercises, had a good effect on correcting the body's posture of blind and partially sighted persons.

  17. Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years

    Science.gov (United States)

    SKODOL, ANDREW E.; PAGANO, MARIA E.; BENDER, DONNA S.; SHEA, M. TRACIE; GUNDERSON, JOHN G.; YEN, SHIRLEY; STOUT, ROBERT L.; MOREY, LESLIE C.; SANISLOW, CHARLES A.; GRILO, CARLOS M.; ZANARINI, MARY C.; McGLASHAN, THOMAS H.

    2012-01-01

    Background A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable ? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period. Method Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas of the Northeastern USA. Patients were assigned to one of five diagnostic groups: schizotypal (STPD) (n=81), borderline (BPD) (n=155), avoidant (AVPD) (n=137), or obsessive–compulsive (OCPD) (n=142) personality disorders or MDD and no PD (n=85), based on the results of semi-structured interview assessments and self-report measures. Impairment in psychosocial functioning was measured using the Longitudinal Interval Follow-up Evaluation (LIFE) at baseline and at three follow-up assessments. Results Significant improvement in psychosocial functioning occurred in only three of seven domains of functioning and was largely the result of improvements in the MDD and no PD group. Patients with BPD or OCPD showed no improvement in functioning overall, but patients with BPD who experienced change in personality psychopathology showed some improvement in functioning. Impairment in social relationships appeared most stable in patients with PDs. Conclusion Impairment in functioning, especially social functioning, may be an enduring component of personality disorder. PMID:15841879

  18. Personality Symptoms and Self-Esteem as Correlates of Psychopathology in Child Psychiatric Patients: Evaluating Multiple Informant Data

    Science.gov (United States)

    De Pauw, Sarah S. W.; Mervielde, Ivan; De Clercq, Barbara J.; De Fruyt, Filip; Tremmery, Sabine; Deboutte, Dirk

    2009-01-01

    Research on adulthood posits personality and self-esteem as important predictors of psychopathology. In childhood, however, the study of these relationships is complicated by the lack of consensus on how to combine data from multiple informants of child behavior. This study evaluates the relationships among personality symptoms, self-esteem and…

  19. Empowerment, environment and person-centred care: A qualitative study exploring the hospital experience for adults with cognitive impairment.

    Science.gov (United States)

    Prato, Laura; Lindley, Lyndsay; Boyles, Miriam; Robinson, Louise; Abley, Clare

    2018-01-01

    It is acknowledged that there are many challenges to ensuring a positive hospital experience for patients with cognitive impairment. The study ('Improving hospital care for adults with cognitive impairment') aimed to explore the positive and negative experiences of older adults with cognitive impairment (dementia and delirium) and their relatives and/or carers, during an acute hospital stay, from admission to discharge, using a qualitative, case study methodology. Six participants with cognitive impairment, eight relatives and 59 members of the health care team were recruited. Data was collected via ethnographic, observational periods at each stage of the hospital journey and through the use of semi-structured interviews with relatives, carers and health care staff including: medical staff; nursing staff; physiotherapists and ward managers. Interpretive phenomenological analysis was used to facilitate data analysis. 52 hours 55 minutes of ethnographic observations and 18 interviews with ward staff and relatives were undertaken. Three superordinate themes emerged from the data as crucial in determining the quality of the hospital experience: valuing the person; activities of empowerment and disempowerment and the interaction of environment with patient well-being. Whether the patient's hospital experience was positive or negative was powerfully influenced by family involvement and ward staff actions and communication. Participants identified a requirement for a ward based activity service for patients with cognitive impairment. Further research must be undertaken focusing on the development of ward based activities for patients with cognitive impairment, alongside a move towards care which explores measures to improve and expand relative involvement in hospital care.

  20. Impaired Maintenance of Interpersonal Synchronization in Musical Improvisations of Patients with Borderline Personality Disorder

    Directory of Open Access Journals (Sweden)

    Katrien Foubert

    2017-04-01

    Full Text Available Borderline personality disorder (BPD is a serious and complex mental disorder with a lifetime prevalence of 5.9%, characterized by pervasive difficulties with emotion regulation, impulse control, and instability in interpersonal relationships and self-image. Impairments in interpersonal functioning have always been a prominent characteristic of BPD, indicating a need for research to identify the specific interpersonal processes that are problematic for diagnosed individuals. Previous research has concentrated on self-report questionnaires, unidirectional tests, and experimental paradigms wherein the exchange of social signals between individuals was not the focus. We propose joint musical improvisation as an alternative method to investigate interpersonal processes. Using a novel, carefully planned, ABA′ accompaniment paradigm, and taking into account the possible influences of mood, psychotropic medication, general attachment, and musical sophistication, we recorded piano improvisations of 16 BPD patients and 12 matched healthy controls. We hypothesized that the insecure attachment system associated with BPD would be activated in the joint improvisation and manifest in measures of timing behavior. Results indicated that a logistic regression model, built on differences in timing deviations, predicted diagnosis with 82% success. More specifically, over the course of the improvisation B section (freer improvisation, controls' timing deviations decreased (temporal synchrony became more precise whereas that of the patients with BPD did not, confirming our hypothesis. These findings are in accordance with previous research, where BPD is characterized by difficulties in attachment relationships such as maintaining strong attachment with others, but it is novel to find empirical evidence of such issues in joint musical improvisation. We suggest further longitudinal research within the field of music therapy, to study how recovery of these timing

  1. Effect of discontinuation of antihypertensive medication on orthostatic hypotension in older persons with mild cognitive impairment: the DANTE Study Leiden.

    Science.gov (United States)

    Moonen, Justine E F; Foster-Dingley, Jessica C; de Ruijter, Wouter; van der Grond, Jeroen; de Craen, Anton J M; van der Mast, Roos C

    2016-03-01

    the relationship between antihypertensive medication and orthostatic hypotension in older persons remains ambiguous, due to conflicting observational evidence and lack of data of clinical trials. to assess the effect of discontinuation of antihypertensive medication on orthostatic hypotension in older persons with mild cognitive impairment. a total of 162 participants with orthostatic hypotension were selected from the Discontinuation of Antihypertensive Treatment in Elderly people (DANTE) Study. This randomised clinical trial included community-dwelling participants aged ≥75 years, with mild cognitive impairment, using antihypertensive medication and without serious cardiovascular disease. Participants were randomised to discontinuation or continuation of antihypertensive treatment (ratio 1:1). Orthostatic hypotension was defined as a drop of at least 20 mmHg in systolic blood pressure and/or 10 mmHg in diastolic blood pressure on standing from a seated position. Outcome was the absence of orthostatic hypotension at 4-month follow-up. Relative risks (RR) were calculated by intention-to-treat and per-protocol analyses. at follow-up, according to intention-to-treat analyses, of the 86 persons assigned to discontinuation of antihypertensive medication, 43 (50%) were free from orthostatic hypotension, compared with 29 (38%) of the 76 persons assigned to continuation of medication [RR 1.31 (95% confidence interval (CI) 0.92-1.87); P = 0.13]. Per-protocol analysis showed that recovery from orthostatic hypotension was significantly higher in persons who completely discontinued all antihypertensive medication (61%) compared with the continuation group (38%) [RR 1.60 (95% CI 1.10-2.31); P = 0.01]. in older persons with mild cognitive impairment and orthostatic hypotension receiving antihypertensive medication, discontinuation of antihypertensive medication may increase the probability of recovery from orthostatic hypotension. © The Author 2016. Published by Oxford

  2. Information Technology and Transcription of Reading Materials for the Visually Impaired Persons in Nigeria

    Science.gov (United States)

    Nkiko, Christopher; Atinmo, Morayo I.; Michael-Onuoha, Happiness Chijioke; Ilogho, Julie E.; Fagbohun, Michael O.; Ifeakachuku, Osinulu; Adetomiwa, Basiru; Usman, Kazeem Omeiza

    2018-01-01

    Studies have shown inadequate reading materials for the visually impaired in Nigeria. Information technology has greatly advanced the provision of information to the visually impaired in other industrialized climes. This study investigated the extent of application of information technology to the transcription of reading materials for the…

  3. Hypothyroidism and Risk of Mild Cognitive Impairment in Elderly Persons - A Population Based Study

    Science.gov (United States)

    Parsaik, Ajay K; Singh, Balwinder; Roberts, Rosebud O; Pankratz, Shane; Edwards, Kelly K.; Geda, Yonas E; Gharib, H; Boeve, Bradley F; Knopman, David S; Petersen, Ronald C

    2014-01-01

    IMPORTANCE Association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) is not established. OBJECTIVE To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population based cohort. DESIGN A cross-sectional, population-based study. SETTING Olmsted County, Minnesota. PARTICIPANTS Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia. A total of 2,050 participants were evaluated and underwent in-person interview, neurological evaluation and neuropsychological testing to assess performance in memory, attention/executive function, visuospatial, and language domains. Subjects were diagnosed by consensus as cognitively normal, MCI or dementia according to published criteria. Clinical and subclinical hypothyroidism was ascertained from a medical records-linkage system. MAIN OUTCOME MEASURES Association of clinical and subclinical hypothyroidism with MCI. Results Among 1904 eligible participants, the frequency of MCI was 16% in 1450 subjects with normal thyroid function, 17% in 313 subjects with clinical hypothyroidism, and 18% in 141 subjects with subclinical hypothyroidism. After adjusting for covariates (age, gender, education, education years, sex, ApoE ε 4, depression, diabetes, hypertension, stroke, BMI and coronary artery disease) we found no significant association between clinical or subclinial hypothyroidism and MCI [OR 0.99 (95% CI 0.66–1.48) and OR 0.88 (95% CI 0.38–2.03) respectively]. No effect of gender interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidisn among males was 1.02 (95%CI, 0.57–1.82) and 1.29 (95%CI 0.68–2.44), among females was 1.04 (95% 0.66–1.66) and 0.86 (95% CI 0.37–2.02) respectively. Conclusion In this population based cohort of eldery, neither clinical nor subclinical hypothyrpodism was associated with MCI. Our findings

  4. Mental state decoding impairment in major depression and borderline personality disorder: meta-analysis.

    Science.gov (United States)

    Richman, Mara J; Unoka, Zsolt

    2015-12-01

    Patients with major depression and borderline personality disorder are characterised by a distorted perception of other people's intentions. Deficits in mental state decoding are thought to be the underlying cause of this clinical feature. To examine, using meta-analysis, whether mental state decoding abilities in patients with major depression and borderline personality disorder differ from those of healthy controls. A systematic review of 13 cross-sectional studies comparing Reading in the Mind of the Eyes Test (RMET) accuracy performance of patients with major depression or borderline personality disorder and healthy age-matched controls (n = 976). Valence scores, where reported, were also assessed. Large significant deficits were seen for global RMET performance in patients with major depression (d = -0.751). The positive RMET valence scores of patients with depression were significantly worse; patients with borderline personality disorder had worse neutral scores. Both groups were worse than controls. Moderator analysis revealed that individuals with comorbid borderline personality disorder and major depression did better than those with borderline personality disorder alone on accuracy. Those with comorbid borderline personality disorder and any cluster B or C personality disorder did worse than borderline personality disorder alone. Individuals with both borderline personality disorder and major depression performed better then those with borderline personality disorder without major depression for positive valence. These findings highlight the relevance of RMET performance in patients with borderline personality disorder and major depression, and the importance of considering comorbidity in future analysis. © The Royal College of Psychiatrists 2015.

  5. Body Focused Repetitive Behaviors (BFRBs) and Personality Features

    DEFF Research Database (Denmark)

    Chamberlain, Samuel; Odlaug, Brian Lawrence

    2014-01-01

    have they been incorporated into psychiatric nosological systems. The relationship between BFRBs and aspects of personality has been scarcely researched. Understanding how formal axis-II personality disorders, questionnaire-based measures of personality, or other putatively enduring traits...... such as cognitive impairment, relate to the BFRBs may advance our understanding of the core characteristics of the BFRBs and subsequently lead to greater understanding of their pathophysiology and treatment. This article reviews the existing literature surrounding BFRBs and aspects of personality, and highlights...

  6. Impairments, activity limitations and participation restrictions: Prevalence and associations among persons living with HIV/AIDS in British Columbia

    Directory of Open Access Journals (Sweden)

    Braitstein Paula

    2004-09-01

    Full Text Available Abstract Background To measure the prevalence of and associations among impairments, activity limitations and participation restrictions in persons living with HIV in British Columbia to inform support and care programs, policy and research. Methods A cross-sectional population-based sample of persons living with HIV in British Columbia was obtained through an anonymous survey sent to members of the British Columbia Persons With AIDS Society. The survey addressed the experience of physical and mental impairments, and the experience and level of activity limitations and participation restrictions. Associations were measured in three ways: 1 impact of types of impairment on social restriction; 2 impact of specific limitations on social restriction; and 3 independent association of overall impairments and limitations on restriction levels. Logistic regression was used to measure associations with social restriction, while ordinal logistic regression was used to measure associations with a three-category measure of restriction level. Results The survey was returned by 762 (50.5% of the BCPWA participants. Over ninety percent of the population experienced one or more impairments, with one-third reporting over ten. Prevalence of activity limitations and participation restrictions was 80.4% and 93.2%, respectively. The presence of social restrictions was most closely associated with mental function impairments (OR: 7.0 for impairment vs. no impairment; 95% CI: 4.7 – 10.4. All limitations were associated with social restriction. Among those with ≤ 200 CD4 cells/mm3, odds of being at a higher restriction level were lower among those on antiretrovirals (OR: 0.3 for antiretrovirals vs. no antiretrovirals; 95% CI: 0.1–0.9, while odds of higher restriction were increased with higher limitation (OR: 3.6 for limitation score of 1–5 vs. no limitation, 95%CI: 0.9–14.2; OR: 24.7 for limitation score > 5 vs. no limitation, 95%CI: 4.9–125.0. Among those

  7. Gap analysis : bus signage guidelines for persons with visual impairments : electronic signs

    Science.gov (United States)

    2001-09-01

    This report focuses on the adequacy of Americans with Disabilities Act (ADA) destination signage guidelines for visual technologies used to improve the dissemination of public transit information to the visually impaired. Specifically, this document ...

  8. Dialogue enabling speech-to-text user assistive agent system for hearing-impaired person.

    Science.gov (United States)

    Lee, Seongjae; Kang, Sunmee; Han, David K; Ko, Hanseok

    2016-06-01

    A novel approach for assisting bidirectional communication between people of normal hearing and hearing-impaired is presented. While the existing hearing-impaired assistive devices such as hearing aids and cochlear implants are vulnerable in extreme noise conditions or post-surgery side effects, the proposed concept is an alternative approach wherein spoken dialogue is achieved by means of employing a robust speech recognition technique which takes into consideration of noisy environmental factors without any attachment into human body. The proposed system is a portable device with an acoustic beamformer for directional noise reduction and capable of performing speech-to-text transcription function, which adopts a keyword spotting method. It is also equipped with an optimized user interface for hearing-impaired people, rendering intuitive and natural device usage with diverse domain contexts. The relevant experimental results confirm that the proposed interface design is feasible for realizing an effective and efficient intelligent agent for hearing-impaired.

  9. Reconciling conceptualizations of relationships and person-centred care for older people with cognitive impairment in acute care settings.

    Science.gov (United States)

    Rushton, Carole; Edvardsson, David

    2018-04-01

    Relationships are central to enacting person-centred care of the older person with cognitive impairment. A fuller understanding of relationships and the role they play facilitating wellness and preserving personhood is critical if we are to unleash the productive potential of nursing research and person-centred care. In this article, we target the acute care setting because much of the work about relationships and older people with cognitive impairment has tended to focus on relationships in long-term care. The acute care setting is characterized by archetypal constraints which differentiate it from long-term care, in terms of acuity and haste, task-orientated work patterns and influence from "the rule of medicine," all of which can privilege particular types of relating. In this article, we drew on existing conceptualizations of relationships from theory and practice by tapping in to the intellectual resources provided by nurse researchers, the philosophy of Martin Buber and ANT scholars. This involved recounting two examples of dyadic and networked relationships which were re-interpreted using two complementary theoretical approaches to provide deeper and more comprehensive conceptualizations of these relationships. By re-presenting key tenets from the work of key scholars on the topic relationships, we hope to hasten socialization of these ideas into nursing into the acute care setting. First, by enabling nurses to reflect on how they might work toward cultivating relationships that are more salutogenic and consistent with the preservation of personhood. Second, by stimulating two distinct but related lines of research enquiry which focus on dyadic and networked relationships with the older person with cognitive impairment in the acute care setting. We also hope to reconcile the schism that has emerged in the literature between preferred approaches to care of the older person with cognitive impairment, that is person-centred care versus relationship-centred care

  10. The effects of participation in leisure activities on neuropsychiatric symptoms of persons with cognitive impairment: a cross-sectional study.

    Science.gov (United States)

    Chiu, Yi-Chen; Huang, Chien-Ying; Kolanowski, Ann M; Huang, Hsiu-Li; Shyu, Yeaing Lotus; Lee, Shu-Hwa; Lin, Ching-Rong; Hsu, Wen-Chuin

    2013-10-01

    People with cognitive impairment have been shown to engage in few structured activities. During periods of unoccupied time or boredom, these patients most likely manifest neuropsychiatric symptoms. The purposes of this study were to (1) describe the leisure-activity indicators (variety in leisure activities, appraisal of each activity's restorative function, and leisure dysfunction, i.e. failure to appreciate the importance of restorative aspects of leisure activity), of community-dwelling older Taiwanese adults with cognitive impairment, and (2) explore the relationships between these indicators and neuropsychiatric symptoms in this population. Cross-sectional. Memory disorder and geriatric psychiatric clinics of two hospitals in northern Taiwan. Patient-family caregiver dyads (N=60). Patients' dementia severity, based on Clinical Dementia Rating scores, was 0.5-2.0. Family caregivers completed the Chinese Neuropsychiatric Inventory to assess patients' behavioral problems and the Restorative Activity Questionnaire to assess patients' participation in leisure activities, restorative experience, and leisure dysfunction. On average, patients participated in approximately five individual leisure activities, but very few group leisure activities. The top three leisure activities were watching TV, taking a walk, and talking to relatives and friends. The leisure activities in which participants least commonly engaged were fishing, attending cultural exhibitions, and chess/card playing. All leisure-activity indicators were significantly correlated with disease stage, global cognitive function, and neuropsychiatric symptoms. Two leisure-activity indicators (leisure dysfunction and restorative experiences) were significantly correlated with depressive symptoms. Only leisure dysfunction significantly and consistently predicted neuropsychiatric symptoms. These results can be used by home health or community health nurses to design tailored leisure-activity plans for improving

  11. College Students with Psychiatric Disabilities

    Science.gov (United States)

    Singh, Delar K.

    2011-01-01

    This paper focuses on college students with psychiatric disabilities. It defines and discusses various psychiatric conditions such as mood disorders, anxiety disorders, eating disorders, and personality disorders. It concludes with accommodations that a college professor can make to help these students succeed in higher education. (Contains 1…

  12. [Conception and Content Validation of a Questionnaire Relating to the Potential Need for Information of Visually Impaired Persons with Regard to Services and Contact Persons].

    Science.gov (United States)

    Hahn, U; Hechler, T; Witt, U; Krummenauer, F

    2015-12-01

    A questionnaire was drafted to identify the needs of visually impaired persons and to optimize their access to non-medical support and services. Subjects had to rate a list of 15 everyday activities that are typically affected by visual impairment (for example, being able to orient themselves in the home environment), by indicating the degree to which they perceive each activity to be affected, using a four-stage scale. They had to evaluate these aspects by means of a relevance assessment. The needs profile derived from this is then correlated with individualized information for assistance and support. The questionnaire shall be made available for use by subjects through advisers in some ophthalmic practices and via the internet. The validity of the content of the proposed tool was evaluated on the basis of a survey of 59 experts in the fields of medical, optical and psychological care and of persons involved in training initiatives. The experts were asked to rate the activities by relevance and clarity of the wording and to propose methods to further develop and optimize the content. The validity of the content was quantified according to a process adopted in the literature, based on the parameters Interrater Agreement (IRA) and Content Validity Index (CVI). The results of all responses (n = 19) and the sub-group analysis suggest that the questionnaire adequately reflects the potential needs profile of visually impaired persons. Overall, there was at least 80% agreement among the 19 experts for 93% of the proposed parameterisation of the activities relating to the relevance and clarity of the wording. Individual proposals for optimization of the design of the questionnaire were adopted. Georg Thieme Verlag KG Stuttgart · New York.

  13. Imagining other people’s experiences in a person with impaired episodic memory: the role of personal familiarity

    Directory of Open Access Journals (Sweden)

    Jennifer S. Rabin

    2013-01-01

    Full Text Available Difficulties remembering one’s own experiences via episodic memory may affect the ability to imagine other people’s experiences during theory of mind (ToM. Previous work shows that the same set of brain regions recruited during tests of episodic memory and future imagining are also engaged during standard laboratory tests of ToM. However, hippocampal amnesic patients who show deficits in past and future thinking, show intact performance on ToM tests, which involve unknown people or fictional characters. Here we present data from a developmental amnesic person (H.C. and a group of demographically matched controls, who were tested on a naturalistic test of ToM that involved imagining other people’s experiences in response to photos of personally familiar others (‘pToM’ condition and unfamiliar others (‘ToM’ condition. We also included a condition that involved recollecting past experiences in response to personal photos (‘EM’ condition. Narratives were scored using an adapted autobiographical interview scoring procedure. Due to the visually rich stimuli, internal details were further classified as either descriptive (i.e., details that describe the visual content depicted in the photo or elaborative (i.e., details that go beyond what is visually depicted in the photo. Relative to controls, H.C. generated significantly fewer elaborative details in response to the pToM and EM photos and an equivalent number of elaborative details in response to the ToM photos. These data converge with previous neuroimaging results showing that the brain regions underlying pToM and episodic memory overlap to a greater extent than those supporting ToM. Taken together, these results suggest that detailed episodic representations supported by the hippocampus may be pivotal for imagining the experiences of personally familiar, but not unfamiliar, others.

  14. [Psychiatric treatment sentences.

    DEFF Research Database (Denmark)

    Stevens, Hanne; Nordentoft, Merete; Agerbo, Esben

    2010-01-01

    INTRODUCTION: Previous Danish studies of the increasing number of sentences to psychiatric treatment (SPT) have compared prevalent populations of persons undergoing treatment with incident measures of reported crimes. Examining the period 1990-2006, we studied incident sentences, taking the type...

  15. Cool and hot executive function impairments in violent offenders with antisocial personality disorder with and without psychopathy.

    Directory of Open Access Journals (Sweden)

    Stephane A De Brito

    Full Text Available Impairments in executive function characterize offenders with antisocial personality disorder (ASPD and offenders with psychopathy. However, the extent to which those impairments are associated with ASPD, psychopathy, or both is unknown.The present study examined 17 violent offenders with ASPD and psychopathy (ASPD+P, 28 violent offenders with ASPD without psychopathy (ASPD-P, and 21 healthy non-offenders on tasks assessing cool (verbal working memory and alteration of motor responses to spatial locations and hot (reversal learning, decision-making under risk, and stimulus-reinforcement-based decision-making executive function.In comparison to healthy non-offenders, violent offenders with ASPD+P and those with ASPD-P showed similar impairments in verbal working memory and adaptive decision-making. They failed to learn from punishment cues, to change their behaviour in the face of changing contingencies, and made poorer quality decisions despite longer periods of deliberation. Intriguingly, the two groups of offenders did not differ significantly from the non-offenders in terms of their alteration of motor responses to spatial locations and their levels of risk-taking, indicated by betting, and impulsivity, measured as delay aversion. The performance of the two groups of offenders on the measures of cool and hot executive function did not differ, indicating shared deficits.These documented impairments may help to explain the persistence of antisocial behaviours despite the known risks of the negative consequences of such behaviours.

  16. Cool and hot executive function impairments in violent offenders with antisocial personality disorder with and without psychopathy.

    Science.gov (United States)

    De Brito, Stephane A; Viding, Essi; Kumari, Veena; Blackwood, Nigel; Hodgins, Sheilagh

    2013-01-01

    Impairments in executive function characterize offenders with antisocial personality disorder (ASPD) and offenders with psychopathy. However, the extent to which those impairments are associated with ASPD, psychopathy, or both is unknown. The present study examined 17 violent offenders with ASPD and psychopathy (ASPD+P), 28 violent offenders with ASPD without psychopathy (ASPD-P), and 21 healthy non-offenders on tasks assessing cool (verbal working memory and alteration of motor responses to spatial locations) and hot (reversal learning, decision-making under risk, and stimulus-reinforcement-based decision-making) executive function. In comparison to healthy non-offenders, violent offenders with ASPD+P and those with ASPD-P showed similar impairments in verbal working memory and adaptive decision-making. They failed to learn from punishment cues, to change their behaviour in the face of changing contingencies, and made poorer quality decisions despite longer periods of deliberation. Intriguingly, the two groups of offenders did not differ significantly from the non-offenders in terms of their alteration of motor responses to spatial locations and their levels of risk-taking, indicated by betting, and impulsivity, measured as delay aversion. The performance of the two groups of offenders on the measures of cool and hot executive function did not differ, indicating shared deficits. These documented impairments may help to explain the persistence of antisocial behaviours despite the known risks of the negative consequences of such behaviours.

  17. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability.

    Science.gov (United States)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I M; Krijnen, Wim P; van der Schans, Cees P; Waninge, Aly

    2016-01-01

    The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and physical capacities. However, until recently, the impact of the significantly prevalent visual impairments on the performance of activities of daily living has not yet been revealed within this group. The purpose of this prospective cross-sectional study was to investigate the impact of visual impairment on the performance of activities of daily living for persons with a severe/profound intellectual disability. The Barthel Index (BI) and Comfortable Walking Speed (CWS) were used to measure the ability of performing activities of daily living (ADL) in 240 persons with severe/profound ID and having Gross Motor Functioning Classification System (GMFCS) levels I, II or III; this included 120 persons with visual impairment. The impact of visual impairment on ADL was analyzed with linear regression. The results of the study demonstrated that visual impairment slightly affects the ability of performing activities of daily living (BI) for persons experiencing a severe/profound intellectual disability. GMFCS Levels II or III, profound ID level, and visual impairment each have the effect of lowering BI scores. GMFCS Levels II or III, and profound ID level each have the effect of increasing CWS scores, which indicates a lower walking speed. A main effect of visual impairment is present on CWS, but our results do show a substantive interaction effect between GMFCS level III and visual impairment on Comfortable Walking Speed in persons with a severe/profound intellectual disability. Visual impairment has a slight effect on ability to perform ADL in persons experiencing severe/profound ID. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. 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.

  19. Sticking with the nice guy: trait warmth information impairs learning and modulates person perception brain network activity.

    Science.gov (United States)

    Lee, Victoria K; Harris, Lasana T

    2014-12-01

    Social learning requires inferring social information about another person, as well as evaluating outcomes. Previous research shows that prior social information biases decision making and reduces reliance on striatal activity during learning (Delgado, Frank, & Phelps, Nature Neuroscience 8 (11): 1611-1618, 2005). A rich literature in social psychology on person perception demonstrates that people spontaneously infer social information when viewing another person (Fiske & Taylor, 2013) and engage a network of brain regions, including the medial prefrontal cortex, temporal parietal junction, superior temporal sulcus, and precuneus (Amodio & Frith, Nature Reviews Neuroscience, 7(4), 268-277, 2006; Haxby, Gobbini, & Montgomery, 2004; van Overwalle Human Brain Mapping, 30, 829-858, 2009). We investigate the role of these brain regions during social learning about well-established dimensions of person perception-trait warmth and trait competence. We test the hypothesis that activity in person perception brain regions interacts with learning structures during social learning. Participants play an investment game where they must choose an agent to invest on their behalf. This choice is guided by cues signaling trait warmth or trait competence based on framing of monetary returns. Trait warmth information impairs learning about human but not computer agents, while trait competence information produces similar learning rates for human and computer agents. We see increased activation to warmth information about human agents in person perception brain regions. Interestingly, activity in person perception brain regions during the decision phase negatively predicts activity in the striatum during feedback for trait competence inferences about humans. These results suggest that social learning may engage additional processing within person perception brain regions that hampers learning in economic contexts.

  20. Personal Conflict Impairs Performance on an Unrelated Self-Control Task: Lingering Costs of Uncertainty and Conflict.

    Science.gov (United States)

    Alquist, Jessica L; Baumeister, Roy F; McGregor, Ian; Core, Tammy J; Benjamin, Ilil; Tice, Dianne M

    2018-01-01

    People have the ability to make important choices in their lives, but deliberating about these choices can have costs. The present study was designed to test the hypothesis that writing about conflicted personal goals and values (conflict condition) would impair self-control on an unrelated subsequent task as compared to writing about clear personal goals and values (clarity condition). Personal conflict activates the behavioral inhibition system (BIS; Hirsh, Mar, & Peterson, 2012), which may make it harder for participants to successfully execute self-control. In this large ( N =337), pre-registered study participants in the conflict condition performed worse on anagrams than participants in the clarity condition, and the effect of condition on anagram performance was mediated by a subjective uncertainty measure of BIS activation. This suggests that BIS activation leads to poor self-control. Moreover, given that conflict is inherent in the exercise of self-control, results point to BIS activation as a mechanism for why initial acts of self-control impair self-control on subsequent, unrelated tasks.

  1. Association between antiretroviral exposure and renal impairment among HIV-positive persons with normal baseline renal function

    DEFF Research Database (Denmark)

    Nielsen, Lene Ryom; Mocroft, A.; Kirk, O.

    2013-01-01

    Background. Several antiretroviral agents (ARVs) are associated with chronic renal impairment, but the extent of such adverse events among human immunodeficiency virus (HIV)-positive persons with initially normal renal function is unknown.Methods. D:A:D study participants with an estimated...... glomerular filtration rate (eGFR) of ≥90 mL/min after 1 January 2004 were followed until they had a confirmed eGFR of ≤70 mL/min (the threshold below which we hypothesized that renal interventions may begin to occur) or ≤60 mL/min (a value indicative of moderately severe chronic kidney disease [CKD...... [95% CI, 1.16-1.28], respectively). Associations were unaffected by censoring for concomitant ARV use but diminished after discontinuation of these ARVs.Conclusions. Tenofovir, ritonavir-boosted atazanavir, and ritonavir-boosted lopinavir use were independent predictors of chronic renal impairment...

  2. Facebook as communication support for persons with potential mild acquired cognitive impairment: A content and social network analysis study.

    Science.gov (United States)

    Eghdam, Aboozar; Hamidi, Ulrika; Bartfai, Aniko; Koch, Sabine

    2018-01-01

    Social media has the potential to increase social participation and support for the well-being of individuals with chronic medical conditions. To date, Facebook is the most popular social medium for different types of communication. However, there is a lack of knowledge about the potential use of Facebook as a means of communication for persons with potential Mild Acquired Cognitive Impairment (MACI), a non-progressive mild cognitive impairment after an acquired brain injury. The aim of this study was to explore how persons with potential MACI, specifically persons with perceived brain fatigue after brain injury, communicate through Facebook, to classify the content of the communication and to visualize the frequency and types of interactions. A social network analysis of the interactions between members' and a qualitative content analysis of a whole year's communication of a public Facebook group for Swedish speaking persons (1310 members) with perceived brain fatigue after an illness or injury to the brain were performed. The results showed how members use social media technology and Facebook as a means for communication and support for their condition. Individual group members showed very different patterns of communication and interactions. However, for the group as a whole, the most frequent topics in their communication were related to informational support and banter in posts, and socialization in comments. The findings also showed that the majority of members only communicated with few other members and had few direct communications. The most used communication feature of Facebook was likes in form of "thumbs-up". This study indicated that social media and in this case Facebook is used for communication and social support by persons with potential MACI, and revealed that their communication behavior is similar to the healthy population. Further studies relating specific cognitive problems of the participants to the use of social media would provide more

  3. Facebook as communication support for persons with potential mild acquired cognitive impairment: A content and social network analysis study

    Science.gov (United States)

    Hamidi, Ulrika; Bartfai, Aniko; Koch, Sabine

    2018-01-01

    Introduction Social media has the potential to increase social participation and support for the well-being of individuals with chronic medical conditions. To date, Facebook is the most popular social medium for different types of communication. However, there is a lack of knowledge about the potential use of Facebook as a means of communication for persons with potential Mild Acquired Cognitive Impairment (MACI), a non-progressive mild cognitive impairment after an acquired brain injury. The aim of this study was to explore how persons with potential MACI, specifically persons with perceived brain fatigue after brain injury, communicate through Facebook, to classify the content of the communication and to visualize the frequency and types of interactions. Methods and materials A social network analysis of the interactions between members’ and a qualitative content analysis of a whole year’s communication of a public Facebook group for Swedish speaking persons (1310 members) with perceived brain fatigue after an illness or injury to the brain were performed. Results The results showed how members use social media technology and Facebook as a means for communication and support for their condition. Individual group members showed very different patterns of communication and interactions. However, for the group as a whole, the most frequent topics in their communication were related to informational support and banter in posts, and socialization in comments. The findings also showed that the majority of members only communicated with few other members and had few direct communications. The most used communication feature of Facebook was likes in form of “thumbs-up”. Conclusions This study indicated that social media and in this case Facebook is used for communication and social support by persons with potential MACI, and revealed that their communication behavior is similar to the healthy population. Further studies relating specific cognitive problems of the

  4. The Endocannabinoid System, Aggression, and the Violence of Synthetic Cannabinoid Use, Borderline Personality Disorder, Antisocial Personality Disorder, and Other Psychiatric Disorders.

    Science.gov (United States)

    Kolla, Nathan J; Mishra, Achal

    2018-01-01

    Endogenous and exogenous cannabinoids bind to central cannabinoid receptors to control a multitude of behavioral functions, including aggression. The first main objective of this review is to dissect components of the endocannabinoid system, including cannabinoid 1 and cannabinoid 2 receptors; the endogenous cannabinoids anandamide and 2-arachidonoylglycerol; and the indirect cannabinoid modulators fatty acid amide hydrolase and monoacylglycerol lipase; that have shown abnormalities in basic research studies investigating mechanisms of aggression. While most human research has concluded that the active ingredient of marijuana, Δ9-tetrahydrocannabinol, tends to dampen rather than provoke aggression in acute doses, recent evidence supports a relationship between the ingestion of synthetic cannabinoids and emergence of violent or aggressive behavior. Thus, another objective is to evaluate the emerging clinical data. This paper also discusses the relationship between prenatal and perinatal exposure to cannabis as well as use of cannabis in adolescence on aggressive outcomes. A final objective of the paper is to discuss endocannabinoid abnormalities in psychotic and affective disorders, as well as clinically aggressive populations, such as borderline personality disorder and antisocial personality disorder. With regard to the former condition, decreased anandamide metabolites have been reported in the cerebrospinal fluid, while some preliminary evidence suggests that fatty acid amide hydrolase genetic polymorphisms are linked to antisocial personality disorder and impulsive-antisocial psychopathic traits. To summarize, this paper will draw upon basic and clinical research to explain how the endocannabinoid system may contribute to the genesis of aggressive behavior.

  5. The Endocannabinoid System, Aggression, and the Violence of Synthetic Cannabinoid Use, Borderline Personality Disorder, Antisocial Personality Disorder, and Other Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Nathan J. Kolla

    2018-03-01

    Full Text Available Endogenous and exogenous cannabinoids bind to central cannabinoid receptors to control a multitude of behavioral functions, including aggression. The first main objective of this review is to dissect components of the endocannabinoid system, including cannabinoid 1 and cannabinoid 2 receptors; the endogenous cannabinoids anandamide and 2-arachidonoylglycerol; and the indirect cannabinoid modulators fatty acid amide hydrolase and monoacylglycerol lipase; that have shown abnormalities in basic research studies investigating mechanisms of aggression. While most human research has concluded that the active ingredient of marijuana, Δ9-tetrahydrocannabinol, tends to dampen rather than provoke aggression in acute doses, recent evidence supports a relationship between the ingestion of synthetic cannabinoids and emergence of violent or aggressive behavior. Thus, another objective is to evaluate the emerging clinical data. This paper also discusses the relationship between prenatal and perinatal exposure to cannabis as well as use of cannabis in adolescence on aggressive outcomes. A final objective of the paper is to discuss endocannabinoid abnormalities in psychotic and affective disorders, as well as clinically aggressive populations, such as borderline personality disorder and antisocial personality disorder. With regard to the former condition, decreased anandamide metabolites have been reported in the cerebrospinal fluid, while some preliminary evidence suggests that fatty acid amide hydrolase genetic polymorphisms are linked to antisocial personality disorder and impulsive-antisocial psychopathic traits. To summarize, this paper will draw upon basic and clinical research to explain how the endocannabinoid system may contribute to the genesis of aggressive behavior.

  6. Whole-Person Impairment in Younger Retired NFL Players: The Orthopaedic Toll of a Professional Football Career.

    Science.gov (United States)

    Domb, Benjamin G; Carter, Chris; Finch, Nathan A; Hammarstedt, Jon E; Dunne, Kevin F; Stake, Christine E

    2014-05-01

    Professional American football is a physically demanding, high-impact sport with an elevated risk of injury. Orthopaedic injuries may impose acute, short-term or cumulative consequences throughout a player's lifetime. Several studies have addressed health and psychosocial concerns of an older, retired population of players in the National Football League (NFL); however, minimal research has examined the orthopaedic toll on younger, retired players. This study reports total whole-person impairment (WPI) percentages in a cohort of younger, retired NFL players who presented for disability evaluations based on the use of standardized American Medical Association (AMA) impairment guidelines. Case series; Level of evidence, 4. During the study period of February 2011 to August 2013, 65 younger retired NFL players presented for impairment evaluations. The mean time between retirement and impairment evaluation was 3.1 years (range, 0.3-16.4 years). A complete history and physical examination was performed on all symptomatic joints. A retrospective chart review was conducted on 100% of presenting players to assess orthopaedic burden. Body-part impairment (BPI) percentage for each affected joint was generated. The impairment data for each extremity were then combined with spine impairment data to create WPI percentage. Player demographics, including age, position, and playing time, were also recorded. The average WPI percentage was 37% (range, 19%-53%). Players participating in >30 games (n = 54) had a higher mean WPI percentage (38%) than those playing in 5 seasons (n = 46) were 2.4 times more likely to have a WPI of at least 37% (P = .007). The most common joints players reported as symptomatic were lumbar (n = 63; 97%) and cervical spine (n = 58; 89%). The mean age at evaluation was 33.5 years (range, 27-42 years), and the mean number of seasons played was 7.5 (range, 3-14 seasons). The mean number of games played was 98.4 (range, 2-236 games). This study demonstrated

  7. Psychometric Properties and Normative Data of the Zuckerman-Kuhlman Personality Questionnaire in a Psychiatric Outpatient Sample.

    Science.gov (United States)

    Martínez Ortega, Yolanda; Gomà-I-Freixanet, Montserrat; Valero, Sergi

    2017-01-01

    The Zuckerman-Kuhlman Personality Questionnaire (ZKPQ; Zuckerman, Kuhlman, Joireman, Teta, & Kraft, 1993 ) was designed for the assessment of personality. The goal of this work was to determine the psychometric properties of the ZKPQ, as well as to establish normative data by gender and age in an outpatient sample attending primary mental health care services. We administered the questionnaire to 314 participants (34.7% males) 18 to 81 years old. The most prevalent primary diagnoses were mood (37.9%) and adjustment disorders (35.0%). Concerning the psychometric properties of the ZKPQ, the pattern of internal consistencies was similar to that previously found among general population, student, or clinical samples. Regarding gender differences, a general pattern was found, with women scoring higher on neuroticism and sociability, and lower on aggression-hostility. As for age, in general, scores declined with age. Norm-based decision making has the potential for significant and long-lasting consequences, and the quality of decisions based on score comparisons can be improved when scores are compared to norms fitted to the group of reference. The availability of the ZKPQ norms by gender and age in mental health care will benefit the accuracy of assessment and therapeutic decision making, providing more effective treatment planning overall.

  8. [Tacit metarepresentation and affective sense of personal identity. An approach to understanding severe psychiatric disorders of adolescence and young adulthood].

    Science.gov (United States)

    Balbi, Juan

    2011-01-01

    The results of present-day research in the field of "Dissociation Paradigm", regarding the capacity of the human mind to perceive, learn, and store information that in appearance passes as unnoticed, support the constructivist hypothesis of the active, selective and constructive condition of consciousness, in addition to the existence of a tacit dimension of knowledge that operates in functional relationship with the former. Unconscious mental states are intrinsically intentional. This is to say that they imply a semantic or cognitive connotation that is capable of affecting phenomenical experience and therefore behavior. In addition, the precocious existence of a tacit metarepresentational system in normally developed children has been proven, which is essential for guaranteeing the deployment of the process of functional coevolution between affectivity and consciousness, by which the experience of personal identity is acquired. These discoveries allow the inference of a "tacit affective metarepresentational recurrence", the organizational foundation on which a unified, sustainable, and continuous sense of the experience of personal identity is structured, and also allow us to hypothesize a "tacit metarepresentational mourning", a specific type of grief which is the chief foundation of the majority of psychopathological disorders. This concept may represent a potential explanation of the severe mental disorders of adolescence and young adulthood. The hypothesis of the present work is that, in the ambiguous context of Postmodern Culture, the prolongation of the adolescent period, facilitated by the welfare state, hinders the dealing with the aforementioned mourning, leading to an increment of depressive states and suicidal behavior among young people.

  9. Clinical features and psychiatric comorbidities of borderline personality disorder patients with versus without a history of suicide attempt.

    Science.gov (United States)

    Sher, Leo; Fisher, Amanda M; Kelliher, Caitlin H; Penner, Justin D; Goodman, Marianne; Koenigsberg, Harold W; New, Antonia S; Siever, Larry J; Hazlett, Erin A

    2016-12-30

    Patients with borderline personality disorder (BPD) are at high risk for suicidal behavior. However, many BPD patients do not engage in suicidal behavior. In this study, we compared clinical features of BPD patients with or without a history of suicide attempts and healthy volunteers. Compared with healthy volunteers, both BPD groups had higher Affective Lability Scale (ALS), ALS - Depression-Anxiety Subscale, Barratt Impulsivity Scale (BIS), and Lifetime History of Aggression (LHA) scores and were more likely to have a history of temper tantrums. BPD suicide attempters had higher ALS, ALS - Depression-Anxiety Subscale and LHA scores and were more likely to have a history of non-suicidal self-injury or temper tantrums compared to BPD non-attempters. Also, BPD suicide attempters were more likely to have a history of comorbid major depressive disorder and less likely to have comorbid narcissistic personality disorder (NPD) in comparison to BPD non-attempters. About 50% of study participants in each BPD group had a history of comorbid substance use disorder (SUD). Our study indicates that BPD patients with a history of suicide attempt are more aggressive, affectively dysregulated and less narcissistic than BPD suicide non-attempters. Published by Elsevier Ireland Ltd.

  10. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability.

    Science.gov (United States)

    Janssen, Ian; Heymsfield, Steven B; Ross, Robert

    2002-05-01

    To establish the prevalence of sarcopenia in older Americans and to test the hypothesis that sarcopenia is related to functional impairment and physical disability in older persons. Cross-sectional survey. Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III). Fourteen thousand eight hundred eighteen adult NHANES III participants aged 18 and older. The presence of sarcopenia and the relationship between sarcopenia and functional impairment and disability were examined in 4,504 adults aged 60 and older. Skeletal muscle mass was estimated from bioimpedance analysis measurements and expressed as skeletal muscle mass index (SMI = skeletal muscle mass/body mass x 100). Subjects were considered to have a normal SMI if their SMI was greater than -one standard deviation above the sex-specific mean for young adults (aged 18-39). Class I sarcopenia was considered present in subjects whose SMI was within -one to -two standard deviations of young adult values, and class II sarcopenia was present in subjects whose SMI was below -two standard deviations of young adult values. The prevalence of class I and class II sarcopenia increased from the third to sixth decades but remained relatively constant thereafter. The prevalence of class I (59% vs 45%) and class II (10% vs 7%) sarcopenia was greater in the older (> or = 60 years) women than in the older men (P normal SMI, respectively. Some of the associations between class II sarcopenia and functional impairment remained significant after adjustment for age, race, body mass index, health behaviors, and comorbidity. Reduced relative skeletal muscle mass in older Americans is a common occurrence that is significantly and independently associated with functional impairment and disability, particularly in older women. These observations provide strong support for the prevailing view that sarcopenia may be an important and potentially reversible cause of

  11. Severe MUPS in a sick-listed population : a cross-sectional study on prevalence, recognition, psychiatric co-morbidity and impairment

    NARCIS (Netherlands)

    Hoedeman, R.; Krol, B.; Blankenstein, N.; Koopmans, P.C.; Groothoff, J.W.

    2009-01-01

    Background: Medically unexplained physical symptoms (MUPS) have a high prevalence in the general population and are associated with psychiatric morbidity. There are indications that MUPS are an important determinant of frequent and long-term disability. The primary objective was to assess the

  12. The shorter the better? A follow-up analysis of 10-session psychiatric treatment including the motive-oriented therapeutic relationship for borderline personality disorder.

    Science.gov (United States)

    Kramer, Ueli; Stulz, Niklaus; Berthoud, Laurent; Caspar, Franz; Marquet, Pierre; Kolly, Stéphane; De Roten, Yves; Despland, Jean-Nicolas

    2017-05-01

    There is little research on short-term treatments for borderline personality disorder (BPD). While the core changes may occur only in long-term treatments, short-term treatments may enable the study of early generic processes of engagement in therapy and thus inform about effective treatment components. It was shown that a 10-session version of a psychiatric treatment was effective in reducing borderline symptoms at the end of this treatment [Kramer, U., Kolly, S., Berthoud, L., Keller, S., Preisig, M., Caspar, F., … Despland, J.-N. (2014). Effects of motive-oriented therapeutic relationship in a ten-session general psychiatric treatment for borderline personality disorder: A randomized controlled trial. Psychotherapy and Psychosomatics, 83, 176-186.]. Also, it was demonstrated in a randomized design that adding the motive-oriented therapeutic relationship (MOTR), following an individualized case formulation based on Plan Analysis, further increased general outcome after session 10 and had a positive effect on the early changes in self-esteem and alliance. The present study focuses on the follow-up period after this initial treatment, examining treatment density and outcomes after 6 months and service utilization after 12 months. Outcome was measured using the OQ-45. Results on a sub-sample of N = 40 patients with available OQ-45 data at follow-up (n = 21 for MOTR-treatment, n = 19 for comparison treatment) showed maintenance of gains over the follow-up period, which did not differ between both conditions. It appeared for this sample that MOTR treatments, while using the same number of sessions, lasted more weeks (i.e., lower treatment density, defined as the number of sessions per week), when compared to the treatments without MOTR. Density marginally predicted symptom reduction at follow-up. Patients in MOTR treatments had a greater likelihood of entering structured psychotherapy after the initial sessions than patients in the comparison

  13. Perceived importance and difficulty of online activities among visually impaired persons in Nigeria.

    Science.gov (United States)

    Okonji, Patrick Emeka; Okiki, Olatokunbo Christopher; Ogwezzy, Darlington

    2018-03-26

    This study investigated perceived relevance of and difficulties in access to day-to-day online activities among visually impaired computer users who used screen readers. The 98 participants in the study were grouped into visually impaired adults (VIA; aged 20-59, n = 60) and visually impaired older adults (VIOA; aged 60 and over, n = 38). Data were collected in structured interview questionnaires with Likert scales exploring ratings of perceived importance and difficulty of access to eleven (11) online platforms of various internet activities. Analyses revealed that the two groups did not differ significantly in ratings of perceived importance of 4 major online activities, namely; Sending or reading email (p = 0.5224), Online banking (p = 0.2833), Online shopping (p = 0.1829), and Health information seeking (p = 0.1414). The topmost rated activity of priority among both groups was sending and reading emails. Findings also show that, apart from sending and reading emails, activities rated as important were mostly perceived as difficult to access. The implications of the study for inclusive design and strategies and/or interventions to encourage uptake of internet use among the visually impaired population are discussed.

  14. Influence of Restrictive Ventilation Impairment on Physical Function and Activities of Homebound Elderly Persons

    Directory of Open Access Journals (Sweden)

    Jun Horie

    2011-06-01

    Conclusions: Although patients with restrictive ventilation impairment were unlikely to be aware of their disorder, degradation in systemic stamina had already commenced. It appears that maintaining exercise habits prevented degradation of not only instantaneous walking ability but also of systemic stamina.

  15. Training of Speechreading for Severely Hearing-Impaired Persons by Human and Computer

    DEFF Research Database (Denmark)

    Bothe, Hans-Heinrich

    2007-01-01

    This paper describes evaluation results for a software programme that is intended to be used as a training-aid for lipreading in German. Tests were carried out in schools for hearing-impaired children in Germany which indicate that the ability to lipread increases significantly already after use...... of the software during a short period of time....

  16. Accessibility of Shared Space for visually impaired persons : An inventory in the Netherlands

    NARCIS (Netherlands)

    Havik, Else M; Melis - Dankers, Bart JM; Steyvers, Frank JJM; Kooijman, Aart C

    Shared Space is a concept that comprises the design and planning process of a public space. There are concerns about the accessibility of Shared Spaces for people who are visually impaired. This study provides a systematic overview of the appearance of Shared Spaces in the Netherlands and the

  17. The psychiatric interview

    DEFF Research Database (Denmark)

    Frederiksen, Julie Elisabeth Nordgaard; Sass, Louis A; Parnas, Josef

    2012-01-01

    interview. We address the ontological status of pathological experience, the notions of symptom, sign, prototype and Gestalt, and the necessary second-person processes which are involved in converting the patient's experience (originally lived in the first-person perspective) into an "objective" (third......There is a glaring gap in the psychiatric literature concerning the nature of psychiatric symptoms and signs, and a corresponding lack of epistemological discussion of psycho-diagnostic interviewing. Contemporary clinical neuroscience heavily relies on the use of fully structured interviews...... person), actionable format, used for classification, treatment, and research. Our central thesis is that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects. We claim that in order to perform...

  18. Assessing the contribution of borderline personality disorder and features to suicide risk in psychiatric inpatients with bipolar disorder, major depression and schizoaffective disorder.

    Science.gov (United States)

    Zeng, Ruifan; Cohen, Lisa J; Tanis, Thachell; Qizilbash, Azra; Lopatyuk, Yana; Yaseen, Zimri S; Galynker, Igor

    2015-03-30

    Suicidal behavior often accompanies both borderline personality disorder (BPD) and severe mood disorders, and comorbidity between the two appears to further increase suicide risk. The current study aims to quantify the risk of suicidality conferred by comorbid BPD diagnosis or features in three affective disorders: major depressive disorder (MDD), bipolar disorder (BP) and schizoaffective disorder. One hundred forty-nine (149) psychiatric inpatients were assessed by SCID I and II, and the Columbia Suicide Severity Rating Scale. Logistic regression analyses investigated the associations between previous suicide attempt and BPD diagnosis or features in patients with MDD, BP, and schizoaffective disorder, as well as a history of manic or major depressive episodes, and psychotic symptoms. Comorbid BPD diagnosis significantly increased suicide risk in the whole sample, and in those with MDD, BP, and history of depressive episode or psychotic symptoms. Each additional borderline feature also increased risk of past suicide attempt in these same groups (excepting BP) and in those with a previous manic episode. Of the BPD criteria, only unstable relationships and impulsivity independently predicted past suicide attempt. Overall, among patients with severe mood disorders, the presence of comorbid BPD features or disorder appears to substantially increase the risk of suicide attempts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Health, employment and relationships: Correlates of personal wellbeing in young adults with and without a history of childhood language impairment.

    Science.gov (United States)

    Conti-Ramsden, Gina; Durkin, Kevin; Mok, Pearl L H; Toseeb, Umar; Botting, Nicola

    2016-07-01

    We examine the potential associations between self-rated health, employment situation, relationship status and personal wellbeing in young adults with and without a history of language impairment (LI). In total, 172 24-year-olds from the UK participated, with approximately half (N = 84) having a history of LI. Personal wellbeing was measured using ratings from three questions from the Office for National Statistics regarding life satisfaction, happiness and life being worthwhile. There were similarities between individuals with a history of LI and their age-matched peers in self-rated personal wellbeing. However, regression analyses revealed self-rated health was the most consistent predictor of personal wellbeing for individuals with a history of LI in relation to life satisfaction (21% of variance), happiness (11%) and perceptions that things one does in life are worthwhile (32%). None of the regression analyses were significant for their peers. Similarities on ratings of wellbeing by young adults with and without a history of LI can mask heterogeneity and important differences. Young adults with a history of LI are more vulnerable to the effects of health, employment and relationship status on their wellbeing than their peers. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Longitudinal Modeling of Functional Decline Associated with Pathologic Alzheimer's Disease in Older Persons without Cognitive Impairment.

    Science.gov (United States)

    Wang, Dai; Schultz, Tim; Novak, Gerald P; Baker, Susan; Bennett, David A; Narayan, Vaibhav A

    2018-01-01

    Therapeutic research on Alzheimer's disease (AD) has moved to intercepting the disease at the preclinical phase. Most drugs in late development have focused on the amyloid hypothesis. To understand the magnitude of amyloid-related functional decline and to identify the functional domains sensitive to decline in a preclinical AD population. Data were from the Religious Orders Study and the Rush Memory and Aging Project. Cognitive decline was measured by a modified version of the Alzheimer's Disease Cooperative Study Preclinical Alzheimer Cognitive Composite. The trajectories of functional decline, as measured by the instrumental and basic activities of daily living, were longitudinally modeled in 484 participants without cognitive impairment at baseline and having both a final clinical and a postmortem neuropathology assessment of AD. Individuals with different final clinical diagnoses had different trajectories of cognitive and functional decline. Individuals with AD dementia, minor cognitive impairment, and no cognitive impairment had the most, intermediate, and least declines. While individuals with pathologic AD had significantly more cognitive decline over time than those without, the magnitude of difference in functional decline between these two groups was small. Functional domains such as handling finance and handling medications were more sensitive to decline. Demonstrating the functional benefit of an amyloid-targeting drug represents a significant challenge as elderly people experience functional decline due to a wide range of reasons with limited manifestation attributable to AD neuropathology. More sensitive functional scales focusing on the functional domains sensitive to decline in preclinical AD are needed.

  1. Executive functioning in people with obsessive-compulsive personality traits: evidence of modest impairment.

    Science.gov (United States)

    García-Villamisar, Domingo; Dattilo, John

    2015-06-01

    Investigations of executive dysfunctions among people with obsessive-compulsive personality disorders (OCPD) have yielded inconsistent results. The authors speculate that obsessive-compulsive personality traits (OCPT) from a nonclinical population may be associated with specific executive dysfunctions relative to working memory, attentional set-shifting, and planning. A sample consisting of 79 adults (39 females, 40 males) was divided into high and low scorers on the Personality Diagnostic Questionnaire-4 (PDQ-4; Hyler, 1994). In addition, these participants were interviewed using the SCID-II (First, Spitzer, Gibbon & Williams, 1997) to confirm the presence of symptoms of obsessive-compulsive personality. Participants completed a battery of executive tasks associated with the Cambridge Neuropsychological Test Automated Battery (CANTAB), including Spatial Working Memory, Intradimensional/Extradimensional (ID/ED), Attentional Set-Shifting, and Stockings of Cambridge. Also, self-report measures of executive functions as well as of anxiety and depressive symptoms were administered. The analysis of covariance revealed significant differences between participants with OCPT and controls on the Spatial Working Memory tasks, ID/ED tasks, Stockings of Cambridge, and the Dysexecutive Questionnaire (DEX). Nevertheless, there were no significant differences in the number of problems solved in minimum movements. These results suggest that executive dysfunctions are present in people with prominent OCPT and that there is a high convergence between clinical and ecological measures of executive functions in people with obsessive personality traits.

  2. Mild neurological impairment may indicate a psychomotor endophenotype in patients with borderline personality disorder.

    Science.gov (United States)

    Arbabi, Mohammad; Paast, Negin; Karim, Hamid Reza; Faghfori, Sara; Memari, Amir Hossein

    2016-11-30

    The aim of the present study was to determine whether patients with borderline personality disorder (BPD) show any neurological soft signs compared to healthy controls. Furthermore we sought to examine the role of common symptoms related to BPD, such as depression, anxiety or impulsivity, in association with neurological soft signs. Thirty patients with borderline personality disorder and thirty hospital-based controls were examined for neurological soft signs. The total score of neurological soft signs in BPD was significantly higher than controls. In terms of subscales, patients had higher scores in Sensory Integration and Motor Coordination and other neurological soft signs compared to control group. Multiple regression analysis showed that the impulsivity score was the best significant predictor of neurological soft signs in BPD. The increase of neurological soft signs in patients with BPD may address a non-focal neurological dysfunction in borderline personality disorder. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Sleep problems and daily functioning in children with ADHD: An investigation of the role of impairment, ADHD presentations, and psychiatric comorbidity

    DEFF Research Database (Denmark)

    Virring, Anne; Lambek, Rikke; Jennum, Poul Jørgen

    2017-01-01

    , the Weiss Functional Impairment Rating Scale, and the ADHD Rating Scale. RESULTS: We found a moderate, positive correlation between sleep problems and impaired functioning in both children with ADHD and in typically developed children. ADHD presentations did not differ significantly with respect to sleep......OBJECTIVE: Little systematic information is available regarding how sleep problems influence daytime functioning in children with ADHD, as the role of ADHD presentations and comorbidity is unclear. METHOD: In total, 397 children were assessed with the Children's Sleep Habits Questionnaire...... problem profile, but having a comorbid internalizing or autistic disorder lead to higher sleep problem score. CONCLUSION: Sleep problems and impaired daily functioning were more common in children with ADHD, but the overall association between sleep problems and impaired daily functioning was similar...

  4. Poor Performance on Serial Visual Tasks in Persons with Reading Disabilities: Impaired Working Memory?

    Science.gov (United States)

    Ram-Tsur, Ronit; Faust, Miriam; Zivotofsky, Ari Z.

    2008-01-01

    The present study investigates the performance of persons with reading disabilities (PRD) on a variety of sequential visual-comparison tasks that have different working-memory requirements. In addition, mediating relationships between the sequential comparison process and attention and memory skills were looked for. Our findings suggest that PRD…

  5. Avaliação das limitações no comportamento social em pacientes psiquiátricos de longa permanência The assessment of social role functioning impairments in long-stay psychiatric patients

    Directory of Open Access Journals (Sweden)

    Sylvia Gonçalves

    2001-01-01

    Full Text Available Este texto trata de uma avaliação do comportamento social de pacientes psiquiátricos de longa permanência. Estudos recentes concentram-se nesse tema, considerando-o relevante na transferência do eixo da atenção do hospital para a comunidade. Para avaliar dificuldades e limitações de uma população com longo período de institucionalização, utiliza-se a Social Behavioural Schedule (SBS, que cobre áreas do comportamento referentes às principais dificuldades de pacientes crônicos. Selecionou-se uma amostra de 46 pacientes de uma população de 200 mulheres, com longa história de internação psiquiátrica, residentes em duas moradias protegidas e quatro pavilhões do Núcleo Franco da Rocha (NFR, do Instituto Municipal Juliano Moreira, no Rio de Janeiro. Os resultados obtidos foram comparados aos dados de uma amostra de moradores em um albergue de sem tetos e aos de pacientes de um hospital psiquiátrico, ambos situados em Londres. Os resultados sugerem que significativo percentual dos pacientes que vivem longo tempo em hospitais teriam condições de viver em residências na comunidade.This paper describes an assessment of social role functioning impairments in long-stay psychiatric patients. Most recent studies have concentrated on this theme and these measures are very important to the transfer of care from hospitals to community facilities. In order to assess the long term impairments or disabilities, we have used the Social Behavioural Schedule (SBS that covers behaviour areas which have been shown in previous research to describe the major difficulties exhibited by patients with long-term impairments. Forty-six women were randomized from a range of two hundred women living at the Núcleo Franco da Rocha, a hospitalar unit of Instituto Municipal Juliano Moreira in Rio de Janeiro. The NFR results were compared with a homeless hostels sample and a long stay wards sample, both in London. Despite the average age and the long term

  6. The role of DSM-5 borderline personality symptomatology and traits in the link between childhood trauma and suicidal risk in psychiatric patients.

    Science.gov (United States)

    Bach, Bo; Fjeldsted, Rita

    2017-01-01

    Childhood traumas appear to be linked to suicidal behavior. However, the factors that mediate between these two phenomena are not sufficiently understood. Recent findings suggest that borderline personality disorder (BPD) may explain some of the association. The present study investigated the potential mediating role of BPD symptomatology and traits between reported childhood trauma and suicidal risk in adult psychiatric outpatients ( N  = 124). BPD symptomatology was measured with DSM-5 Section II criterion-counts (SCID-II; Structured Clinical Interview for DSM-IV Axis II), whereas BPD traits were measured with specified DSM-5 Section III traits (PID-5; Personality Inventory for DSM-5). Childhood traumas were self-reported (CTQ; Childhood Trauma Questionnaire), whereas level of suicidal risk was measured with a structured interview (MINI Suicidality Module; Mini International Neuropsychiatric Interview). Mediation effects were tested by bias-corrected (10.000 boot-strapped samples) confidence intervals. BPD features account for a considerable part of the cross-sectional association between childhood trauma and level of suicidal risk, even when controlling for the influence of gender, age, and educational level. This finding remained stable when testing the model without the suicidality-related BPD criterion and PID-5 items. DSM-5 Section II BPD criterion-counts explained 67% of the total effect, whereas DSM-5 Section III BPD traits accounted for 82% of the total effect. The specific DSM-5 Section III trait facets of "Depressivity" (52%) and "Perceptual Dysregulation" (37%) accounted for most of this effect. The findings provide preliminary support for the proposed mediation model indicating that BPD features may help explain relations between childhood trauma and elevated suicidal risk in adult life, in particular for DSM-5 Section III personality traits of depressivity (e.g., pessimism, guilt, and shame) and perceptual dysregulation (e.g., dissociation). To

  7. Psychopathic Personality Traits Associated with Abnormal Selective Attention and Impaired Cognitive Control

    Science.gov (United States)

    Sadeh, Naomi; Verona, Edelyn

    2008-01-01

    The current study investigated how mechanisms of attention that have been well-characterized in the cognitive psychology literature (Lavie, Hirst, De Fockert, & Viding, 2004; Maylor & Lavie, 1998) may be differentially associated with psychopathic traits in non-incarcerated men. Previous research on cognition and psychopathy indicates that primary psychopathic traits are associated with over-focused attention and/or reduced processing of information peripheral to the focus of attention. Conversely, deficits in executive functioning, such as working memory and cognitive control, are implicated in secondary psychopathic traits. Results revealed a significant relationship between traits typically associated with primary psychopathy (e.g., low anxiety, social dominance, fearlessness, callousness) and reduced processing of task-irrelevant distractors, suggesting diminished basic attentional capacity among individuals high on these traits. In contrast, some characteristics linked to secondary psychopathy (e.g., social alienation, cynicism) showed a positive relationship with impaired working memory functioning, indicative of deficits in cognitive control, whereas other traits (i.e., self-centeredness, antagonism) did not. These results suggest that psychopathic traits are differentially related to selective impairments in attentional functioning, which may help explain the observed heterogeneity in psychopathic manifestations. PMID:18763886

  8. Cognitive decline impairs financial and health literacy among community-based older persons without dementia.

    Science.gov (United States)

    Boyle, Patricia A; Yu, Lei; Wilson, Robert S; Segawa, Eisuke; Buchman, Aron S; Bennett, David A

    2013-09-01

    Literacy is an important determinant of health and well-being across the life span but is critical in aging, when many influential health and financial decisions are made. Prior studies suggest that older persons exhibit lower literacy than younger persons, particularly in the domains of financial and health literacy, but the reasons why remain unknown. The objectives of this study were to: (a) examine pathways linking diverse resources (i.e., education, word knowledge, cognitive function, and decision making style) to health and financial literacy among older persons and determine the extent to which the relation of age with literacy represents a direct effect versus an indirect effect due to decrements in specific cognitive functions (i.e., executive functions and episodic memory); and (b) test the hypothesis that declines in executive function and episodic memory are associated with lower literacy among older persons without dementia. Six-hundred and forty-five community-based older persons without dementia underwent detailed assessments of diverse resources, including education, word knowledge, cognitive function (i.e., executive function, episodic memory) and decision making style (i.e., risk aversion), and completed a measure of literacy that included items similar to those used in the Health and Retirement Study, such as numeracy, financial concepts such as compound inflation and knowledge of stocks and bonds, and important health concepts such as understanding of drug risk and Medicare Part D. Path analysis revealed a strong effect of age on literacy, with about half of the effect of age on literacy due to decrements in executive functions and episodic memory. In addition, executive function had an indirect effect on literacy via decision making style (i.e., risk aversion), and education and word knowledge had independent effects on literacy. Finally, among (n = 447) persons with repeated cognitive assessments available for up to 14 years, regression

  9. Teaching a Person with Memory Impairment Smartphone Use for Emergencies during Outdoors Walking: Case Report

    Directory of Open Access Journals (Sweden)

    Jennifer H. Maze

    2018-02-01

    Full Text Available Safety issues arise during the performance of activities as dementia advances. Occupational therapists collaborate with dementia clients and their caregivers to find solutions and strategies to prolong safe activity participation. Additionally, occupational therapists teach through demonstration showing engagement in specific activities may no longer be safe. We present the case of a 70-year-old male with mild dementia. His caregiver believes he needs to use a smartphone for safety during outdoors walking; the client’s enjoyed and valued occupation. This case report illustrates smartphone use may be difficult to learn for a person with mild dementia. It highlights the need for the caregiver and person with dementia to receive education together for best understanding. New technologies for community mobility such as outdoors walking are considered.

  10. Lack of semantic priming effects in famous person recognition in Mild Cognitive Impairment.

    Science.gov (United States)

    Brambati, Simona M; Peters, Frédéric; Belleville, Sylvie; Joubert, Sven

    2012-04-01

    Growing evidence indicates that individuals with Mild Cognitive Impairment (MCI) manifest semantic deficits that are often more severe for items that are characterized by a unique semantic and lexical association, such as famous people and famous buildings, than common concepts, such as objects. However, it is still controversial whether the semantic deficits observed in MCI are determined by a degradation of semantic information or by a deficit in intentional access to semantic knowledge. Here we used a semantic priming task in order to assess the integrity of the semantic system without requiring explicit access to this system. This paradigm may provide new insights in clarifying the nature of the semantic deficits in MCI. We assessed the semantic and repetition priming effect in 13 individuals with MCI and 13 age-matched controls who engaged in a familiarity judgment task of famous names. In the semantic priming condition, the prime was the name of a member of the same occupation category as the target (Tom Cruise-Brad Pitt), while in the repetition priming condition the prime was the same name as the target (Charlie Chaplin-Charlie Chaplin). The results showed a defective priming effect in MCI in the semantic but not in the repetition priming condition. Specifically, when compared to controls, MCI patients did not show a facilitation effect in responding to the same occupation prime-target pairs, but they showed an equivalent facilitation effect when the target was the same name as the prime. The present results provide support to the hypothesis that the semantic impairments observed in MCI cannot be uniquely ascribed to a deficit in intentional access to semantic information. Instead, these findings point to the semantic nature of these deficits and, in particular, to a degraded representation of semantic information concerning famous people. Copyright © 2011 Elsevier Srl. All rights reserved.

  11. 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.

  12. Categorizing Health Outcomes and Efficacy of mHealth Apps for Persons With Cognitive Impairment: A Systematic Review.

    Science.gov (United States)

    Bateman, Daniel R; Srinivas, Bhavana; Emmett, Thomas W; Schleyer, Titus K; Holden, Richard J; Hendrie, Hugh C; Callahan, Christopher M

    2017-08-30

    Use of mobile health (mHealth) apps is growing at an exponential rate in the United States and around the world. Mild cognitive impairment (MCI), Alzheimer disease, and related dementias are a global health problem. Numerous mHealth interventions exist for this population, yet the effect of these interventions on health has not been systematically described. The aim of this study is to catalog the types of health outcomes used to measure effectiveness of mHealth interventions and assess which mHealth interventions have been shown to improve the health of persons with MCI, Alzheimer disease, and dementia. We searched 13 databases, including Ovid MEDLINE, PubMed, EMBASE, the full Cochrane Library, CINAHL, PsycINFO, Ei Compendex, IEEE Xplore, Applied Science & Technology Source, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar from inception through May 2017 for mHealth studies involving persons with cognitive impairment that were evaluated using at least one quantitative health outcome. Proceedings of the Annual ACM Conferences on Human Factors in Computing Systems, the ACM User Interface Software and Technology Symposium, and the IEEE International Symposium on Wearable Computers were searched in the ACM Digital Library from 2012 to 2016. A hand search of JMIR Publications journals was also completed in July 2017. After removal of duplicates, our initial search returned 3955 records. Of these articles, 24 met final inclusion criteria as studies involving mHealth interventions that measured at least one quantitative health outcome for persons with MCI, Alzheimer disease, and dementia. Common quantitative health outcomes included cognition, function, mood, and quality of life. We found that 21.2% (101/476) of the fully reviewed articles were excluded because of a lack of health outcomes. The health outcomes selected were observed to be inconsistent between studies. For those studies with quantitative health outcomes, more than half (58%) reported

  13. Implications of the information and communication technologies (ICT in the socialization of hearing-impaired persons. A case study: Zaragoza

    Directory of Open Access Journals (Sweden)

    Milagros Mayor Pérez

    2015-06-01

    Full Text Available Access to ICT is an important issue in contemporary societies, especially in vulnerable groups. From a case study of hearing impaired people living in Zaragoza, we study the assumption of ICT as a resource for socializing as well as the opinions and asses on them. In general, members of this group recognize the value and importance of ICT to information, communication and socialization. There are differences in their access between deaf persons with knowing of sign language or without it. Trends such as the increased use of smartphones replacing computers or valuation of certain risks or dangers associated ICT are identified. The domain in the use of ICT is conditioned by variables such as knowing of sign language, the age and condition of digital native.

  14. Self-reported emotional dysregulation but no impairment of emotional intelligence in borderline personality disorder: an explorative study.

    Science.gov (United States)

    Beblo, Thomas; Pastuszak, Anna; Griepenstroh, Julia; Fernando, Silvia; Driessen, Martin; Schütz, Astrid; Rentzsch, Katrin; Schlosser, Nicole

    2010-05-01

    Emotional dysfunction is a key feature of patients with borderline personality disorder (BPD) but emotional intelligence (EI) has rarely been investigated in this sample. This study aimed at an investigation of ability EI, general intelligence, and self-reported emotion regulation in BPD. We included 19 patients with BPD and 20 healthy control subjects in the study. EI was assessed by means of the Mayer-Salovey-Caruso emotional intelligence test and the test of emotional intelligence. For the assessment of general intelligence, we administered the multidimensional "Leistungsprüfsystem-Kurzversion." The emotion regulation questionnaire and the difficulties in Emotion Regulation Scale were used to assess emotion regulation. The patients with BPD did not exhibit impairments of ability EI and general intelligence but reported severe impairments in emotion regulation. Ability EI was related both to general intelligence (patients and controls) and to self-reported emotion regulation (patients). In conclusion, emotional dysfunction in BPD might primarily affect self-perceived behavior rather than abilities. Intense negative emotions in everyday life may trigger dysfunctional emotion regulation strategies in BPD although patients possess sufficient theoretical knowledge about optimal regulation strategies.

  15. [Cognitive impairments in persons exposed to radiation during the period of prenatal development].

    Science.gov (United States)

    Burtovaya, E Yu; Kantina, T E; Belova, M V; Akleyev, A V

    2015-01-01

    To assess the cognitive status in persons exposed to ionizing radiation in prenatal period. The study included in-utero exposed people (n = 77), and the comparison group (n = 73), which consisted of people who lived in the territories of the Chelyabinsk Oblast that were not radioactive. The following methods were used: clinical, clinical-psychological (Mini-Mental State Examination (MMSE), the WAIS test, the proverb interpretation task, neurophysiological (EEG) methods, laboratory-based methods (cholesterol, high and low-density lipoproteins, triglycerides, cortisol, melatonin), and methods of statistical data processing. The number of people with non-psychotic mental disorders with the prevalence of organic mental disorders (cognitive and asthenic) was significantly higher among in-utero exposed subjects. A neurophysiological study revealed more severe changes in the bioelectric brain activity with the presence of pathological and theta-rhythms in exposed persons. The clinical-psychological study revealed a significant decrease in the analytic/synthetic ability in exposed people and significantly lower level of the general and verbal IQ. These changes were accompanied by higher levels of cortisol and melatonin which led to the activation and tension of the adaptation mechanisms in in-utero exposed subjects.

  16. Situational analysis of communication of HIV and AIDS information to persons with visual impairment: a case of Kang'onga Production Centre in Ndola, Zambia.

    Science.gov (United States)

    Chintende, Grace Nsangwe; Sitali, Doreen; Michelo, Charles; Mweemba, Oliver

    2017-04-04

    Despite the increases in health promotion and educational programs on HIV and AIDS, lack of information and communication on HIV and AIDS for the visually impaired persons continues. The underlying factors that create the information and communication gaps have not been fully explored in Zambia. It is therefore important that, this situational analysis on HIV and AIDS information dissemination to persons with visual impairments at Kang'onga Production Centre in Ndola was conducted. The study commenced in December 2014 to May 2015. A qualitative case study design was employed. The study used two focus group discussions with males and females. Each group comprised twelve participants. Eight in-depth interviews involving the visually impaired persons and five key informants working with visually impaired persons were conducted. Data was analysed thematically using NVIVO 8 software. Ethical clearance was sought from Excellency in Research Ethics and Science. Reference Number 2014-May-030. It was established that most visually impaired people lacked knowledge on the cause, transmission and treatment of HIV and AIDS resulting in misconceptions. It was revealed that health promoters and people working with the visually impaired did not have specific HIV and AIDS information programs in Zambia. Further, it was discovered that the media, information education communication and health education were channels through which the visually impaired accessed HIV and AIDS information. Discrimination, stigma, lack of employment opportunities, funding and poverty were among the many challenges identified which the visually impaired persons faced in accessing HIV and AIDS information. Integration of the visually impaired in HIV and AIDS programs would increase funding for economic empowerment and health promotions in order to improve communication on HIV and AIDS information. The study showed that, the visually impaired persons in Zambia are not catered for in the dissemination of HIV

  17. First steps in designing an all-in-one ICT-based device for persons with cognitive impairment: evaluation of the first mock-up.

    Science.gov (United States)

    Boman, Inga-Lill; Persson, Ann-Christine; Bartfai, Aniko

    2016-03-07

    This project Smart Assisted Living involving Informal careGivers++ (SALIG) intends to develop an ICT-based device for persons with cognitive impairment combined with remote support possibilities for significant others and formal caregivers. This paper presents the identification of the target groups' needs and requirements of such device and the evaluation of the first mock-up, demonstrated in a tablet. The inclusive design method that includes end-users in the design process was chosen. First, a scoping review was conducted in order to examine the target group's need of an ICT-based device, and to gather recommendations regarding its design and functionalities. In order to capture the users' requirements of the design and functionalities of the device three targeted focus groups were conducted. Based on the findings from the publications and the focus groups a user requirement specification was developed. After that a design concept and a first mock-up was developed in an iterative process. The mock-up was evaluated through interviews with persons with cognitive impairment, health care professionals and significant others. Data were analysed using content analysis. Several useful recommendations of the design and functionalities of the SALIG device for persons with cognitive impairment were identified. The main benefit of the mock-up was that it was a single device with a set of functionalities installed on a tablet and designed for persons with cognitive impairment. An additional benefit was that it could be used remotely by significant others and formal caregivers. The SALIG device has the potentials to facilitate everyday life for persons with cognitive impairment, their significant others and the work situation for formal caregivers. The results may provide guidance in the development of different types of technologies for the target population and for people with diverse disabilities. Further work will focus on developing a prototype to be empirically tested

  18. Piracetam treatment in patients with cognitive impairment.

    Science.gov (United States)

    Rao, Mukund G; Holla, Bharath; Varambally, Shivarama; Raveendranathan, Dhanya; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2013-01-01

    Piracetam is a cognitive-enhancing agent that is used for the treatment of cognitive impairments of various etiologies. Little is known about its side effect profile, especially in those with psychiatric illness. We herewith present two cases with cognitive impairment who had contrasting responses to piracetam. One of them with organic amnestic syndrome had significant improvement, whereas the other who had an organic personality change as well as a family history of mental illness had significant worsening of behavioral problems after piracetam was introduced. This report highlights the need for caution in the use of piracetam, especially in those with past or family history of psychiatric illness. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Informed consent from cognitively impaired persons participating in research trials: comparative law observations.

    Science.gov (United States)

    Petrini, Carlo

    2011-01-01

    This article addresses the ethical requirements to be considered when conducting clinical trials involving human subjects whose mental condition limits their ability to understand the information and to express fully autonomous and informed consent. It does not address other categories of vulnerable persons, such as children, or advanced directives concerning end-of-life care. There are many ethical issues entailed in clinical trials involving subjects with mental disabilities: how to obtain informed consent, balancing risks and benefits, balancing individual benefits with collective scientific and social interests, legal representation and many more. This article focuses on the issues surrounding the concept of minimal risk and the relationship between informed consent and risk. These issues are addressed with particular emphasis on the regulations adopted by the European Union and the federal government of the United States of America. The conclusion proposes a list of working criteria.

  20. Informed consent from cognitively impaired persons participating in research trials: comparative law observations

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2011-12-01

    Full Text Available This article addresses the ethical requirements to be considered when conducting clinical trials involving human subjects whose mental condition limits their ability to understand the information and to express fully autonomous and informed consent. It does not address other categories of vulnerable persons, such as children, or advanced directives concerning end-of-life care. There are many ethical issues entailed in clinical trials involving subjects with mental disabilities: how to obtain informed consent, balancing risks and benefits, balancing individual benefits with collective scientific and social interests, legal representation and many more. This article focuses on the issues surrounding the concept of minimal risk and the relationship between informed consent and risk. These issues are addressed with particular emphasis on the regulations adopted by the European Union and the federal government of the United States of America. The conclusion proposes a list of working criteria.

  1. New orientation and accessibility option for persons with visual impairment: transportation applications for remote infrared audible signage.

    Science.gov (United States)

    Crandall, William; Bentzen, Billie Louise; Myers, Linda; Brabyn, John

    2001-05-01

    BACKGROUND: For a blind or visually impaired person, a vital prerequisite to accessing any feature of the built environment is being able to find this feature. Braille signs, even where available, do not replace the functions of print signage because they cannot be read from a distance. Remotely readable infrared signs utilise spoken infrared message transmissions to label key environmental features, so that a blind person with a suitable receiver can locate and identify them from a distance. METHODS: Three problems that are among the most challenging and dangerous faced by blind travellers are negotiating complex transit stations, locating bus stops and safely and efficiently crossing light-controlled intersections. We report the results of human factors studies using a remote infrared audible sign system (RIAS), Talking Signs(R), in these critical tasks, examining issues such as the amount of training needed to use the system, its impact on performance and safety, benefits for different population subgroups and user opinions of its value. RESULTS: Results are presented in the form of both objective performance measures and in subjects' ratings of the usefulness of the system in performing these tasks. Findings are that blind people can quickly and easily learn to use remote infrared audible signage effectively and that its use improves travel safety, efficiency and independence.? CONCLUSIONS: The technology provides equal access to a wide variety of public facilities.

  2. Impaired self-reflection in psychiatric disorders among adults: a proposal for the existence of a network of semi independent functions.

    Science.gov (United States)

    Dimaggio, Giancarlo; Vanheule, Stijn; Lysaker, Paul H; Carcione, Antonino; Nicolò, Giuseppe

    2009-09-01

    Self-reflection plays a key role in healthy human adaptation. Self-reflection might involve different capacities which may be impaired to different degrees relatively independently of one another. Variation in abilities for different forms of self-reflection are commonly seen as key aspects of many adult mental disorders. Yet little has been written about whether there are different kinds of deficits in self-reflection found in mental illness, how those deficits should be distinguished from one another and how to characterize the extent to which they are interrelated. We review clinical and experimental literature and suggest four different forms of deficits in self-reflection: (a) sense of ownership of one's own thoughts and actions, (b) emotional awareness, (c) distinction between fantasy and reality and (d) the integration of a range of different views of oneself and others. We propose how these different impairments in self-reflection are linked with one another.

  3. Insulin sensitivity, insulin release and glucagon-like peptide-1 levels in persons with impaired fasting glucose and/or impaired glucose tolerance in the EUGENE2 study

    DEFF Research Database (Denmark)

    Laakso, M; Zilinskaite, J; Hansen, T

    2008-01-01

    AIMS/HYPOTHESIS: We examined the phenotype of individuals with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) with regard to insulin release and insulin resistance. METHODS: Non-diabetic offspring (n=874; mean age 40+/-10.4 years; BMI 26.6+/-4.9 kg/m(2)) of type 2 diabetic...

  4. Facing the Problem: Impaired Emotion Recognition During Multimodal Social Information Processing in Borderline Personality Disorder.

    Science.gov (United States)

    Niedtfeld, Inga; Defiebre, Nadine; Regenbogen, Christina; Mier, Daniela; Fenske, Sabrina; Kirsch, Peter; Lis, Stefanie; Schmahl, Christian

    2017-04-01

    Previous research has revealed alterations and deficits in facial emotion recognition in patients with borderline personality disorder (BPD). During interpersonal communication in daily life, social signals such as speech content, variation in prosody, and facial expression need to be considered simultaneously. We hypothesized that deficits in higher level integration of social stimuli contribute to difficulties in emotion recognition in BPD, and heightened arousal might explain this effect. Thirty-one patients with BPD and thirty-one healthy controls were asked to identify emotions in short video clips, which were designed to represent different combinations of the three communication channels: facial expression, speech content, and prosody. Skin conductance was recorded as a measure of sympathetic arousal, while controlling for state dissociation. Patients with BPD showed lower mean accuracy scores than healthy control subjects in all conditions comprising emotional facial expressions. This was true for the condition with facial expression only, and for the combination of all three communication channels. Electrodermal responses were enhanced in BPD only in response to auditory stimuli. In line with the major body of facial emotion recognition studies, we conclude that deficits in the interpretation of facial expressions lead to the difficulties observed in multimodal emotion processing in BPD.

  5. [The contribution of living arrangements in the provision of care for elderly persons with functional impairments in São Paulo, Brazil].

    Science.gov (United States)

    Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lúcia; Lima, Fernão Dias de

    2005-01-01

    To describe the functional performance, need for assistance, and living arrangements of elderly persons in the city of São Paulo, Brazil, as part of a project called Health, Well-being, and Aging in Latin America and the Caribbean (the "SABE project"). In 2000, 2 143 individuals 60 years of age or older were interviewed, using the standardized SABE questionnaire. The sample was obtained in two stages, using census sectors with replacement and probability proportional to population. To have the desired number of respondents 75 or older, additional homes close to the selected census sectors were found, with weighting of the final results. The functional performance of the elderly persons was measured in terms of their ability to perform basic activities of daily living (walking across a room, eating, lying down on a bed and getting up from it, using the bathroom, dressing and undressing, and bathing) and to carry out instrumental activities of daily living (buying and preparing food, performing light and heavy household chores, using the telephone, taking medications, and handling money). Functional impairment was defined as the need for assistance in performing at least one of the basic or instrumental activities. There were 66 types of living arrangements (household composition) identified and grouped into seven categories, according to with whom an elderly person lived and whether the other residents of the household were relatives or not. Of the individuals interviewed, 19.2% presented a functional impairment in basic activities and 26.5% in instrumental activities. The impairments were more common among women and among persons 75 or older. The proportion of elderly persons with an impairment who received help with basic activities ranged from 25.6% (lying down on the bed and getting up) to 70.5% (eating). With instrumental activities, the proportion receiving assistance ranged from 79.7% (light domestic chores) to 97.8% (buying food). With respect to living

  6. Using the System of Least Prompts to Teach Personal Hygiene Skills to a High School Student with Comorbid Visual Impairment and Autism Spectrum Disorder

    Science.gov (United States)

    Probst, Kristi M.; Walker, Virginia L.

    2017-01-01

    Introduction: This study evaluated the effectiveness of a workshop and follow-up coaching sessions on the implementation of the system of least prompts procedure by classroom team members and explored whether this intervention resulted in personal hygiene skill acquisition by a male high school student with comorbid visual impairment and autism…

  7. A Technology-Assisted Learning Setup as Assessment Supplement for Three Persons with a Diagnosis of Post-Coma Vegetative State and Pervasive Motor Impairment

    Science.gov (United States)

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Lanzilotti, Crocifissa; Bosco, Andrea; Megna, Gianfranco; De Tommaso, Marina

    2009-01-01

    Post-coma persons in an apparent condition of vegetative state and pervasive motor impairment pose serious problems in terms of assessment and intervention options. A technology-based learning assessment procedure might serve for them as a diagnostic supplement with possible implications for rehabilitation intervention. The learning assessment…

  8. Preoccupied Attachment and Emotional Dysregulation: Specific Aspects of Borderline Personality Disorder or General Dimensions of Personality Pathology?

    Science.gov (United States)

    Scott, Lori N.; Kim, Yookyung; Nolf, Kimberly A.; Hallquist, Michael N.; Wright, Aidan G.C.; Stepp, Stephanie D.; Morse, Jennifer Q.; Pilkonis, Paul A.

    2013-01-01

    Emotional dysregulation and impaired attachment are seen by many clinical researchers as central aspects of borderline personality disorder (BPD). Alternatively, these constructs may represent general impairments in personality that are nonspecific to BPD. Using multitrait-multimethod models, we examined the strength of associations among preoccupied attachment, difficulties with emotion regulation, BPD features, and features of two other personality disorders (i.e., antisocial and avoidant) in a combined psychiatric outpatient and community sample of adults. Results suggested that preoccupied attachment and difficulties with emotion regulation shared strong positive associations with each other and with each of the selected personality disorders. However, preoccupied attachment and emotional dysregulation were more strongly related to BPD features than to features of other personality disorders. Our findings suggest that although impairments in relational and emotional domains may underlie personality pathology in general, preoccupied attachment and emotional dysregulation also have specificity for understanding core difficulties in those with BPD. PMID:23586934

  9. Preoccupied attachment and emotional dysregulation: specific aspects of borderline personality disorder or general dimensions of personality pathology?

    Science.gov (United States)

    Scott, Lori N; Kim, Yookyung; Nolf, Kimberly A; Hallquist, Michael N; Wright, Aidan G C; Stepp, Stephanie D; Morse, Jennifer Q; Pilkonis, Paul A

    2013-08-01

    Emotional dysregulation and impaired attachment are seen by many clinical researchers as central aspects of borderline personality disorder (BPD). Alternatively, these constructs may represent general impairments in personality that are nonspecific to BPD. Using multitraitmultimethod models, the authors examined the strength of associations among preoccupied attachment, difficulties with emotion regulation, BPD features, and features of two other personality disorders (i.e., antisocial and avoidant) in a combined psychiatric outpatient and community sample of adults. Results suggested that preoccupied attachment and difficulties with emotion regulation shared strong positive associations with each other and with each of the selected personality disorders. However, preoccupied attachment and emotional dysregulation were more strongly related to BPD features than to features of other personality disorders. Findings suggest that although impairments in relational and emotional domains may underlie personality pathology in general, preoccupied attachment and emotional dysregulation also have specificity for understanding core difficulties in those with BPD.

  10. Poor Decision Making Is a Consequence of Cognitive Decline among Older Persons without Alzheimer’s Disease or Mild Cognitive Impairment

    Science.gov (United States)

    Boyle, Patricia A.; Yu, Lei; Wilson, Robert S.; Gamble, Keith; Buchman, Aron S.; Bennett, David A.

    2012-01-01

    Objective Decision making is an important determinant of health and well-being across the lifespan but is critical in aging, when many influential decisions are made just as cognitive function declines. Increasing evidence suggests that older adults, even those without dementia, often make poor decisions and are selectively vulnerable to scams. To date, however, the factors associated with poor decision making in old age are unknown. The objective of this study was to test the hypothesis that poor decision making is a consequence of cognitive decline among older persons without Alzheimer’s disease or mild cognitive impairment. Methods Participants were 420 non-demented persons from the Memory and Aging Project, a longitudinal, clinical-pathologic cohort study of aging in the Chicago metropolitan area. All underwent repeated cognitive evaluations and subsequently completed assessments of decision making and susceptibility to scams. Decision making was measured using 12 items from a previously established performance-based measure and a self-report measure of susceptibility to scams. Results Cognitive function data were collected over an average of 5.5 years prior to the decision making assessment. Regression analyses were used to examine whether the prior rate of cognitive decline predicted the level of decision making and susceptibility to scams; analyses controlled for age, sex, education, and starting level of cognition. Among 420 persons without dementia, more rapid cognitive decline predicted poorer decision making and increased susceptibility to scams (p’s<0.001). Further, the relations between cognitive decline, decision making and scams persisted in analyses restricted to persons without any cognitive impairment (i.e., no dementia or even mild cognitive impairment). Conclusions Poor decision making is a consequence of cognitive decline among older persons without Alzheimer’s disease or mild cognitive impairment, those widely considered

  11. Comprehensive Psychiatric Evaluation

    Science.gov (United States)

    ... Facts for Families Guide Facts for Families - Vietnamese Comprehensive Psychiatric Evaluation No. 52; Updated October 2017 Evaluation ... with serious emotional and behavioral problems need a comprehensive psychiatric evaluation. Comprehensive psychiatric evaluations usually require a ...

  12. Neurophysiological evidence of impaired self-monitoring in schizotypal personality disorder and its reversal by dopaminergic antagonism.

    Science.gov (United States)

    Rabella, Mireia; Grasa, Eva; Corripio, Iluminada; Romero, Sergio; Mañanas, Miquel Àngel; Antonijoan, Rosa M; Münte, Thomas F; Pérez, Víctor; Riba, Jordi

    2016-01-01

    Schizotypal personality disorder (SPD) is a schizophrenia-spectrum disorder characterized by odd or bizarre behavior, strange speech, magical thinking, unusual perceptual experiences, and social anhedonia. Schizophrenia proper has been associated with anomalies in dopaminergic neurotransmission and deficits in neurophysiological markers of self-monitoring, such as low amplitude in cognitive event-related brain potentials (ERPs) like the error-related negativity (ERN), and the error positivity (Pe). These components occur after performance errors, rely on adequate fronto-striatal function, and are sensitive to dopaminergic modulation. Here we postulated that analogous to observations in schizophrenia, SPD individuals would show deficits in self-monitoring, as measured by the ERN and the Pe. We also assessed the capacity of dopaminergic antagonists to reverse these postulated deficits. We recorded the electroencephalogram (EEG) from 9 SPD individuals and 12 healthy controls in two separate experimental sessions while they performed the Eriksen Flanker Task, a classical task recruiting behavioral monitoring. Participants received a placebo or 1 mg risperidone according to a double-blind randomized design. After placebo, SPD individuals showed slower reaction times to hits, longer correction times following errors and reduced ERN and Pe amplitudes. While risperidone impaired performance and decreased ERN and Pe in the control group, it led to behavioral improvements and ERN amplitude increases in the SPD individuals. These results indicate that SPD individuals show deficits in self-monitoring analogous to those in schizophrenia. These deficits can be evidenced by neurophysiological measures, suggest a dopaminergic imbalance, and can be reverted by dopaminergic antagonists.

  13. Anxiety disorders: Psychiatric comorbidities and psychosocial ...

    African Journals Online (AJOL)

    Anxiety disorders: Psychiatric comorbidities and psychosocial stressors ... were present for 98.1% of patients and 36.9% had multiple anxiety disorders. ... and the comorbidity of anxiety and personality disorders should receive further attention.

  14. Parasitic Diseases and Psychiatric Illness

    OpenAIRE

    Weiss, Mitchell Gralnick

    1994-01-01

    Distinguishing parasitic diseases from other infections and tropical medical disorders based on microbiological classification is a matter of convenience. Organic brain syndromes are associated with both protozoan and helminthic infections; side-effects of drugs commonly used to treat parasitoses may impair mood and cause anxiety, agitation or psychosis. Emotional states may in turn affect the experience of medical illness. Psychiatrically significant features of medical illness are determine...

  15. Psychiatric Aspects of Childhood Epilepsy

    OpenAIRE

    Raman Deep PATTANAYAK; Rajesh SAGAR

    2012-01-01

    How to Cite this Article: Pattanayak RD, Sagar R. Psychiatric Aspects of Childhood Epilepsy. Iran J Child Neurol 2012;6(2):9-18.Childhood epilepsy is a chronic, recurrent disorder of unprovoked seizures. Theonset of epilepsy in childhood has significant implications for brain growth anddevelopment. Seizures may impair the ongoing neurodevelopmental processes and compromise the child’s intellectual and cognitive functioning, leading totremendous cognitive, behavioral and psychosocial consequen...

  16. [Level of Development of Clinical Ethics Consultation in Psychiatry - Results of a Survey Among Psychiatric Acute Clinics and Forensic Psychiatric Hospitals].

    Science.gov (United States)

    Gather, Jakov; Kaufmann, Sarah; Otte, Ina; Juckel, Georg; Schildmann, Jan; Vollmann, Jochen

    2018-04-17

    The aim of this article is to assess the level of development of clinical ethics consultation in psychiatric institutions in North Rhine-Westphalia. Survey among medical directors, directors of nursing and administrative directors of all psychiatric acute clinics and forensic psychiatric hospitals in North Rhine-Westphalia. 113 persons working in psychiatric acute clinics responded (reponse rate: 48 %) and 13 persons working in forensic psychiatric hospitals (response rate 54 %). We received at least one response from 89 % of all psychiatric acute clinics and from 100 % of all forensic psychiatric hospitals. 90 % of the responding psychiatric acute clinics and 29 % of the responding forensic psychiatric hospitals have already implemented clinical ethics consultation. Clinical ethics consultation is more widespread in psychiatric institutions than was hitherto assumed. Future medical ethics research should therefore give greater attention to the methodology and the quality of clinical ethics consultation in psychiatric practice. © Georg Thieme Verlag KG Stuttgart · New York.

  17. How Do Persons with Mild Acquired Cognitive Impairment Use Information and Communication Technology and E-Services? Results from a Swedish National Survey.

    Science.gov (United States)

    Eghdam, Aboozar; Bartfai, Aniko; Oldenburg, Christian; Koch, Sabine

    2016-01-01

    Mild acquired cognitive impairment is a term used to describe a sub-group of persons with mild cognitive impairment who are expected to reach a stable cognitive level over time. One tactic that can be considered for further developing treatment for this group is the use of information and communication technology and e-services. The purpose of this study was to investigate the current use of regular e-services and social media by this group as well as their user experiences. Data were collected through a self-administered survey and analyzed using quantitative methods. The questionnaire included questions regarding the participants' use of and experience with e-services. Categorization of e-services was based on and cross-validated with the International Classification of Functioning, Disability and Health (ICF). To estimate participants' degree and type of impairment, the Cognitive Failure Questionnaire (CFQ), measuring cognitive difficulties in performing everyday tasks, was added. In total, 282 persons with acquired brain injury participated in the survey. The participants' CFQ scores showed that they were suffering from mild to moderate cognitive impairments, most often acquired from traumatic brain injuries (40%). The majority (89%) used e-services in different categories whereof the most popular and essential ones were communication services (59%) and banking (39%) services. Participants with higher total CFQ scores (>58) used more e-services in most of the categories compared to participants with lower scores (services to be trustworthy and supportive in different contexts. The usage of electronic devices decreased by age with the exception of electronic tablets that were used by older participants approximately as frequently as by other age groups. Although persons with mild to moderate acquired brain injury used various e-services that are not customized for them, very few participants used self-care health services (apps) and readers (e-readers). Further

  18. Psychiatric comorbidity in forensic psychiatry.

    Science.gov (United States)

    Palijan, Tija Zarković; Muzinić, Lana; Radeljak, Sanja

    2009-09-01

    For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many violent offenders have multiple psychiatric diagnoses. Recent studies have confirmed causal relationship between major psychiatric disorders and concomitant substance abuse (comorbidity) in 50-80% of forensic cases. In general, there is a high level of psychiatric comorbidity in forensic patients with prevalence of personality disorders (50-90%), mood disorders (20-60%) and psychotic disorders (15-20%) coupled with substance abuse disorders. Moreover, the high prevalence of psychiatric comorbidities could be found in mentally retarded individuals, as well as, in epileptic patients. Drugs and alcohol abuse can produce serious psychotoxic effects that may lead to extreme violent behavior and consequently to serious criminal offence such as physical assault, rape, armed robbery, attempted murder and homicide, all due to an altered brain function and generating psychotic-like symptoms. Studies have confirmed a significant statistical relevance in causal relationship between substance abuse and violent offences. In terms of forensic psychiatry, the comorbidity strongly contributes in the process of establishing psychiatric diagnosis of diminished mental capacity or insanity at the time of the offence in the course of clinical assessment and evaluation of violent offenders. Today, the primary focus of forensic psychiatry treatment services (in-patient or community) is management of the violent offenders with psychiatric comorbidity which requires a multilevel, evidence based approach to

  19. The Scandinavian Solutions for Wellness study - a two-arm observational study on the effectiveness of lifestyle intervention on subjective well-being and weight among persons with psychiatric disorders.

    Science.gov (United States)

    Porsdal, Vibeke; Beal, Catherine; Kleivenes, Ole Kristian; Martinsen, Egil W; Lindström, Eva; Nilsson, Harriet; Svanborg, Pär

    2010-06-10

    Solutions for Wellness (SfW) is an educational 3-month program concerning nutrition and exercise for persons with psychiatric disorders on psychotropic medication, who have weight problems. This observational study assessed the impact of SfW on subjective well-being, weight and waist circumference (WC). Data was collected at 49 psychiatric clinics. Where the SfW program was offered patients could enter the intervention group; where not, the control group. Subjective well-being was measured by the Subjective Well-being under Neuroleptics scale (SWN), at baseline, at the end of SfW participation, and at a follow-up 6 months after baseline. Demographic, disease and treatment data was also collected. 314 patients enrolled in the SfW group, 59 in the control group. 54% of the patients had schizophrenia, 67% received atypical antipsychotics, 56% were female. They averaged 41 +/- 12.06 years and had a BMI of 31.4 +/- 6.35. There were significant differences at baseline between groups for weight, SWN total score and other factors. Stepwise logistic models controlling for baseline covariates yielded an adjusted non-significant association between SfW program participation and response in subjective well-being (SWN increase). However, statistically significant associations were found between program participation and weight-response (weight loss or gain weight and WC but not with improved subjective well-being as measured with the SWN scale.

  20. Type D personality is associated with impaired psychological status and unhealthy lifestyle in Icelandic cardiac patients: a cross-sectional study.

    Science.gov (United States)

    Svansdottir, Erla; van den Broek, Krista C; Karlsson, Hrobjartur D; Gudnason, Thorarinn; Denollet, Johan

    2012-01-18

    Type D (distressed) personality has been associated with adverse cardiac prognosis and poor emotional well-being in cardiac patients, but it is still unclear what mechanisms link Type D personality with poor clinical outcomes in cardiac patients. In the present cohort of Icelandic cardiac patients, we examined potential pathways that may explain this relationship. The objectives were to examine 1) the association between Type D personality and impaired psychological status, and to explore whether this association is independent of disease severity; and 2) the association between Type D personality and an unhealthy lifestyle. A sample of 268 Icelandic coronary angiography patients (74% males (N = 199); mean age 62.9 years (SD 10.5), range 28-85 years) completed the Type D Scale (DS14), Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS) at hospitalization. Health-related behaviors were assessed 4 months following angiography. Clinical data were collected from medical files. Type D personality was associated with an increased risk of anxiety (OR 2.97, 95% CI:1.55-5.69), depression (OR 4.01, 95% CI:1.42-11.29), and stress (OR 5.99, 95% CI:3.08-11.63), independent of demographic variables and disease severity. Furthermore, fish consumption was lower among Type Ds, as 21% of Type Ds versus 5% of non-Type Ds consumed fish unhealthy lifestyle in Icelandic cardiac patients. Future studies should further investigate the association between Type D personality and health-related behaviors.

  1. Perspectives on Personal Pronoun Reversal in Children with ASD: A Critical Review

    Directory of Open Access Journals (Sweden)

    David Brehme

    2014-03-01

    Full Text Available Personal pronoun reversal (PPR, characterised by inverse use of personal pronouns (typically first and second person is a hallmark of an autism spectrum disorder diagnosis (ASD; American Psychiatric Association, 2013. This literature review examines different theories accounting for the occurrence of PPR, in particular Kanner’s (1943 original view of PPR as echolalia, PPR as a result of impaired understanding of discourse roles (e.g. Tager-Flusberg, 1994, and PPR due to impaired theory of mind (Boucher, 2003. These existing theories are critiqued as overly simplistic, and the review argues that more complex theories are required to adequately explain the available evidence on PPR.

  2. Type D personality is associated with impaired psychological status and unhealthy lifestyle in Icelandic cardiac patients: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Svansdottir Erla

    2012-01-01

    Full Text Available Abstract Background Type D (distressed personality has been associated with adverse cardiac prognosis and poor emotional well-being in cardiac patients, but it is still unclear what mechanisms link Type D personality with poor clinical outcomes in cardiac patients. In the present cohort of Icelandic cardiac patients, we examined potential pathways that may explain this relationship. The objectives were to examine 1 the association between Type D personality and impaired psychological status, and to explore whether this association is independent of disease severity; and 2 the association between Type D personality and an unhealthy lifestyle. Methods A sample of 268 Icelandic coronary angiography patients (74% males (N = 199; mean age 62.9 years (SD 10.5, range 28-85 years completed the Type D Scale (DS14, Hospital Anxiety and Depression Scale (HADS, and Perceived Stress Scale (PSS at hospitalization. Health-related behaviors were assessed 4 months following angiography. Clinical data were collected from medical files. Results Type D personality was associated with an increased risk of anxiety (OR 2.97, 95% CI:1.55-5.69, depression (OR 4.01, 95% CI:1.42-11.29, and stress (OR 5.99, 95% CI:3.08-11.63, independent of demographic variables and disease severity. Furthermore, fish consumption was lower among Type Ds, as 21% of Type Ds versus 5% of non-Type Ds consumed fish p p = 0.024 and to use antidepressants (17% versus 9%, p = 0.049 and sleeping pills (49% versus 33%, p = 0.019 compared to non-Type Ds. Type D personality was not associated with other health-related behaviors, aside from trends towards less fruit and vegetable consumption, and more weight gain. Conclusion Type D personality was associated with psychological distress and an unhealthy lifestyle in Icelandic cardiac patients. Future studies should further investigate the association between Type D personality and health-related behaviors.

  3. Early maladaptive schema-related impairment and co-occurring current major depressive episode-related enhancement of mental state decoding ability in borderline personality disorder.

    Science.gov (United States)

    Unoka, Zsolt Szabolcs; Fogd, Dóra; Seres, Imola; Kéri, Szabolcs; Csukly, Gábor

    2015-04-01

    Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addition, the authors' aim was to evaluate the effects of a co-occurring current major depressive episode (MDE) on the MSD performance of BPD patients. Seventy-eight BPD patients (34 with MDE) and 76 matched healthy controls (HC) were assessed for Reading the Mind in the Eyes Test (RMET) and the level of EMS. The authors found that impairment in the total RMET performance, as well as specific impairment regarding the recognition of positive and neutral items, was associated with EMS, and enhanced vigilance to negative mental states was characteristic to BPD with MDE. Results suggest that MSD ability is altered in two independent ways in BPD.

  4. Type D personality and depressive symptoms are independent predictors of impaired health status in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W

    2008-01-01

    To examine whether Type D personality exerts a stable, independent effect on health status in CHF over time, adjusted for depressive symptoms.......To examine whether Type D personality exerts a stable, independent effect on health status in CHF over time, adjusted for depressive symptoms....

  5. Treat with Care: The Right to Informed Consent for Medical Treatment of Persons with Mental Impairments in Australia

    NARCIS (Netherlands)

    McSherry, Bernadette; Waddington, Lisa

    2017-01-01

    One of the most controversial questions that arose during negotiations on the United Nations Convention on the Rights of Persons (CRPD) concerned whether or not health interventions could ever be performed without the recipient’s consent. This is particularly important in relation to persons with

  6. Parental psychiatric hospitalisation and offspring schizophrenia

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

    2009-01-01

    The risk of schizophrenia has been linked with a family history of schizophrenia and less strongly with other psychiatric disorders in family members. Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Case Register, we studied the relationship between offspring risk...... of schizophrenia and a range of psychotic and non-psychotic psychiatric diagnoses in parents. Psychiatric admission data after 1969 were available for 7047 cohort members born between 1959 and 1961, and for 7006 mothers and 6993 fathers. Univariate analysis showed that neurosis, alcohol and substance dependence...... in both parents were associated with elevated risk of offspring schizophrenia; in addition, maternal schizophrenia, affective disorder and personality disorder were associated with elevated risk. Controlling for parental age, parental social status, and parental psychiatric co-diagnosis, offspring risk...

  7. Potential barriers and facilitators for implementation of an integrated care pathway for hearing-impaired persons: an exploratory survey among patients and professionals

    Directory of Open Access Journals (Sweden)

    Verschuure Hans

    2007-04-01

    Full Text Available Abstract Background Because of the increasing costs and anticipated shortage of Ear Nose and Throat (ENT specialists in the care for hearing-impaired persons, an integrated care pathway that includes direct hearing aid provision was developed. While this direct pathway is still under investigation, in a survey we examined expectations and potential barriers and facilitators towards this direct pathway, of patients and professionals involved in the pathway. Methods Two study populations were assessed: members of the health professions involved in the care pathway for hearing-impaired persons (general practitioners (GPs, hearing aid dispensers, ENT-specialists and clinical audiologists and persons with hearing complaints. We developed a comprehensive semi-structured questionnaire for the professionals, regarding expectations, barriers, facilitators and conditions for implementation. We developed two questionnaires for persons with hearing complaints, both regarding evaluations and preferences, and administered them after they had experienced two key elements of the direct pathway: the triage and the hearing aid fitting. Results On average GPs and hearing aid dispensers had positive expectations towards the direct pathway, while ENT-specialists and clinical audiologists had negative expectations. Professionals stated both barriers and facilitators towards the direct pathway. Most professionals either supported implementation of the direct pathway, provided that a number of conditions were satisfied, or did not support implementation, unless roughly the same conditions were satisfied. Professionals generally agreed on which conditions need to be satisfied. Persons with hearing complaints evaluated the present referral pathway and the new direct pathway equally. Many, especially older, participants stated however that they would still visit the GP and ENT-specialist, even when this would not be necessary for reimbursement of the hearing aid, and

  8. The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W

    2005-01-01

    Chronic heart failure (CHF) is a serious condition that is associated with impaired health status and a high prevalence of depressive symptoms. To date, little is known about the determinants of health status and depressive symptoms in CHF. Therefore, the aim of this study was to assess whether T...

  9. The Physical Costs and Psychosocial Benefits of Travel Aids for Persons Who Are Visually Impaired or Blind.

    Science.gov (United States)

    Gitlin, L. N.; Mount, J.; Lucas, W.; Weirich, L. C.; Gramberg, L.

    1997-01-01

    This study investigated the musculoskeletal consequences of travel aids, particularly white canes and guide dogs, as perceived by 21 individuals (ages 27-68) with visual impairments or blindness. They experienced a variety of negative physical effects that they denied, ignored, or minimized because of benefits derived from being independently…

  10. The influence of olfactory impairment in vital, independently living older persons on their eating behaviour and foodliking

    NARCIS (Netherlands)

    Kremer, S.; Holthuysen, N.T.E.; Boesveldt, S.

    2014-01-01

    These two studies investigated eating behaviour and food liking of independently living Dutch older people with and without olfactory impairment. In the first study, an internet survey was conducted in relation to their olfactory status (n = 512; age 55–91). Hyposmic older people reported eating the

  11. [Religious/spiritual well-being in mentally ill persons II: the development of a short scale and comparison scores for clinical psychiatric groups and healthy controls].

    Science.gov (United States)

    Unterrainer, Human-Friedrich; Kapfhammer, Hans-Peter

    2014-01-01

    The Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB) was successfully applied in several clinical as well as non-clinical studies. However, the original version of the scale often showed to be as too comprehensive especially for clinical surroundings. There for the aim of this study is to develop a short version of the scale comprising 12 items. Based on a sample representative of the Austrian general population (N = 1,500), a first MI-RSWB short version is developed by means of factor- and reliability analysis. Furthermore the new short version of the scale is initially validated through several indicators of mental illness. The MI-RSWB short version shows convincing psychometric properties. The total scale as well as the sub scales exhibit at least a sufficient internal consistency. A significant negative association with several indicators of psychiatric illness is also confirmed for the short version of the scale. The MI-RWSB 12 scale is especially recommended for further research focusing on the clinical relevance of religiosity and spirituality.

  12. The role of sex and autonomy-connectedness in internalizing and externalizing personality pathology, coping and axis-I pathology : Among psychiatric and healthy elderly

    NARCIS (Netherlands)

    Bachrach, N.; Croon, M.A.; Bekker, M.H.J.

    2017-01-01

    Objectives: In the current study we investigated the relationship of sex and autonomy-connectedness with internalizing and externalizing personality disorder symptoms (PDS), coping and axis-I pathology in older age. Method: A path model was tested which was based on neo-analytical object relation,

  13. Racial Bias in Personality Assessment: Using the MMPI-2 to Predict Psychiatric Diagnoses of African American and Caucasian Chemical Dependency Inpatients

    Science.gov (United States)

    Monnot, Matthew J.; Quirk, Stuart W.; Hoerger, Michael; Brewer, Linda

    2009-01-01

    An assessment of predictive bias was conducted on numerous scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989), including the Restructured Clinical (RC) scales, in the prediction of clinical diagnostic status for African American and Caucasian male…

  14. Familiality of Psychiatric Disorders and Risk of Postpartum Psychiatric Episodes

    DEFF Research Database (Denmark)

    Bauer, Anna E; Maegbaek, Merete L; Liu, Xiaoqin

    2018-01-01

    OBJECTIVE: Postpartum psychiatric disorders are common and morbid complications of pregnancy. The authors sought to evaluate how family history of psychiatric disorders is associated with postpartum psychiatric disorders in proband mothers with and without a prior psychiatric history by assessing...

  15. Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014.

    Science.gov (United States)

    Kim, Scott Y H; De Vries, Raymond G; Peteet, John R

    2016-04-01

    Euthanasia or assisted suicide (EAS) of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands. However, little is known about the practice, and it remains controversial. To describe the characteristics of patients receiving EAS for psychiatric conditions and how the practice is regulated in the Netherlands. This investigation reviewed psychiatric EAS case summaries made available online by the Dutch regional euthanasia review committees as of June 1, 2015. Two senior psychiatrists used directed content analysis to review and code the reports. In total, 66 cases from 2011 to 2014 were reviewed. Clinical and social characteristics of patients, physician review process of the patients' requests, and the euthanasia review committees' assessments of the physicians' actions. Of the 66 cases reviewed, 70% (n = 46) were women. In total, 32% (n = 21) were 70 years or older, 44% (n = 29) were 50 to 70 years old, and 24% (n = 16) were 30 to 50 years old. Most had chronic, severe conditions, with histories of attempted suicides and psychiatric hospitalizations. Most had personality disorders and were described as socially isolated or lonely. Depressive disorders were the primary psychiatric issue in 55% (n = 36) of cases. Other conditions represented were psychotic, posttraumatic stress or anxiety, somatoform, neurocognitive, and eating disorders, as well as prolonged grief and autism. Comorbidities with functional impairments were common. Forty-one percent (n = 27) of physicians performing EAS were psychiatrists. Twenty-seven percent (n = 18) of patients received the procedure from physicians new to them, 14 of whom were physicians from the End-of-Life Clinic, a mobile euthanasia clinic. Consultation with other physicians was extensive, but 11% (n = 7) of cases had no independent psychiatric input, and 24% (n = 16) of cases involved disagreement among consultants. The euthanasia review committees found

  16. Technological Advances in Psychiatric Nursing: An update.

    Science.gov (United States)

    Bostrom, Andrea C

    2016-06-01

    Understanding and treating mental illness has improved in many ways as a result of the fast pace of technological advances. The technologies that have the greatest potential impact are those that (1) increase the knowledge of how the brain functions and changes based on interventions, (2) have the potential to personalize interventions based on understanding genetic factors of drug metabolism and pharmacodynamics, and (3) use information technology to provide treatment in the absence of an adequate mental health workforce. Technologies are explored for psychiatric nurses to consider. Psychiatric nurses are encouraged to consider the experiences of psychiatric patients, including poor health, stigmatization, and suffering. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A multi-faceted knowledge translation approach to support persons with stroke and cognitive impairment: evaluation protocol.

    Science.gov (United States)

    McEwen, Sara E; Donald, Michelle; Dawson, Deirdre; Egan, Mary Y; Hunt, Anne; Quant, Sylvia; Runions, Sharron; Linkewich, Elizabeth

    2015-11-05

    Patients with cognitive impairments following a stroke are often denied access to inpatient rehabilitation. The few patients with cognitive impairment admitted to rehabilitation generally receive services based on outdated impairment-reduction models, rather than recommended function-based approaches. Both reduced access to rehabilitation and the knowledge-to-practice gap stem from a reported lack of skills and knowledge regarding cognitive rehabilitation on the part of inpatient rehabilitation team members. To address these issues, a multi-faceted knowledge translation (KT) initiative will be implemented and evaluated. It will be targeted specifically at the inter-professional application of the cognitive orientation to daily occupational performance (CO-OP). CO-OP training combined with KT support is called CO-OP KT. The long-term objective of CO-OP KT is to optimize functional outcomes for individuals with stroke and cognitive impairments. Three research questions are posed: 1. Is the implementation of CO-OP KT associated with a change in the proportion of patients with cognitive impairment following a stroke accepted to inpatient rehabilitation? 2. Is the implementation of CO-OP KT associated with a change in rehabilitation clinicians' practice, knowledge, and self-efficacy related to implementing the CO-OP approach, immediately following and 1 year later? 3. Is CO-OP KT associated with changes in activity, participation, and self-efficacy to perform daily activities in patients with cognitive impairment following stroke at discharge from inpatient rehabilitation and at 1-, 3-, and 6-month follow-ups? Three interrelated studies will be conducted. Study 1 will be a quasi-experimental, interrupted time series design measuring monthly summaries of stroke unit level data. Study 2, which relates to changes in health care professional practice and self-efficacy, will be a single group pre-post evaluation design incorporating chart audits and a self-report survey

  18. Psychiatric disorders of patients seeking obesity treatment

    Directory of Open Access Journals (Sweden)

    Lin Hung-Yen

    2013-01-01

    Full Text Available Abstract Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.

  19. Review: a conceptual model of perceived burden of informal caregivers for older persons with a severe functional psychiatric syndrome and concomitant problematic behaviour.

    Science.gov (United States)

    Zegwaard, Marian I; Aartsen, Marja J; Cuijpers, Pim; Grypdonck, Mieke Hf

    2011-08-01

    This literature review aims to delineate the determinants of perceived burden by informal caregivers and provide insight into the interrelatedness between these determinants. Despite the attention given to the various determinants of perceived burden, their interrelatedness has not been unravelled. Insight into this interrelatedness is mandatory for the development of successful, complex, multivariate interventions to reduce perceived burden of informal caregivers. DESIGN; Systematic review. Four electronic databases, CINAHL, Embase psychiatry, Medline, Psychinfo and reference lists of selected articles, were searched. Publications between January 1985-2008 were included if they concerned mental illness, burden and care giving. Articles were selected according to predefined inclusion and exclusion criteria. The results of mostly descriptive, cross-sectional and univariate research and the more process-oriented results coming from qualitative burden research are organised in a process orientated conceptual scheme or model adapted from the stress-theoretical framework by Lazarus and Folkman. The model indicates that perceived burden must be understood through the individual appraisal of stressors and the availability and use of internal and external resources. Perceived burden is the outcome of multiple, clinically overlapping psychiatric problems, problematic behaviour and functional disabilities. So far, intervention programs to reduce perceived burden of informal caregivers have not devoted much attention to the interrelatedness of the origins of burden. The conceptual model provides an overview of the various determinants of perceived burden and a clear picture of the possible interrelatedness appears. This overview of the most important sources of burden helps to develop a complex, multivariate intervention that is comprehensive, long-term, individually tailored and has the flexibility to meet the dynamics of burden over time. Use of the conceptual model is

  20. The role of sex and autonomy-connectedness in internalizing and externalizing personality pathology, coping and axis-I pathology: among psychiatric and healthy elderly.

    Science.gov (United States)

    Bachrach, Nathan; Croon, Marcel; Bekker, Marrie

    2017-06-01

    In the current study we investigated the relationship of sex and autonomy-connectedness with internalizing and externalizing personality disorder symptoms (PDS), coping and axis-I pathology in older age. A path model was tested which was based on neo-analytical object relation, attachment- and primary-personality theory, among 100 clinical and 106 non-clinical elderly. In line with our model, autonomy-connectedness (self-awareness and capacity of managing new situations) was strongly associated to internalizing PDS in both groups. In both groups, neither sex nor autonomy-connectedness predicted externalizing PDS. Sex, internalizing as well as externalizing PDS and reactive defensive coping were associated to axis-I psychopathology. We conclude that sex and autonomy-connectedness were, similarly as in adult populations, associated to internalizing PDS and axis-I pathology. Treatment of elderly with internalizing PDS and axis-I psychopathology should therefore focus on enhancing autonomy-connectedness.

  1. Whose life is it anyway? An exploration of five contemporary ethical issues that pertain to the psychiatric nursing care of the person who is suicidal: part one.

    Science.gov (United States)

    Cutcliffe, John R; Links, Paul S

    2008-08-01

    It is self-evident that ethical issues are important topics for consideration for those involved in the care of the person who is suicidal. Nevertheless, despite the obvious relationship between Mental Health nurses and care of the person who is suicidal, such nurses have hitherto been mostly silent on these matters. As a result, this two-part paper focuses on a number of contemporary issues which might help inform the ethical discourse and resultant Mental Health nursing care of the person who is suicidal. Part one of this paper focuses on the issues: Whose life is it anyway? Harming of our bodies and the inconsistency in ethical responses and, Is suicide ever a reasonable thing to do? The authors find that this contemporary view within the suicidology academe and the corresponding legal position in most western (developed) countries is that the individual owns his/her own body. Yet given that contemporary mental healthcare policy and associated practice positions do not reflect view, this can easily lead to the scenario where a Mental Health nurse is faced with a major ethical dilemma, and the corresponding probability of moral distress. The authors also find that it is inaccurate to posit a simple positive correlation between the potential seriousness and/or extent of bodily harm and the degree of paternalistic removal of an individual's rights to personal body ownership. Lastly, the authors find that the relevant theoretical and ethical literature in this area suggests, at least for some and under certain conditions, suicide can be the right thing to do.

  2. The Scandinavian Solutions for Wellness study - a two-arm observational study on the effectiveness of lifestyle intervention on subjective well-being and weight among persons with psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Nilsson Harriet

    2010-06-01

    Full Text Available Abstract Background Solutions for Wellness (SfW is an educational 3-month program concerning nutrition and exercise for persons with psychiatric disorders on psychotropic medication, who have weight problems. This observational study assessed the impact of SfW on subjective well-being, weight and waist circumference (WC. Methods Data was collected at 49 psychiatric clinics. Where the SfW program was offered patients could enter the intervention group; where not, the control group. Subjective well-being was measured by the Subjective Well-being under Neuroleptics scale (SWN, at baseline, at the end of SfW participation, and at a follow-up 6 months after baseline. Demographic, disease and treatment data was also collected. Results 314 patients enrolled in the SfW group, 59 in the control group. 54% of the patients had schizophrenia, 67% received atypical antipsychotics, 56% were female. They averaged 41 ± 12.06 years and had a BMI of 31.4 ± 6.35. There were significant differences at baseline between groups for weight, SWN total score and other factors. Stepwise logistic models controlling for baseline covariates yielded an adjusted non-significant association between SfW program participation and response in subjective well-being (SWN increase. However, statistically significant associations were found between program participation and weight-response (weight loss or gain Conclusions SfW program participation was associated with maintaining or decreasing weight and WC but not with improved subjective well-being as measured with the SWN scale.

  3. Reliability of the American Medical Association guides' model for measuring spinal range of motion. Its implication for whole-person impairment rating.

    Science.gov (United States)

    Nitschke, J E; Nattrass, C L; Disler, P B; Chou, M J; Ooi, K T

    1999-02-01

    Repeated measures design for intra- and interrater reliability. To determine the intra- and interrater reliability of the lumbar spine range of motion measured with a dual inclinometer, and the thoracolumbar spine range of motion measured with a long-arm goniometer, as recommended in the American Medical Association Guides. The American Medical Association Guides (2nd and 4th editions) recommend using measurements of thoracolumbar and lumbar range of movement, respectively, to estimate the percentage of permanent impairment in patients with chronic low back pain. However, the reliability of this method of estimating impairment has not been determined. In all, 34 subjects participated in the study, 21 women with a mean age of 40.1 years (SD, +/- 11.1) and 13 men with a mean age of 47.7 years (SD, +/- 12.1). Measures of thoracolumbar flexion, extension, lateral flexion, and rotation were obtained with a long-arm goniometer. Lumbar flexion, extension, and lateral flexion were measured with a dual inclinometer. Measurements were taken by two examiners on one occasion and by one examiner on two occasions approximately 1 week apart. The results showed poor intra- and interrater reliability for all measurements taken with both instruments. Measurement error expressed in degrees showed that measurements taken by different raters exhibited systematic as well as random differences. As a result, subjects measured by two different examiners on the same day, with either instrument, could give impairment ratings ranging between 0% and 18% of the whole person (excluding rotation), in which percentage impairment is calculated using the average range of motion and the average systematic and random error in degrees for the group for each movement (flexion, extension, and lateral flexion). The poor reliability of the American Medical Association Guides' spinal range of motion model can result in marked variation in the percentage of whole-body impairment. These findings have

  4. The prediction of the level of personality organization on reduction of psychiatric symptoms and improvement of work ability in short- versus long-term psychotherapies during a 5-year follow-up.

    Science.gov (United States)

    Knekt, Paul; Lindfors, Olavi; Keinänen, Matti; Heinonen, Erkki; Virtala, Esa; Härkänen, Tommi

    2017-09-01

    How level of personality organization (LPO) predicts psychiatric symptoms and work ability in short- versus long-term psychotherapies is poorly known. We investigated the importance of the LPO on the benefits of short-term versus long-term psychotherapies. A cohort study based on 326 outpatients with mood or anxiety disorder was allocated to long-term (LPP) and short-term (SPP) psychodynamic psychotherapy, and solution-focused therapy (SFT). The LPO was assessed by interview at baseline and categorized into neuroses and higher level borderline. Outcome was assessed at baseline and 4-9 times during a 5-year follow-up, using self-report and interview-based measures of symptoms and work ability. For patients receiving SPP, improvement in work ability, symptom reduction, and the remission rate were more considerable in patients with neuroses than in higher level borderline patients, whereas LPP or SFT showed no notable differences in effectiveness in the two LPO groups. In patients with neuroses, improvement was more considerable in the short-term therapy groups during the first year of follow-up, and in higher level borderline patients LPP was more effective after 3 years of follow-up. The remission rate, defined as both symptom reduction and lack of auxiliary treatment, was higher in LPP than in SPP for both the LPO groups considered. In neuroses, short-term psychotherapy was associated with a more rapid reduction of symptoms and increase in work ability, whereas LPP was more effective for longer follow-ups in both LPO groups. Further large-scale studies are needed. Level of personality organization is relevant for selection between short- and long-term psychotherapies. Short-term therapy gives faster benefits for neurotic patients but not for patients with higher level borderline personality organization. Sustained remission from symptoms is more probable after long-term than short-term therapy. © 2016 The British Psychological Society.

  5. Differences in the use of everyday technology among persons with MCI, SCI and older adults without known cognitive impairment.

    Science.gov (United States)

    Malinowsky, Camilla; Kottorp, Anders; Wallin, Anders; Nordlund, Arto; Björklund, Eva; Melin, Ilse; Pernevik, Anette; Rosenberg, Lena; Nygård, Louise

    2017-07-01

    To use valid subjective reports sensible to cognitive decline is vital to identify very early signs of dementia development. Use of everyday technology (ET) has been shown to be sensitive to differentiate adults with mild cognitive impairment (MCI) from controls, but the group with subjective cognitive impairment (SCI) has not yet been examined. This study aims to investigate and compare self-perceived ability in ET use and number of ETs reported as actually used in a sample of older adults with SCI, MCI, and older adults with no known cognitive impairment, i.e. Older adults with MCI (n = 29), SCI ( n = 26), and controls (n = 30) were interviewed with the short version of the Everyday Technology Use Questionnaire (S-ETUQ) to capture self-perceived ability in ET use and number of ETs used. To generate individual measures of ability to use ET, Rasch analysis was used. The measures were then compared group-wise using ANCOVA. The numbers of ETs used were compared group-wise with ANOVA. Controls versus SCI and MCI differed significantly regarding ETs reported as used, but not SCI versus MCI. Similarly, in ability to use ET, controls versus SCI and MCI differed significantly but not SCI versus MCI. The significantly lower numbers of ETs reported as actually used and the lower ability in SCI and MCI groups compared to controls suggest that ET use is affected already in very minor cognitive decline. This indicates that self-reported ET use based on the S-ETUQ is sensitive to detect changes already in SCI.

  6. The role of serotonin in personality inference: tryptophan depletion impairs the identification of neuroticism in the face.

    Science.gov (United States)

    Ward, Robert; Sreenivas, Shubha; Read, Judi; Saunders, Kate E A; Rogers, Robert D

    2017-07-01

    Serotonergic mechanisms mediate the expression of personality traits (such as impulsivity, aggression and anxiety) that are linked to vulnerability to psychological illnesses, and modulate the identification of emotional expressions in the face as well as learning about broader classes of appetitive and aversive signals. Faces with neutral expressions signal a variety of socially relevant information, such that inferences about the big five personality traits, including Neuroticism, Extraversion and Agreeableness, can be accurately made on the basis of emotionally neutral facial photographs. Given the close link between Neuroticism and psychological distress, we investigated the effects of diminished central serotonin activity (achieved by tryptophan depletion) upon the accuracy of 52 healthy (non-clinical) adults' discriminations of personality from facial characteristics. All participants were able to discriminate reliably four of the big five traits. However, the tryptophan-depleted participants were specifically less accurate in discriminating Neuroticism than the matched non-depleted participants. These data suggest that central serotonin activity modulates the identification of not only negative facial emotional expression but also a broader class of signals about personality characteristics linked to psychological distress.

  7. 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

  8. Adapting for Impaired Patrons.

    Science.gov (United States)

    Schuyler, Michael

    1999-01-01

    Describes how a library, with an MCI Corporation grant, approached the process of setting up computers for the visually impaired. Discusses preparations, which included hiring a visually-impaired user as a consultant and contacting the VIP (Visually Impaired Persons) group; equipment; problems with the graphical user interface; and training.…

  9. Psychiatric effects of cannabis use.

    Science.gov (United States)

    Tunving, K

    1985-09-01

    That cannabis use may provoke mental disturbances is well known to Scandinavian psychiatrists today. A review of the psychiatric aspects of cannabis use is given, and the clinical signs of 70 cases of cannabis psychoses collected in Sweden are described. The bluntness and "amotivation" following chronic cannabis use are discussed. Anxiety reactions, flashbacks, dysphoric reactions and an abstinence syndrome are all sequels of cannabis use. Three risk groups begin to emerge: a) Young teenage cannabis users who lose some of their capacity to learn complex functions and who flee from reality to a world of dreams. With its sedative effect, cannabis could modify such emotions as anger and anxiety and slow down the liberation process of adolescence. b) Heavy daily users, often persons who cannot cope with depression or their life circumstances. c) Psychiatric patients whose resistance to relapses into psychotic reactions might be diminished according to the psychotropic effects of cannabis.

  10. Neurophysiological evidence of impaired self-monitoring in schizotypal personality disorder and its reversal by dopaminergic antagonism

    OpenAIRE

    Mireia Rabella; Eva Grasa; Iluminada Corripio; Sergio Romero; Miquel Àngel Mañanas; Rosa Mª. Antonijoan; Thomas F. Münte; Víctor Pérez; Jordi Riba

    2016-01-01

    BACKGROUND: Schizotypal personality disorder (SPD) is a schizophrenia-spectrum disorder characterized by odd or bizarre behavior, strange speech, magical thinking, unusual perceptual experiences, and social anhedonia. Schizophrenia proper has been associated with anomalies in dopaminergic neurotransmission and deficits in neurophysiological markers of self-monitoring, such as low amplitude in cognitive event-related brain potentials (ERPs) like the error-related negativity (ERN), and the erro...

  11. Psychiatric comorbidities in patients from seven families with autosomal dominant cortical tremor, myoclonus, and epilepsy.

    Science.gov (United States)

    Coppola, Antonietta; Caccavale, Carmela; Santulli, Lia; Balestrini, Simona; Cagnetti, Claudia; Licchetta, Laura; Esposito, Marcello; Bisulli, Francesca; Tinuper, Paolo; Provinciali, Leandro; Minetti, Carlo; Zara, Federico; Striano, Pasquale; Striano, Salvatore

    2016-03-01

    The objective of this report was to assess the psychiatric comorbidity in a group of patients affected by autosomal dominant cortical tremor, myoclonus, and epilepsy (ADCME). Reliable and validated psychodiagnostic scales including the BDI (Beck Depression Inventory), STAI-Y1 and 2 (State-Trait Anxiety Inventory - Y; 1 and 2), MMPI-2 (Minnesota Multiphasic Personality Inventory - 2), and QoLIE-31 (Quality of Life in Epilepsy Inventory - 31) were administered to 20 patients with ADCME, 20 patients with juvenile myoclonic epilepsy (JME), and 20 healthy controls. There was a higher prevalence of mood disorders in patients with ADCME compared to patients with JME and healthy controls, particularly depression (p=0.035 and p=0.017, respectively) and state anxiety (p=0.024 and p=0.019, respectively). Trait anxiety was not different from JME (p=0.102) but higher than healthy controls (p=0.017). The myoclonus score positively correlated with both state (rho: 0.58, p=0.042) and trait anxiety (rho: 0.65, p=0.011). These psychiatric features were also often associated with pathological traits of personality: paranoid (OR: 25.7, p=0.003), psychasthenia (OR: 7.0, p=0.023), schizophrenia (OR: 8.5, p=0.011), and hypomania (OR: 5.5, p=0.022). Finally, in patients with ADCME, decreased quality of life correlated with these psychiatric symptoms. Patients with ADCME show a significant psychiatric burden that impairs their quality of life. A comprehensive psychiatric evaluation should be offered at the time of diagnosis to detect these comorbidities and to treat them. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014

    Science.gov (United States)

    Kim, Scott Y H; De Vries, Raymond; Peteet, John R

    2017-01-01

    Importance Euthanasia and/or physician assisted suicide of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands. However, little is known about the practice and it remains very controversial. Objective To describe the characteristics of patients receiving euthanasia/assisted suicide for psychiatric conditions and how the practice is regulated in the Netherlands. Design and Setting A review of psychiatric euthanasia/assisted suicide case summaries made available online by the Dutch Regional Euthanasia Review Committees, as of 1 June 2015. Two senior psychiatrists used directed content analysis to review and code the reports. 66 cases from 2011–14 were reviewed. Main Outcomes Clinical and social characteristics of patients, physician review process of the patients’ requests, and the Review Committees’ assessments of the physicians’ actions. Results 70% (46 of 66) of patients were women, 32% were over 70 years-old, 44% were between 50–70, and 24% were 30–50. Most had chronic, severe conditions, with histories of attempted suicides and psychiatric hospitalizations. A majority had personality disorders and were described as socially isolated or lonely. Depressive disorders were the primary issue in 55% of cases. Other conditions represented were psychotic, PTSD/anxiety, somatoform, neurocognitive, and eating disorders, as well as prolonged grief and autism. Co-morbidities with functional impairments were common. A minority (41%) of physicians performing euthanasia/assisted suicide were psychiatrists. 18 (27%) patients received the procedure from physicians new to them, 15 (23%) of whom were physicians from the End-of-Life Clinic, a mobile euthanasia clinic. Consultation with other physicians was extensive, but 11% of cases had no independent psychiatric input and 24% of cases involved disagreement among consultants. The Review Committee found one case to have failed to meet legal due care criteria. Conclusions and

  13. [Behavioural problems and personality change related to cerebral amyloid angiopathy].

    Science.gov (United States)

    Gahr, Maximilian; Connemann, Bernhard J; Schönfeldt-Lecuona, Carlos

    2012-11-01

    Cerebral amyloid angiopathy (CAA) belongs to the group of amyloidoses that are characterized by the deposition of insoluble and tissue-damaging amyloid proteins. Spontaneous intracerebral hemorrhage is the common clinical presentation of CAA resulting from the degenerative effect of beta amyloid on the cerebral vascular system. Though CAA is rather a neurological disease psychiatric symptoms can occur and even dominate the clinical picture. A case report is presented in order to illustrate the association between CAA and psychiatric symptoms. We report the case of a 54-year-old female patient with radiologic references to a probable CAA and mild cognitive impairment who developed behavioural difficulties and personality change that necessitated a psychiatric treatment. Psychiatric symptoms were most likely due to CAA. CAA can be associated with psychiatric symptoms and hence should be considered in the treatment of elderly patients with behavioural problems or personality changes. Diagnostic neuroimaging and examination of cerebrospinal fluid is recommended. © Georg Thieme Verlag KG Stuttgart · New York.

  14. For Debate: Personalized Health Care: As Exemplified by Home Sodium Measurements in a Child with Central Diabetes Insipidus and Impaired Thirst Perception.

    Science.gov (United States)

    van der Linde, A A A; van Herwaarden, A E; Oosting, J D; Claahsen-van der Grinten, H L; de Grouw, E P L M

    2018-04-01

    We describe a 6-year old boy with central diabetes insipidus (CDI) caused by destruction of the pituitary gland due to treatment of an optical pathway glioma. He has been treated with chemotherapy and has had several debulking operations over the past years and consequently developed central hypocortisolism, hypothyroidism and CDI. The treatment of CDI was gravely complicated by an impaired thirst perception and compulsive drinking behavior. He was frequently seen at the ER or admitted due to dysregulation of fluid balance. In order to provide better self-reliance, home point of care testing (POCT) sodium measurement was introduced. Realizing POCT sodium measurement resulted in a significant decrease of ER visits and clinical admissions due to dysregulation of fluid balance. This case is an example of personalized health care and has led to better self-reliance and quality of life. Copyright© of YS Medical Media ltd.

  15. Grit or Honesty-Humility? New Insights into the Moderating Role of Personality between the Health Impairment Process and Counterproductive Work Behavior.

    Science.gov (United States)

    Ceschi, Andrea; Sartori, Riccardo; Dickert, Stephan; Costantini, Arianna

    2016-01-01

    It is acknowledged that chronic job demands may be depleting workers' stamina resulting in burnout conditions and ultimately causing further health problems. This relation, known as health impairment process, has recently been considered as a possible explanation for the emergence of counterproductive work behavior (CWB). The present work aims to examine the role of two personality traits (i.e., Grit and Honesty-Humility) in this process. The results, based on a sample of 208 private service sector employees, confirm the presence of a fully mediated process and show how Honesty-Humility positively moderates the relationship between job demands and exhaustion, whereas Grit has a negative effect on the relation between exhaustion and CWB. Implications for assessment procedure and hiring decisions are discussed.

  16. Grit or Honesty-Humility? New insights into the moderating role of personality between the health impairment process and counterproductive work behavior

    Directory of Open Access Journals (Sweden)

    Andrea Ceschi

    2016-12-01

    Full Text Available It is acknowledged that chronic job demands may be depleting workers’ stamina resulting in burnout conditions and ultimately causing further health problems. This relation, known as health impairment process, has recently been considered as a possible explanation for the emergence of counterproductive work behavior (CWB. The present work aims to examine the role of two personality traits (i.e., Grit and Honesty–Humility in this process. The results, based on a sample of 208 private service sector employees, confirm the presence of a fully mediated process and show how Honesty–Humility positively moderates the relationship between job demands and exhaustion, whereas Grit has a negative effect on the relation between exhaustion and CWB. Implications for assessment procedure and hiring decisions are discussed.

  17. The relationship between event-related potentials, stress perception and personality type in patients with multiple sclerosis without cognitive impairment: A pilot study.

    Science.gov (United States)

    Waliszewska-Prosół, Marta; Nowakowska-Kotas, Marta; Kotas, Roman; Bańkowski, Tomasz; Pokryszko-Dragan, Anna; Podemski, Ryszard

    2018-06-08

    The clinical course of multiple sclerosis (MS) can vary significantly among patients and is affected by exogenous and endogenous factors. Among these, stress and personality type have been gaining more attention. The aim of this study was to investigate the parameters of event-related potentials (ERPs) with regards to stress perception and personality type, as well as cognitive performance in MS patients. The study group consisted of 30 MS patients and 26 healthy controls. Auditory ERPs were performed in both groups, including an analysis of P300 and N200 response parameters. The Perceived Stress Scale (PSS) was used in the MS group to measure the perception of stress. The D-type Scale (DS14) scale was used to determine the features of Type D personality, characterized by social inhibition and negative affectivity. The score on the PSS corresponded with a moderate or high level of stress perception in 63% of MS patients, while 23% of patients presented with a Type D personality. P300 latencies were significantly longer (p = 0.001), N200 amplitudes were significantly higher (p = 0.004), and N200 latencies were longer in MS patients than in the controls. Strong positive correlations were found between N200 and P300 amplitudes, as well as between the DS14 and PSS results. Most MS patients experience moderate to severe stress. ERP abnormalities were found in MS patients who did not have overt cognitive impairment and showed correlations with stress levels and negative affectivity. Event-related potentials may be useful in assessing the influence of stress and emotions on the course of MS.

  18. Hearing aid fitting in older persons with hearing impairment: the influence of cognitive function, age, and hearing loss on hearing aid benefit.

    Science.gov (United States)

    Meister, Hartmut; Rählmann, Sebastian; Walger, Martin; Margolf-Hackl, Sabine; Kießling, Jürgen

    2015-01-01

    To examine the association of cognitive function, age, and hearing loss with clinically assessed hearing aid benefit in older hearing-impaired persons. Hearing aid benefit was assessed using objective measures regarding speech recognition in quiet and noisy environments as well as a subjective measure reflecting everyday situations captured using a standardized questionnaire. A broad range of general cognitive functions such as attention, memory, and intelligence were determined using different neuropsychological tests. Linear regression analyses were conducted with the outcome of the neuropsychological tests as well as age and hearing loss as independent variables and the benefit measures as dependent variables. Thirty experienced older hearing aid users with typical age-related hearing impairment participated. Most of the benefit measures revealed that the participants obtained significant improvement with their hearing aids. Regression models showed a significant relationship between a fluid intelligence measure and objective hearing aid benefit. When individual hearing thresholds were considered as an additional independent variable, hearing loss was the only significant contributor to the benefit models. Lower cognitive capacity - as determined by the fluid intelligence measure - was significantly associated with greater hearing loss. Subjective benefit could not be predicted by any of the variables considered. The present study does not give evidence that hearing aid benefit is critically associated with cognitive function in experienced hearing aid users. However, it was found that lower fluid intelligence scores were related to higher hearing thresholds. Since greater hearing loss was associated with a greater objective benefit, these results strongly support the advice of using hearing aids regardless of age and cognitive function to counter hearing loss and the adverse effects of age-related hearing impairment. Still, individual cognitive capacity might

  19. The prevalence of personality disorders in psychiatric outpatients with borderline intellectual functioning: Comparison with outpatients from regular mental health care and outpatients with mild intellectual disabilities.

    Science.gov (United States)

    Wieland, Jannelien; Van Den Brink, Annemarie; Zitman, Frans G

    2015-01-01

    There is little research on the subject of personality disorder (PD) in individuals with borderline intellectual functioning (BIF). Unlike in most countries, in the Netherlands, patients with BIF are eligible for specialized mental health care. This offers the unique possibility of examining the rates of PDs in patients, who in other countries are treated relatively invisibly in regular mental health care. To compare, in a naturalistic setting, the frequency of PD diagnoses in outpatients with BIF with outpatients from regular mental health care and outpatients with mild ID. We compared the rates of all DSM-IV-TR axis II PDs in outpatients with BIF (BIF group; n = 235) with rates of the same disorders in outpatients from regular mental health care (RMHC group; n = 1026) and outpatients with mild intellectual disability (ID) (mild ID group; n = 152) in a naturalistic cross-sectional anonymized medical chart review. Over half of the patients with BIF (52.8%) were diagnosed with a PD, compared with one in five in the RMHC group (19.3%) and one in three of the mild ID group (33.6%). All PD diagnoses, except for cluster A PDs and histrionic PDs, were most frequently diagnosed in the BIF group. PD NOS and borderline PD were the most frequently diagnosed PDs in BIF. The majority of PD patients had one or more comorbid axis I disorder. There is a high frequency of PD diagnoses in BIF outpatients in daily clinical practice. In anticipation of further scientific research, results suggest that PDs should not be overlooked in patients with BIF.

  20. From mental disorder to iatrogenic hypogonadism: dilemmas in conceptualizing gender identity variants as psychiatric conditions.

    Science.gov (United States)

    Meyer-Bahlburg, Heino F L

    2010-04-01

    The categorization of gender identity variants (GIVs) as "mental disorders" in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association is highly controversial among professionals as well as among persons with GIV. After providing a brief history of GIV categorizations in the DSM, this paper presents some of the major issues of the ongoing debate: GIV as psychopathology versus natural variation; definition of "impairment" and "distress" for GID; associated psychopathology and its relation to stigma; the stigma impact of the mental-disorder label itself; the unusual character of "sex reassignment surgery" as a psychiatric treatment; and the consequences for health and mental-health services if the disorder label is removed. Finally, several categorization options are examined: Retaining the GID category, but possibly modifying its grouping with other syndromes; narrowing the definition to dysphoria and taking "disorder" out of the label; categorizing GID as a neurological or medical rather than a psychiatric disorder; removing GID from both the DSM and the International Classification of Diseases (ICD); and creating a special category for GIV in the DSM. I conclude that-as also evident in other DSM categories-the decision on the categorization of GIVs cannot be achieved on a purely scientific basis, and that a consensus for a pragmatic compromise needs to be arrived at that accommodates both scientific considerations and the service needs of persons with GIVs.

  1. Psychiatric analysis of suicide attempt subjects due to maxillofacial gunshot.

    Science.gov (United States)

    Oztürk, Serdar; Bozkurt, Ali; Durmus, Muzaffer; Deveci, Mustafa; Sengezer, Mustafa

    2006-11-01

    The studies of maxillofacial gunshot injuries mainly focused on evaluating the surgical interventions and physical outcomes of the procedures. In this study we aimed to analyze the pre- and post-injury psychiatric status of the patients with self-inflicted gunshot wounds to the face. This study is based on 12 subjects who attempted suicide resulting in extensive maxillofacial injuries using guns placed beneath their chins. The psychiatric evaluation was conducted by interview and using SCID-I, SCID-II, MMPI, Rosenberg Self-Esteem Scale and Suicide Probability Scale. Two subjects were healthy, 1 had bereavement, 6 had current and 5 had previous MDD (major depressive disorder), 2 had dysthymic disorder, 3 had alcohol abuse, 2 had drug abuse and 4 had antisocial personality disorder. The suicidal group was more socially introverted according to MMPI. According to Rosenberg self-esteem subscale, self esteem, the constancy of self respect and depressive mood subtests were statistically significant in the suicide group compared to the healthy controls (P suicide. The changes in the physical facial appearance after the suicide attempt caused impairment of self-esteem and the constancy of self-respect. Similar to other studies, none of our patients reattempted suicide and all tried to return to their pre-injury lifestyle and appeared to accommodate to the stigma of their physical deformities. Early diagnosis and treatment should be considered as a factor to reduce the risk for suicide attempt.

  2. 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).

  3. Self-reported nonrestorative sleep in fibromyalgia – relationship to impairments of body functions, personal function factors, and quality of life

    Directory of Open Access Journals (Sweden)

    Liedberg GM

    2015-08-01

    Full Text Available Gunilla M Liedberg,1 Mathilda Björk,2 Björn Börsbo31Department of Social and Welfare Studies, Linköping University, Norrköping, 2Rehabilitation Centre and Department of Medical and Health Sciences, 3Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH, Linköping University, Linköping, SwedenPurpose: The purpose of this study was: 1 to determine variables that might characterize good or bad sleep; and 2 to describe the relationship between sleep, impairment of body functions, personal function factors, and quality of life based on quality of sleep in women with fibromyalgia (FM. Methods: This cross-sectional descriptive study included 224 consecutive patients diagnosed at a specialist center. These patients were mailed a questionnaire concerning sleep, body functions, personal factors, and health-related quality of life. In total, 145 completed questionnaires were collected. Results: Using sleep variables (sleep quality, waking up unrefreshed, and tiredness when getting up, we identified two subgroups – the good sleep subgroup and the bad sleep subgroup – of women with FM. These subgroups exhibited significantly different characteristics concerning pain intensity, psychological variables (depressed mood, anxiety, catastrophizing, and self-efficacy, impairments of body functions, and generic and health-related quality of life. The good sleep subgroup reported a significantly better situation, including higher employment/study rate. The bad sleep subgroup reported a greater use of sleep medication. Five variables determined inclusion into either a good sleep or a bad sleep subgroup: pain in the evening, self-efficacy, anxiety, and according to the Short Form health survey role emotional and physical functioning. Conclusion: This study found that it was possible to identify two subgroups of women with FM based on quality of sleep variables. The two subgroups differed significantly with respect to pain, psychological

  4. Seasonality of suicides with and without psychiatric illness in Denmark

    DEFF Research Database (Denmark)

    Yip, P.S.; Yang, K.C.; Qin, Ping

    2006-01-01

    This paper studied the seasonality of suicides among persons with and without psychiatric illness in Denmark from 1970 to 1999. A non-homogenous Poisson process was used to examine the data. The seasonality of suicides was shown to be associated with gender and their psychiatric histories...

  5. Psychiatric trainees in Finland 2001.

    Science.gov (United States)

    Putkonen, Hanna; Holi, Matti; Kaltiala-Heino, Riittakerttu; Korkeila, Jyrki; Eronen, Markku

    2005-01-01

    This study examined Finnish psychiatric trainees' views on their education. This was a survey study of nationwide data on Finnish psychiatric trainees in 2001. The quality of training was considered at least moderate by 84% of the respondents. Training on epidemiology, on taking history and status, and on psychopharmacology was considered the best. Quality was rated bad for training in leadership and administration, and educating the community. Research was done by 20%, and a personal clinical supervisor was appointed to 52% of the respondents. Offensive treatment had been experienced by 49% of the trainees in this study. Generally, studies of training also reflect strengths and weaknesses of the profession. Based on our results, it seems especially that training in leadership and in educating the community need to be improved; both of these are quintessential skills to survive in the struggle for economic and human resources. Furthermore, treatment of the trainees could still be better; attention should be paid to supervision of all trainees. Moreover, research must become more attractive. Psychiatry can be developed by the development of psychiatric training.

  6. 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.

  7. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...

  8. [General considerations on psychiatric interconsultation].

    Science.gov (United States)

    Carpinacci, J A

    1975-03-01

    This paper attempts to follow the evolution of some general ideas on Psychiatric Interconsulting. It is the result of six years' work at Ramos Mejía Hospital, Buenos Aires. Progressive transformations were imposed by daily practice on our team's theoretical and technical conceptions. We started with an individualistic-phenomenical approach, and we were forced to switch to a dynamical-situational one. The general working model we use at present is briefly summarized, emphasizing the important role played by Psychiatric Interconsulting in the change of the medical cultural patterns prevailing at present in our milieu. Two main factors for the role of privilege played by the Interconsulting team are set forth: one is conceptual, the other is pragmatic. From a conceptual standpoint, the theoretical basis of Psychiatric Interconsulting is much broader than those of other specialities, like clinical practice or surgery, for it includes, besides Biology, the Psychological and Socio-Historical determinants of the disturbance the diseases man suffers. From a pragmatic standpoint, the boundaries of human and physical fields within which Psychiatric Interconsulting is operating, go beyond the scope of daily medical practice. Their place could be located in between formal traditional wefts, relating to institutional structures as well as to specific medical practice. Professionals working at Interconsulting are usually required at general wards, at consulting offices, at emergency wards, in corridors, or even at the bar. They are interested not only in specific medical problems; they encompass the whole range of personal and institutional framework, and consider the whole situation in a comprehensive approach. Knowledge acquired in this widened professional field, together with actual experience in dealing with people in distress, are the main sources for theoretical conceptualization of new activities, as well as for building pragmatic tools to modify the official medical

  9. Association of Oxidative Stress with Psychiatric Disorders.

    Science.gov (United States)

    Hassan, Waseem; Noreen, Hamsa; Castro-Gomes, Vitor; Mohammadzai, Imdadullah; da Rocha, Joao Batista Teixeira; Landeira-Fernandez, J

    2016-01-01

    When concentrations of both reactive oxygen species and reactive nitrogen species exceed the antioxidative capability of an organism, the cells undergo oxidative impairment. Impairments in membrane integrity and lipid and protein oxidation, protein mutilation, DNA damage, and neuronal dysfunction are some of the fundamental consequences of oxidative stress. The purpose of this work was to review the associations between oxidative stress and psychological disorders. The search terms were the following: "oxidative stress and affective disorders," "free radicals and neurodegenerative disorders," "oxidative stress and psychological disorders," "oxidative stress, free radicals, and psychiatric disorders," and "association of oxidative stress." These search terms were used in conjunction with each of the diagnostic categories of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders and World Health Organization's International Statistical Classification of Diseases and Related Health Problems. Genetic, pharmacological, biochemical, and preclinical therapeutic studies, case reports, and clinical trials were selected to explore the molecular aspects of psychological disorders that are associated with oxidative stress. We identified a broad spectrum of 83 degenerative syndromes and psychiatric disorders that were associated with oxidative stress. The multi-dimensional information identified herein supports the role of oxidative stress in various psychiatric disorders. We discuss the results from the perspective of developing novel therapeutic interventions.

  10. Clinical Utility of the DSM-5 Alternative Model of Personality Disorders

    DEFF Research Database (Denmark)

    Bach, Bo; Markon, Kristian; Simonsen, Erik

    2015-01-01

    In Section III, Emerging Measures and Models, DSM-5 presents an Alternative Model of Personality Disorders, which is an empirically based model of personality pathology measured with the Level of Personality Functioning Scale (LPFS) and the Personality Inventory for DSM-5 (PID-5). These novel...... instruments assess level of personality impairment and pathological traits. Objective. A number of studies have supported the psychometric qualities of the LPFS and the PID-5, but the utility of these instruments in clinical assessment and treatment has not been extensively evaluated. The goal of this study...... was to evaluate the clinical utility of this alternative model of personality disorders. Method. We administered the LPFS and the PID-5 to psychiatric outpatients diagnosed with personality disorders and other nonpsychotic disorders. The personality profiles of six characteristic patients were inspected...

  11. Narcissistic personality disorder in DSM-V--in support of retaining a significant diagnosis.

    Science.gov (United States)

    Ronningstam, Elsa

    2011-04-01

    Narcissistic personality disorder, NPD, has been excluded as a diagnostic category and independent personality disorder type in the Personality and Personality Disorder Work Group's recent proposal for DSM-5 Personality and Personality Disorders. The aim of this paper is to present supporting evidence in favor of keeping NPD as a personality type with a set of separate diagnostic criteria in DSM-5. These include: the prevalence rate, extensive clinical and empirical reports and facts, its psychiatric, social and societal significance especially when associated to functional vocational and interpersonal impairment, social and moral adaptation, and acute suicidality. Proposals for a clinically relevant and empirically based definition of narcissism, a description of the narcissistic personality disorder type, and a set of diagnostic criteria for NPD are outlined.

  12. Psychiatric disorders and health service utilization in unemployed youth

    OpenAIRE

    2010-01-01

    Abstract Aim Youth unemployment is associated with increased levels of anxiety, depression, alcohol abuse, reduced self-esteem and satisfaction with life. Up to date data based on standardized psychiatric diagnostic assessments in adolescent or young adult unemployment is very scarce. To our knowledge, this study has, for the first time, assessed both Axis-I (non-personality) and Axis-II (personality) psychiatric disorders and related constructs in a pres...

  13. The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: a randomized controlled trial.

    Science.gov (United States)

    Young, Kim-Wan; Ng, Petrus; Kwok, Timothy; Cheng, Daphne

    2017-01-01

    Persons with mild cognitive impairment (PwMCI) are at a higher risk of developing dementia than those without cognitive impairment. This research study aims to evaluate the effectiveness of a holistic health group intervention, which is based on the holistic brain health approach as well as an Eastern approach to health care, on improving the cognitive ability of Chinese PwMCI. In a randomized controlled trial (RCT), 38 Chinese PwMCI were randomly assigned to either a 10-session holistic health intervention group or the control group. The holistic health treatment group attempted to promote the acceptance of their illness, enhance memory and coping skills, develop a positive lifestyle, maintain positive emotions, and facilitate emotional support among participants. The 10-session holistic health group intervention was structured, with each session conducted once per week and ~90 minutes in length. Control group patients and their family caregivers received standardized basic educational materials that provided basic information on cognitive decline for them to read at home. The Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive ability of PwMCI in the pre- and posttreatment periods by a research assistant who was blind to the group assignment of the participants. The paired-samples t -test indicated that the treatment group (n=18) showed significant improvement in the MoCA score, whereas the control group (n=20) did not. Moreover, 2×2 (group × time) repeated-measures analysis of covariance (ANCOVA) demonstrated that the holistic health group treatment was significantly more effective than the control intervention in improving the MoCA score, with a moderate effect size, and improving the delayed recall (ie, short-term memory), with a strong effect size, after controlling for age, sex, education, and marital status. This present RCT provides evidence to support the feasibility and effectiveness of the holistic health group intervention in

  14. A Resource Guide for Signs of Sexual Assault. A Supplement to: Preventing Sexual Abuse of Persons with Disabilities: A Curriculum for Hearing Impaired, Physically Disabled, Blind and Mentally Retarded Students.

    Science.gov (United States)

    O'Day, Bonnie

    Part of a curriculum unit on preventing sexual abuse of persons with disabilities, the manual is intended to help instructors present the material to hearing impaired students. Illustrations of sign language are presented for such terms as sexual contact, sexual assault, incest, same sex assault (man/woman), rape (acquaintance/marital), exposer,…

  15. A pilot study of cognitive training with and without transcranial direct current stimulation to improve cognition in older persons with HIV-related cognitive impairment

    Directory of Open Access Journals (Sweden)

    Ownby RL

    2016-10-01

    Full Text Available Raymond L Ownby,1 Amarilis Acevedo2 1Department of Psychiatry and Behavioral Medicine, 2College of Psychology, Nova Southeastern University, Fort Lauderdale, FL, USA Background: In spite of treatment advances, HIV infection is associated with cognitive deficits. This is even more important as many persons with HIV infection age and experience age-related cognitive impairments. Both computer-based cognitive training and transcranial direct current stimulation (tDCS have shown promise as interventions to improve cognitive function. In this study, we investigate the acceptability and efficacy of cognitive training with and without tDCS in older persons with HIV. Patients and methods: In this single-blind randomized study, participants were 14 individuals of whom 11 completed study procedures (mean age =51.5 years; nine men and two women with HIV-related mild neurocognitive disorder. Participants completed a battery of neuropsychological and self-report measures and then six 20-minute cognitive training sessions while receiving either active or sham anodal tDCS over the left dorsolateral prefrontal cortex. After training, participants completed the same measures. Success of the blind and participant reactions were assessed during a final interview. Assessments were completed by an assessor blind to treatment assignment. Pre- and post-training changes were evaluated via analysis of covariance yielding estimates of effect size. Results: All participants believed that they had been assigned to active treatment; nine of the 11 believed that the intervention had improved their cognitive functioning. Both participants who felt the intervention was ineffective were assigned to the sham condition. None of the planned tested interactions of time with treatment was significant, but 12 of 13 favored tDCS (P=0.08. All participants indicated that they would participate in similar studies in the future. Conclusion: Results show that both cognitive training via

  16. Animal cruelty and psychiatric disorders.

    Science.gov (United States)

    Gleyzer, Roman; Felthous, Alan R; Holzer, Charles E

    2002-01-01

    Animal cruelty in childhood, although generally viewed as abnormal or deviant, for years was not considered symptomatic of any particular psychiatric disorder. Although animal cruelty is currently used as a diagnostic criterion for conduct disorder, research establishing the diagnostic significance of this behavior is essentially nonexistent. In the current study, investigators tested the hypothesis that a history of substantial animal cruelty is associated with a diagnosis of antisocial personality disorder (APD) and looked for associations with other disorders commonly diagnosed in a population of criminal defendants. Forty-eight subjects, criminal defendants who had histories of substantial animal cruelty, were matched with defendants without this history. Data were systematically obtained from the files by using four specifically designed data retrieval outlines. A history of animal cruelty during childhood was significantly associated with APD, antisocial personality traits, and polysubstance abuse. Mental retardation, psychotic disorders, and alcohol abuse showed no such association.

  17. [Compulsive buying and psychiatric comorbidity].

    Science.gov (United States)

    Mueller, Astrid; Mühlhans, Barbara; Silbermann, Andrea; Müller, Ulrike; Mertens, Christian; Horbach, Thomas; Mitchell, James E; de Zwaan, Martina

    2009-08-01

    Compulsive buying is an excessive behavior that has begun to receive attention from researchers in recent years. The current study provides an overview of research on compulsive buying and examines the psychiatric co-morbidity in a German female treatment seeking compulsive buying sample in comparison with age and gender-matched normal buying control groups. Thirty women suffering from compulsive buying disorder, 30 community controls, and 30 bariatric surgery candidates were assessed with the German versions of the Structured Clinical Interview for DSM-IV diagnoses (SCID). Women with compulsive buying disorder showed significantly higher prevalence rates of affective, anxiety, and eating disorders compared to community controls, and suffered significantly more often from affective and anxiety disorders compared to bariatric surgery candidates. The compulsive buying group presented with the highest rates of personality disorders, most commonly avoidant, depressive, obsessive-compulsive, and borderline personality disorder, and reported the highest prevalence rates of other impulse control disorders, especially for intermittent explosive disorder. The findings suggest an elevated psychiatric co-morbidity in patients with compulsive buying disorder.

  18. [Psychiatric disorders and neurological comorbidity in children with intellectual disability].

    Science.gov (United States)

    Wriedt, Elke; Wiberg, Anja; Sakar, Vehbi; Noterdaeme, Michele

    2010-05-01

    This article gives an overview of the consultant child and adolescent psychiatric services in the region of Upper Bavaria (Germany). The data of 257 children and adolescents with intellectual disability and psychiatric disorders were evaluated. About 14% of the children with ID in special schools or day care centers, and 40% of the children with ID in residential care showed a definite psychiatric disorder. The most frequently diagnosed disorders were adjustment disorders, hyperkinetic disorders and conduct disorders, as well as emotional problems and pervasive developmental disorders. Children with severe intellectual disability had more additional somatic disorders and were more impaired in their psychosocial functions. The results show the need for psychiatric services for children and adolescents with intellectual disability and psychiatric disorders. The development and implementation of integrative and interdisciplinary models is necessary to allow for adequate medical care for these patients.

  19. Social communication impairments: pragmatics.

    Science.gov (United States)

    Russell, Robert L

    2007-06-01

    Social communication or pragmatic impairments are characterized and illustrated as involving inappropriate or ineffective use of language and gesture in social contexts. Three clinical vignettes illustrate different pragmatic impairments and the wealth of diagnostic information that can be garnered from observation of a child's social communication behavior. Definitions of, and developmental milestones in, domains of pragmatic competence are provided. Several screening instruments are suggested for use in assessing pragmatic competence within the time-frame of a pediatric examination. Frequent comorbid psychiatric conditions are described and a sample of current neurobiologic research is briefly summarized.

  20. Psychiatric comorbidity in patients with spasmodic dysphonia: a controlled study

    Science.gov (United States)

    Gündel, H; Busch, R; Ceballos‐Baumann, A; Seifert, E

    2007-01-01

    Objectives To study the prevalence of psychiatric comorbidity assessed by a structured clinical interview in patients with spasmodic dysphonia (SD) compared with patients suffering from vocal fold paralysis (VFP). Methods In 48 patients with SD and 27 patients with VFP, overall psychiatric comorbidity was studied prospectively using the Structured Clinical Interview for DSM‐IV Axis I disorders. Physical disability and psychometric variables were assessed with standardised self‐rating questionnaires. Results 41.7% of SD subjects and 19.5% of the control group met DSM‐IV clinical criteria for current psychiatric comorbidity (p<0.05). Significant predictors of psychiatric comorbidity in SD were severity of voice impairment and subjective assessment of “satisfaction with health”. As a limitation, the severity of voice impairment in patients with SD was nearly twice as high, and their illness had lasted nearly twice as long. Conclusions We found a high prevalence of psychiatric comorbidity in patients with SD. The significant correlation between current psychiatric comorbidity and the extent of voice pathology may point to an especially strong interaction between somatic and psychiatric complaints in SD. PMID:17615166

  1. Hyperthyroidism and psychiatric morbidity

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  2. Psychiatric morbidity in prisoners

    Science.gov (United States)

    Kumar, Vinod; Daria, Usha

    2013-01-01

    Background: Prisoners are having high percentage of psychiatric disorders. Majority of studies done so far on prisoners are from Western countries and very limited studies from India. Aim: Study socio-demographic profile of prisoners of a central jail and to find out current prevalence of psychiatric disorders in them. Materials and Methods: 118 prisoners were selected by random sampling and interviewed to obtain socio-demographic data and assessed on Indian Psychiatric Interview Schedule (IPIS) with additional required questions to diagnose psychiatric disorders in prisoners. Results: Mean age of prisoners was 33.7 years with 97.5% males, 57.6% from rural areas and 65.3% were married. Average education in studied years was 6.6 years and 50.8% were unskilled workers. 47.4% were murderers while 20.3% of drugs related crimes. 47.5% were convicted and history of criminal behavior in family was in 32.2% prisoners. Current prevalence of psychiatric disorders was 33%. Psychotic, depressive, and anxiety disorders were seen in 6.7%, 16.1%, and 8.5% prisoners respectively. 58.8% had history of drug abuse/dependence prior to imprisonment. Conclusion: One prison of Hadoti region of Rajasthan is full of people with mental-health problems who collectively generate significant levels of unmet psychiatric treatment need. Prisons are detrimental to mental-health. Beginning of reforms is the immediate need. PMID:24459308

  3. Psychiatric Problems in Patients with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Munevver Tunel

    2012-06-01

    Full Text Available Cancer is a physical disorder with concurrent mental and social components. During cancer, the feelings of fear, hopelessness, guilt, helplessness, abandonment perceived as a crisis leading to destruction in the suffering person. Breast cancer is the most common type of cancer among women. Prevalence of psychiatric disorders among cancer patients is approximately 50% and most of disorders are related with the occurrence of cancer and cancer treatment. Majority of patients present with major depression, adjustment disorder, anxiety disorders, sleep disorders, suicidial ideation, and delirium. Treatment of psychiatric disorders and cancer therapy should be conducted along with special consideration of drug interactions. This article reviews the adaptation process experienced by individuals during diagnosis and treatment of breast cancer, it psychological effects, resulting psychiatric comorbidites and their treatments. [Archives Medical Review Journal 2012; 21(3.000: 189-219

  4. The dignity of the child in a psychiatric hospital

    Directory of Open Access Journals (Sweden)

    Błażej Kmieciak

    2012-12-01

    their rights. Particularly important in such situations is the way the dialogue with the patient is conducted, besides the patient has to be informed about the consequences of infringement of the norms and rules. This should be reflected in the rules of the psychiatric unit. Furthermore, special importance within the respect for the dignity of the minor/juvenile patient in the psychiatric unit is ascribed to the use of a long-term direct coercion in case of a patient with severe mental impairment and/or autism, strongly agitated, aggressive or self-aggressive. The principle of the respect for the dignity of the patient requires notification of the patient, regardless of her/his condition, about the planned activities, immobilization of the patient in the near presence of the other staff, personal analysis of the patient’s health condition by the physician who ordered or prolonged the coercion (every 4 hours, by the nurse (control of the condition – every 15 minutes. However, the use of direct coercion and adherence to the principle of “the least disturbance” do not reduce the patient’s discomfort. Introduction of additional detailed executory rules does not eliminate the conflict between the respect for the dignity of the patient and the effectiveness of undertaken activities, the patient’s safety, the other patients’ comfort and multilateral staff encumbrance.

  5. Registration, psychiatric evaluation and adherence to psychiatric treatment after suicide attempt

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Søgaard, Mette

    2005-01-01

    Persons who are treated at hospital after attempted suicide comprise a high-risk group for suicide. The proposal for a National Programme for Prevention of Suicide and Suicide Attempt in Denmark recommends that all persons who attempt suicide should be offered treatment and that treatment should....... Only few patients were not referred to any treatment at all, but among the patients referred to psychiatric treatment, only those admitted involuntarily received treatment in 100% of the planned cases. For outpatient treatment in the suicide prevention clinic, the percentage that attended planned...... be implemented, using a supportive and guiding principle. The aim of the present study is to investigate whether patients receive psychiatric evaluation after a suicide attempt, and whether they receive the psychiatric treatment to which they are referred. In the Copenhagen Hospital Corporation in four emergency...

  6. 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.

  7. Psychiatric comorbidity in DSM-III-R hypochondriasis.

    Science.gov (United States)

    Barsky, A J; Wyshak, G; Klerman, G L

    1992-02-01

    Forty-two DSM-III-R hypochondriacs from a general medical clinic were compared with a random sample of 76 outpatients from the same setting. Patients completed a research battery that included a structured diagnostic interview (Diagnostic Interview Schedule) and self-report questionnaires to measure personality disorder caseness, functional impairment, and hypochondriacal symptoms. Psychiatric morbidity in the hypochondriacal sample significantly exceeded that of the comparison sample. Hypochondriacs had twice as many lifetime Axis I diagnoses, twice as many Diagnostic Interview Schedule symptoms, and three times the level of personality disorder caseness as the comparison group. Of the hypochondriacal sample, 88% had one or more additional Axis I disorders, the overlap being greatest with depressive and anxiety disorders. One fifth of the hypochondriacs had somatization disorder, but the two conditions appeared to be phenomenologically distinct. Hypochondriacal patients with coexisting anxiety and/or depressive disorder (secondary hypochondriasis) did not differ greatly from hypochondriacal patients without these comorbid conditions (primary hypochondriasis). Because the nature of hypochondriasis remains unclear and requires further study, we suggest that its nosologic status not be altered in DSM-IV.

  8. Psychiatric care in the German prison system.

    Science.gov (United States)

    Lehmann, Marc

    2012-01-01

    The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

  9. Who's boarding in the psychiatric emergency service?

    Science.gov (United States)

    Simpson, Scott A; Joesch, Jutta M; West, Imara I; Pasic, Jagoda

    2014-09-01

    When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a "boarder." The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student's t-tests and multivariate regression. 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients.

  10. The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: a randomized controlled trial

    Science.gov (United States)

    Young, Kim-wan; Ng, Petrus; Kwok, Timothy; Cheng, Daphne

    2017-01-01

    Purpose Persons with mild cognitive impairment (PwMCI) are at a higher risk of developing dementia than those without cognitive impairment. This research study aims to evaluate the effectiveness of a holistic health group intervention, which is based on the holistic brain health approach as well as an Eastern approach to health care, on improving the cognitive ability of Chinese PwMCI. Research methods In a randomized controlled trial (RCT), 38 Chinese PwMCI were randomly assigned to either a 10-session holistic health intervention group or the control group. The holistic health treatment group attempted to promote the acceptance of their illness, enhance memory and coping skills, develop a positive lifestyle, maintain positive emotions, and facilitate emotional support among participants. The 10-session holistic health group intervention was structured, with each session conducted once per week and ~90 minutes in length. Control group patients and their family caregivers received standardized basic educational materials that provided basic information on cognitive decline for them to read at home. The Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive ability of PwMCI in the pre- and posttreatment periods by a research assistant who was blind to the group assignment of the participants. Results The paired-samples t-test indicated that the treatment group (n=18) showed significant improvement in the MoCA score, whereas the control group (n=20) did not. Moreover, 2×2 (group × time) repeated-measures analysis of covariance (ANCOVA) demonstrated that the holistic health group treatment was significantly more effective than the control intervention in improving the MoCA score, with a moderate effect size, and improving the delayed recall (ie, short-term memory), with a strong effect size, after controlling for age, sex, education, and marital status. Conclusion This present RCT provides evidence to support the feasibility and effectiveness of

  11. Time Perception and Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Hatice Ceviz

    2013-09-01

    Full Text Available Time perception is an ability which we use in every moment of daily life, that guides the formation and continuation of our behaviors and from an evolutionary perspective ensures survival. Internal clock models help us to understand time perception. Time perception is known to vary between individuals and particular situations. This variability is explained with the mechanisms which is associated with the processes related to attention, the speed of the internal clock and the memory unit. It is suggested that time perception is mainly associated with the activities of dopamine and acetylcholine. Some dopaminergic psychoactive substances like cocaine and amphetamine have all been shown to change time perception by increasing the speed of internal clock while on the other hand some antipsychotic drugs make an opposite change in time perception by descreasing the speed of the clock. Similarly, time perception is affected in some psychiatric disorders and an ethiopathological relationship between time perception disturbances and psychiatric disorders is suggested. In this article time perception changes in schizophrenia, attention deficit/hyperactivity syndrome, depression, anxiety disorders and personality disorders are briefly reviewed.

  12. Psychiatric Aspects of Infertility

    Directory of Open Access Journals (Sweden)

    Hacer Sezgin

    2014-06-01

    Full Text Available Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Family is an important institution in maintaining human existence and raising individuals in line with society's expectations. Fertility and reproduction are seen as universal functions unique to women with raising children as the expected result of the family institution. Incidence of infertility has increased recently and can become a life crisis for a couple. Even though not being able to have a child affects both sexes emotionally, women feel greater amounts of stress, pressure, anxiety, and depression.Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict, gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessaryon the course of infertility treatment, pregnancy rates, and childbirth. The most important underlying causes of high levels of stress and anxiety that infertile women experience are the loss of maternity, reproduction, sense of self, and genetic continuity. In this review article is to investigate the relationship between medically unexplained symptoms and psychiatric symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 165-185

  13. Gambling and Personality Dimensions

    DEFF Research Database (Denmark)

    Odlaug, Brian Lawrence; Chamberlain, Samuel

    2014-01-01

    , which has further catalyzed a debate over the contribution of personality traits (rather than just personality disorders) to the manifestation and maintenance of psychiatric conditions such as Gambling Disorder. This selective review considers relationships between gambling and personality traits....... The possible existence of distinct subtypes of Gambling Disorder, defined via personality traits, is highlighted, along with consideration of whether objective neurocognitive markers could serve as proxy markers of ‘personality’ more amenable to scientific dissection rather than relying on questionnaire...

  14. Psychiatric Illness in Mentally Retarded Adolescents: Clinical Features.

    Science.gov (United States)

    Masi, Gabriele

    1998-01-01

    Describes the clinical features of the most important psychiatric disorders in mentally retarded adolescents: mood disorders, psychotic disorders, severe behavioral disorders, personality disorders, anxiety disorders, and attention-deficit The impact of mental retardation on personality development is confirmed by the high psychopathological…

  15. [Suicidal behavior: a psychiatric emergency situation, suicide prevention: a psychiatric obligation].

    Science.gov (United States)

    Wolfersdorf, M; Schneider, B; Schmidtke, A

    2015-09-01

    In German psychiatry suicidal behavior is seen as sign of a psychiatric crisis in a person in the context of psychopathology, psychodynamics and psychosocial situation. Psychiatric disorders are found in up to 90% of people who commit suicide and the time span following the decision to commit suicide is often very short, within 24 h. Suicide prevention is a central duty and obligation in psychiatry and psychotherapy. This article gives an overview on the current state of knowledge on suicide from a clinical point of view.

  16. Psychiatric Symptoms in Children Diagnosed with an Autism Spectrum Disorder: An Examination of Gender Differences

    Science.gov (United States)

    Worley, Julie A.; Matson, Johnny L.

    2011-01-01

    In addition to the triad of impairments experienced by children and adolescents diagnosed with Autism Spectrum Disorders (ASD), they often present with symptoms of psychiatric disorders. To date, very few studies have examined gender differences in regards to psychiatric symptoms in children and adolescents diagnosed with an ASD. Thus, the current…

  17. Risk factors for violence among long-term psychiatric in-patients: a ...

    African Journals Online (AJOL)

    Previous research has linked aggressive behaviour to certain genetic conditions ... defects – such as impaired social information processing, socio-. Risk factors for ... The complex influence of diagnosis on psychiatric patients' risk of violence ...

  18. Associations between Pathological Gambling and Psychiatric Comorbidity among Help-Seeking Populations in Hong Kong

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2012-01-01

    Full Text Available Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. The objectives of this study were to (a determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (N=201 who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, and adjustment disorder. Results showed that 63.7% of participants had lifetime comorbid psychiatric disorder. The most common comorbid psychiatric mental disorders were mood disorders, adjustment disorder, and substance use disorders. Pathological gamblers with psychiatric comorbidities were significantly more severe in psychopathology, psychosocial functioning impairment, and gambling problems than those without the disorders.

  19. Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders.

    Science.gov (United States)

    Coffey, Scott F; Banducci, Anne N; Vinci, Christine

    2015-11-01

    Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, obsessive-compulsive and tic disorders, personality disorders, eating disorders, and insomnia. CBT uses targeted strategies to help patients adopt more adaptive patterns of thinking and behaving, which leads to positive changes in emotions and decreased functional impairments. Strategies include identifying and challenging problematic thoughts and beliefs, scheduling pleasant activities to increase environmental reinforcement, and extended exposure to unpleasant thoughts, situations, or physiologic sensations to decrease avoidance and arousal associated with anxiety-eliciting stimuli. CBT can be helpful in the treatment of posttraumatic stress disorder by emphasizing safety, trust, control, esteem, and intimacy. Prolonged exposure therapy is a CBT technique that includes a variety of strategies, such as repeated recounting of the trauma and exposure to feared real-world situations. For attention-deficit/hyperactivity disorder, CBT focuses on establishing structures and routines, and clear rules and expectations within the home and classroom. Early intensive behavioral interventions should be initiated in children with autism before three years of age; therapy consists of 12 to 40 hours of intensive treatment per week, for at least one year. In many disorders, CBT can be used alone or in combination with medications. However, CBT requires a significant commitment from patients. Family physicians are well suited to provide collaborative care for patients with psychiatric disorders, in concert with cognitive behavior therapists.

  20. What Can Psychiatric Disorders Tell Us about Neural Processing of the Self?

    Science.gov (United States)

    Zhao, Weihua; Luo, Lizhu; Li, Qin; Kendrick, Keith M

    2013-01-01

    Many psychiatric disorders are associated with abnormal self-processing. While these disorders also have a wide-range of complex, and often heterogeneous sets of symptoms involving different cognitive, emotional, and motor domains, an impaired sense of self can contribute to many of these. Research investigating self-processing in healthy subjects has facilitated identification of changes in specific neural circuits which may cause altered self-processing in psychiatric disorders. While there is evidence for altered self-processing in many psychiatric disorders, here we will focus on four of the most studied ones, schizophrenia, autism spectrum disorder (ASD), major depression, and borderline personality disorder (BPD). We review evidence for dysfunction in two different neural systems implicated in self-processing, namely the cortical midline system (CMS) and the mirror neuron system (MNS), as well as contributions from altered inter-hemispheric connectivity (IHC). We conclude that while abnormalities in frontal-parietal activity and/or connectivity in the CMS are common to all four disorders there is more disruption of integration between frontal and parietal regions resulting in a shift toward parietal control in schizophrenia and ASD which may contribute to the greater severity and delusional aspects of their symptoms. Abnormalities in the MNS and in IHC are also particularly evident in schizophrenia and ASD and may lead to disturbances in sense of agency and the physical self in these two disorders. A better future understanding of how changes in the neural systems sub-serving self-processing contribute to different aspects of symptom abnormality in psychiatric disorders will require that more studies carry out detailed individual assessments of altered self-processing in conjunction with measurements of neural functioning.

  1. Aggression in Psychiatric Wards

    DEFF Research Database (Denmark)

    Hvidhjelm, Jacob; Sestoft, Dorte; Skovgaard, Lene Theil

    2016-01-01

    Health care workers are often exposed to violence and aggression in psychiatric settings. Short-term risk assessments, such as the Brøset Violence Checklist (BVC), are strong predictors of such aggression and may enable staff to take preventive measures against aggression. This study evaluated...

  2. Eponymous Psychiatric Syndromes Revisited.

    Science.gov (United States)

    Naguy, Ahmed

    2018-02-22

    This report provides an anthology of psychiatric eponyms. Clinically, many of these described syndromes represent valid diagnostic constructs and may accommodate the atypical cases that defy the official diagnostic designation in the current classificatory systems in psychiatry. © Copyright 2018 Physicians Postgraduate Press, Inc.

  3. Psychiatric Advance Directives: Getting Started

    Science.gov (United States)

    ... News Legal Issues Search for: About PADs A psychiatric advance directive (PAD) is a legal document that ... decisions during a mental health crisis. Getting Started Psychiatric advance directives (PADs) are relatively new legal instruments ...

  4. The American Psychiatric Association's resource document on guidelines for psychiatric fitness-for-duty evaluations of physicians.

    Science.gov (United States)

    Anfang, Stuart A; Faulkner, Larry R; Fromson, John A; Gendel, Michael H

    2005-01-01

    The psychiatric evaluation of a physician's fitness for duty is an undertaking that is both important to patients' well-being and to the physician-subject of the evaluation. It is necessary that psychiatrists who agree to perform such evaluations proceed in a careful and thorough manner. This document was developed to provide general guidance to the psychiatric evaluators in these situations. It was prepared by the American Psychiatric Association (APA) Council on Psychiatry and Law and Corresponding Committee on Physician Health, Illness, and Impairment, of which the authors are members. The Resource Document was approved by the APA Joint Reference Committee in June 2004. APA Resource Documents do not represent official policy of the American Psychiatric Association. This Resource Document was edited to conform to Journal style and has therefore been modified slightly from the original document approved by the APA.

  5. [Tinnitus and psychiatric comorbidities].

    Science.gov (United States)

    Goebel, G

    2015-04-01

    Tinnitus is an auditory phantom phenomenon characterized by the sensation of sounds without objectively identifiable sound sources. To date, its causes are not well understood. The perceived severity of tinnitus correlates more closely to psychological and general health factors than to audiometric parameters. Together with limbic structures in the ventral striatum, the prefrontal cortex forms an internal "noise cancelling system", which normally helps to block out unpleasant sounds, including the tinnitus signal. If this pathway is compromised, chronic tinnitus results. Patients with chronic tinnitus show increased functional connectivity in corticolimbic pathways. Psychiatric comorbidities are common in patients who seek help for tinnitus or hyperacusis. Clinicians need valid screening tools in order to identify patients with psychiatric disorders and to tailor treatment in a multidisciplinary setting.

  6. Video modeling for the development of personal hygiene skills in youth with autism spectrum disorder.

    Science.gov (United States)

    Piccin, S; Crippa, A; Nobile, M; Hardan, A Y; Brambilla, P

    2018-04-01

    Autism spectrum disorder (ASD) is a neurodevelopmental disorder mainly characterised by deficits in social communication as well as by narrow patterns of behaviour and interests (American Psychiatric Association, 2013), often accompanied by language, intellectual and sensory impairments. The severity of these impairments may lead to deficits in the development of daily living activities such as simple meal preparation and feeding, community skills (e.g. buying groceries), personal care (e.g. dressing) and personal hygiene skills (bathing, toileting, hand washing, teeth brushing) needed for independence. Among others, the lack of independence in personal hygiene skills increases the burden of the caregiver and makes children with ASD more dependent (Flynn & Healy, 2012). Therefore, it is important to develop tools for helping individuals with ASD in increasing their ability to perform these basic life activities which will lead to savings that can be invested in other critical areas of needs.

  7. Psychiatric diagnosis and aggression before acute hospitalisation.

    Science.gov (United States)

    Colasanti, A; Natoli, A; Moliterno, D; Rossattini, M; De Gaspari, I F; Mauri, M C

    2008-09-01

    To examine the predictors of aggressive behaviours occurring before acute hospitalisation. We analysed 350 acute admissions to a psychiatric ward during a 12-month period. The diagnoses were formulated according to the DSM IV axis I and II criteria. Aggressive behaviours occurring in the week before admission were retrospectively assessed using the modified overt aggression scale. The patients' clinical and sociodemographic variables, concurrent drug or alcohol abuse, and admission status were recorded at the time of admission. Aggressive and violent behaviours were highly prevalent, respectively, in 45% and 33% of the cases. Violence before admission was independently associated with drug abuse, involuntary admission status, and severe psychopathology. A diagnosis of a psychotic disorder did not increase the risk of aggression or violence, compared to the other psychiatric diagnoses. Personality disorders were significantly more associated to aggressive behaviours than psychotic disorders. The diagnosis of psychotic disorder is a poor predictor of aggression in a sample of psychiatric patients. Other clinical and non-clinical variables are associated to aggression before hospitalisation: they include drug abuse, involuntary admission status, general severity of symptoms, and diagnosis of personality disorder.

  8. Culture and psychiatric diagnosis.

    Science.gov (United States)

    Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

    2013-01-01

    Since the publication of DSM-IV in 1994, neurobiologists and anthropologists have criticized the rigidity of its diagnostic criteria that appear to exclude whole classes of alternate illness presentations, as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopathology. Experts in culture and mental health have responded to these criticisms by revising the very process of diagnosis for DSM-5. Specifically, the DSM-5 Cultural Issues Subgroup has recommended that concepts of culture be included more prominently in several areas: an introductory chapter on Cultural Aspects of Psychiatric Diagnosis - composed of a conceptual introduction, a revised Outline for Cultural Formulation, a Cultural Formulation Interview that operationalizes this Outline, and a glossary on cultural concepts of distress - as well as material directly related to culture that is incorporated into the description of each disorder. This chapter surveys these recommendations to demonstrate how culture and context interact with psychiatric diagnosis at multiple levels. A greater appreciation of the interplay between culture, context, and biology can help clinicians improve diagnostic and treatment planning. Copyright © 2013 APA*

  9. Poverty and Psychiatric Diagnosis in the U.S.: Evidence from the Medical Expenditure Panel Survey

    OpenAIRE

    Brandon Vick; Kristine Jones; Sophie Mitra

    2010-01-01

    Background: A number of social programs are targeted at persons with psychiatric diagnosis with the intention of reducing poverty. Previous studies have shown that persons with psychiatric conditions are more likely to be poor and face disparities in education and employment outcomes. A better understanding of the severity of poverty faced by persons and families with diagnosis is necessary for better policy targeting and monitoring. Aims of the Study: This paper seeks to measure the prevalen...

  10. Beyond Type D personality

    DEFF Research Database (Denmark)

    Pelle, Aline J; Pedersen, Susanne S.; Szabó, Balázs M

    2009-01-01

    Type D personality has been associated with impaired health status in chronic heart failure (CHF), but other psychological factors may also be important.......Type D personality has been associated with impaired health status in chronic heart failure (CHF), but other psychological factors may also be important....

  11. Executive functions and psychiatric symptoms in drug-refractory juvenile myoclonic epilepsy.

    Science.gov (United States)

    Walsh, Jordana; Thomas, Rhys H; Church, Carla; Rees, Mark I; Marson, Anthony G; Baker, Gus A

    2014-06-01

    The pattern of executive dysfunction reported in juvenile myoclonic epilepsy (JME) resembles that of patients with cluster B personality disorders. This study examined whether executive dysfunction and maladaptive behavior reported in patients with JME are related. Sixty patients with drug-refractory JME were administered tests of intellect, memory, and executive dysfunction. Anxiety, depression, personality traits, impact of epilepsy, and perceived cognitive effects of antiepileptic drugs were measured. Half of the cohort exhibited moderate to severe anxiety symptoms. The patients performed most poorly on naming ability and inhibition switching. Duration of epilepsy exacerbated poor performance on inhibition switching. Females presented with pathological scores for neurotic and introvert traits and males for introvert traits. Abnormal personality traits and psychiatric disorders were associated with worse intellectual and executive functioning. People with extreme Eysenck Personality Scale - Brief Version (EPQ-BV) scores demonstrated the greatest level of executive impairment. Furthermore, the same degree of dysfunction was not seen in any individual with unremarkable EPQ-BV scores. This study indicates that specific patterns of executive dysfunction are related to maladaptive behavior in JME. Distinct behavioral patterns may be used to identify functional and anatomical differences between people with JME and for stratification to enable gene discovery. Copyright © 2014. Published by Elsevier Inc.

  12. Tension‑Type Headache - Psychiatric Perspective

    Directory of Open Access Journals (Sweden)

    João Campos Mendes

    2013-11-01

    Full Text Available Introduction: The tension‑type headaches (Ctt are the most frequent headaches in the general population and those with higher socio‑economic impact, given the high degree of disability they cause. Objective: The authors propose to conduct a review of the available literature on the subject, from a psychiatric perspective. Discussion: Several studies have identified a higher prevalence of psychiatric disorders, personality traits and ineffective coping mechanisms in patients with Ctt, so it is essential to understand this relationship and the impact of these psychopathological factors on this kind of headaches. Conclusion: Their clinical and therapeutic approach is hampered by these and other factors and multiple strategies of pharmacological and psycho‑behavioral treatment have been used on them, however, scientific evidence is still scarce.

  13. 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.

  14. Current comorbidity among consecutive adolescent psychiatric outpatients with DSM-IV mood disorders.

    Science.gov (United States)

    Karlsson, Linnea; Pelkonen, Mirjami; Ruuttu, Titta; Kiviruusu, Olli; Heilä, Hannele; Holi, Matti; Kettunen, Kirsi; Tuisku, Virpi; Tuulio-Henriksson, Annamari; Törrönen, Johanna; Marttunen, Mauri

    2006-06-01

    To compare selected characteristics (age, sex, age of onset for depression, impairment, severity of depression, somatic comorbidity, and treatment status) of adolescents with currently comorbid and non-comorbid depression. A sample of 218 consecutive adolescent (13-19 years) psychiatric outpatients with depressive disorders, and 200 age- and sex-matched school-attending controls were interviewed for DSM-IV Axis I and Axis II diagnoses. Current comorbidity, most commonly with anxiety disorders, was equally frequent (>70%) in outpatients and depressed controls. Younger age (OR 0.20; 95% CI 0.08, 0.51) and male gender (OR 0.02; 95% CI 0.09, 0.55) were associated with concurrent disruptive disorders. Current comorbidity with substance use disorders (SUD) was independent of age (OR 1.13; 95% CI 0.51, 2.49) and sex (OR 0.51; 95% CI 0.22, 1.17). Personality disorders associated with older age (OR 2.06; 95% CI 1.10, 3.86). In multivariable logistic regression analysis, impairment (GAF impairment.

  15. Psychiatric symptoms and CAG expansion in Huntington`s disease

    Energy Technology Data Exchange (ETDEWEB)

    Weber, M.W.; Schmid, W.; Spiegel, R. [Univ. of Zuerich (Switzerland)

    1996-02-16

    The mutation responsible for Huntington`s disease (HD) is an elongated CAG repeat in the coding region of the IT15 gene. A PCR-based test with high sensitivity and accuracy is now available to identify asymptomatic gene carriers and patients. An inverse correlation between CAG copy number and age at disease onset has been found in a large number of affected individuals. The influence of the CAG repeat expansion on other phenotypic manifestations, especially specific psychiatric symptoms has not been studied intensively. In order to elucidate this situation we investigated the relation between CAG copy number and distinct psychiatric phenotypes found in 79 HD-patients. None of the four differentiated categories (personality change, psychosis, depression, and nonspecific alterations) showed significant differences in respect to size of the CAG expansion. In addition, no influence of individual sex on psychiatric presentation could be found. On the other hand in patients with personality changes maternal transmission was significantly more frequent compared with all other groups. Therefore we suggest that clinical severity of psychiatric features in HD is not directly dependent on the size of the dynamic mutation involved. The complex pathogenetic mechanisms leading to psychiatric alterations are still unknown and thus genotyping does not provide information about expected psychiatric symptoms in HD gene carriers. 40 refs., 1 fig., 2 tabs.

  16. Personality Traits in Huntington's Disease

    DEFF Research Database (Denmark)

    Larsen, Ida Unmack; Mortensen, Erik Lykke; Vinther-Jensen, Tua

    2016-01-01

    Huntington's disease (HD) is associated with risk for developing psychiatric symptoms. Vulnerability or resilience to psychiatric symptoms may be associated with personality traits. This exploratory study, aimed to investigate personality traits in a large cohort of HD carriers and at risk gene......-expansion negative individuals (HD non-carriers), exploring whether carrying the HD gene or growing up in an HD family influences personality traits. Forty-seven HD carriers, Thirty-nine HD non-carriers, and 121 healthy controls answered the Danish version of the revised NEO personality inventory. Comparisons...... symptoms. Our findings suggest that, there is no direct effect of the HD gene on personality traits, but that personality assessment may be relevant to use when identifying individuals from HD families who are vulnerable to develop psychiatric symptoms....

  17. The MMPI-2 in chronic psychiatric illness.

    Science.gov (United States)

    Bosch, Peggy; Van Luijtelaar, Gilles; Van Den Noort, Maurits; Schenkwald, Julia; Kueppenbender, Nicole; Lim, Sabina; Egger, Jos; Coenen, Anton

    2014-10-01

    While previous studies on the MMPI-2 in patients with schizophrenia and depression have used mixed samples of both early stage and chronic psychiatric patients. Here, it is investigated whether chronicity itself might have a differential effect on the MMPI-2 profiles of these patients and whether demoralization 'associated with long-term illness' affects the scales of the MMPI-2. Thirty long-term patients with schizophrenia, 30 long-term patients with depression, and 30 healthy participants completed the MMPI-2. Groups were compared on Clinical Scales and on the Restructured Clinical (RC) Scales. Patients with schizophrenia differed from patients with depression on 14 MMPI-2 scales and from healthy controls on 10 scales, generally showing mean UT-scores 65, indicating impaired functioning. Demoralization was higher in patients with depression than in patients with schizophrenia and both psychiatric groups differed from the healthy control group. It is concluded that long-term patients with depression show impaired functioning and high demoralization, while long-term patients with schizophrenia surprisingly show near normal functioning and less demoralization. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  18. The progression of coeliac disease: its neurological and psychiatric implications.

    Science.gov (United States)

    Campagna, Giovanna; Pesce, Mirko; Tatangelo, Raffaella; Rizzuto, Alessia; La Fratta, Irene; Grilli, Alfredo

    2017-06-01

    The aim of the paper is to show the various neurological and psychiatric symptoms in coeliac disease (CD). CD is a T cell-mediated, tissue-specific autoimmune disease which affects genetically susceptible individuals after dietary exposure to proline- and glutamine-rich proteins contained in certain cereal grains. Genetics, environmental factors and different immune systems, together with the presence of auto-antigens, are taken into account when identifying the pathogenesis of CD. CD pathogenesis is related to immune dysregulation, which involves the gastrointestinal system, and the extra-intestinal systems such as the nervous system, whose neurological symptoms are evidenced in CD patients. A gluten-free diet (GFD) could avoid cerebellar ataxia, epilepsy, neuropathies, migraine and mild cognitive impairment. Furthermore, untreated CD patients have more symptoms and psychiatric co-morbidities than those treated with a GFD. Common psychiatric symptoms in untreated CD adult patients include depression, apathy, anxiety, and irritability and schizophrenia is also common in untreated CD. Several studies show improvement in psychiatric symptoms after the start of a GFD. The present review discusses the state of the art regarding neurological and psychiatric complications in CD and highlights the evidence supporting a role for GFD in reducing neurological and psychiatric complications.

  19. Selective cognitive and psychiatric manifestations in Wolfram Syndrome.

    Science.gov (United States)

    Bischoff, Allison N; Reiersen, Angela M; Buttlaire, Anna; Al-Lozi, Amal; Doty, Tasha; Marshall, Bess A; Hershey, Tamara

    2015-05-30

    Wolfram Syndrome (WFS) is known to involve diabetes mellitus, diabetes insipidus, optic nerve atrophy, vision loss, hearing impairment, motor abnormalities, and neurodegeneration, but has been less clearly linked to cognitive, sleep, and psychiatric abnormalities. We sought to determine whether these abnormalities are present in children, adolescents, and young adults with WFS compared to age- and gender-matched individuals with and without type 1 diabetes using standardized measures. Individuals with genetically-confirmed WFS (n = 19, ages 7-27) were compared to age- and gender- equivalent groups of individuals with type 1 diabetes (T1DM; n = 25), and non-diabetic healthy controls (HC: n = 25). Cognitive performance across multiple domains (verbal intelligence, spatial reasoning, memory, attention, smell identification) was assessed using standardized tests. Standardized self- and parent-report questionnaires on psychiatric symptoms and sleep disturbances were acquired from all groups and an unstructured psychiatric interview was performed within only the WFS group. The three groups were similar demographically (age, gender, ethnicity, parental IQ). WFS and T1DM had similar duration of diabetes but T1DM had higher HbA1C levels than WFS and as expected both groups had higher levels than HC. The WFS group was impaired on smell identification and reported sleep quality, but was not impaired in any other cognitive or self-reported psychiatric domain. In fact, the WFS group performed better than the other two groups on selected memory and attention tasks. However, based upon a clinical evaluation of only WFS patients, we found that psychiatric and behavioral problems were present and consisted primarily of anxiety and hypersomnolence. This study found that cognitive performance and psychological health were relatively preserved WFS patients, while smell and sleep abnormalities manifested in many of the WFS patients. These findings contradict past case and

  20. Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic.

    Science.gov (United States)

    Hylwa, Sara A; Foster, Ashley A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

    2012-01-01

    Delusional infestation, which encompasses both delusions of parasitosis and delusions of infestation with inanimate objects (sometimes called Morgellons disease), has been said to represent a distinct and encapsulated delusion, that is, a stand-alone diagnosis. Anecdotally, we have observed that patients with delusional infestation often have one or more psychiatric comorbid conditions and that delusional infestation should not be regarded as a stand-alone diagnosis. The purpose of this study was to identify whether patients with delusional infestation have psychiatric comorbid conditions. We therefore identified patients who had been formally evaluated in the Department of Psychiatry during their visit to Mayo Clinic. We retrospectively searched for and reviewed the cases of all patients with delusional infestation seen from 2001 through 2007 at Mayo Clinic, Rochester, Minnesota, and who underwent psychiatric evaluation. The diagnoses resulting from psychiatric evaluation were analyzed. During the 7-year study period, 109 patients seen for delusional infestation at Mayo Clinic were referred to the Department of Psychiatry, 54 (50%) of whom actually followed through with psychiatric consultation. Of these 54 patients, 40 (74%) received additional active psychiatric diagnoses; 14 patients (26%) had delusional infestation alone. Abnormal personality traits were rarely documented. Most patients with delusional infestation have multiple coexisting or underlying psychiatric disorders. Therefore, evaluation by a psychiatrist, when possible, is advised for all patients with delusional infestation. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  1. Post-Coma Persons with Motor and Communication/Consciousness Impairments Choose among Environmental Stimuli and Request Stimulus Repetitions via Assistive Technology

    Science.gov (United States)

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Lanzilotti, Crocifissa; Oliva, Doretta; Megna, Gianfranco

    2010-01-01

    This study assessed whether a program based on microswitch and computer technology would enable three post-coma participants (adults) with motor and communication/consciousness impairments to choose among environmental stimuli and request their repetition whenever they so desired. Within each session, 16 stimuli (12 preferred and 4 non-preferred)…

  2. In Search of Executive Impairment in Pathological Gambling: A Neuropsychological Study on Non-treatment Seeking Gamblers.

    Science.gov (United States)

    Kapsomenakis, Alexandros; Simos, Panagiotis G; Konstantakopoulos, Georgios; Kasselimis, Dimitrios S

    2018-02-17

    Pathological gambling is characterized by a persisting maladaptive and recurrent behavior with severe social and psychological consequences. There is evidence of strong comorbidity with psychiatric manifestations as well as cognitive mainly involving executive functions. This study aimed to investigate impairment in executive functions and working memory, and personality traits in a sample of Greek gamblers. Twenty-four men involved in various gambling activities were recruited from ecological settings as probable pathological gamblers. They were assessed with a comprehensive neuropsychological battery involving several executive tasks, the Zuckerman-Kuhlman Personality Questionnaire, the Hospital Anxiety Depression Scale, and the Difficulties in Emotion Regulation Scale. An age- and education-level matched group of 21 men without history of habitual gambling served as controls. As a group, gamblers displayed significantly lower scores on indices of inhibition, decision making and self-reported emotional awareness, and scored higher on impulsivity/sensation seeking personality traits. Notably, gamblers scored similarly or significantly higher on measures of verbal and visuospatial working memory, cognitive flexibility, processing speed, verbal fluency, and sustained attention. Overall, we argue that gamblers do present with specific cognitive deficits, but there is no evidence for a generalized executive impairment, and further stress the importance of investigating cognitive, personality, and psychiatric aspects of gambling on the basis of an ecologically valid sampling.

  3. Psychiatric disorders in long-term sickness absence -- a population-based cross-sectional study

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen; Bech, Per

    2009-01-01

    AIMS: The study estimates the incidence of psychiatric disorders in long-term sickness absence (LSA; more than eight weeks of continuous sickness absence) over one year. The study is the first accounting for everybody on LSA by linking a psychiatric assessment for all persons on LSA to public...... registers. METHODS: In a Danish population of 120,000 inhabitants all 2,414 incident persons on LSA within one year were posted a questionnaire, of whom 1,121 (46.4%) responded. In a two phase design the 1,121 sick-listed persons were screened for psychiatric disorders. Phase 2 consisted of 844 people...

  4. Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes; a cross-sectional study.

    Science.gov (United States)

    Björk, Sabine; Juthberg, Christina; Lindkvist, Marie; Wimo, Anders; Sandman, Per-Olof; Winblad, Bengt; Edvardsson, David

    2016-08-22

    Earlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay. Cross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test. The results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units. The prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and

  5. Diagnostic Efficiency among Psychiatric Outpatients of a Self-Report Version of a Subset of Screen Items of the Structured Clinical Interview for DSM-IV-TR Personality Disorders (SCID-II)

    Science.gov (United States)

    Germans, Sara; Van Heck, Guus L.; Masthoff, Erik D.; Trompenaars, Fons J. W. M.; Hodiamont, Paul P. G.

    2010-01-01

    This article describes the identification of a 10-item set of the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) items, which proved to be effective as a self-report assessment instrument in screening personality disorders. The item selection was based on the retrospective analyses of 495 SCID-II interviews. The…

  6. Social cognition and levels of personality organization in patients with somatoform disorders: a case-control study.

    Science.gov (United States)

    Koelen, Jurrijn A; Eurelings-Bontekoe, Elisabeth H M; van Broeckhuysen-Kloth, Saskia A M; Snellen, Wim M; Luyten, Patrick

    2014-03-01

    Social cognition and its association with level of personality organization (PO) were examined in 163 patients with severe somatoform disorders (SFDs) and 151 psychiatric (PSA) control patients. Social cognition was measured with the Social Cognition and Object Relations Scale, which assessed both affective and cognitive facets of social cognition. Levels of PO were assessed using theory-driven profiles of the Dutch Short Form of the Minnesota Multiphasic Personality Inventory (MMPI). The SFD patients exhibited impairments in the cognitive facets of social cognition but not more so than the PSA controls. The results for the affective aspects indicated that the SFD patients exhibited lower levels of emotional investment yet higher affect tone in interactions than the PSA controls. In contrast to the control group, level of PO was not associated with social cognition in SFD. Together, the results indicated that impairments in complexity of mental representations are not specific to SFD patients, yet impairments in emotional investment may be specific to SFD.

  7. Web of Objects Based Ambient Assisted Living Framework for Emergency Psychiatric State Prediction

    Science.gov (United States)

    Alam, Md Golam Rabiul; Abedin, Sarder Fakhrul; Al Ameen, Moshaddique; Hong, Choong Seon

    2016-01-01

    Ambient assisted living can facilitate optimum health and wellness by aiding physical, mental and social well-being. In this paper, patients’ psychiatric symptoms are collected through lightweight biosensors and web-based psychiatric screening scales in a smart home environment and then analyzed through machine learning algorithms to provide ambient intelligence in a psychiatric emergency. The psychiatric states are modeled through a Hidden Markov Model (HMM), and the model parameters are estimated using a Viterbi path counting and scalable Stochastic Variational Inference (SVI)-based training algorithm. The most likely psychiatric state sequence of the corresponding observation sequence is determined, and an emergency psychiatric state is predicted through the proposed algorithm. Moreover, to enable personalized psychiatric emergency care, a service a web of objects-based framework is proposed for a smart-home environment. In this framework, the biosensor observations and the psychiatric rating scales are objectified and virtualized in the web space. Then, the web of objects of sensor observations and psychiatric rating scores are used to assess the dweller’s mental health status and to predict an emergency psychiatric state. The proposed psychiatric state prediction algorithm reported 83.03 percent prediction accuracy in an empirical performance study. PMID:27608023

  8. A Psychiatric Residency Curriculum on the Care of African American Patients

    Science.gov (United States)

    Harris, Herbert W.; Felder, Diane; Clark, Michelle O.

    2004-01-01

    Training psychiatric residents to address cross-cultural issues in their practice of psychiatry is a necessary objective of contemporary psychiatric education. Cultural issues play a critical role in the formation and expression of a patient's personality. In addition, they are a major determinant of the context in which mental illness develops.…

  9. A Psychiatric Primer for Programs Serving People with Developmental Disabilities. Monograph #101.

    Science.gov (United States)

    Dal Pozzo, Earlene; Bernstein, Gail S.

    Intended for personnel in programs serving persons with developmental disabilities, the booklet provides basic information about the major psychiatric disorders and their treatment. Five sections cover: the major disorders; medications--uses and problems; assessment; cooordination of services; and psychiatric emergencies. Major disorders such as…

  10. Qualities of a psychiatric mentor: a quantitative Singaporean survey.

    Science.gov (United States)

    Tor, Phern-Chern; Goh, Lee-Gan; Ang, Yong-Guan; Lim, Leslie; Winslow, Rasaiah-Munidasa; Ng, Beng-Yeong; Wong, Sze-Tai; Ng, Tse-Pin; Kia, Ee-Heok

    2011-11-01

    Psychiatric mentors are an important part of the new, seamless training program in Singapore. There is a need to assess the qualities of a good psychiatric mentor vis-à-vis those of a good psychiatrist. An anonymous survey was sent out to all psychiatry trainees and psychiatrists in Singapore to assess quantitatively the relative importance of 40 qualities for a good psychiatrist and a good mentor. The response rate was 48.7% (74/152). Factor analysis showed four themes among the qualities assessed (professional, personal values, relationship, academic-executive). A good mentor is defined by professional, relationship, and personal-values qualities. Mentors have significantly higher scores than psychiatrists for two themes (relationship and academic-executive). Being a good mentor, in Asia, means being a good psychiatrist first and foremost but also requires additional relationship and academic-executive skills. Mentors should be formally trained in these additional skills that were not part of the psychiatric curriculum.

  11. Behavioural and psychiatric symptoms in cognitive neurology.

    Science.gov (United States)

    Robles Bayón, A; Gude Sampedro, F

    2017-03-01

    Behavioural and psychiatric symptoms (BPS) are frequent in neurological patients, contribute to disability, and decrease quality of life. We recorded BPS prevalence and type, as well as any associations with specific diagnoses, brain regions, and treatments, in consecutive outpatients examined in a cognitive neurology clinic. A retrospective analysis of 843 consecutive patients was performed, including a review of BPS, diagnosis, sensory impairment, lesion topography (neuroimaging), and treatment. The total sample was considered, and the cognitive impairment (CI) group (n=607) was compared to the non-CI group. BPS was present in 59.9% of the patients (61.3% in the CI group, 56.4% in the non-CI group). One BPS was present in 31.1%, two in 17.4%, and three or more in 11.4%. BPS, especially depression and anxiety, are more frequent in women than in men. Psychotic and behavioural symptoms predominate in subjects aged 65 and older, and anxiety in those younger than 65. Psychotic symptoms appear more often in patients with sensory impairment. Psychotic and behavioural symptoms are more prevalent in patients with degenerative dementia; depression and anxiety in those who suffer a psychiatric disease or adverse effects of substances; emotional lability in individuals with a metabolic or hormonal disorder; hypochondria in those with a pain syndrome; and irritability in subjects with chronic hypoxia. Behavioural symptoms are more frequent in patients with anomalies in the frontal or right temporal or parietal lobes, and antipsychotics constitute the first line of treatment. Leaving standard treatments aside, associations were observed between dysthymia and opioid analgesics, betahistine and statins, and between psychotic symptoms and levodopa, piracetam, and vasodilators. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Prototype diagnosis of psychiatric syndromes

    Science.gov (United States)

    WESTEN, DREW

    2012-01-01

    resolve the thorny issue of the relation between psychiatric diagnosis and functional impairment. PMID:22294998

  13. [Mentally Ill Parents in Psychiatric Hospitals].

    Science.gov (United States)

    Markwort, Ilka; Schmitz-Buhl, Mario; Christiansen, Hanna; Gouzoulis-Mayfrank, Euphrosyne

    2016-09-01

    Offsprings of psychiatric patients are burdened and they are at risk of developing a mental disorder themselves. All admissions in a psychiatric hospital within a period of 6 months were screened for parenthood of underaged children. They were given standardized questionnaires for child behavior (SDQ), parenting behavior and subjective need for help in parenting. 21.5 % (N = 439) of the patients had underaged children, 194 patients participated in the study. They considered their children as having more psychological/behavioral problems than a control group (N = 97). Patients with personality or affective disorders and patients with a high level of psychiatric comorbidity rated their children most problematic. Although patients did not differ from controls in the evaluation of their parenting style, they expressed a higher need for help in parenting. Parenting and education issues need to be considered in the treatment of mentally ill patients. Effective support could be a relief for families and help to prevent mental disorders in offsprings. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Patterns of admission to acute psychiatric in-patient facilities: a national survey in Italy.

    Science.gov (United States)

    Preti, A; Rucci, P; Santone, G; Picardi, A; Miglio, R; Bracco, R; Norcio, B; de Girolamo, G

    2009-03-01

    A proper understanding of patterns of care represents a crucial step in improving clinical decision making and enhancing service provision. Only a few studies, however, have explored global patterns of psychiatric admissions nationwide, and none have been undertaken in Italy. Sociodemographic, clinical and treatment-related information was collected for 1577 patients admitted to 130 public and 36 private in-patient facilities in Italy during an index period in the year 2004. All patients were also rated using the 24-item Brief Psychiatric Rating Scale (BPRS) and the Personal and Social Performance (PSP) rating scales. Non-affective psychoses (36%) were the most common diagnoses and accounted to a large extent for compulsory admissions. Private facilities were more likely to admit patients with organic mental disorders and substance abuse/dependence and less likely to admit patients with non-affective psychoses. Overall, 77.8% of patients had been receiving treatment by a mental health professional in the month prior to admission. In 54% of cases, the admission was solicited by patients' family members. The main factors preceding admission were impairment in work or social functioning, social withdrawal, and conflict with family members. Agitation, delusions and/or hallucinations, and the presence of multiple problems were associated with compulsory admissions, whereas depressive and anxiety symptoms were associated with voluntary admissions. In a mixed, public-private psychiatric care system, like the Italian one, public and private facilities admit patients with widely different clinical characteristics and needs. Family support represents an important resource for most patients, and interventions specifically addressed to relieving family burden are warranted.

  15. Personality Inventory for DSM-5-Short Form (PID-5-SF): Reliability, Factorial Structure, and Relationship With Functional Impairment in Dual Diagnosis Patients.

    Science.gov (United States)

    Díaz-Batanero, Carmen; Ramírez-López, Juan; Domínguez-Salas, Sara; Fernández-Calderón, Fermín; Lozano, Óscar M

    2017-11-01

    Section III of the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition ( DSM-5) has generated a personality paradigm consisting of 25 personality facets identified in five domains. The developed assessment instrument Personality Inventory for DSM-5 (PID-5) has showed good psychometric properties, but the potential for certain improvements still remain. In this article, a sample of 282 dual diagnosis patients is used to provide evidence of the psychometric properties of the PID-5-Short Form. The mean value of Cronbach's alpha coefficients reached .73 on the facets and .84 for domains and test-retest values ranged between .57 to .83 for facets and .70 to .87 for the domains. Confirmatory factor analyses conducted showed good fit on both models tested: the five correlated factor structure and hierarchical structure of personality traits. The WHODAS 2.0 domains of understanding and communicating, and participating in society, appear to show the strongest relationship with personality facets. In general, the PID-5-Short Form shows adequate psychometric properties for use in dual diagnosis patients.

  16. 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 ...

  17. Psychiatric disorders in single and multiple sexual murderers.

    Science.gov (United States)

    Hill, Andreas; Habermann, Niels; Berner, Wolfgang; Briken, Peer

    2007-01-01

    Sexual homicides - and particularly offenders with multiple victims - receive much attention in the general public as well as among forensic experts. The aim of this study was to assess psychiatric disorders in a large sample of sexual murderers and to identify disorders related to multiple sexual homicides. Psychiatric court reports from 20 German forensic psychiatrists on 166 men who had committed a sexual homicide were evaluated for psychiatric disorders according to DSM-IV, including standardized instruments for personality disorders (criteria from the Structured Clinical Interview) and psychopathy (Psychopathy Checklist-Revised). Offenders with a single sexual homicide victim (n = 130) were compared to those with multiple victims (n = 36). High lifetime prevalence rates were found for substance abuse or dependence, paraphilias (especially sexual sadism), sexual dysfunctions and personality disorders (especially antisocial, borderline, sadistic and schizoid). In the multiple sexual murderer group sexual sadism, voyeurism, sadistic, antisocial and schizoid personality disorders were more frequent than in the single-victim group; none of the multiple offenders was diagnosed with a mood disorder. Multiple sexual murderers are characterized by disorders in three major psychopathological domains: sexual as well as 'character' sadism, antisociality and schizoid personality. A thorough diagnostic evaluation of Axis I as well as Axis II disorders should be part of risk assessments in sexual homicide perpetrators. Although the study was a retrospective investigation on psychiatric court reports, the size of the sample and consistency with results from previous studies give confidence that the identified group differences are unlikely to be due to methodological limitations.

  18. Migraine and its psychiatric comorbidities.

    Science.gov (United States)

    Minen, Mia Tova; Begasse De Dhaem, Olivia; Kroon Van Diest, Ashley; Powers, Scott; Schwedt, Todd J; Lipton, Richard; Silbersweig, David

    2016-07-01

    Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Psychiatric comorbidity : fact or artifact?

    NARCIS (Netherlands)

    van Loo, Hanna; Romeijn, Johannes

    The frequent occurrence of comorbidity has brought about an extensive theoretical debate in psychiatry. Why are the rates of psychiatric comorbidity so high and what are their implications for the ontological and epistemological status of comorbid psychiatric diseases? Current explanations focus

  20. Alcohol Abuse and Other Psychiatric Disorders

    Science.gov (United States)

    ... Psychiatric Disorders Other Substance Abuse HIV/AIDS Other Psychiatric Disorders In the current Diagnostic and Statistical Manual ... and other substance use disorders are defined as psychiatric disorders. Many individuals who misuse alcohol also abuse ...

  1. Aggression control therapy for violent forensic psychiatric patients: method and clinical practice.

    NARCIS (Netherlands)

    Hornsveld, R.H.J.; Nijman, H.L.I.; Hollin, C.R.; Kraaimaat, F.W.

    2008-01-01

    Aggression control therapy is based on Goldstein, Gibbs, and Glick's aggression replacement training and was developed for violent forensic psychiatric in- and outpatients (adolescents and adults) with a (oppositional-defiant) conduct disorder or an antisocial personality disorder. First, the

  2. “Learning-talks in science museums: how a visually impaired person interprets the educational material at the museum of microbiology”

    Directory of Open Access Journals (Sweden)

    Alessandra Fernandes Bizerra

    2012-03-01

    Full Text Available The processes of science communication and science education became especially important in the last quarter of the last century. Science museums, as non-formal spaces have an important role in amplifying and refining these processes. Being spaces open to the general public will be expected to develop programs that include all of its citizens. The Museum of Microbiology of the Butantan Institute has developed a series of activities and educational materials focusing on microorganisms that were designed to facilitate a closer integration of the visually impaired public with the scientific culture. In the present study, we sought to understand how visually deficient visitors interpreted the materials presented, determine the level of understanding that the use of these materials provided and study the significance attributed to them. Visually impaired visitors were interviewed during their interactions with the materials with the aid of an audio guide, and the talks generated were analyzed within interpretative categories. The most frequent category was “Strategic talk (Use” (11.8%, in which the visually deficient visitors gave their opinions concerning the uses of the Micro-Touch Program. Two other categories, “Affective talk (Pleasure” (10.2% and “Perceptual talk (Identification” (8.6% were also established. A combination of tactile and auditory tools was fundamental to solve problems and to the creation of visual representations that are important to constructing and understanding scientific concepts and to facilitate the organization of theoretical thought. We suggest here the necessity of elaborating activities contents that favors the establishment of conceptual talks and considering the previously acquired knowledge of visually impaired visitors during the design of displays, providing higher frequency of other learning talks

  3. Forensic psychiatric nursing: skills and competencies: II clinical aspects.

    Science.gov (United States)

    Mason, T; Coyle, D; Lovell, A

    2008-03-01

    This study reports on research undertaken to identify the skills and competencies of forensic psychiatric nurses working in secure psychiatric services in the UK. The rationale for this research is the lack of clarity in the role definition of nurses working in these environments and the specific content that may underscore the curriculum for training forensic nurses. Over 3300 questionnaires were distributed to forensic psychiatric nurses, non-forensic psychiatric nurses and other disciplines and information obtained on (1) the perceived clinical problems that give forensic nurses the most difficulty; (2) the skills best suited to overcome those problems; and (3) the priority aspects of clinical nursing care that needs to be developed. A 35% response rate was obtained with 1019 forensic psychiatric nurses, 110 non-forensic psychiatric nurses and 43 other disciplines. The results highlighted a 'top ten' list of main problems with possible solutions and main areas for development. The conclusions drawn include a focus on skills and competencies regarding the management of personality disorders and the management of violence and aggression.

  4. Forensic psychiatric nursing: skills and competencies: I role dimensions.

    Science.gov (United States)

    Mason, T; Lovell, A; Coyle, D

    2008-03-01

    This paper reports on an investigation into the skills and competencies of forensic psychiatric nurses from the perspective of three groups: (A) forensic psychiatric nurses; (B) non-forensic psychiatric nurses; and (C) other disciplines. A national survey of forensic psychiatric services in the UK was conducted, and information gathered on the perceived skills and competencies in this growing field of psychiatric practice. From 3360 questionnaires, 1172 were returned, making a response rate of 35%. The results indicate a small discrepancy between forensic nurses' and non-forensic nurses' perceptions of the role constructs of forensic practice. However, a larger difference was noted between nurses' perceptions and other disciplines' perceptions of the constituent parts to forensic psychiatric nursing. Nurses tended to focus on personal qualities both in relation to themselves and the patients, while the other disciplines focused on organizational structures both in defining the role and in the resolution of perceived deficits. The findings have implications for multidisciplinary working, as well as policy formulation and curriculum development in terms of the skills and competencies of forensic nurse training.

  5. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability

    NARCIS (Netherlands)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I.M.; Krijnen, Wim; van der Schans, Cees; Waninge, Aly

    2015-01-01

    Background The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to the quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and

  6. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability

    NARCIS (Netherlands)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I. M.; Krijnen, Wim P.; Schans, van der Cees P.; Waninge, Aly

    Background: The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and

  7. How psychiatric patients perceive the public's stereotype of mental illness.

    Science.gov (United States)

    Freidl, M; Lang, T; Scherer, M

    2003-05-01

    It is well established that the general public has devaluating attitudes towards psychiatric patients. In order to avoid rejection, many of these patients develop coping strategies, such as withdrawal and concealing their treatment history. These efforts are in themselves stressing, which might have negative consequences for the course of the disorder. It is not clear, however, how many and which patients do actually perceive the public's stereotype as threatening and, therefore, expect rejection. Ninety psychiatric patients and a sample of 1042 persons of the Austrian general population were asked whether they agreed with five devaluating statements about mental patients contained in a questionnaire developed by Link et al. Matched pairs comparisons and multiple logistic regression were employed in order to find out whether patients agreed with these statements to the same extent as the general population did. For the statements that most people believe that psychiatric patients are "less intelligent", "less trustworthy" and "taken less seriously", patients thought significantly less often than the general population that most people devalue mental patients. For two statements ("personal failure", "think less of") no difference was found. It seems that some psychiatric patients are less convinced than the general population that most people devalue psychiatric patients in specific respects; these patients might fear rejection less than other patients do. Those who actually fear rejection might need antistigma assistance more urgently than the first group.

  8. Conceptions of narcissism and the DSM-5 pathological personality traits.

    Science.gov (United States)

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

    2013-06-01

    The Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) features two conceptions of Narcissistic Personality Disorder (NPD), one based on the retained DSM-IV's categorical diagnosis and the other based on a model that blends impairments in personality functioning with a specific trait profile intended to recapture DSM-IV NPD. Nevertheless, the broader literature contains a richer array of potential conceptualizations of narcissism, including distinguishable perspectives from psychiatric nosology, clinical observation and theory, and social/personality psychology. This raises questions about the most advantageous pattern of traits to use to reflect various conceptions of narcissistic pathology via the Personality Inventory for the DSM-5 (PID-5). In this study, we examine the associations of the Personality Disorder Questionnaire-Narcissistic Personality Disorder scale, Narcissistic Personality Inventory-16, and the Pathological Narcissism Inventory and the PID-5 dimensions and facets in a large sample (N = 1,653) of undergraduate student participants. Results point to strong associations with PID-5 Antagonism scales across narcissism measures, consistent with the DSM-5's proposed representation of NPD. However, additional notable associations emerged with PID-5 Negative Affectivity and Psychoticism scales when considering more clinically relevant narcissism measures.

  9. [Reducing the Care-Related Burdens of a Family Caregiver of a Person With Mild Cognitive Impairment: A Home-Based Case Management Program].

    Science.gov (United States)

    Chen, Min-Chia; Chiu, Yi-Chen; Wei, Pi-Mei; Hsu, Wen-Chuin

    2017-06-01

    The long-term care of cognitively impaired patients with concomitant behavioral problems brings great stress and burdens to family caregivers. The present article describes a family caregiver with multiple chronic diseases who concurrently shouldered primary care responsibilities for her husband, a patient with mild cognitive impairment, problematic behaviors, and medication non-adherence issues. The period of care was between September 23rd and December 29th, 2015. Data on physiological, psychological, and social burdens were collected based on a stress process model for family caregiving. We then applied a home-based, individually tailored intervention, which included nursing education, skills training, listening/counseling, and resource connecting, that effectively helped the family caregiver reduce her burdens. Our assessment identified nursing-care-related problems as the primary source of caregiver burden in this case, with identified stressors including a lack of knowledge regarding patient care, medication management problems, sleep disorders, and inadequate social resources. Using continuous care interactions, we established a trust relationship with the family caregiver, prioritized her needs, and provided dementia care knowledge and skills, which gradually improved her caregiving competence. Our instruction included increasing caregiver understanding of the disease course of dementia, related problematic behaviors, and medication management. Our intervention enhanced the disease awareness of the caregiver and helped her become more positive about her caregiving tasks. Therefore, the negative impacts on her family were reduced. Social support and long-term care resources further reduced her burden and improved her quality of life.

  10. Personalized medicine in psychiatry

    DEFF Research Database (Denmark)

    Wium-Andersen, Ida Kim; Vinberg, Maj; Kessing, Lars Vedel

    2017-01-01

    Background: Personalized medicine is a model in which a patient’s unique clinical, genetic, and environmental characteristics are the basis for treatment and prevention.  Aim, method, and results: This review aims to describe the current tools, phenomenological features, clinical risk factors......, and biomarkers used to provide personalized medicine. Furthermore, this study describes the target areas in which they can be applied including diagnostics, treatment selection and response, assessment of risk of side-effects, and prevention.  Discussion and conclusion: Personalized medicine in psychiatry....... The discussion proposes possible solutions to narrow this gap and to move psychiatric research forward towards personalized medicine....

  11. Psychiatric Consultation and Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Sheila Specker

    2009-01-01

    Full Text Available Background A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method Consecutive one-year referrals (524 to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results Of the referrals, 176 met criteria for substance use disorders (SUD (57% alcohol; 25% other drugs; 18% both alcohol and other drugs. Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in data

  12. Psychiatric Consultation and Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Sheila Specker

    2009-11-01

    Full Text Available Background: A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives: 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method: Consecutive one-year referrals (524 to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results: Of the referrals, 176 met criteria for substance use disorders (SUD (57% alcohol; 25% other drugs; 18% both alcohol and other drugs. Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions: These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in

  13. Communication difficulties in children identified with psychiatric problems

    OpenAIRE

    Helland, Wenche Andersen

    2010-01-01

    Several studies have pointed to an overlap between different developmental psychopathological conditions and language impairments, and difficulties with communication have been identified in children of various diagnostic backgrounds. This thesis is based on three empirical studies, and the purposes are to investigate communication difficulties as reported by parents, in children identified with psychiatric problems as well as to evaluate a Norwegian adaptation of the Children’...

  14. Psychiatric Morbidity Among Suicide Attempters Who Needed ICU Intervention

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    MMA Shalahuddin Qusar

    2010-04-01

    Full Text Available Background: Suicide is a tragic and serious but preventable public health problem all over the world including Bangladesh. Committing suicide has become a burning issue and mortality rate increases especially in young females. Psychiatric evaluation is needed in suicide attempted patients for better management plan to reduce such unnatural mortality, as well as the impairment related to suicidal thought and psychiatric disorders. Objectives: To assess the psychiatric disorders and conditions that needed sufficient clinical attention among the suicide attempters who needed ICU intervention. Methods: This cross-sectional study was carried out in an Intensive Care Unit (ICU of a private hospital of Dhaka City from July 2008 to December 2008. Total forty four subjects of attempted suicide were included in the study and psychiatric diagnosis was made by using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV by psychiatrists after initial physical problems subsided. Results: The most common psychiatric diagnosis was Major Depressive Disorder. Female suffered more and among them attention-seeking behaviors were frequent. Thirty-four patients (77.3% had previous history of psychiatric disorder. Chemicals (like; organophosphorous, kerosene, harpic and other medicine overdose ingestion was the most frequently used method by the suicide attempters. Conclusion: This study may be helpful for further research regarding suicide attempters and its' association with mental problems. In primary health care setting, the physicians may get a clue to design a system for preventing, early recognition and managing suicidal ideas, thoughts and attempts. Psychiatric consultation should be made mandatory for all patients admitted following attempted suicide. DOI: 10.3329/bsmmuj.v2i2.4761 BSMMU J 2009; 2(2: 73-77

  15. 20 CFR 404.1511 - Definition of a disabling impairment.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Definition of a disabling impairment. 404... Definition of a disabling impairment. (a) Disabled workers, persons disabled since childhood and, for months... disabling impairment is an impairment (or combination of impairments) which, of itself, is so severe that it...

  16. Psychiatric morbidity in perimenopausal women

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    Biswajit L Jagtap

    2016-01-01

    Full Text Available Background: Women in the perimenopausal period are reported to be vulnerable to psychiatric disorders. Aim: To assess the psychiatric morbidity in perimenopausal women aged 45–55 years. Materials and Methods: This cross-sectional, observational, hospital-based study was conducted at the Department of Psychiatry in a tertiary care hospital attached to a medical college. The study sample consisted of consecutive women in perimenopause as diagnosed by a gynecologist and written informed consent for inclusion in the study. Women with a previous history of psychiatric illnesses, with a major medical illness, or who had undergone surgical menopause were excluded from the study. All women were evaluated with a brief questionnaire for collecting demographic and clinical information and the Mini International Neuropsychiatric Interview for assessing psychiatric disorders. Results: Of the 108 women in perimenopause included in the study, 31% had depressive disorder, 7% had anxiety, while 5% had depressive disorder with anxiety features. Psychiatric morbidity was significantly more in women having lesser education, from rural background, with a history of psychiatric illness in the family, a later age of menarche, and in the late stage of perimenopause. Conclusions: Women in the perimenopause affected by psychiatric morbidity were most commonly diagnosed with depression. As perimenopause is a time of vulnerability in women, attention to signs and symptoms of depression may be required so that they may lead a more productive life.

  17. Understanding migraine and psychiatric comorbidity.

    Science.gov (United States)

    Seng, Elizabeth K; Seng, Cynthia D

    2016-06-01

    This article describes recent trends in our understanding of the role of psychiatric disorders in the experience and treatment of migraine, and the role of migraine in the experience and treatment of psychiatric disorders. Although the majority of studies evaluating psychiatric comorbidity in migraine have focused on depression, anxiety, and bipolar disorders are highly associated with migraine and relevant for prognosis and treatment planning. Comorbid psychiatric disorders may be associated with poorer treatment response for some acute pharmacotherapies; however, people with comorbid migraine and mood or anxiety disorders can achieve large responses to preventive pharmacologic and behavioral therapies. Emerging research is developing and evaluating behavioral treatments designed to manage cooccurring migraine and mood or anxiety disorders. Stigma related to psychiatric disorders has been well characterized, and could exacerbate extant migraine-related stigma. Anxiety and mood disorders are prevalent in people with migraine, although not ubiquitous. Psychiatric comorbidity is associated with greater migraine symptoms and disability; however, people with comorbid depression or anxiety are amenable to preventive migraine treatment. Research regarding migraine treatment strategies optimized for people with comorbid psychiatric disorders is critical to advancing care and reducing stigma for this important subpopulation of people with migraine.

  18. An evaluation of behavioural and personality differences between native and non-native male adolescents in the Netherlands ordered into treatment in a forensic psychiatric outpatient clinic, and their non-violent peers.

    NARCIS (Netherlands)

    Hornsveld, R.H.J.; Cuperus, H.; Vries, E.T. de; Kraaimaat, F.W.

    2008-01-01

    BACKGROUND: In a previous study of the dynamic criminogenic needs of violent outpatients we did not differentiate between native and non-native adolescents, but differences between personality traits and problem behaviours may require adaptations to any treatment programme. AIM: To compare, in the

  19. Barriers to and facilitators of employment for people with psychiatric disabilities in Africa: a scoping review.

    Science.gov (United States)

    Ebuenyi, I D; Syurina, E V; Bunders, J F G; Regeer, B J

    2018-01-01

    Despite the importance of inclusive employment, described in Goal 8 of the Sustainable Development Goals (SDGs), employment of persons with psychiatric disabilities in Africa is lower than among the general population. The aim of this scoping review is to explore evidence related to the barriers to and facilitators of employment of persons with psychiatric disabilities in Africa. A literature search was conducted using six relevant electronic databases of articles published between 1990 and 2017. Eight studies were identified and analysed regarding barriers and facilitators of employment of persons with psychiatric disabilities. The dynamic adaptation of the bio-psycho-social model was used as an analytical framework. Identified barriers include ill health, (anticipated) psychiatric illness, social stigma and discrimination, negative attitudes among employers and the lack of social support and government welfare. Facilitators of employment include stability of mental illness, heightened self-esteem, a personal decision to work despite stigma, competitive and supported employment, reduction in social barriers/stigma and workplace accommodations. Employment of persons with psychiatric disabilities is essential, yet there is dearth of scientific evidence to identify contextual models that might be useful in African countries and other low-and middle countries (LMICs). This gap in information would benefit from further research to improve the employment rates of persons with psychiatric disabilities in Africa.

  20. Barriers to and facilitators of employment for people with psychiatric disabilities in Africa: a scoping review

    Science.gov (United States)

    Syurina, E. V.; Regeer, B. J.

    2018-01-01

    ABSTRACT Background: Despite the importance of inclusive employment, described in Goal 8 of the Sustainable Development Goals (SDGs), employment of persons with psychiatric disabilities in Africa is lower than among the general population. Objective: The aim of this scoping review is to explore evidence related to the barriers to and facilitators of employment of persons with psychiatric disabilities in Africa. Methods: A literature search was conducted using six relevant electronic databases of articles published between 1990 and 2017. Results: Eight studies were identified and analysed regarding barriers and facilitators of employment of persons with psychiatric disabilities. The dynamic adaptation of the bio-psycho-social model was used as an analytical framework. Identified barriers include ill health, (anticipated) psychiatric illness, social stigma and discrimination, negative attitudes among employers and the lack of social support and government welfare. Facilitators of employment include stability of mental illness, heightened self-esteem, a personal decision to work despite stigma, competitive and supported employment, reduction in social barriers/stigma and workplace accommodations. Conclusion: Employment of persons with psychiatric disabilities is essential, yet there is dearth of scientific evidence to identify contextual models that might be useful in African countries and other low-and middle countries (LMICs). This gap in information would benefit from further research to improve the employment rates of persons with psychiatric disabilities in Africa. PMID:29764342

  1. Psychiatric adverse effects of chloroquine

    Directory of Open Access Journals (Sweden)

    Anna Bogaczewicz

    2017-06-01

    Full Text Available Chloroquine is a prototype antimalarial drug, widely used in several branches of medicine. Antimalarial drugs are used in the treatment of various dermatological, immunological, rheumatological and infectious diseases. Examples of off-labelled indications for chloroquine analogues use include dermatomyositis, sarcoidosis, polymorphous light eruption, disseminated granuloma annulare and porfiria cutanea tarda. There is a relatively small number of adverse effects related to chloroquine analogues used in standard doses, such as gastrointestinal disturbances, headaches, skin reactions, hypotension, convulsions, extrapyramidal symptoms and visual disturbances. Psychiatric side effects of chloroquine seem to be rare, but may manifest in a wide range of symptoms, such as confusion, disorientation, ideas of persecution, agitation, outbursts of violence, loss of interest, feeling sad, suicidal ideas and impaired insight. There is also a report of a manic episode with psychotic features in the course of bipolar disorder, and another case report of persecutory delusions, anxiety, derealisation and visual illusions triggered by chloroquine. The duration of psychiatric symptoms usually ranges from one to two weeks, and symptoms usually disappear within several days following cessation of chloroquine usage and starting psychiatric treatment where indicated. This article reviews the case studies of patients diagnosed with mental disorders resulting from the use of chloroquine, and discusses the management in such cases.

  2. Screening of alcohol use disorders in psychiatric outpatients: influence of gender, age, and psychiatric diagnosis.

    Science.gov (United States)

    Sánchez Autet, Mónica; Garriga, Marina; Zamora, Francisco Javier; González, Idilio; Usall, Judith; Tolosa, Leticia; Benítez, Concepción; Puertas, Raquel; Arranz, Belén

    2017-07-14

    Alcohol use disorders (AUD) are 2 times higher among psychiatric patients than in the general population. The under-recognition of this dual diagnosis can entail several negative outcomes. Early assessment with a screening tool like the CAGE questionnaire could be an opportunity to improve patients' prognoses. The objective of this study is to assess AUD risk in an outpatient psychiatric sample with a modified CAGE, considering the influence of age, gender and clinical psychiatric diagnosis. An observational, multicentric, descriptive study was carried out. The 4-item CAGE scale, camouflaged in a healthy lifestyle questionnaire, was implemented, using a cut-off point of one. 559 outpatients were assessed. 54% were female and the average age was 50.07 years. 182 patients presented a CAGE score ≥1 (45.1% of men and 21.9% of women). Gender was the strongest predictor of a positive result in CAGE, as men were 3.03 times more likely to score ≥1 on the CAGE questionnaire (p < .001, 95% CI: 0.22-0.49). Patients with bipolar and personality disorders had the highest rates of CAGE scores ≥1 (45.2 and 44.9%, respectively), with a significant association between diagnosis and a positive score (p = .002). Patients above 60 years were 2.5 times less likely to score ≥1 on the CAGE (p = .017, 95% CI: 0.19-0.85). Specific screening questionnaires, like the CAGE scale, can be an easy and useful tool in the assessment of AUD risk in psychiatric outpatients. Male patients with a bipolar or personality disorder present a higher risk of AUD.

  3. The cerebellum and psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Joseph ePhillips

    2015-05-01

    Full Text Available The cerebellum has been considered for a long time to play a role solely in motor coordination. However, studies over the past two decades have shown that the cerebellum also plays a key role in many motor, cognitive, and emotional processes. In addition, studies have also shown that the cerebellum is implicated in many psychiatric disorders including attention deficit hyperactivity disorder, autism spectrum disorders, schizophrenia, bipolar disorder, major depressive disorder and anxiety disorders. In this review, we discuss existing studies reporting cerebellar dysfunction in various psychiatric disorders. We will also discuss future directions for studies linking the cerebellum to psychiatric disorders.

  4. Psychiatric disorders in myasthenia gravis

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    Mariana Inés Ybarra

    2011-04-01

    Full Text Available OBJECTIVE: To investigate the prevalence of psychiatric disorders in patients with myasthenia gravis (MG. METHOD: Forty-one patients with MG answered to a structured psychiatric interview (MINI-Plus. RESULTS: Eleven (26.1% patients were diagnosed with a depressive disorder and 19 (46.3% were diagnosed with an anxiety disorder. Patients with dysthymia were older (p=0.029 and had longer disease duration (p=0.006. Patients with social phobia also had longer disease duration (p=0.039. CONCLUSION: Psychiatric disorders in MG are common, especially depressive and anxiety disorders.

  5. Clinician Ratings of Vulnerable and Grandiose Narcissistic Features: Implications for an Expanded Narcissistic Personality Disorder Diagnosis.

    Science.gov (United States)

    Stanton, Kasey; Zimmerman, Mark

    2017-12-07

    Conceptualizations of narcissistic personality disorder (NPD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychiatric Association, 2013) have been criticized for focusing too exclusively on grandiose narcissistic traits (e.g., exploitativeness and entitlement) and failing to capture vulnerable narcissistic features (e.g., feelings of inadequacy). We extended prior grandiose and vulnerable narcissism research by examining the degree to which clinician ratings of traits related to grandiosity overlapped with traits related to vulnerability in a large sample of adult outpatients (N = 2,149). We also examined relations with other psychopathology and psychosocial impairment for both (a) narcissistic trait configurations including both vulnerable and grandiose features and (b) configurations focusing on grandiose narcissistic traits. Structural results indicated that some personality features related to vulnerability (e.g., perfectionism and inadequacy) were unrelated to ratings of grandiose narcissistic personality features. Additionally, our results suggest that emphasizing vulnerable features within narcissism trait configurations may increase NPD's overlap with other disorders (e.g., borderline personality disorder and social anxiety) and does not appear to discriminate pathological narcissism from antisocial personality disorder, a disorder with which NPD is highly comorbid. Finally, scores on configurations defined only by grandiose narcissistic traits related positively to all psychosocial impairment indicators, although configurations also including vulnerable features generally showed stronger relations with psychosocial impairment. The implications of these findings in regard to future conceptualizations of NPD are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Functional status of persons with chronic fatigue syndrome in the Wichita, Kansas, population

    Directory of Open Access Journals (Sweden)

    Reyes Michele

    2003-10-01

    Full Text Available Abstract Background Scant research has adequately addressed the impact of chronic fatigue syndrome on patients' daily activities and quality of life. Enumerating specific problems related to quality of life in chronic fatigue syndrome patients can help us to better understand and manage this illness. This study addresses issues of functional status in persons with chronic fatigue syndrome and other fatiguing illnesses in a population based sample, which can be generalized to all persons with chronic fatigue. Methods We conducted a random telephone survey in Wichita, Kansas to identify persons with chronic fatigue syndrome and other fatiguing illnesses. Respondents reporting severe fatigue of at least 1 month's duration and randomly selected non-fatigued respondents were asked to participate in a detailed telephone interview. Participants were asked about symptoms, medical and psychiatric illnesses, and about physical, social, and recreational functioning. Those meeting the 1994 chronic fatigue syndrome case definition, as determined on the basis of their telephone responses, were invited for clinical evaluation to confirm a diagnosis of chronic fatigue syndrome. For this analysis, we evaluated unemployment due to fatigue, number of hours per week spent on work, chores, and other activities (currently and prior to the onset of fatigue, and energy level. Results There was no difference between persons with chronic fatigue syndrome and persons with a chronic fatigue syndrome-like illness that could be explained by a medical or psychiatric condition for any of the outcomes we measured except for unemployment due to fatigue (15% vs. 40%, P Conclusions Persons with chronic fatigue syndrome are as impaired as persons whose fatigue could be explained by a medical or psychiatric condition, and they have less energy than non-fatigued controls.

  7. [Adult attention deficit/hyperactivity disorder, associated symptoms and comorbid psychiatric disorders: diagnosis and pharmacological treatment].

    Science.gov (United States)

    Paslakis, G; Schredl, M; Alm, B; Sobanski, E

    2013-08-01

    Adult attention deficit/hyperactivity disorder (ADHD) is characterised by inattention and/or hyperactivity and impulsivity and is a frequent psychiatric disorder with childhood onset. In addition to core symptoms, patients often experience associated symptoms like emotional dysregulation or low self-esteem and suffer from comorbid disorders, particularly depressive episodes, substance abuse, anxiety or sleep disorders. It is recommended to include associated symptoms and comorbid psychiatric disorders in the diagnostic set-up and in the treatment plan. Comorbid psychiatric disorders should be addressed with disorder-specific therapies while associated symptoms also often improve with treatment of the ADHD core symptoms. The most impairing psychiatric disorder should be treated first. This review presents recommendations for differential diagnosis and treatment of adult ADHD with associated symptoms and comorbid psychiatric disorders with respect to internationally published guidelines, clinical trials and expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Care systematization in psychiatric nursing within the psychiatric reform context.

    Science.gov (United States)

    Hirdes, A; Kantorski, L P

    2002-02-01

    The aim of this study was to approach care systematization in psychiatric nursing in two psychiatric disorder patients who attended 'Nossa Casa', São Lourenço do Sul, RS, Brazil. Nossa Casa services psychiatric patients in the community, focussing on: (i) permanence in their environment, allowing patients to remain close to their families and social spheres; (ii) integral attendance to meet individual needs; (iii) respecting individual differences; (iv) rehabilitation practices; and (v) social reinsertion. Concepts and assumptions of the psychiatric reform and the Irving's nursing process were used as theoretical-methodological references to elaborate this systematization. A therapeutic project for the psychiatric patient was elaborated, in accordance with the interdisciplinary proposal accepted by Nossa Casa. Interdisciplinary team intervention, guided by a previously discussed common orientation and defined through an individualized therapeutic project, allowed for an effective process of psychosocial rehabilitation. The authors concluded that a therapeutic project based on the mentioned premises leads to consistent, comprehensive, dialectical and ethical assistance in mental health, thereby reinstating the citizenship of psychiatric patients.

  9. Psychiatric Comorbidity and Physical Correlates in Alcohol-dependent Patients.

    Science.gov (United States)

    Gauba, Deepak; Thomas, Pramod; Balhara, Yatan P S; Deshpande, Smita N

    2016-01-01

    To examine the prevalence and pattern of comorbidity in alcohol dependence and its relationship with physical and laboratory findings. Eighty males with alcohol dependence were examined using the Hindi version of Diagnostic Interview for Genetic Studies, the International Classification of Disease-10 th Edition Personality Disorder Examination, Alcohol Use Disorder Identification Test for alcohol use, global assessment of functioning, blood sampling electrocardiogram, and ultrasonogram. Eighty-seven percent had a comorbid Axis I or an Axis II psychiatric disorder, over 78% had nicotine dependence, and 56% had comorbid Axis II disorder, antisocial personality being the most common. Gamma glutamyl transpeptidase levels were significantly associated with comorbidity. High comorbidity of Axis I psychiatric disorders was found among persons with alcohol dependence. Axis II disorders were also present.

  10. Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 part I: description and rationale

    NARCIS (Netherlands)

    Skodol, A.E.; Clark, L.A.; Bender, D.S.; Krueger, R.F.; Morey, L.C.; Verheul, R.; Alarcon, R.D.; Bell, C.C.; Siever, L.J.; Oldham, J.M.

    2011-01-01

    A major reconceptualization of personality psychopathology has been proposed for DSM-5 that identifies core impairments in personality functioning, pathological personality traits, and prominent pathological personality types. A comprehensive personality assessment consists of four components:

  11. SUBJECTIVE COGNITIVE COMPLAINTS IN A PATIENT WITH KERATOCONUS: COGNITIVE IMPAIRMENT OR

    Directory of Open Access Journals (Sweden)

    Ara G. Kaprelyan

    2012-11-01

    Full Text Available Keratoconus is a disorder affecting the cornea, characterized by its variably progressive central thinning, which results in conically shaped protrusion. Patients with keratoconus are sometimes described as having peculiar personality characteristics. We present the case of a patient with keratoconus, complaining of impairment of concentration and memory disturbances. He reported slow progression of the complaints but was fully capable of performing his professional and social activities. Neuropsychological assessment confirmed fluctuations of active attention and diminished concentration. Long term memory was within normal limits, but closer to the lower level. MMSE score was 27. No significant changes were observed one year after baseline assessment. No major psychiatric disorder was found. In this clinical case we are tempted to discuss the possible role of keratoconus, which, as it has been described in the literature, could lead to some slight changes of behavior, forming a "keratoconic personality".

  12. Psychiatric diagnoses, trauma, and suicidiality

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    Elklit Ask

    2007-04-01

    Full Text Available Abstract Background This study aimed to examine the associations between psychiatric diagnoses, trauma and suicidiality in psychiatric patients at intake. Methods During two months, all consecutive patients (n = 139 in a psychiatric hospital in Western Norway were interviewed (response rate 72%. Results Ninety-one percent had been exposed to at least one trauma; 69 percent had been repeatedly exposed to trauma for longer periods of time. Only 7% acquired a PTSD diagnosis. The comorbidity of PTSD and other psychiatric diagnoses were 78%. A number of diagnoses were associated with specific traumas. Sixty-seven percent of the patients reported suicidal thoughts in the month prior to intake; thirty-one percent had attempted suicide in the preceding week. Suicidal ideation, self-harming behaviour, and suicide attempts were associated with specific traumas. Conclusion Traumatised patients appear to be under- or misdiagnosed which could have an impact on the efficiency of treatment.

  13. Visual Impairment

    Science.gov (United States)

    ... site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Visual Impairment KidsHealth / For Teens / Visual Impairment What's in ...

  14. Psychiatric sequelae of induced abortion.

    Science.gov (United States)

    Gibbons, M

    1984-03-01

    An attempt is made to identify and document the problems of comparative evaluation of the more recent studies of psychiatric morbidity after abortion and to determine the current consensus so that when the results of the joint RCGP/RCOG study of the sequelae of induced abortion become available they can be viewed in a more informed context. The legalization of abortion has provided more opportunities for studies of subsequent morbidity. New laws have contributed to the changing attitudes of society, and the increasing acceptability of the operation has probably influenced the occurrence of psychiatric sequelae. The complexity of measuring psychiatric sequelae is evident from the many terms used to describe symptomatology and behavioral patterns and from the number of assessment techniques involved. Numerous techniques have been used to quantify psychiatric sequelae. Several authors conclude that few psychiatric problems follow an induced abortion, but many studies were deficient in methodology, material, or length of follow-up. A British study in 1975 reported a favorable outcome for a "representative sample" of 50 National Health Service patients: 68% of these patients had an absence of or only mild feelings of guilt, loss, or self reproach and considered abortion as the best solution to their problem. The 32% who had an adverse outcome reported moderate to severe feelings of guilt, regret, loss, and self reproach, and there was evidence of mental illness. In most of these cases the adverse outcome was related to the patient's environment since the abortion. A follow-up study of 126 women, which compared the overall reaction to therapeutic abortion between women with a history of previous mild psychiatric illness and those without reported that a significantly different emotional reaction could not be demonstrated between the 2 groups. In a survey among women seeking an abortion 271 who were referred for a psychiatric opinion regarding terminations of pregnancy

  15. Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases.

    Science.gov (United States)

    Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Dain, S

    2013-02-01

    In this Part II psychiatric disorders coexisting with organic diseases are discussed. "Comorbidity phenomenon" defines the not univocal interrelation between medical illnesses and psychiatric disorders, each other negatively influencing morbidity and mortality. Most severe psychiatric disorders, such as schizophrenia, bipolar disorder and depression, show increased prevalence of cardiovascular disease, related to poverty, use of psychotropic medication, and higher rate of preventable risk factors such as smoking, addiction, poor diet and lack of exercise. Moreover, psychiatric and organic disorders can develop together in different conditions of toxic substance and prescription drug use or abuse, especially in the emergency setting population. Different combinations with mutual interaction of psychiatric disorders and substance use disorders are defined by the so called "dual diagnosis". The hypotheses that attempt to explain the psychiatric disorders and substance abuse relationship are examined: (1) common risk factors; (2) psychiatric disorders precipitated by substance use; (3) psychiatric disorders precipitating substance use (self-medication hypothesis); and (4) synergistic interaction. Diagnostic and therapeutic difficulty concerning the problem of dual diagnosis, and legal implications, are also discussed. Substance induced psychiatric and organic symptoms can occur both in the intoxication and withdrawal state. Since ancient history, humans selected indigene psychotropic plants for recreational, medicinal, doping or spiritual purpose. After the isolation of active principles or their chemical synthesis, higher blood concentrations reached predispose to substance use, abuse and dependence. Abuse substances have specific molecular targets and very different acute mechanisms of action, mainly involving dopaminergic and serotoninergic systems, but finally converging on the brain's reward pathways, increasing dopamine in nucleus accumbens. The most common

  16. Multiple diabetic complications, as well as impaired physical and mental function, are associated with declining balance function in older persons with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Hong XF

    2017-01-01

    Full Text Available Xiufang Hong,1,2 Xujiao Chen,2 Jiaojiao Chu,2 Shanshan Shen,2 Qichen Chai,2 Gaobo Lou,2 Lingyan Chen2 1Zhejiang Chinese Medical University, 2Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, People’s Republic of China Objective: To investigate whether there is a difference in balance function between older persons with and without diabetes mellitus (DM, and to identify whether mediating factors, such as diabetic complications, Instrumental Activities of Daily Living (IADL score, Mini-Mental State Examination (MMSE score, as well as hemoglobin A1c (HbA1c, fasting plasma glucose (FPG, serum total cholesterol (TC, triglycerides (TG, and low-density lipoprotein (LDL, are associated with balance function in older persons with DM.Methods: In this cross-sectional study, a total of 208 older persons were divided into a DM group (n=80 and a control group who did not have DM (n=128. Balance function was evaluated with the Tinetti performance-oriented mobility assessment (POMA, which includes balance and gait subscales. Activities of daily living (ADL, IADL, and the MMSE were also measured. Fall incidents in last 12 months, the use of walking aids, fear of falling, comorbidities, and polypharmacy were recorded. Diabetic complications were recorded, and HbA1c, FPG, TC, TG, and LDL were measured in the patients of the DM group.Results: Fall incidents in last 12 months were higher in the DM group than in the control group (P<0.01. POMA score as well as ADL and IADL scores were lower in the diabetic group than the control group (P<0.05. Within the diabetic group, the POMA score was positively related to the ADL score (odds ratio [OR], 11.7; 95% confidence interval [CI], 3.076–44.497; P<0.01, IADL score (OR, 16.286; 95% CI, 4.793–55.333; P<0.01, and MMSE score (OR, 10.524; 95% CI, 2.764–40.074; P<0.01, but was negatively related to age (OR, 7.707; 95% CI, 2.035–29.185; P<0.01 and diabetic complication (OR, 6.667; 95% CI, 2.279–19

  17. Inpatient Suicide in a Chinese Psychiatric Hospital

    Science.gov (United States)

    Li, Jie; Ran, Mao-Sheng; Hao, Yuantao; Zhao, Zhenhuan; Guo, Yangbo; Su, Jinghua; Lu, Huixian

    2008-01-01

    Little is known about the risk factors for suicide among psychiatric inpatients in China. In this study we identified the risk factors of suicide among psychiatric inpatients at Guangzhou Psychiatric Hospital. All psychiatric inpatients who died by suicide during the 1956-2005 period were included in this study. Using a case-control design, 64…

  18. Psychiatric aspects of induced abortion.

    Science.gov (United States)

    Stotland, Nada L

    2011-08-01

    Approximately one third of the women in the United States have an abortion during their lives. In the year 2008, 1.21 million abortions were performed in the United States (Jones and Koolstra, Perspect Sex Reprod Health 43:41-50, 2011). The psychiatric outcomes of abortion are scientifically well established (Adler et al., Science 248:41-43, 1990). Despite assertions to the contrary, there is no evidence that abortion causes psychiatric problems (Dagg, Am J Psychiatry 148:578-585, 1991). Those studies that report psychiatric sequelae suffer from severe methodological defects (Lagakos, N Engl J Med 354:1667-1669, 2006). Methodologically sound studies have demonstrated that there is a very low incidence of frank psychiatric illness after an abortion; women experience a wide variety of feelings over time, including, for some, transient sadness and grieving. However, the circumstances that lead a woman to terminate a pregnancy, including previous and/or ongoing psychiatric illness, are independently stressful and increase the likelihood of psychiatric illness over the already high baseline incidence and prevalence of mood and anxiety disorders among women of childbearing age. For optimal psychological outcomes, women, including adolescents, need to make autonomous and supported decisions about problem pregnancies. Clinicians can help patients facing these decisions and those who are working through feelings about having had abortions in the past.

  19. [Interest of psychiatric guidelines in managing agitation in intensive care].

    Science.gov (United States)

    Lazignac, Coralie; Ricou, Bara; Dan, Liviu; Virgillito, Salvatore; Adam, Eric; Seyedi, Majid; Cicotti, Andrei; Azi, Amine; Damsa, Cristian

    2007-02-14

    This paper discusses the importance of psychiatric guidelines and the position of the psychiatrist in the management of agitation in the intensive care unit. The use of psychiatric validated scales to assess agitation seems to ameliorate the quality of care in psychiatry, but also in intensive care. Psychiatric experts' recommendations for managing agitation are given, which is useful to create an open discussion with the intensivists. The use of sedative medication to protect the patient, staff and to prevent an escalation of violence remains a personal choice for each practitioner, depending on individual patient needs and context. In the treatment of agitated patients, an equilibrium needs to be found between the subjective dimension and the available data from evidence based medicine.

  20. Trauma-Related Dissociation Is Linked With Maladaptive Personality Functioning

    Directory of Open Access Journals (Sweden)

    Antonella Granieri

    2018-05-01

    Full Text Available Background: Extensive research has demonstrated the positive associations among the exposure to traumatic experiences, the levels of dissociation, and the severity of psychiatric symptoms in adults. However, it has been hypothesized in clinical literature that an excessive activation of the dissociative processes following multiple traumatic experiences may jeopardize the psychological and behavioral functioning of the individuals, fostering higher levels of maladaptive personality functioning.Methods: The study involved 322 adult volunteers from Italy. Participants completed measures on traumatic experiences, dissociation, and maladaptive personality traits.Results: The number of traumatic experiences reported by participants were positively associated with dissociation scores and maladaptive personality scores. Mediation analyses showed that dissociation acted as a partial mediator in the relationship between traumatic experiences and overall maladaptive personality functioning. Regression curve analyses showed that the positive association between maladaptive personality functioning and dissociation was stronger among participants with higher exposure to traumatic experiences.Conclusion: Exposure to multiple traumatic experiences may increase the risk for an excessive activation of the dissociative processes, which in turn may generate severe impairments in multiple domains of personality functioning.

  1. Comorbid Visual and Psychiatric Disabilities Among the Chinese Elderly: A National Population-Based Survey.

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    Guo, Chao; Wang, Zhenjie; Li, Ning; Chen, Gong; Zheng, Xiaoying

    2017-12-01

    To estimate the prevalence of, and association between, co-morbid visual and psychiatric disabilities among elderly (>65 years-of-age) persons in China. Random representative samples were obtained using multistage, stratified, cluster sampling, with probabilities proportional to size. Standard weighting procedures were used to construct sample weights that reflected this multistage, stratified cluster sampling survey scheme. Logistic regression models were used to elucidate associations between visual and psychiatric disabilities. Among the Chinese elderly, >160,000 persons have co-morbid visual and psychiatric disabilities. The weighted prevalence among this cohort is 123.7 per 100,000 persons. A higher prevalence of co-morbid visual and psychiatric disabilities was found in the oldest-old (pvisual disability was significantly associated with a higher risk of having a psychiatric disability among persons aged ≥80 years-of-age [adjusted odds ratio, 1.24; 95% confidence interval (CI), 1.03-1.54]. A significant number of Chinese elderly persons were living with co-morbid visual and psychiatric disabilities. To address the challenge of these co-morbid disorders among Chinese elders, it is incumbent upon the government to implement additional and more comprehensive prevention and rehabilitation strategies for health-care systems, reinforce health promotion among the elderly, and improve accessibility to health-care services.

  2. Are there more personality disorders in treatment-seeking patients with eating disorders than in other kind of psychiatric patients? A two control groups comparative study using the IPDE

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    Izaskun Marañón

    2007-01-01

    Full Text Available The aims of this ex post facto study were to determine the comorbidity of personality disorders (PD with eating disorders (ED, to establish the prominent characteristics of eating disorders subtypes and to compare PDs appeared in patients with EDs with those in other clinical and normal samples. Using the International Personality Disorders Examination (IPDE, 84 outpatients with EDs were compared with 23 mentally disordered women and with 23 normative women. All the statistical analyses have been carried out using non-parametric analyses. 54.8% of ED sample met criteria for at least one PD compared to 21.7% of non-ED patients and to 8.7% of normative control group. The most common PDs in the ED group were the obsessivecompulsive, borderline and avoidant, without any differences among the EDs groups. More than a half of the subjects with anorexia nervosa and bulimia nervosa met the criteria for at least one PD and this was a specific characteristic of patients with an ED.

  3. The revolution in psychiatric diagnosis: problems at the foundations.

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    Galatzer-Levy, Isaac R; Galatzer-Levy, Robert M

    2007-01-01

    The third edition of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-III; 1974) not only revolutionized psychiatric diagnosis, it transformed and dominated American psychiatry. The nosology of psychiatry had been conceptually confusing, difficult to apply, and bound to widely questioned theories. Psychiatry and clinical psychology had been struggling with their scientific status. DSM attempted to solve psychiatry's problems by making psychiatry more like its authors' perception of general medicine. It tried to avoid theory, especially psychoanalytic theories, by discussing only observable manifestations of disorders. But DSM is actually highly theory-bound. It implicitly and powerfully includes an exclusively "medical" model of psychological disturbance, while excluding other psychiatric ideas. Its authors tried to meet what they saw as "scientific standards." To a surprising extent, DSM reflects its creators' personal distaste for psychoanalysis. The result is that DSM rests on a narrow philosophical perspective. The consequences of its adoption are widespread: it has profoundly affected drug development and other therapeutic studies, psychiatric education, attitudes toward patients, the public perception of psychiatry, and administrative and legal decisions. This article explores how DSM's most problematic features arise from its history in psychiatric controversies of the 1960s and its underlying positivistic philosophy.

  4. Who’s Boarding in the Psychiatric Emergency Service?

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    Simpson, Scott A.; Joesch, Jutta M.; West, Imara I.; Pasic, Jagoda

    2014-01-01

    Introduction When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES) has been sugg