Prevalence Of Personality Disorders Research Articles

Psychological predictors of negative treatment outcome with Erenumab in chronic migraine: data from an open label long-term prospective study

BackgroundMonoclonal antibodies (mABs) targeting the calcitonin gene-related peptide (CGRP) pathway represent the first disease-specific preventive migraine therapy. Growing evidence suggests that they are effective in the preventive treatment of difficult-to-treat patients. In this study, we evaluated the psychological predictors of the outcome of treatment with the anti-CGRP monoclonal antibody erenumab in patients with chronic migraine (CM).MethodsSeventy-five patients with CM who had already failed at least 3 preventive therapies received erenumab every 28 days for a period of 12 months. Before the first administration, patients received a full psychological evaluation using The Structured Clinical Interview for DSM-5 Clinician Version (SCID-5-CV) to assess personality disturbances (primary outcome), mood and anxiety disorders, and as well specific questionnaires to evaluate alexithymia traits, childhood traumas, and current stressors (secondary outcomes).ResultsAfter 12 months of treatment, 53 patients reported a reduction of at least 50% in headache days/per month (Responders), whereas 22 did not (Non Responders). When compared to Responders, Non Responders were characterized by a higher prevalence of personality disorders belonging to Cluster C (avoidant, dependent, and obsessive-compulsive) (77% vs 37%, p = .001). Non Responders were also characterized by a higher prevalence of anxiety disorders (90% vs 60%, p = 0.007), showed more alexithymic traits (51.7 ± 13.7 vs 42.9 ± 14.3, p = 0.017), and reported a higher number of 'at least serious' current stressors (3.2 ± 4.0 vs 0.8 ± 1.4, p < .0001) than Responders. At the multivariate analysis, higher prevalence of Cluster C personality disorders (OR 3.697; p = 0.05) and higher number of ‘at least serious’ life events (OR 1.382; p = 0.017) arose as prognostic factors of erenumab failure.ConclusionsErenumab confirmed its effectiveness in a population of difficult-to-treat migraine. The presence of “anxious-fearful” personality together with current stressors and anxiety represent negative predictors of treatment outcome.Trial registrationThe study protocol was registered at clinicaltrials.gov (NCT04361721).

Prevalence, Factor Structure, and Heritability of Avoidant Personality Disorder.

To review the community prevalence, factor structure, and heritability of avoidant personality disorder (AVPD), we reviewed the literature of empirical studies reported between years 1980 and 2020. Community point prevalence rates ranged from 0.8% to 5%, with one study of women older than 25 years finding a lifetime rate of 9.3%. A weighted point prevalence for studies involving both men and women was 3.3%. All factor analytic studies indicated a one factor solution. The themes were social inadequacy, feeling inferior, and fears of social rejection. Family studies of heritability for AVPD ranged from 0.18 to 0.56. Twin studies ranged from 0.28 to 0.71. The weighted average for heritability was 0.55. AVPD is an important clinical issue because it is prevalent in the community and has high morbidity and high heritability. Its single factor seems to suggest evaluation and treatment should be straightforward, but despite this, it tends to be underdiagnosed and undertreated.

High Prevalence of Borderline Personality Disorder Among Psychiatric Inpatients Admitted for Suicidality

Borderline personality disorder (BPD) is associated with high risk of suicidality and high rates of health care utilization; however, the prevalence and characteristics of BPD among inpatients admitted for suicidality are unknown. In the present study of 72 adult psychiatric inpatients admitted for suicide risk, BPD was highly prevalent (n = 31; 43.1%), but 68% were misdiagnosed by admitting providers. Compared to patients without BPD, those with BPD were significantly younger, were prescribed more psychiatric medications, were more depressed, and had greater suicide ideation. Patients with BPD were also three times as likely to be readmitted to a psychiatric hospital at 30, 90, and 180 days postdischarge for an average of almost 9 days of inpatient care per patient for the first 180 days. In this sample, BPD was highly prevalent, underdiagnosed, and associated with frequent readmissions, findings that highlight the importance of improved recognition and access to specialized treatments.

Prevalence of Personality Disorders among Female Sentenced Prisoners in Erbil Adult Reformatory Prison

Background: Personality Disorder is “an enduring pattern of inner experiences and behavior that deviates markedly from the expectations of the individual‟s culture. Aim of the study: To determine the prevalence rate of personality disorders among female sentenced prisoners and its correlation between socio-demographic and crime characteristics with the types of personality disorders of the study population. Patients and Methods: Quantitative, descriptive study was conducted in Erbil Adult Reformatory Prison in Erbil City in Iraq, from October 2014 to August 2015. The study population included 26 adult females .The Questionnaire was consisting of three parts; the first part included sociodemographic characteristics of female sentenced prisoners, the second part contain the crime characteristics, and the third part was composed of a standardized questionnaire which is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, that consists of three clusters A, B, and C of personality disorders. Correlation coefficient r-test was calculated for obtaining the reliability of the questionnaire and the content validity was determined through 10 experts. Results: Showed that most of the study sample was in the age group between 18-27 years old. Majority of the samples were illiterate, married, house wife and from urban area. Theft was the most common crime. The highest prevalence of personality disorders was the schizoid personality disorder. Conclusions: All types of personality disorders have a non-significant relationship with the sociodemographic characteristics of age, education, marital status, and with crime characteristics of study sample.

Publications on personality disorders in Brazilian journals: a narrative review

Despite the prevalence of personality disorders (PD) and their association with several harmful health outcomes, previous reports found a low number of studies on PDs conducted in Brazil. We conducted a narrative review to investigate the current state of research in Brazil focusing on PDs. The search was performed in BVS-Psi, PePSIC, and Google Scholar databases. We focused on papers published in Brazilian journals as a criterion to select studies conducted in Brazil and/or coordinated by Brazilian researchers. A total of 177 papers were included. Approximately 60% of papers were empirical studies, although only 47.17% of them had clinical samples. Borderline and Antisocial were the most recurrently investigated PDs. Two scales were usually administered, IDCP and PID-5. SCID-II was administered in less than 5% of empirical studies. We proposed an agenda for research on PDs in Brazil, including guidelines and directions eminently urgent to the studies to be conducted in Brazil.

Personality Disorders, Risky Behaviors, and Adversity: The Moderating Role of Resilience.

Individuals with personality disorders (PDs) comprise 30% to 40% of individuals receiving mental health treatment. Treatment of PDs is exceedingly difficult; therefore, research has focused on PD etiology and preventative factors. One known influence on PD etiology is adverse childhood experiences (ACEs). ACEs are associated with increased prevalence of several health risk behaviors (HRBs), including engagement in substance use, criminal, and risky sexual behavior. One protective factor, childhood resiliency, predicts lower prevalence of PDs and engagement in HRBs. We hypothesized that increased prevalence of ACEs would predict higher levels of PD symptoms and HRBs engagement. Furthermore, we predicted that childhood resiliency would moderate the relation between ACEs, PD symptoms, and HRBs. In the present study, students (N = 531) completed the Adverse Childhood Experiences survey, the Self-Administered - Standardized Assessment of Personality Abbreviated Scale, and the Childhood Youth and Resiliency Measure-28. They also responded to questions about substance use, criminal, and sexual behavior which were used to define a latent HRB variable. Structural equation modeling was conducted to examine study hypotheses. As hypothesized, we found positive relations between ACEs, PD symptoms, and our HRB latent variable. Childhood resiliency moderated both ACE and PD symptom paths. At lower levels of reported ACEs, individuals high in childhood resiliency reported fewer PD symptoms and HRBs than individuals low in childhood resiliency. At high levels of ACEs, childhood resiliency did not serve as a protective factor. Additionally, study findings suggest that childhood resiliency factors are integral for protecting against the development of these disorders.

Prevalence of borderline personality disorder and its association with demographic factors among university students of Pakistan

Borderline Personality Disorder (BPD) is a psychological disorder, which could cause severe problems in self-functioning, emotion regulation, and interpersonal relationships. This study aimed to assess BPD among university students and evaluating the association of BPD with demographic factors among the students. Three private sector universities were selected from Lahore. A cross-sectional survey was conducted by using questionnaire composed of demographic factors (gender, age and university) and Borderline Personality Inventory (BPI- cut 20). An estimated data of 700 undergraduates was collected through stratified sampling technique. The collected data was analyzed through SPSS (Version 17). There were (46%) males and (54%) female participants, whose mean age was 21 ± 1.81 years, at the time of data collection. The findings indicated, BPD (≥10) in majority (62%) of the participants. BPD was more prevalent among the age group of 18-21 years. Application of the Chi-square test confirmed non-significant association (p < 0.05) between age, and gender, with BPD. The strength of the relationship was assessed through the odds ratio (OR). Association between gender and BPD (OR= 1.026, CI= 0.755-1.392) and age and BPD (OR= 0.880, CI= 0.637-1.216), university and BPD (OR= 0.531, CI=0.381-0.742) reported a statistically significant association with BPD (p<0.001). Further the Logistic regression affirmed, impact of rank, of the educational institution (university) had significant effect on prevalence of BPD. Therefore, it is concluded that students (young adults) are more at risk of being affected by BPD, who are studying in the universities with higher socio-economic status. So, it can be supposed that environment (rank, location and circumstances) of the university is one of the dominating factors playing a significant role in the prevalence of BPD among young adults.

Exploring the prevalence of personality disorder and the feasibility of using the SAPAS as a screening tool for personality disorder in an emergency department in India.

Personality disorders (PD) lead to frequent emergency department (ED) visits. Existing studies have evaluated high-risk ED populations in Western settings. PD screening tools, such as the Standardized Assessment of Personality - Abbreviated Scale (SAPAS), have thus far only been validated in Western populations. This study aimed to establish the screened prevalence of PD, and to evaluate the performance of the SAPAS as a screening tool within an ED setting in India. The study took place in the ED of a private multi-speciality hospital in Kolkata, India. All attendees were approached during two days per week over three months, except those who were medically unfit to participate. The SAPAS and the International Personality Disorder Examination (IPDE) were translated into Bengali and then used as screening tools for PD and as the reference standard for PD diagnosis. Out of 120 ED attendees approached, 97 participated (48 men and 49 women), of whom 24% met the criteria for a diagnosis of PD. A cut-off score of 4 on the SAPAS provided the best trade-off between sensitivity and specificity for detecting PD. The prevalence of PD was similar to Western samples, and the SAPAS showed promise for use in a non-Western setting.

Prevalence of borderline personality disorder and its association with demographic factors among university students of Pakistan

Borderline Personality Disorder (BPD) is a psychological disorder, which could cause severe problems in self-functioning, emotion regulation, and interpersonal relationships. This study aimed to assess BPD among university students and evaluating the association of BPD with demographic factors among the students. Three private sector universities were selected from Lahore. A cross-sectional survey was conducted by using questionnaire composed of demographic factors (gender, age and university) and Borderline Personality Inventory (BPI- cut 20). An estimated data of 700 undergraduates was collected through stratified sampling technique. The collected data was analyzed through SPSS (Version 17). There were (46%) males and (54%) female participants, whose mean age was 21 ± 1.81 years, at the time of data collection. The findings indicated, BPD (≥10) in majority (62%) of the participants. BPD was more prevalent among the age group of 18-21 years. Application of the Chi-square test confirmed non-significant association (p 0.05) between age, and gender, with BPD. The strength of the relationship was assessed through the odds ratio (OR). Association between gender and BPD (OR= 1.026, CI= 0.755-1.392) and age and BPD (OR= 0.880, CI= 0.637-1.216), university and BPD (OR= 0.531, CI=0.381-0.742) reported a statistically significant association with BPD (p0.001). Further the Logistic regression affirmed, impact of rank, of the educational institution (university) had significant effect on prevalence of BPD. Therefore, it is concluded that students (young adults) are more at risk of being affected by BPD, who are studying in the universities with higher socio-economic status. So, it can be supposed that environment (rank, location and circumstances) of the university is one of the dominating factors playing a significant role in the prevalence of BPD among young adults.

Factors for suicide attempt recurrence among patients with borderline personality disorder

IntroductionThe prevalence of borderline personality disorder (BPD) is significant, ranging from 0.5% to 5.9% in the general population. This personality disorder is associated with high rates of suicide attempt and for suicide attempt recurrence.ObjectivesReview recent studies of predictors of suicide attempt and for suicide attempt recurrence in patients with borderline personality disorder.MethodsThis is a literature review via Medline and Sciences Direct. The database was searched using the combination of the keywords “borderline” with “suicide”, “borderline personality disorder” with “suicide”, “borderline personality disorder” with “suicide attempts” “borderline personality disorder” with “suicide recurrence”.ResultsRecently it has been shown that BPD has a greater correlation with suicidal behavior than that of characterized depressive disorders. Several studies have shown that suicidal behavior in patients with BPD was associated with the coexistence of antisocial personality disorder, depression, hostility, impulsivity, a high number of suicide attempts and a first suicide attempt at a young age. Recently it has been established that the predictors of suicidal recidivism are the high number of suicide attempts, the female sex and single life status.ConclusionsSpecial attention should be paid to predictive factors for suicide attempt and for suicide attempt recurrence in the clinical evaluation of patients with borderline personality disorder, especially in suicidal crisis.

Culture and personality disorders-a case series

IntroductionPersonality disorders comprise a set of diagnosis characterized by inflexible, pervasive and enduring patterns of cognition, affect, behavioural and social interaction. The status of research on the personality among different cultures implies the universality of traits and disorders, as well as, their measuresacross cultures.ObjectivesTo study the prevalence of personality disorders in foreigner patients.MethodsIn this retrospective case series, clinicaldata was collected from 40 patients who were hospitalized at the short-stay inpatient psychiatric service of the Príncipe de Asturias University Hospital during 2018.ResultsNineteen (47.5%) patients were European, ten (25%) were from South America, nine (22.5%) were Africanand two (5%) were Asian. Eight patients were diagnosed of diverse personality disorders. Seven (87.5%) of them were European, and only one (12.5%) was from South America.ConclusionsThis case series suggests various directions for future research. The fact that patients diagnosed with personalitydisorders were mainly European could indicate diverse conclusions. It would question the universality of personality disorders out of a Euro-american frame of reference. It would also point out the difficulty of diagnosing personality disorders, taking into consideration language, awareness of cultural values,traditions, interactional patterns, and social norms. More studies of traits and personality are needed, taking into account the culture and the society in which patients have grown and in which they currently live.DisclosureNo significant relationships.

Profiles of women participating in an internet-based prenatal mental health platform (HOPE – Healthy Outcomes of Prenatal and Postnatal Experiences)

• Two of three women who registered to participate in this Internet-based prenatal mental health platform reported a history of depression or anxiety. • Rates of current probable depression and anxiety were roughly one in four participants. • The prevalence of borderline personality disorder (BPD) in this study was 12.5% which is notably higher than the reported value of 4.4% in the general population. • Concerning rates of abuse, 27.6% with a history of abuse and 23.4% with a history of emotional abuse. • Almost 40% of women reported dissatisfaction with the support the received from their mother in childhood. As mental healthcare expands to web-apps, smartphones, and other technologies, it is important to understand the psychological profiles of women who self-select to participate in perinatal mental health digital platform randomized control trials. There are concerns that those seeking internet-based mental health treatments may not be representative of the general perinatal populations seeking face-to-face treatments resulting in a lack of generalizability. The aim of this study is to describe the demographic and psychological profiles of prenatal women seeking treatment over the internet for mental health concerns as compared to the general perinatal population seeking mental health treatments. This was a descriptive study involving pregnant women across Alberta, Canada, aged 18–47 years old. Profiles were collected through self-report baseline demographics and mental health information using the Edinburgh Postnatal Depression Scale (EPDS), Antenatal Risk Questionnaire (ANRQ), Depression Anxiety Stress Scale (DASS-21)- Anxiety and Stress Subscales, and Maclean Screening Instrument for Borderline Personality Disorder (MSI-BPD). A total of 887 women completed self-reported baseline demographic data and 590 women completed baseline mental health data. Mean age of women was 31.3 years with a mean pregnancy gestational age of 15.3 weeks). A history of depression was reported by 36.3%, a history of anxiety was reported by 20.8% of women, and a history of abuse and emotional abuse was reported in 27.7% and 23.5% of women. At baseline, 57.6% of women had clinically significant mental health risk scores, 24.3% of women had probable minor depression, and mild to moderate levels of anxiety were reported in 23.2% of women. Borderline personality disorder was reported by 12.5% of women. Overall, this sample of pregnant women has prevalence rates of depression, anxiety, and stress that are comparable to those rates found in pregnant women in the general population. This suggests that there is broad utility for and consumer interest in internet-based mental health treatments.

Age bias in the criteria for antisocial personality disorder

The prevalence of antisocial personality disorder (ASPD) decreases with age. As such, research regarding ASPD typically focuses on children and younger adults. The apparent age-specific prevalence of ASPD may be due, in part, to diagnostic criteria informed by research excluding older adults. The present study sought to better understand the manifestation of ASPD in older adults and investigate potential age bias in the diagnostic criteria. Item response theory methods were used to the diagnostic criteria for ASPD with data from the National Epidemiologic Survey on Alcohol and Related Conditions Wave III. The measurement of three ASPD criteria showed uniform differential item functioning (DIF), suggesting that older adults were less likely to endorse the item than younger adults despite having the same level of underlying personality disorder. The items with DIF are related to the following criteria for ASPD: Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest (3 items with DIF); irritability and aggressiveness, as indicated by repeated physical fights or assaults (1 item with DIF); and consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations (1 item with DIF). Results of the present study can be used to inform the development of criteria that better capture the age-specific experience of this disorder. Improved criteria will result in increased diagnostic accuracy, systematic estimation of the prevalence, improved assessments, and more effective treatment options for this complex population.

Early life factors of schizotypal personality disorder in adolescents: A systematic review.

INTRODUCTION: Schizotypal personality disorder (SPD) affects 4% of the general population in the United States. The identification of early life factors (ELFs) that confer risk to SPD in adolescents (ages 10-24years old) has become a major focus of clinical research on schizophrenia-spectrum disorders. This systematic review aims to determine what ELFs contribute to the onset of SPD in the adolescent population. A systematic search of PubMed, PsycINFO, Psychiatry online, Scopus, Web of Science, EMBASE and CINAHL databases was conducted using relevant keywords. Data were extracted using a standardized form following PRISMA guidelines. Twenty-four studies met the criteria for inclusion. ELFs in the development of SPD were grouped into two important clusters: (a) prenatal and early postnatal factors; (b) childhood trauma and parental factors. Mental health nurses, especially nurses in primary care, should be aware of potentially modifiable ELF. Longitudinal research is needed to determine the causative roles of these ELF play in the occurrence of SPD by using rigorous measurements. These findings call for awareness of the modifiable ELF for SPD and also inform possible future interventions to reduce these risks, such as parent-training or environmental enrichment programmes.

Psychiatric comorbidities in patients with psychogenic nonepileptic seizures

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

Important Dependency-Associated Community Resources among Elderly Individuals with a Low Level of Social Support in China.

Background: The prevalence of dependency personality disorder is high among elderly individuals with a low level of social support. The objective of this study was to explore the dependency associated with important community resources among elderly individuals with a low level of social support from the perspective of resource demand. Methods: The population-based cross-sectional study was conducted in 22 locations in China. A total of 950 participants aged ≥60 years were selected using a complex multistage sampling design. All the data were collected using questionnaires via face-to-face interviews. The dependency was assessed using the standardized Chinese version of the Minnesota Multiphasic Personality Inventory-II. Community resources were assessed using 43 items. Logistic regression analysis was used to evaluate the association between dependency and important community resources. Results: Bivariate analysis showed that the level of social support was negatively associated with levels of income (p < 0.001) and education (p = 0.008) and was positively associated with social communication and interactions (p < 0.001). The logistic regression analysis showed that the emergency call or survival monitoring system (ECSMS) was the most important community resource that was significantly associated with the levels of dependency; the odds ratio was 2.64 (95% CI, 1.07–3.91; p = 0.031) among elderly individuals with a low level of social support. Conclusions: The levels of dependency were most significantly associated with the ECSMS among elderly individuals with a low level of social support. Our results suggest that improving the ECSMS can be the main problem in the development of community resources.

High Prevalence of Borderline Personality Disorder Among Psychiatric Inpatients Admitted for Suicidality.

Borderline personality disorder (BPD) is associated with high risk of suicidality and high rates of health care utilization; however, the prevalence and characteristics of BPD among inpatients admitted for suicidality are unknown. In the present study of 72 adult psychiatric inpatients admitted for suicide risk, BPD was highly prevalent (n = 31; 43.1%), but 68% were misdiagnosed by admitting providers. Compared to patients without BPD, those with BPD were significantly younger, were prescribed more psychiatric medications, were more depressed, and had greater suicide ideation. Patients with BPD were also three times as likely to be readmitted to a psychiatric hospital at 30, 90, and 180 days postdischarge for an average of almost 9 days of inpatient care per patient for the first 180 days. In this sample, BPD was highly prevalent, underdiagnosed, and associated with frequent readmissions, findings that highlight the importance of improved recognition and access to specialized treatments.

The prevalence of severe personality disorder in perpetrators of homicide.

Current UK evidence on the prevalence of personality disorder in homicide is lacking. The aims were to estimate the prevalence of personality disorder in homicide perpetrators from court reports and carry out a dimensional assessment in keeping with the new ICD-11 classification of the prevalence of severe personality disorder. Associations between severe personality disorder and sociodemographic, historical and offence-related characteristics were then explored. Six hundred court reports from a national case series of homicide perpetrators in England and Wales were analysed using a document-derived version of the Personality Assessment Schedule (PAS-DOC), providing categorical and dimensional personality assessments. The prevalence of personality disorder and severe personality disorder was estimated. Factors associated with the diagnosis of severe personality disorder were examined. The prevalence of personality disorder using the PAS-DOC was 56.3% (95% confidence interval 52.3%, 60.3%), compared with 16% as diagnosed in reports. Severe personality disorder was present in 62% (n=338) of all those with a personality disorder and was significantly associated with homicides of strangers and previous violence. Severe personality disorder is highly prevalent among perpetrators of homicide, and the finding that it is more prevalent when strangers are the victims stresses both the need for early identification of those at risk of developing severe personality disorder and the development of appropriate early preventive interventions. There is also a need for the development of effective treatment and interventions for those with established severe personality disorder and better identification of this level of disorder by psychiatrists. The forthcoming ICD-11 classification should help in this endeavour. © 2021 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

Personality Disorders among Patients with Mental and Behavioral Disorders due to Psychoactive Substance Use in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study

Introduction: Personality disorders is comprised of deeply ingrained and enduring behavioral patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations." Personality Disorders are frequently occurring among patients with substance use disorders. Co-occurrence of substance use disorders and personality disorder is associated with a greater functional impairment affecting treatment adherence. This study's objective was to find out the prevalence of personality disorders among substance use disorders from the Department of Psychiatry and Mental Health, of a tertiary care center of Nepal.&#x0D; Methods: A descriptive cross-sectional study was done at the Department of Psychiatry and Mental Health of Shree Birendra Hospital, Chhauni, Kathmandu, Nepal. The ethical approval was approved by the Institutional Review Committee prior to the study. The International Personality Disorder Examination ICD-10 module interview schedule was used to determine personality disorders. There were 100 patients, 86 males and 14 females of age ranging between 18-59 years, from different education levels, socioeconomic statuses, and ethnicities.&#x0D; Results: Of the total 100 patients, 63% of the patients with substance use disorders were found to have either single 24 (24%) or multiple 39 (39%) personality disorders. The most frequently identified disorders were Emotionally Unstable Borderline Type 34 (34%), Anxious Personality Disorder 27 (27%), Emotionally Unstable Impulsive Type 27 (27%).&#x0D; Conclusions: Present study indicates that personality disorders were highly comorbid with patients of substance use disorders with either single or multiple personality disorders. Personality disorders mostly found in substance use disorders are Emotional Unstable Borderline Type, Anxious Personality Disorder, and Emotional Unstable impulsive Type.

Referential Activity Differentially Mediates Expression of Positive and Negative Emotions in Borderline Personality Disorder.

Borderline Personality Disorder (BPD) is a high risk and prevalent personality disorder that is associated with increased negative emotions, decreased positive emotions, and impairments in symbolization and impaired reflective functioning. These dimensions, while they may impact one another, have not been investigated concurrently from qualitative, linguistic narratives. We hypothesized a BPD group would have lower expression of positive emotions and greater expression of negative emotions and less reflective function than healthy controls. Additionally, we explored the role of referential activity (an index of symbolic capacity) between BPD and healthy controls in the context of valenced emotional expression. An adult, female BPD group (n = 13) and a demographically matched healthy control group (n = 14) were recruited and administered the Adult Attachment Interview and/or the Object Relations Inventory. Computerized text analyses were used to assess positive emotion and negative emotion, the Weighted Referential Activity Dictionaries to assess referential activity, and the Computerized Reflective Function dictionary. On the Object Relations Inventory, the BPD group expressed more frequent negative emotions and less frequent positive emotions; on the Adult Attachment Interview, the BPD group exhibited less expression of positive emotions. There were no differences between BPD and controls on referential activity or reflective functioning on either interview. However, BPD status fully mediated the significant relationship between referential activity and negative emotion expression. The BPD group utilized more referential activity when expressing negative emotions than controls. Conversely, the control group utilized more referential activity when expressing positive emotions than controls. Referential activity seems to play an important role in explaining the BPD versus control difference in valenced linguistic emotional expression. Furthermore, these results suggest the object relations inventory elicits more robust linguistic features relevant to BPD.