Prevalence Of Personality Disorders Research Articles

Comorbidity, Treatment, and Service Utilization Patterns in Difficult-to-Treat Depression Patients: A Retrospective Study in a Portuguese Community Mental Health Team

Background and Objectives: Observational studies with data from real-world clinical practice with patients with difficult-to-treat depression (DTD) are rare. This study aims to collect observational data from the real-world clinical practice of a Portuguese community mental health team (CMHT) on the prevalence of DTD and to explore differences between DTD and non-DTD groups. Materials and Methods: We conducted a retrospective chart review study using data from Electronic Health Records (EHRs) of adult patients with psychiatric disorders followed by a CMHT from the Department of Psychiatry of the Coimbra Local Health Unit (between 1 December 2020–31 December 2022). The Dutch Measure for quantification of Treatment Resistance in Depression (DM-TRD) was used to assess the degree of treatment resistance and the Charlson Comorbidity Index (CCI) to measure medical comorbidity. Results: A quantity of 473 patients were referred to Cantanhede CMHT for a first assessment. Of these, 219 patients met the criteria for a primary diagnosis of any depressive disorder. Assistant psychiatrists identified 57 patients with DTD during follow-up (approximately 26%). The DTD group had higher rates of depressive episodes, greater depression severity, increased service use, higher DM-TRD scores, and a higher prevalence of comorbid anxiety symptoms, personality disorders, and severe medical comorbidities. The DTD group also had a higher prescription rate of antidepressants. Differences were observed in the use of antidepressant augmentation strategies and in the prescription of anticoagulant/antiplatelet drugs and analgesics, with higher prescription rates in the DTD group. We found correlations between DM-TRD and CCI scores, and between DM-TRD scores and all service use variables. Conclusions: Our results are consistent with a similar study in the United Kingdom, highlighting the need for a different approach to the management of DTD patients, who continue to live with a significant burden despite usual pharmacological and non-pharmacological treatments.

Associations between neurolinguistic deficits and personality traits in people with epilepsy.

People with epilepsy (PWE) have been hypothesized to have higher prevalence of personality disorders and cognitive disorders. The objective of this study was to investigate the controversial notion of "epileptic personality," a series of supposedly specific personality traits of people with epilepsy (PWE). For this purpose, 29 individuals with Mesial Temporal lobe Epilepsy (MTLE) and 23 with Juvenile myoclonic epilepsy (JME) as confirmed by electroencephalography (EEG), MRI scans and clinical examination, underwent a thorough neuropsychological and personality assessment. The resulting neuropsychological profiles were statistically analyzed considering possible personality disorders, character traits, cognitive and linguistic deviations from 20 healthy controls (HC). Our findings suggest accumulative cognitive and linguistic deficits in individuals with epilepsy compared to controls. It is possible that these might be misinterpreted as personality disorders. Specifically, personality traits (p = 0.049) and verbal fluency (p = 0.013), were significantly different between PWEs and controls. Also, the type of epilepsy and lateralization seem to affect executive function (p = 0.049) and pragmatology scores (p < 0.001), exhibiting differences in subgroup analysis. Different theories are considered as plausible pathophysiological explanations for the aforementioned differences. This research might serve as a basis to further investigate the cognitive aspects of epilepsy and possible pharmacological interventions, which are currently lacking.

The Mental Suffering of Cocaine-Addicted Patients: A Retrospective Analysis of Personality Disorders' Prevalence and Their Association with Psychopathological Symptoms.

(1) Background: The observational retrospective study aimed to investigate the prevalence of personality disorders (PDs) and their association with psychopathological symptoms in a group of patients with cocaine addiction. (2) Methods: Ninety-five medical records of the Pathological Addictions Service of the National Health Service of Lecce (Italy) were analyzed. PDs were diagnosed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and psychopathological symptoms were investigated through the Symptom Checklist 90-Revised (SCL-90-R). (3) Results: Ninety-two out of ninety-five patients met the criteria for at least one PD (96.8%), almost 35% had two Cluster B PDs, and over 25% had three Cluster B PDs. Nine out of ninety-five people met the criteria for all Cluster B PDs. Among the Cluster B PDs, it emerged that the most frequent diagnosis was that of narcissistic-borderline-antisocial (over 20% of the total sample). The analysis highlighted that mental suffering is prevalent in those with multiple comorbid Cluster B PDs. Specifically, depression and psychoticism exceed the clinical cut-off (T score > 63) in all patient groups. At the same time, anxiety and obsessions-compulsions are complained of only by those with more than two PDs as well as the level of general distress. Furthermore, anxiety, hostility, and paranoid ideation are significantly higher in the group of patients with more than three PDs. (4) Conclusions: Further studies should better investigate the relationship between the two aspects and describe the causal effects of PDs on psychopathological symptoms or, on the contrary, the effects of the substance on mental health and the worsening of personality alterations.

Association patterns of antisocial personality disorder across substance use disorders

There is a high prevalence of antisocial personality disorder (ASPD) in individuals affected by substance use disorders (SUD). However, there is limited information on the specific patterns of association of ASPD with SUD severity and specific SUD diagnostic criteria. We investigated the association of alcohol, cannabis, cocaine, opioid, and tobacco use disorders (AUD, CanUD, CocUD, OUD, and TUD, respectively) in 1660 individuals with ASPD and 6640 controls matched by sex (24% female), age, and racial/ethnic background in a sample ascertained for addiction-related traits. Generalized linear regressions were used to test ASPD with respect to the five DSM-5 SUD diagnoses, their severity (i.e., mild, moderate, severe), and their diagnostic criteria. We found that ASPD is associated with the diagnosis and severity of AUD (Odds Ratio, ORs = 1.89 and 1.25), CanUD (ORs = 2.13 and 1.32), and TUD (ORs = 1.50 and 1.21) (ps < 0.003). Of the specific diagnostic criteria, the “hazardous use” criterion showed the strongest association with ASPD across the five SUDs investigated (from ORTUD = 1.88 to ORCanUD = 1.37). However, when criteria of different SUDs were included in the same model, ASPD was independently associated only with TUD “hazardous use” and CocUD “attempts to quit”. Attempting to quit cocaine was inversely related to the presence of ASPD and remained significant (OR = 0.57, 95% confidence interval = 0.36–0.89) after controlling for interactive effects with sex. The current work provides novel insights into ASPD-SUD comorbidity, supporting the existence of different SUD patterns among individuals affected by ASPD.

Sex and gender differences in the Italian forensic psychiatric population: a residences for the execution of security measures study

Although sex and gender differences are well-known in psychiatry, their research in the forensic psychiatric population is still limited. This study is aimed at bridging this gap by examining gender-specific factors and treatment needs among forensic psychiatric patients who are highly dangerous. By retrospectively analyzing data from a 1-year observational study on the Italian Residences for the Execution of Security Measures (REMS) patients (n = 730), we compared the main sociodemographic, clinical, and criminological variables between n = 80 female and n = 650 male patients. Female offenders exhibited a higher prevalence of personality (p < 0.001) and depressive disorders (p < 0.001), as well as more severe crimes leading to REMS admission, notably homicide or attempted homicide (p < 0.05). Furthermore, female offenders had a less frequent history of substance abuse (p < 0.001) than male offenders. Despite these differences, there was no evidence of gender-based differences in different sociodemographic and clinical parameters. This study highlights gender differences in forensic psychiatric patients and underscores the importance of nuanced assessment for implementing tailored interventions in forensic psychiatric care.

Homeless people: a review of personality disorders.

Personality disorders in homeless people pose a challenge to the medical community and society, requiring specialized approaches for these super-difficult patients. The prevalence of personality disorders is higher in homeless populations than in the general population. However, there is a knowledge gap regarding personality disorders among people experiencing homelessness, and the implications of this lack of recognition are substantial. This paper provides a brief narrative review of personality disorders among homeless individuals. The primary importance and specificity of these disorders in this population remain unexplored. We searched PubMed and Web of Science databases in February and November 2023 using the keywords 'homeless' and 'personality disorder', and selected fifty-eight studies to be included in this literature review. The main themes of the results were personality disorders in homeless individuals and comorbid psychiatric disorders; risk factors and other psychological and behavioral data; clinical and intervention outcomes; and challenges linked to assessment, treatment, and intervention. The homeless population experiences significant diagnostic variability and the diagnosis of personality disorders is still evolving, contributing to difficulties in diagnosis, assessment, and treatment. A future challenge is to raise clinical awareness and optimize research knowledge, assessment, and intervention in personality disorders among homeless individuals with comorbid psychiatric disorders.

Personality disorders and addiction A study of 54 patients

IntroductionPersonality disorders are very often comorbid with addictions and are known to have a negative impact on the development of substance use disorder.ObjectivesEvaluate the prevalence of personality disorder in patients with problematic use of psychoactive substances followed at Ar Razi hospital Determine the relationship between different personality disorders and the clinical aspects of psychoactive substance useMethodsThis is a descriptive and analytical cross-sectional study carried out among 54 patients followed at Ar-Razi hospital Salé in Morocco for problematic use of psychoactive substances from June 1 to September 15, 2023 (Diagnosis assessed by DSM 5) Data collection was done using a questionnaire including clinical and socio-demographic characteristics and data on addiction to psychoactive and behavioral substances. The psychometric scale used to assess personality disorder: Personality Disorder Questionnaire (PDQ-4+)ResultsWe recruited 54 patients with age ranges from 18 to 45 years, with a male predominance. The average age at the start of psychoactive substance use was 15 years. Tobacco is the most used substance followed by cannabis Antisocial, histrionic and borderline personality disorders were the most common in our population. There was a statistically significant difference between specific personality disorder and the presence of severe psychoactive substance use disorderConclusionsThe frequency of personality disorders is high among subjects with problematic use of psychoactive substances. It is necessary to take care of them simultaneously (integrated care) in order to improve the prognosisDisclosure of InterestNone Declared

Level of personality functioning among outpatients with predominant anxiety symptoms

IntroductionDimensional diagnosis of personality disorders has as its main criterion the assessment of the level of functionality. And in patients with other diagnostic categories, there is a difference in the degree of functioning, as well as a difference in the course and prognosis of the disorder. The reason for such a different course may be the existence of a certain degree of personality dysfunctionality.ObjectivesThe aim of the study is to determine the prevalence of personality disorder in patients with neurotic disorder and predominantly anxiety symptomatology.MethodsA descriptive cross-sectional study was made to determine personality disorder in patients with neurotic disorder (F40-F48, excluding those where the disorder is related to stress F43) and predominantly anxiety symptomatology. The HAM-A scale was used to assess anxiety, and the LPFS-BF-2.0 was used to assess the level of personality functioning. The results were processed by descriptive statistical analysis.ResultsThe study included 25 individuals (N 25, 64% women), aged between 18 and 65 years (mean age 44.16, SD 13.20) with a diagnosed neurotic disorder. All subjects had elevated anxiety symptomatology, mean HAM-A score was 35.36 (SD 7.76). The assessment of the level of personality functioning with the LPFS-BF-2.0 gave the following results: 20% of people have a personality difficulty, 12% have a mild personality disorder, 32% have a moderate and 4% have a severe personality disorder.Conclusions According to the obtained results, 68% of people with a neurotic disorder and a high degree of anxiety have a certain degree of personality dysfunction. The prevalence of personality disorder in individuals with neurotic disorder is high (48%). These results lead to the conclusion that people with pronounced anxiety often have a disruption in personality. In people with a high level of anxiety, an assessment should be made for the level of functioning of the person, as well as for the existence of a personality disorder, and the treatment should be adjusted according to the results obtained. In addition to the treatment of the emerging symptoms, the personality dysfunctions should also be treated.Disclosure of InterestNone Declared

Systematically Informed Literature Review: What is the Prevalence of Borderline Personality Disorder (BPD) in Adolescents, 13-17, using DSM-5 Criteria?

IntroductionIn child &amp; adolescent mental health settings, borderline personality disorder (BPD) is a dominant and substantial condition with high occurrence rates seen in community, crisis, and in-patient settings. Previously because of multiple concerns, BPD diagnosis in adolescents was considered questionable and was perceived to be invalid. However, in light of the evidence, recent guidelines and diagnostic manuals affirm the diagnosis in the under-18 population.ObjectivesGiven its existence in adolescents and that DSM-5 (from 2013) allows diagnosing BPD in adolescents, a study was conducted in 2019 to explore what current literature had to say about its prevalence.MethodsTo answer this, a systematically informed literature review tried to look at the evidence. The hypothesis was that not many clinicians or researchers are aware of or using the opportunity to diagnose and thus manage BPD in adolescents, i.e., early in the course of this illness. Four databases were searched- PubMed, Embase, Medline, and Psycinfo- with the following inclusion &amp; exclusion criteria: 1.Age: Adolescents (13-17).2.BPD (disorder not traits or features).3.Language – English, not just the abstract in English.4.Time limit &amp; diagnostic criteria (2013 onwards, DSM-5).5.Full length articles not Abstracts alone.6.No geographical limit.7.Contacted academics personally for additional data.Following search terms were used: Borderline Personality Disorder, BPD, EUPD, Emotionally Unstable Personality disorder, DSM V, DSM 5, Diagnostic and Statistical Manual of Mental Disorders 5, DSM-5, Prevalence, Rate.ResultsAll searches yielded 525 results. Other sources didn’t identify any other records to be included. Out of these 525 results, 74 were duplicates. The inclusion and exclusion criteria were applied on the remaining resources. Of the remaining records, 133 were in language other than English, and thus, were excluded. Remaining 318 articles were assessed for eligibility. Of these, 196 had used diagnostic criteria or rating scales based on previous diagnostic criteria, and thus were excluded. Furthermore, 41 articles had focused on a totally other clinical question than ours. 79 articles had the wrong age range as per our diagnostic criteria. Thus, the total number of articles which met inclusion and exclusion criteria was 02. The results showed higher rates of BPD in adolescents, especially in those exposed to online sexual solicitation (OSS) (355 vs 13%) and in females (80% of cases).Image:Conclusions Despite the research and diagnostic allowance, there still seems to be reluctance among clinicians to diagnose BPD in adolescents. We advise consideration of BPD in adolescents if clinical picture indicates and application of the relevant criteria so patients can get appropriate treatment and support that they need.Disclosure of InterestNone Declared

Pharmacotherapy and psychotherapy interventions in patients with borderline personality disorder in outpatient clinical practice

IntroductionDespite the high prevalence of borderline personality disorder (BPD) in the population, the evidence regarding approaches to therapy for BPD is inconsistent. No psychopharmacological medications are approved for the treatment of BPD, yet most patients with BPD are treated with pharmacotherapy. Meanwhile, psychotherapy is the method of choice for the treatment of BPD. Little is known about the clinical practice of BPD treatment in Russia, since most studies have been conducted in Western countries.ObjectivesThe aim of the study: analysis of approaches to treatment of BPD in real outpatient clinical practice in Saint-Petersburg, Russia.MethodsFifty patients (72% female; n=36; mean age 22.4±4.3) who were treated in an outpatient community care were included in the study. Diagnosis was made according to the ICD-10 criteria (F60.31), as it does in clinical practice in Russia. Research methods included a clinical-catamnestic method.ResultsAll examined patients received pharmacotherapy. Twenty-four patients (48.0%) received monotherapy with a selective serotonin reuptake inhibitor antidepressant. The remaining patients (52.0%) received two or more psychotropic medications simultaneously. The most frequent combination of psychopharmacotherapeutic agents was a combination of an antidepressant and a mood stabilizer. Analysis of therapy revealed that antipsychotics (always of the second generation) as well as mood stabilizers were prescribed to target emotional instability and impulsivity as symptoms of BPD, as well as increased self-harming behavior in order to reduce impulsivity. Despite the assumption that the simultaneous prescription of several medications to patients with BPD was due to the presence of a comorbid psychiatric diagnosis, this was not confirmed (p&gt;0.05). Most of the patients (n=42; 84.0%) received individual and group psychotherapy (cognitive-behavioral with elements of dialectical-behavioral therapy). It was found that patients who received psychotherapy had a faster response to pharmacotherapy (p&lt;0.05).ConclusionsAn analysis of approaches to the treatment of BPD in outpatient clinical practice in Saint-Petersburg, Russia, showed a predominance of medication-assisted psychopharmacotherapy (selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers) over the frequency of prescription of psychotherapeutic care. In none of the cases was a first-line psychotherapy method (with proven efficacy for BPD) used. An assessment of the availability of psychotherapeutic care for patients with BPD is required. An earlier initiation of psychotherapeutic care after the BPD diagnosis is recommended, which may lead to an increase in the effectiveness of psychiatric care for patients with BPD in outpatient clinical practice.Disclosure of InterestNone Declared

PREVALENȚA ȘI TIPURILE DE TULBURĂRI DE PERSONALITATE LA FEMEILE PRIVATE DE LIBERTATE

This article presents the results of an empirical study aimed at establishing the prevalence and types of personality disorders encountered among women in custody in Romanian prisons. It is important to emphasize that incarcerated women in Romania represent a category of inmates that has been insufficiently investigated regarding personality disorders. To date, there are no specific studies conducted among this group of inmates in Romania on this topic. The research sample consisted of definitively sentenced incarcerated women (N=200 respondents) serving their sentences in the only prison in Romania that exclusively houses women, distributed across all detention regimes. The SCID-II Personality Questionnaire was used, designed to identify and evaluate personality disorders according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The percentage distribution shows that obsessive-compulsive (82%) and borderline (80%) personality disorders are among the most prevalent observed in incarcerated women included in this study. For other personality disorders, a prevalence ranging from 11,5% to 75% was observed. The result of this research have significant practical implications, providing a solid foundation for the development of specific intervention programs dedicated to this category. Thus, specialists in the penitentiary administration system can use this data to create programs based on a genuine understanding of these women`s profiles.

Childhood maltreatment and personality disorders in adolescents and adults with psychotic or non-psychotic disorders.

While the attention to personality disorders (PD) and childhood maltreatment (CM) has grown in recent years, there remains limited understanding of the prevalence and distinctions of PD and CM in clinical populations of Chinese adolescents in comparison to adults. A total of 1,417 participants were consecutively sampled from patients diagnosed with either psychotic or non-psychotic disorders in the psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. The participants were categorized into two groups based on their age: adolescents (aged 15-21 years) and adults (aged 22-35 years). PDs were evaluated using a self-reported personality diagnostic questionnaire and a structured clinical interview, while CMs were assessed using the Chinese version of the Child Trauma Questionnaire Short Form. When comparing self-reported PD traits and CM between adolescents and adults, differences emerge. Adolescents, particularly in the psychotic disorder group, exhibit more pronounced schizotypal PD traits (p=0.029), and this pattern extends to non-psychotic disorders (p<0.001). Adolescents in the non-psychotic disorder group also report higher levels of emotional abuse (p=0.014), with a notable trend in physical abuse experiences compared to adults (p=0.057). Furthermore, the most prevalent PDs in the clinical sample are avoidant, borderline, and obsessive-compulsive PDs. Among patients with psychotic disorders, adolescents exhibit higher rates of schizoid, schizotypal, and obsessive-compulsive PDs compared to adults. Logistic regression analyses highlight distinct predictors for psychotic and non-psychotic disorders in adolescents and adults. The findings emphasize distinct differences in PDs and CMs between adolescent and adult groups, shedding light on their potential roles in psychotic and non-psychotic disorders.

Personality disorder coverage, prevalence, and convergence: do the DSM-5's two models of personality disorder identify the same patients?

Research on the Alternative DSM-5 Model for Personality Disorders (AMPD) in DSM-5's Section-III has demonstrated acceptable interrater reliability, a largely consistent latent structure, substantial correlations with theoretically and clinically relevant measures, and evidence for incremental concurrent and predictive validity after controlling for DSM-5's Section II categorical personality disorders (PDs). However, the AMPD is not yet widely used clinically. One clinician concern may be caseness - that the new model will diagnose a different set of PD patients from that with which they are familiar. The primary aim of this study is to determine whether this concern is valid, by testing how well the two models converge in terms of prevalence and coverage. Participants were 305 psychiatric outpatients and 302 community residents not currently in mental-health treatment who scored above threshold on the Iowa Personality Disorder Screen (Langbehn et al., ). Participants were administered a semi-structured interview for DSM-5 PD, which was scored for both Section II and III PDs. Convergence across the two PD models was variable for specific PDs, Good when specific PDs were aggregated, and Very Good for 'any PD.' Results provide strong evidence that the AMPD yields the same overall prevalence of PD as the current model and, further, identifies largely the same overall population. It also addresses well-known problems of the current model, is more consistent with the ICD-11 PD model, and provides more complete, individualized characterizations of persons with PD, thereby offering multiple reasons for its implementation in clinical settings.

Characteristics for Low, High and Very High Emergency Department Use for Mental Health Diagnoses from Health Records and Structured Interviews.

Patients with mental health diagnoses (MHD) are among the most frequent emergency department (ED) users, suggesting the importance of identifying additional factors associated with their ED use frequency. In this study we assessed various patient sociodemographic and clinical characteristics, and service use associated with low ED users (1-3 visits/year), compared to high (4-7) and very high (8+) ED users with MHD. Our study was conducted in four large Quebec (Canada) ED networks. A total of 299 patients with MHD were randomly recruited from these ED in 2021-2022. Structured interviews complemented data from network health records, providing extensive data on participant profiles and their quality of care. We used multivariable multinomial logistic regression to compare low ED use to high and very high ED use. Over a 12-month period, 39% of patients were low ED users, 37% high, and 24% very high ED users. Compared with low ED users, those at greater probability for high or very high ED use exhibited more violent/disturbed behaviors or social problems, chronic physical illnesses, and barriers to unmet needs. Patients previously hospitalized 1-2 times had lower risk of high or very high ED use than those not previously hospitalized. Compared with low ED users, high and very high ED users showed higher prevalence of personality disorders and suicidal behaviors, respectively. Women had greater probability of high ED use than men. Patients living in rental housing had greater probability of being very high ED users than those living in private housing. Using at least 5+ primary care services and being recurrent ED users two years prior to the last year of ED use had increased probability of very high ED use. Frequency of ED use was associated with complex issues and higher perceived barriers to unmet needs among patients. Very high ED users had more severe recurrent conditions, such as isolation and suicidal behaviors, despite using more primary care services. Results suggested substantial reduction of barriers to care and improvement on both access and continuity of care for these vulnerable patients, integrating crisis resolution and supported housing services. Limited hospitalizations may sometimes be indicated, protecting against ED use.

Suicidal ideation among prisoners: analysis with a gender perspective in a five-year follow-up (2017-2022).

There is a high incidence of self-harming behavior in the prison setting, with a suicide rate that is higher than that of the general population. Previous studies describe the association of sociodemographic, clinical, and criminological factors with the risk of suicide in the male prison population, but there is little research that specifically analyses suicidal behavior among women. The objective of this study is to analyze the characteristics of inmates who are admitted to a psychiatric unit for suicidal thoughts or attempted suicide. Descriptive and comparative analysis of 97 inmates (68 men, 29 women) admitted to the Unidad de Hospitalización Psiquiátrica Penitenciaria de Cataluña (UHPP-C), for suicidal ideation, between January 1, 2017, and December 31, 2022. There are differences in terms of place of birth, with a more significant presence of African nationalities in non-national males, while foreign inmates tend to come from Latin American countries. Men have a lower mean age, longer admissions, and a higher readmission rate. They also suffer from more psychotic and addictive disorders. Women have a higher prevalence of personality disorders and affective symptoms. There are sociodemographic and clinical differences between male and female prison inmates who require admission for suicidal ideation. Including a gender perspective in studies on suicide risk in the prison population can provide a solid foundation for future studies, thus allowing a more complete understanding of suicidal ideation and intervention needs in the prison population.

Prevalence of Obsessive-Compulsive Personality Disorder in Medical Students

Objective: Obsessive-compulsive personality disorder (OCPD) is a cluster C personality disorder, and the most prevalent one. It is mainly characterized by perfectionism and can cause distress and functional impairment in the individual. This study aimed to determine the prevalence of OCPD in medical students, investigate the effect of this disorder on students’ academic performance, and discover any possible related factors.&#x0D; Methods: This cross-sectional observational study consisted of 508 medical students enrolled at the University of Jordan in 2021. It utilized a questionnaire that enquired about their sociodemographic information, academic information, and study habits. It also contained questions about the diagnostic criteria of OCPD from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and questions from the Personality Inventory for the DSM-5 (PID-5) to assess the presence of the rigid perfectionism personality trait.&#x0D; Results: Fifty-one percent of the studied sample either fulfilled the DSM-5 criteria or showed moderate or high expression of rigid perfectionism, according to the PID-5. More than two-thirds of the students able to be diagnosed with OCPD reported being overwhelmed with anxiety and stress at times of exams, and 41.5% stated that they skip sleep before exams even though they have finished studying.&#x0D; Conclusion: The reported prevalence of 51.18% in medical students is ten times the prevalence of OCPD in the general population. There was no association between OCPD and the students’ gender or academic performance. Students affected by OCPD seem to experience overwhelming amounts of stress and may need mental health support in the form of regular check-ups and counseling services.

Impact of congenital heart disease on personality disorders in adulthood.

Adults with congenital heart disease (ACHD) constitute an ever-growing patient population characterized by high risks for cardiovascular- and mental disorders. Personality disorders (PDs) are associated with adverse physical and mental health. Studies assessing PD prevalence in ACHD are lacking. Personality disorder point prevalence was assessed in 210 ACHD by Structured Clinical Interview for Axis-II Personality Disorders (SCID-II) and compared to meta-analytical data from the general population (GP). Depression and anxiety were measured by self-report (Hospital Anxiety and Depression Scale, HADS) and clinician rating (Montgomery-Åsberg depression rating scale, MADRS). Childhood maltreatment was assessed with the Childhood Trauma Questionnaire and quality-of-life (QOL) with the World Health Organization QOL Scale. PD prevalence was markedly higher in ACHD compared to GP (28.1 vs. 7.7%). Particularly borderline (4.8 vs. 0.9%) and cluster C (i.e. anxious or fearful; 17.1 vs. 3.0%) PDs were overrepresented. PD diagnosis was associated with a surgery age ≤12 years (χ²(1) = 7.861, ϕ = 0.195, P = 0.005) and higher childhood trauma levels (U = 2583.5, Z = -3.585, P < 0.001). ACHD with PD reported higher anxiety (HADS-A: U = 2116.0, Z = -5.723, P < 0.001) and depression (HADS-D: U = 2254.5, Z = -5.392, P < 0.001; MADRS: U = 2645.0, Z = -4.554, P < 0.001) levels and lower QOL (U = 2538.5, Z = -4.723, P < 0.001). Personality disorders, particularly borderline- and cluster C, are significantly more frequent in ACHD compared to GP and associated with depression, anxiety, and decreased QOL. Data from the GP suggest an association with adverse cardiometabolic and mental health. To ensure guideline-based treatment, clinicians should be aware of the increased PD risk in ACHD.

Differences in clinical presentation between newly diagnosed bipolar I and II disorders: A naturalistic study

AimThis naturalistic clinical study aims to investigate differences between newly diagnosed patients with bipolar type I (BDI) and bipolar type II (BDII) disorders in socio-demographic and clinical characteristics, affective symptoms, cognition, functioning and comorbidity with personality disorders. MethodsThe BD diagnosis and type were confirmed using the Schedules for Clinical Assessment in Neuropsychiatry. Affective symptoms were assessed with the Young Mania Rating Scale, the Hamilton Depression Rating Scale, the Major Depressive Index, and the Altman Self-Rating Mania Scale. Functional impairment was assessed with the Functional Assessment Short Test. Cognitive impairment was evaluated by the Screen for Cognitive Impairment in Psychiatry and the Cognitive Complaints in Bipolar Disorder Rating Assessment. Finally, comorbid personality disorders were assessed with the Standardized Assessment of Personality-Abbreviated Scale and structured interview Structured Clinical Interview for DSM-disorders. Results383 newly diagnosed patients were included (BDI: n = 125; BDII: n = 258). Against expectations, we found no more depressive symptoms in BDII compared with BDI nor any differences in cognitive, childhood trauma or overall functional impairment. The only difference was lower occupational impairment in the BDII group. LimitationsThe self-reported measures of cognitive difficulties and childhood trauma involved potential bias (recall or other). Despite BD being newly diagnosed a diagnostic delay was observed. ConclusionPatients newly diagnosed with BDII and BDI had similar burdens of depressive symptoms and cognitive and overall functional impairment, however patients with BDI had lower occupational functioning. No statistically significant difference was found in prevalence of comorbid personality disorders between patients with BDI and BDII.

Conséquences à l’adolescence des violences sexuelles dans l’enfance : penser le repérage au cours de l’hospitalisation pédopsychiatrique des adolescents

IntroductionFew studies have systematically searched for a history of sexual violence in adolescents with severe psychiatric disorders hospitalized in departments of child psychiatry. Here, we present the results of a retrospective study conducted on the records of all adolescents hospitalized in a child psychiatry department in the Seine Saint-Denis department between 2017 and 2021. Study objectivesThe aim of the study was to investigate the frequency of Antecedents of Sexual Aggression (AAS) in adolescents hospitalized in child psychiatry departments and to attempt to describe chronological and symptomatological links between these antecedents and hospitalization in child psychiatry, with the aim of proposing possible screening and management recommendations. Material and methodsWe conducted a retrospective study based on analysis of the medical records of 141 adolescents hospitalized in a child psychiatry department between 2017 and 2021. ResultsBy recalling the epidemiology of sexual aggression in childhood and adolescence (frequent, involving both boys and girls, in a third of cases intrafamilial, and in about half of the situations uncrushed and unaccompanied) our study underlines the importance of their detection by physicians and caregivers. The significantly higher prevalence of suicide attempts and self-harm should draw particular attention to the risk of a history of sexual assault, as these symptoms are strongly associated in our study. The significantly higher prevalence of depression and borderline personality disorder may provide a better understanding of the repercussions of sexual assault in adolescence. The short delay between the sexual assault and its disclosure in our observation, and the fact that most disclosures of intra-family sexual assaults were made during hospitalization, underline the value of systematic hospitalization of adolescents, particularly after a suicide attempt. The reassuring environment of hospitalization may encourage a more rapid disclosure of sexual assault, and thus lessen its devastating psychic effects during adolescence. A potential weakness of our study is that, even in a specialized service, such antecedents are probably still undervalued and insufficiently noted in medical records. More attention should certainly be paid during child psychiatric interviews to any history of sexual assault. Nevertheless, given the scarcity of systematic studies on the subject, this study paves the way for prospective studies. Recommendations can also be made for less serious situations, with no proven psychiatric disorders, but following a suicide attempt. In such cases, the patient could be hospitalized in a pediatric ward, with appropriate psychological support, rather than in a child psychiatry ward. Regardless of where adolescents who have attempted suicide are psychologically cared for, greater attention needs to be paid to any history of sexual aggression, so as to identify it as early as possible, provide secondary prevention and avoid the psychic deterioration of the adolescent process which would be weakened as a result.

Prevalence of Personality Disorders among Males and Females between the Ages of 15 and 65 in Yazd in 2017

Background: Personality disorder is a type of mental disorder in which a rigid and unhealthy pattern of thinking, functioning, and behaving may be seen. A person with a personality disorder has trouble perceiving and relating to situations and people. Limited research has been done on the prevalence of personality disorders in Iran. This study aims at investigating the prevalence of personality disorders among males and females between the ages 15 and 65 in Yazd, Iran.&#x0D; Methods: The dataset for this cross-sectional study was extracted from a dataset of a national survey conducted on personality disorders of Iranians. The contents relevant to Yazd City were included here with a sample of 1827 people. Among the participants, 852 males and 975 females answered the personality disorders questionnaire (MILON).&#x0D; Results: Findings indicated that except histrionic and narcissistic patterns, the high rate of the rest of patterns was greater among females, which indicated that in most cases females significantly suffered higher clinical-related personality disorders. Moreover, personality disorders were more prevalent among females (29.8) compared to males (24.3).&#x0D; Conclusion: This area requires extensive investigation. More evidence is needed regarding the differential impact of personality disorders regarding men and women in other areas of Iran.