Personality Disorder Research Articles

Meaning in Life as an Outcome of Inpatient or Day-Hospital Psychotherapy for Personality Disorder.

Psychotherapy may contribute to the experience of meaning in life. This study investigated meaning in life among patients with personality disorders during inpatient or day-hospital psychotherapy. Meaning in life was approached from two conceptual perspectives: personality functioning with an emphasis on self-direction and existential psychology. We investigated changes in the sense of meaning in life and accounted for changes in depressive symptoms and identity and interpersonal pathology. Using pre-post measures, Livesley's General Assessment of Personality Disorder, especially, the Lack-of-Meaning-Purpose-and-Direction subscale and Steger's Meaning-in-Life Presence subscale were administered to 75 patients with personality disorders during inpatient or day-hospital psychotherapy for 8-12 months. Regression models showed that levels of the lack and presence of meaning decreased and increased during treatment, respectively, controlled for changes in depressive symptoms. Decreased identity pathology was significantly associated with changes in the lack or presence of meaning. Meaning in life may act as an outcome variable in intensive psychotherapy for personality disorders. The development of identity and self-direction may restore or create the ability to give life meaning.

Early maladaptive schemas as mediators between childhood maltreatment and adult psychopathology in psychiatric inpatients.

Early maladaptive schemas are well-established mechanisms between childhood maltreatment (i.e., abuse and neglect) and psychopathology in adulthood. However, research has not yet examined the unique contribution of childhood maltreatment, while controlling for the family dysfunction-related experiences, in shaping specific EMS domains and their associations with distinct psychopathological outcomes. Our aim was to examine the unique role of childhood maltreatment, while controlling for the effects of family dysfunction on early maladaptive schemas and subsequently on personality disorders and psychological distress using structural equation modelling and network analysis. A total of 2,011 unique inpatients aged 18 to 80 years (M = 39.7, SD = 14.18; 53.4% women) admitted to the Alexianen Zorggroep Tienen Psychiatric Hospital between 2011 and 2021 were included in this study. Self-report questionnaires were completed as part of the hospital admission process. Data were analyzed using structural equation modeling and network analysis. The results showed positive associations between childhood maltreatment, family dysfunction, early maladaptive schema domains, symptoms of personality disorders, and psychological distress. Accounting for the effects of family dysfunction-related experiences, early maladaptive schema played a significant mediating role in the association between childhood maltreatment and psychopathological outcomes. The results highlighted the central role of the domains disconnection/rejection and impaired autonomy/performance for personality disorders and psychological distress. There were no significant gender-specific differences in the network of relationships between the variables. These results demonstrate the key role of EMS in the domains of disconnection/rejection and impaired autonomy/performance in the association between childhood maltreatment and personality pathology and psychological distress in psychiatric inpatients. Clinical implications, study limitations, and recommendations for future research are discussed.

Paraphilias, problematic sexual behaviours and personality disorder-To what extent are they linked?

Since DSM-III, mental disorders have been classified based on overt symptoms and behaviours rather than underlying psychological and personality processes. This study examines the occurrence of personality dysfunction in individuals with paraphilic disorders and problematic sexual behaviours. The Shedler-Westen Assessment Procedure (SWAP-200), a clinician-rated assessment measure of personality disorders, was administered in a sample of 303 patients referred to a specialist forensic psychotherapy clinic. Sixty-six percent (N =200) of the sample were diagnosable with traits of one or more DSM-5 personality disorders, and 35% (N =106) were diagnosable with categorical DSM-5 personality disorders. When an alternative set of empirically derived personality diagnoses was examined, 94% (N =285) had significant traits of the personality syndromes, and 62% (N =188) of the sample met criteria for categorical diagnoses. Paraphilic fantasies and behaviours may be linked to underlying personality pathology, suggesting implications for assessment and treatment.

The use of Experience Sampling Method in psychopharmacological studies: A systematic review.

The Experience Sampling Method (ESM) is increasingly used to validate and assess treatment effects. We conducted a systematic review to update, and extend, the previous review by Bos et al. (2015), by performing literature searches in PubMed, PsycInfo, and EMBASE. Search queries included every DSM-disorder, ATC-listed psychotropic medication, and multiple search-terms for ESM. Studies included medicated psychiatric patients who filled-out ambulatory prompts ≥2/day. Templates served to distil research themes. The majority of the 79 included studies involved substance use- (n = 47), mood- (n = 17), and psychotic disorders (n = 11). Less studied were anxiety disorders and PTSD (n = 3), and ADHD (n = 1). We identified six research themes:1)Effects of psychopharmacological treatment on symptoms and factors influencing outcome, 2)Fluctuations of psychiatric symptoms in medicated patients, 3)Prediction of relapse, exacerbation of symptoms or medication non-compliance, 4)Added value of ESM compared to care as usual, 5)Using ESM to establish treatment response-trajectories, 6)Acceptability and feasibility of newly-devised ESM-applications. This review reveals that ESM is predominantly used in psychopharmacological studies to monitor treatment effects and establish fluctuations of momentary psychiatric symptoms. Future research might facilitate personalising psychopharmacological prescribing decisions using ESM. Currently underrepresented patient groups include elderly patients, and personality disorders. Finally, to facilitate ESM-implementation multiple context-levels should be optimised.

Application of microarray patches for the transdermal administration of psychedelics drugs in micro-doses

Throughout history, psychedelic compounds have been used for religious, spiritual and recreational purposes. A plethora of studies have reported the use of psychedelic compounds in the treatment of various conditions, such as alcoholism, addictions, depressive state to borderline schizophrenia, personality disorder, among other mental disorders. Psychedelic microdosing, a common technique in recent years, involves the consumption of small doses of psychedelic drugs for therapeutic purposes. This study investigated the potential of hydrogel-forming microarray patches (HF-MAPs) to deliver N,N-dimethyltryptamine (DMT), 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT), and mescaline (MES) in small doses through the skin. To this purpose, HF-MAPs were prepared using poly(vinyl alcohol) (PVA) and poly(vinyl pyrrolidone) (PVP), using citric acid as the crosslinker. Two different reservoirs, containing PVP and PVA as the main components and poly(ethylene)glycol 400 (PEG400) and glycerol as plasticising agents, were used to deliver all the drugs from the HF-MAPs. Franz cells studies in excised neonatal porcine skin demonstrated that the permeation of DMT, 5-MeO-DMT and MES was better from the PEG400 reservoir, showing a permeation of 60.71 %, 59.61 % and 41.85 % respectively. Pharmacokinetic studies in rats showed that HF-MAP technology as a strategy for microdosing psychedelic compounds was also demonstrated with DMT. AUCt0-final for the HF-MAP cohort (7186 ± 1296 ng/mL*h) was significantly greater than the IM cohort (1803 ± 53.25 ng/mL*h) (p = 0.0020), with a relative bioavailability of ∼ 72 %. Considering their pharmacokinetic profile, the frequency of DMT dosing could be reduced with HF-MAP when compared to the IM route.

National Implementation of a Crisis Resolution Home Treatment (CRHT) Team in Malta: Insights From the First Two Years of Operation.

Crisis Resolution Home Treatment (CRHT) teams have become a widespread alternative to psychiatric hospitalisation. Despite their popularisation, Malta has only recently introduced a CRHT team. The aims of the current study were to investigate (i) patient characteristics, (ii) factors influencing patients' length of follow-up (LoFU) and (iii) predictors of clinical outcomes. Descriptive and quantitative non-identifiable data were collected and analysed for patients utilising the CRHT service within its first 2 years of operation (n = 643). One-way ANOVA tests investigated influencing factors for LoFU, whereas binary logistic regressions deduced predictive factors for clinical outcomes. Patients without acute psychiatric disorders had the shortest LoFU, indicating that the team received inappropriate referrals. Patients were most likely to have extended LoFU if they were diagnosed with OCD & related disorders and were most likely to be diagnosed with an underlying personality disorder if they were diagnosed with anxiety & phobic disorders. Continuity of care facilitates discharge planning. Patients receiving the CRHT service in Malta are most comparable with health systems that prefer to hospitalise patients with a higher risk profile. The high occurrence of personality disorders necessitates staff to have interdisciplinary knowledge and an appropriate skill mix.

The societal costs of avoidant personality disorder.

The study aims to estimate the societal costs of avoidant personality disorder (AvPD). Cross-sectional data on AvPD patients during 2017-2020 were retrieved from the quality register of the Norwegian Network for Personality Disorders. Cost estimations were based on a bottom-up approach, using a structured interview covering the 6-month period prior to initial assessment. Unit costs were retrieved from public records. The human capital approach was used to calculate productivity losses. Diagnoses were determined according to DSM-5 by semi-structured diagnostic interviews (SCID-5-PD). Mean societal costs were €19,378 for the total group (N = 410). The subgroup with a single diagnosis (n = 270) incurred €18,818, whereas the subgroup with at least one comorbid PD (n = 140) incurred €20,458. The difference between the two subgroups was not statistically significant. The largest cost component was productivity loss (69%), whereas health service costs constituted 31%. The main contributors to societal costs from the health service cost components were inpatient treatment (18%) and individual outpatient treatment (11%). In conclusion, societal costs for AvPD patients were high, on the same level as borderline PD, schizotypal PD, and schizophrenia, and higher than anxiety disorders, depression, and rheumatoid arthritis. In the future, development of effective AvPD treatment programs enhancing personality functioning and workforce participation is important in order reduce the cost of illness.

Experience of childhood adversity and maladaptive personality traits: Magnitude and specificity of the association in a clinical sample of adult outpatients.

The relationship between the experience of childhood adversity (CA) and the development of personality disorders (PDs) has been well documented. The dimensional PD alternative model (AMPD) has been introduced in nosography in 2013, and so far it is been used for CA research mostly on non-clinical samples. We included in our study 137 psychiatric outpatients who were screened for history of maternal antipathy (MA), paternal antipathy (PA), maternal neglect (MN), paternal neglect (PN), maternal physical abuse (MPA), paternal physical abuse (PPA) and sexual abuse (SA) using the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and underwent personality assessment using the Personality Inventory for DSM-5. Applying CECA.Q cut-off scores, rates of participants reporting CA were as follows: 14.6% MA; 13.9% PA; 13.1% MN; 10.2% PN; 25.5% MPA; 24.8% PPA; and 22.6% SA. In multivariate regression models, accounting for age, gender and exposure to other types of CA, exposure to MA was associated with increased negative affect, detachment, disinhibition and psychoticism; exposure to PA with increased disinhibition; and exposure to SA with increased antagonism, disinhibition and psychoticism. All effect sizes were small, except for a moderate effect of SA on psychoticism. Results pointed to a small but specific and independent effect of MA on most maladaptive personality traits; a possible specific role of the paternal figure for externalizing traits; and a moderate effect of SA on psychoticism. The cumulative exposure to multiple CAs significantly predicted all maladaptive personality traits, with much larger effect sizes compared to those calculated for single CAs. CA explained the higher proportion of variance for antagonism and psychoticism. In conclusion, exposure to specific forms of childhood abuse was associated with specific maladaptive traits in psychiatric outpatients, even if the effect of cumulative multiple CAs was larger.

Obsessive-compulsive personality disorder increases cognitive inflexibility in people with coronary artery disease.

Cardiovascular diseases such as coronary artery disease (CAD) have a high prevalence of psychiatric comorbidities, that may impact clinically relevant outcomes (e.g., cognitive impairment and executive dysfunction). Obsessive-compulsive personality disorder (OCPD) is a common psychiatric comorbidity in CAD. It has a distinct cognitive profile characterised by inflexible thinking and executive dysfunction, which in turn may affect treatment adherence. However, the impact of OCPD on cognitive functioning in CAD is under-researched. We aimed to investigate the impact of OCPD on executive function in individuals with CAD undergoing rehabilitation, using cognitive tests relating to inflexibility and executive planning. Seventy-eight adults (median age 59 [53.0-66.0] years) with CAD were tested within three days of hospital admission for cardiac rehabilitation occurring within two weeks of experiencing an episode of unstable angina or myocardial infarction. The Compulsive Personality Assessment Scale (CPAS) was used to evaluate OCPD traits. Neurocognitive testing was performed using the Cambridge Automated Neuropsychological Test Battery (CANTAB) including tests of set shifting (Intra-Extra Dimensional [IED] Set Shifting), and executive planning (Stockings of Cambridge [SOC]). Ten individuals with CAD fulfilled the operational criteria for DSM-5 OCPD. Individuals with comorbid OCPD made more IED intra-dimensional shift reversal errors (2.0 [2.0-4.0] vs. 1.0 [1.0-2.0], p=.004), reflecting a difficulty inhibiting previously learnt responses. When all participants were analysed as a group, negative associations were found between individual OCPD traits and other aspects of cognitive performance. Hoarding trait was associated with increased initial thinking time on the SOC at five moves (ρ=0.242, p=.033), while the need for control and rigidity traits were each associated with increased initial thinking time on the SOC at two moves (respectively, ρ=0.259, p=.022; ρ=0.239, p=.035), reflecting slower executive planning. A preoccupation with details trait was associated with fewer errors on a compound discrimination stage of the IED (ρ=-0.251, p=.026). After controlling these correlations for gender and age, significant associations remained with hoarding (β=0.243, p=.036), need for control (β=0.341, p=.005) and rigidity (β=0.259, p=.038) traits. Preliminary evidence suggests that individuals with CAD and comorbid OCPD traits show greater inflexibility than those without OCPD. Several OCPD traits were associated with slower planning, even after controlling them for age and gender. This may have implications for the success of rehabilitation.

Psychometric Properties of the Persian Version of PID5BF + M in Iranian Drug Users.

This study aimed to adapt and evaluate the psychometric properties of the PID5BF + M as a brief measure for assessing DSM-5 and ICD-11 personality disorder traits in Iranian drug users. The sample consisted of 380 participants, including both clinical (28.68%) and nonclinical (71.32%) groups, with 43.7% female participants. All participants completed the Personality Inventory for DSM-5 and ICD-11 Brief Form-Modified (PID5BF + M), the Symptom Checklist-25 (SCL-25), the Brief Five-Factor Inventory (BFI-10), the Level of Personality Functioning Scale-Brief Form (LPFS-BF 2.0), and the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). The findings revealed that the PID5BF + M demonstrates strong psychometric properties, with a six-factor structure that is culturally appropriate for the Iranian population. Significant associations were found between the ICD-11/DSM-5 traits and both internalizing and externalizing symptoms, as well as with normal personality factors. The PID5BF + M appears to be a valid and reliable tool for assessing DSM-5 and ICD-11 personality disorder traits in Iranian drug users, showing promising potential for use in clinical and research settings within this cultural context.

Understanding Compliance Rates in Suicide Research During the Post-Discharge Period.

The period following discharge from psychiatric hospitalization is one of particularly elevated suicide risk. It is essential to better understand risk factors for suicide during this period; however, retention and compliance in longitudinal research can be a challenge with high-risk populations. We examined compliance rates in the six-month period following psychiatric hospital discharge among 174 adults (149 psychiatric patients and 25 healthy controls) across three data collection methods: ecological momentary assessment (EMA), weekly clinical assessment phone calls, and clinical follow-up assessments at two- and six-months post-discharge. We examined whether clinical and demographic characteristics influenced compliance rates. Results suggested low rates of EMA compliance, but strong rates of completion of weekly phone calls and follow-up assessments. Compared to psychiatric patients, healthy controls completed more EMA and weekly phone calls, but not follow-up assessments. Participants who met current diagnostic criteria for a major depressive episode and who scored above the clinical threshold for borderline personality disorder symptoms had lower EMA compliance rates. These findings have important implications for strategies to improve patient engagement in research during this high-risk period.

Disruption of Epistemic Trust in Borderline Personality Disorder: A Possible Adaptation to Avoid Making Costly Mistakes.

This paper applies error management theory (EMT) (Haselton and Buss 2000) to explore how disruptions in epistemic trust-trust in communicated information-can be understood as adaptive responses to early adversity in individuals with borderline personality disorder (BPD). I propose that epistemic mistrust (EM) and epistemic credulity (EC), characterized by inappropriate trust patterns, arise from the differential costs of trusting unreliable versus mistrusting reliable information. Although these biases may seem maladaptive, they function as evolutionary survival mechanisms in response to harsh environments. Signal detection analysis can provide empirical evidence for these trust biases by assessing how individuals with BPD make trust-related decisions. Clinically, understanding these biases as evolutionary adaptations helps reduce stigma and informs evolutionary-informed interventions to recalibrate trust responses and improve interpersonal relationships. This approach highlights the significance of integrating evolutionary perspectives in treating trust disturbances in BPD.

First psychometric evaluation of the Mexican Spanish version of the 11-item BPFSC-11 and convergence with maladaptive self and interpersonal functioning.

The Borderline Personality Features Scale for Children (BPFSC-11) is a well-used, short, and easy-to-administer measure of borderline traits in young people. The aim of the current study was to evaluate the psychometric properties of the Mexican Spanish version of the BPFSC-11 in a large community-based sample of Mexican adolescents. In addition, we evaluated the convergence between the borderline construct as measured by the BPFSC-11 and general personality functioning consistent with more contemporary personality disorder formulations to assess the nomological net of the BPFSC-11 total score. A sample of 1212 adolescents (52.6% female, mean age = 15.11, SD = 1.74) were recruited from the community through schools in Mexico City and Michoacán area. Reliability of the BPFSC-11 was good (α = 0.805; ω = 0.806). A confirmatory factor analysis (CFA) model testing the unidimensional factor structure of the 11 items of the BPFSC-11 provided good fit (X2[44] = 137.96, p < 0.001; root mean square error of approximation (RMSEA) = 0.04 [90% CI: 0.03, 0.05]; comparative fit index (CFI) = 0.96; standardized root mean square residual (SRMR) = 0.03). Both configural and metric invariance for gender and age were demonstrated; however, only partial scalar invariance could be demonstrated with some items showing "bias" for gender and age. The Mexican Spanish BPFSC-11 also showed strong convergence with measures assessing contemporary conceptualization of general personality functioning. The Mexican Spanish BPFSC-11 appears to show similarly strong psychometric properties of other versions of the BPFSC-11; and the borderline construct as assessed with the BPFSC-11 shows good conversion with general personality functioning in adolescents.

Narcissistic personality disorder and emotion regulation in psychiatric inpatients.

Emotional regulation difficulties in those with narcissistic personality disorder can cause problematic social and occupational functioning and inhibit treatment. Identifying which aspects of emotion regulation difficulties narcissistic personality disorder (NPD) patients have can help inform treatment. Adult psychiatric inpatients (N = 108) were assessed on measures of emotion regulation. Propensity score matching (PSM) was utilized to match inpatients with a diagnosis of NPD (n = 54) to psychiatric peers on several criteria. An analysis of variance compared groups at admission and discharge. A moderation analysis was used to explore the effects of neuroticism across the treatment for NPD, and cut scores were used to explore the effect of neuroticism on NPD patients at admission and discharge. NPD patients demonstrated more difficulties with impulse control, engaging in goal-directed behaviours, clarity of emotions, emotional regulation strategies, and experiential avoidance at admission. NPD patients experienced difficulties with impulse control and acceptance of emotional responses at discharge. They were also more likely to end treatment before their peers. Neuroticism was a moderating factor in treatment of patients with NPD, with high neuroticism aligning with greater gains across treatment; however, high neuroticism NPD patients continued to report more difficulties with experiential avoidance and strategies for emotional regulation. Use of self-report measures, reliance on DSM criteria for NPD diagnoses, and the generalizability to non-inpatient populations. NPD patients benefit from treatment but continue to struggle with aspects of emotion regulation. Addressing these aspects may help NPD patients receive more benefits from treatment.

Intensive Short-Term Dynamic Psychotherapy for Complex, Chronic, and Treatment-Resistant Conditions.

Over the past 50 years, intensive short-term dynamic psychotherapy (ISTDP) has been developed, implemented, and evaluated with respect to the treatment of a broad spectrum of complex, chronic, and treatment-resistant conditions. This therapy was developed specifically to treat a range of patients, including those who are highly defensive, those who experience the repression of emotions, and those who have cognitive-perceptual disruptions along with primitive defenses. These three groups of patients are characterized by patterns of attachment trauma and deficits related to neglect. Among the many categories of mental illness with these features that ISTDP can treat, personality disorders, treatment-resistant depression, and somatic symptoms have been the most frequently studied. In this article, the authors provide an overview of the ISTDP treatment method with regard to complex, chronic, and treatment-resistant conditions and summarize evidence for its effectiveness for diverse patient populations. On the basis of the available evidence, ISTDP warrants consideration as a tool for the management of diverse populations who have chronic and complex conditions and have not responded to other treatments.

Good Psychiatric Management of Borderline Personality Disorder and Co-Occurring Autism Spectrum Disorder.

Borderline personality disorder has been estimated to occur among about 4% of those with autism spectrum disorder. This co-occurrence can escalate the challenges of treating either condition separately, and patients often face severe challenges in psychosocial and occupational functioning. Clinicians need guidance to manage a high degree of complexity, using standards of care and a synthesis of what is known so far, to navigate the currently limited armamentarium of clinical tools. This article reviews the available scientific research and clinical experience with respect to diagnosis, psychoeducation, treatment framework, safety management, other co-occurring disorders, and multimodal treatments. It also discusses future directions for generating new knowledge to improve the care of patients with this important co-occurrence. Although the discussion explores the unique complexity and relative lack of clinical guidelines at present, good psychiatric management serves as a clinical framework that anchors treatment approaches as the evidence base develops.

Reviewing the evidence on pharmacological interventions for people with borderline personality disorder

Reviewing the evidence on pharmacological interventions for people with borderline personality disorder

The Index of Consensual Sexual Sadism (ICSS): Scale development, validation, measurement invariance, and nomological network comparisons with everyday sadism.

Sexual sadism has long been of interest to scholars and clinicians in psychology, and most research on sexual sadism has focused on forensic samples. However, recently, research has uncovered the existence of sexual sadism in general populations. Measures designed to assess sexual sadism in the general population are lacking. To address this gap, we created the Index of Consensual Sexual Sadism (ICSS) and performed some initial psychometric testing of its structure, measurement invariance, validity (e.g., distinguishment from everyday sadism), and reliability. In this preregistered study, separate samples of community adults and undergraduates (N = 1,391; Mage = 24.21, SDage = 10.92, rangeage = 18-85; 68.40% female; 76.10% White) completed the ICSS and measures of sadistic pleasure in sexual and nonsexual contexts, normal personality traits (HEXACO), personality disorder traits, antagonistic personality features (e.g., psychopathy), frequency of sadistic sexual fantasies, romantic relationship satisfaction, and social desirability. The ICSS demonstrated a unidimensional structure that was invariant across the tested groupings of sample type, sex, and age; in addition, the scale had only a trivial relation to social desirability bias, and it related to the other outcomes in a way that highlighted its construct validity and distinguished it from everyday sadism. The ICSS seems a viable candidate for assessing consensual sexual sadism so that clinicians and researchers can begin evaluating the full spectrum of sexual sadism. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

How Do Personality Dysfunction and Maladaptive Personality Traits Predict Time to Premature Discontinuation of Pharmacological Treatment of ADHD?

Non-adherence to medication is common in the adult ADHD clinical group. The goal of this pre-registered study was to examine whether the DSM-5 Alternative Model of Personality Disorder (AMPD), generality personality dysfunction (LPFS-BF 2.0) or maladaptive personality traits (PID-5), can predict time to premature discontinuation of pharmacological treatment beyond other known factors. A sample of 284 adult patients with ADHD (60.6% female; Mage = 32.31 years) were investigated for medication adherence from 2018 to 2023, using time-to-event analytic methods. Of the sample, 54 were found to have discontinued treatment prematurely without consulting their physician. Interestingly this group was prescribed considerably lower doses before discontinuation than adhering patients. General personality dysfunction and maladaptive antagonistic personality traits are implicated in varying degrees, with the specific maladaptive personality facets Intimacy Avoidance and Deceitfulness (PID-5) significantly predicting time to premature discontinuation of ADHD medication beyond other known reasons for non-adherence. The broader implication is that the emerging personality pathology models hold promise to predict non-adherence in the adult ADHD population.

Accidental Autoerotic Deaths and Mental Disorder: A Scoping Review.

Accidental autoerotic death, more commonly known as "autoerotic asphyxia," is an extreme paraphilic behavior wherein individuals induce cerebral hypoxia during self-stimulated sexual activities, often by constricting the neck or obstructing respiratory passages. Data on accidental deaths caused by autoerotic play is very low because of the non-disclosure of the mode/circumstances of death or non-paralleled forensic systems in many countries. There is a high likelihood of coexisting mental disorders with such behavior. This review identifies the association of any comorbid mental disorder with accidental autoerotic deaths. On August 23, 2023, a systematic literature search was carried out through Cochrane, PubMed, ScienceDirect, and SCOPUS, and studies identified in the English language were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) guideline. Eighteen studies identified specific mental disorders with autoerotic deaths, including paraphilia, vaginismus, gender dysphoria, multiplex paraphilia, alcohol dependence, bipolar disorder, borderline personality disorder, and substance use disorder. Inhalant use like chloroform, toluene, and xylene was implicated during autoerotic fantasies. Prospective clinical screening and comprehensive multicentric psychological autopsy studies are needed to clarify the prevalence of accidental autoerotic death and related mental health conditions in the future. Given the possibility of accidental death, it remains to be seen whether paraphilia involving a single harmful event could be classified as a specifier within the impulsive-compulsive-reward spectrum, similar to how newer diagnostic systems address substance use disorders.