Risk For Personality Disorder Research Articles

An epidemiological survey on personality disorder in Andalusia (the PISMA-ep PD study).

Despite a significant clinical and social burden, there is a relative scarcity of epidemiological studies on Personality Disorder (PD). To determine the current prevalence of PD and the psychosocial correlates associated with this in the Andalusian population. We carried out a cross-sectional population mental-health survey in Andalusia, southern Spain. Thus, 4,518 randomly selected participants were interviewed following sampling using different standard stratification levels. We used the Spanish version of the SAPAS to estimate PD prevalence. In addition, a full battery of other instruments was utilized to explore global functionality, childhood abuse, maltreatment, threatening life events, personality traits (neuroticism, impulsivity and paranoia), medical and psychiatric comorbidities, family history of psychological problems and other potential risk factors for PD. PD prevalence (10.8%; 95% CI [9.8, 11.7]) and ran two different multivariate models for PD. We obtained the highest PD prevalence in those affected by any mental disorder plus those reporting having suffered childhood abuse, particularly sexual abuse. Additional potential risk factors or correlates of PD identified were: younger age, lower levels of functioning, less social support, poorer general health, having suffered maltreatment, threatening life events, higher suicidal risk scores and higher levels of both neuroticism and impulsivity. This study reports PD prevalence and risk correlates in consonance with similar findings reported in other Western populations. However, longitudinal studies are needed to elicit a more thorough group of prospective determinants of PD.

Do self and interpersonal dysfunction cross-sectionally mediate the association between adverse childhood experiences and personality pathology?

Two primary limitations of research on the association between adverse childhood experiences (ACEs) and personality disorder (PD) are (1) failure to consider mechanisms of association and (2) inconsistent results due, in part, to inconsistent approaches to quantifying ACE exposure. The current study will address these limitations by examining the cross-sectional mediating role of self- and interpersonal dysfunction on the association between ACE and three PDs (antisocial, schizotypal, and borderline) using three quantifications of ACE exposure (cumulative, individual, and unique risk). Participants were 149 current or recent psychiatric patients, and data analyses were performed through estimation of a series of cross-sectional mediation models. Taken together, results suggest that (1) the association between ACE and PD is moderate, (2) self- and interpersonal dysfunction cross-sectionally mediate this association, (3) after accounting for variance shared among ACEs, associations between specific ACE subtypes and PD were negligible, (4) much of the association between ACE and PD is accounted for by general processes impacted by all forms of ACE and implicated in all forms of PD, and (5) emotional neglect may uniquely contribute to self- and interpersonal dysfunction and thereby, PD risk.

Predictors of prospective suicide attempts in a group at risk of personality disorder following self-poisoning.

Patients with personality disorder (PD) are at risk for suicidal behavior and are frequently admitted for this reason to emergency departments. In this context, researchers have tried to identify predictors of their suicidal acts, however, the studies have been mostly retrospective, and uncertainty remains. To prospectively explore factors associated with suicide attempts (SA) in individuals screened for PD from the ecological context of emergencies. Patients were recruited from two emergency departments after a self-poisoning episode (n = 310). PDQ-4+ (risk of PD), TAS-20 (alexithymia), SIS (suicidal intent), H (hopelessness), BDI-13 (depression), AUDIT (alcohol consumption), and MINI (comorbidity) questionnaires were completed. SA over the subsequent two years were identified by mailed questionnaires and hospitals' active files. Logistic regression analyses were performed. Having a previous suicidal attempt was linked to a 2.7 times higher chance of recurrence after 6 months, whereas the TAS-20 showed a 1.1 times higher risk at 18 months (OR = 1.1) and the BDI at 24 months (OR = 1.2). Each one-unit increment in TAS-20 and BDI-13 scores increased the risk of SA by 9.8 and 20.4% at 18 and 24 months, respectively. Some clinical features, such as alcohol dependence, suicide intent, and hopelessness, may not be reliable predictors of SA among PD patients. However, in the short term, previous SA and, in the long term, depression and alexithymia may be the most robust clinical predictors to consider in our sample of patients with self-poisoning SA.Clinical trial registration: [ClinicalTrials.gov], NCT00641498 24/03/2008 [#2006-A00450-51].

The relationship between psychiatric symtoms and childhood trauma

IntroductionRecent evidences suggest that situations of abandonment, neglect and abuse are risks factores for onset of psychopatology in adulthood. This association occus in that traumatic events in the early stages of development and may trigger severe and disabling psychiatric disorders in adults.ObjectivesThe presente study aimed to evaluate the associations between the occurence and severity of chidhood trauma and the development of psychiatric disorders in hospitalized teenagers of the Hospital Psychiatric Vida Londrina/Pr.MethodsThe sample was consisted of 14 psychiatric patients, evaluated for severity of psychiatric symtoms by the Back Scale for Suicid Ideation (BSI); Beck Depression Inventory (BDI); Beck Anxiety Inventory (BAI); Back Hopelessness Scale (HAD) and the Barratt Impulsiveness Scale (BIS-11).ResultsIn the sample studie, 84% of the teenegers reports that they had some type of childhood trauma. The results indicate that traumas are associated mainly with the development of mood disorders and also with increasin severity of psychiatric symptoms, specially the depressive symptoms, hopelessness, suicidal ideation and impulsivity. Teenagers with emocional neglect, emocional abuse and physical neglect demonstrated having five times more risk of personality disorder. Individuals who suffered physical abuse; sexual abuse and physical neglect presentes at three times more risk of commiting suicid attemps.ConclusionsThese data demonstrate the relevance of trauma childhood as a trigger for psychiatric symptoms.Disclosure of InterestNone Declared

Le modèle alternatif des troubles de la personnalité en population française : évaluation avec des outils brefs

ObjectivesThe aim of this work was to study whether the French versions of the brief tools available to clinicians within the framework of the Alternative Model of Personality Disorders (AMPD) can account for the risks of personality disorders in the general population. Tools are available to accurately investigate either the Level of Personality Functioning (LPF) or the Pathological Personality Dimensions (PPD) which in turn allow the validation of the relevance of the AMPD for its criteria A and B. As these tools, such as Morey's Level of Personality Functioning Scale Self Rated (LPFS-SR) for Criteria A or the Personality Inventory for DSM-5 (PID5) by Krueger et al. for Criteria B, are lengthy, the question arises as to the use of the short tools derived from them. MethodData was collected from a sample of 433 people recruited on a volunteer basis with a complete protocol. The sample was predominantly female (83% female, 16% male, 2 people who did not wish to report their gender) and rather young (67% were 18–24 years old). The short version, the LPFS- BF of Hutsbaut et al., which we used in this work allows, as confirmed by several works, to consider on the basis of 12 items the global level of personality functioning. In order to assess the pathological dimensions of personality (PPD), we chose the short version of the Personality Inventory for DSM 5 (PID 5 BF) by Krueger et al. and used its validated French translation that satisfies the factor composition of the original version: Negative Affectivity, Antagonism, Detachment, Disinhibition and Psychoticism. To assess the intensity of personality disorders we used the dedicated subscale (Items 19 and 20) that the DSM 5 proposes in its Cross-Cutting Symptoms Measures of Level 1, in its French translation. A score higher than 2 was our Gold Standard when we tested the metric capacity of the two questionnaires to evaluate the A Criteria and then the B Criteria of the AMPD. ResultsThe overall results (Table 1) show levels that place the group in a non-clinical level. In terms of the severity of personality disorders it can be seen that 27 % are at risk of personality disorder (PDs>2). Comparing these two sub-groups (Table 1), we observed significant differences for all the factors studied, pointing towards a higher score for people at risk of PDs. A logistic regression analysis of the evaluation of persons at risk lead us to find that gender and age do not have a significant influence (p=0.225 and p=0.065 respectively) in a valid model (chi square=157, df=4, p<0.001) including the overall score on the LPFS (z=5.76, p<0.001) and the PID 5 (z=2.26, p<0.001). The Area Under the Curve (AUC=0.859) of this translation (Table 3) is consistent with the original version (AUC=0.84). It has metrological qualities (Sn=73.91%, Sp=85.33%, LR+=5.1, LR−=0.3005) that allowed us to use a threshold of 24 as a discriminant of a risk of moderate or severe personality disorder. In addition, if we followed the AMPD and considered the threshold of 24 on the LFPS-BF to be a risk score for personality disorder, we could see (Fig. 2) that the scores on the PID 5 BF fairly well reflected the expected pattern with a large AUC (0.901). According to the AMPD, the cut-points for the dimensions that would evoke the presence of criteria B in the case of the presence of criterion A (LPFS-BF>24) could be either a score greater than 2 for Negative Affectivity, a score greater than 0.8 for Detachment, Antagonism and Disinhibition, or a score greater than 1.2 for Psychoticism (Table 4). DiscussionThe translation of the LPFS-BF that we used in this work has sufficient qualities to assess situations at risk of personality disorders when higher than 24. Its consistency was good (=0.84), and its factor composition in two factors (Self and Interpersonal Relations) was equivalent to the original version. The use of PID5-BF could therefore be used as a complement to the screening of AMPD A criteria, with a 25 for cut-point. The evaluation of the AMPD B criteria with the PID5-BF seemed relevant in view of our results; each of the subscales seemed to be able to correctly evaluate (AUC) persons with an LPFS-BF score at risk. However, the risk thresholds need to be confirmed in further work because of the essential role that the dimensions play in the diagnosis of types of personality disorders.

THE TENDENCY OF PERSONALITY DISORDER SCREENING IN EARLY ADULTHOOD

Background: Personality disorder is often under-diagnosed in normal population. It is important to detect personality disorder through screening at an early stage.Purpose: This study was carried out to assess personality disorder risk among nursing student in educational setting.Methods: A descriptive quantitative study was adopted. The sampling technique used in this research was consecutive sampling. The Indonesian version of Personality Disorder Screening (PDS) questionnaire was distributed. Data were analyzed using descriptive and frequencies to describe the demographic characteristics and risk of personality disorder based on cluster. There were 546 nursing student in nursing educational setting. Of these, 49 met the criteria for the inclusion criteria.Results: The result showed that the majority of the participants were girls (86%), with age 20 years (60%). This study revealed that the most dominant of high risk personality disorder was narcissistic (57%) in Cluster B and the least dominant of high risk personality was avoidant (4%) in Cluster C.Conclusion: The results of this study provide important information for nursing school to prevent actual personality disorder among nursing student. These findings highlight the need for further research to determine the extent of personality disorder type and its influence in nursing school.Keywords: Nursing student; Personality disorder; Screening; Descriptive quantitative.

Pathways to incarceration: an examination of childhood maltreatment and personality psychopathology in incarcerated adults

ABSTRACT Early-life exposure to childhood maltreatment, whether physically-, emotionally-, and/or sexually-based has been linked consistently to psychological distress throughout the lifespan, including the development of personality disorders (PDs). Individuals with PD diagnoses are at an increased risk for criminal behavior, and borderline and antisocial PDs are particularly common in forensic settings. However, little research has assessed associations among all three variables: childhood maltreatment, personality psychopathology, and adult criminal behavior. The current study sought to address this gap in the literature by examining the associations among childhood maltreatment, maladaptive personality domains, and adult criminal behavior broadly, as well as examining the mediation pathway from childhood maltreatment to maladaptive personality to adult criminal behavior. Data collection for the current study occurred at a county jail in the Southern United States (n = 180), where participants were administered self-report measures of demographics, adult arrest history, maladaptive personality, and childhood trauma. Pearson correlation and path analyses were used to examine the data, and support was found for both broad associations of childhood maltreatment with maladaptive personality domains and adult criminal behavior, and a relationship between childhood maltreatment and adult criminal behavior, which was mediated by maladaptive personality. Implications and directions for future research are discussed.

Paranoia and risk of personality disorder in the general population.

We hypothesized that paranoia is associated with personality disorder (PD) in the general population. This was a population-based cross-sectional survey carried out in Andalusia (Spain) using a representative sample of 4507 participants. Paranoia was measured using the Green Paranoid Thought Scale, and risk of having a PD was screened using the Standardized Assessment of Personality Abbreviated Scale whilst borderline personality disorder (BPD) was measured with the CEPER-III Exploratory Interview of Personality disorder. Adjusted Pearsons' correlations between paranoia and PD or BPD were calculated. Paranoia was associated with the risk of having PD and, more robustly, with BPD. Both associations held true for both personality outcomes (PD and BPD) when tested for two Green Paranoid Thought Scale paranoia subtypes (persecutory and reference) after accounting for the effects of age, sex and child abuse. Paranoia seems to either augment the risk for, or be part of, PD/BPD. © 2019 John Wiley & Sons, Ltd.

Using the SAPAS to identify risk for personality disorders among psychiatric outpatients in India: A feasibility study.

Personality disorders (PDs) are common among psychiatric outpatients and are associated with increased morbidity and worse treatment outcomes. Epidemiological research conducted among this population in Asian countries is limited, reflecting a significant gap in the current literature. One barrier to this research is the lack of appropriate screening tools. The current research assessed the feasibility of using the SAPAS (Standardized Assessment of Personality-Abbreviated Scale) screening tool to identify individuals at high risk of PD in an Indian psychiatric outpatient population and provides an initial estimate of PD prevalence by using a validated diagnostic interview, the ICD-10 International Personality Disorder Examination. The findings suggest that whilst use of the SAPAS was feasible, acceptable to patients and led to clinically useful findings, when using the recommended cut-off score of 4, the SAPAS largely overdiagnoses the risk for PD in psychiatric outpatients in India (positive predictive value=26.3%). The estimated prevalence of personality disorder in the sample was 11.1%, based on administering the International Personality Disorder Examination diagnostic interview to high-risk patients scoring 4 and above on the SAPAS, which is higher than previous estimates for this population and still likely to be an underestimation. Future studies should translate the measure into Bengali and evaluate its sensitivity and specificity at different cut-off points in order to optimize its use in Indian populations. Copyright © 2017 John Wiley & Sons, Ltd.

Association between childhood adversity and a diagnosis of personality disorder in young adulthood: a cohort study of 107,287 individuals in Stockholm County

Childhood adversity (CA) may increase the risk for later developing of personality disorder (PD). However, less is known about the association between cumulative CA and PD, and the role of childhood psychopathology and school performance. The current study examined the relationship between a range of CAs and a diagnosis of PD in young adulthood, and the roles of childhood psychopathology and school performance in this relationship. All individuals born in Stockholm County 1987–1991 (n = 107,287) constituted our cohort. Seven CAs were measured between birth and age 14: familial death, parental criminality, parental substance abuse and psychiatric morbidity, parental separation and/or single-parent household, household public assistance and residential instability. Individuals were followed from their 18th birthday until they were diagnosed with PD or until end of follow-up (December 31st 2011). Adjusted estimates of risk of PD were calculated as hazard ratios (HR) with 95% confidence intervals (CI). Associations were observed between cumulative CA and PD. During the follow-up 770 individuals (0.7%) were diagnosed with PD. Individuals exposed to 3+ CAs had the highest risks of being diagnosed with PD (HR 3.0, 95% CI 2.4–3.7). Childhood psychopathology and low school grades further increased the risk of PD among individuals exposed to CA. Cumulative CA is strongly associated with a diagnosis of PD in young adulthood. Our findings indicate that special attention should be given in schools and health services to children exposed to adversities to prevent decline in school performance, and to detect vulnerable individuals that may be on negative life-course trajectories.

Patologiczna Wielka Piątka: próba zbudowania pomostu pomiędzy psychiatryczną klasyfikacją zaburzeń a cechowym modelem osobowości zdrowej

The fifth edition of the DSM diagnostic manual has presented a hybrid system of personality disorder diagnosis, which integrates categorical and dimensional approach to diagnosis, building a kind of bridge between psychiatric classifications of disorders and psychological research on the structure of normal personality. The key element of this system is a new dimensional model of pathological personality traits. This article presents the results of the empirical verification of this model in Poland. The participants in the study were 754 individuals from the nonclinical population, aged 16–86 (M = 36.45, SD = 16.65), including 52% women. Normal personality traits were measured by means of the Revised NEO Personality Inventory (NEO-PI-R), and pathological personality traits – by means of the Personality Inventory for DSM-5 (PID-5); the risk of personality disorders was determined on the basis of SCID-II (Structured Clinical Interview for DSM-IV Axis II) questionnaire scores. The obtained results proved to be consistent with the expectations: (1) on the level of the five broad traits, the pathological DSM-5 model strongly corresponds to the Five-Factor Model of normal personality; (2) the DSM-5 model predicts the categories of disorders better than the Five-Factor Model does.

Patologiczna Wielka Piątka: próba zbudowania pomostu pomiędzy psychiatryczną klasyfikacją zaburzeń a cechowym modelem osobowości zdrowej

The fifth edition of the DSM diagnostic manual has presented a hybrid system of personality disorder diagnosis, which integrates categorical and dimensional approach to diagnosis, building a kind of bridge between psychiatric classifications of disorders and psychological research on the structure of normal personality. The key element of this system is a new dimensional model of pathological personality traits. This article presents the results of the empirical verification of this model in Poland. The participants in the study were 754 individuals from the nonclinical population, aged 16–86 (M = 36.45, SD = 16.65), including 52% women. Normal personality traits were measured by means of the Revised NEO Personality Inventory (NEO-PI-R), and pathological personality traits – by means of the Personality Inventory for DSM-5 (PID-5); the risk of personality disorders was determined on the basis of SCID-II (Structured Clinical Interview for DSM-IV Axis II) questionnaire scores. The obtained results proved to be consistent with the expectations: (1) on the level of the five broad traits, the pathological DSM-5 model strongly corresponds to the Five-Factor Model of normal personality; (2) the DSM-5 model predicts the categories of disorders better than the Five-Factor Model does.

Who is becoming personality disordered? A register-based follow-up study of 508 inpatient adolescents

BackgroundOur aim was to investigate which clinical and socio-demographic factors among adolescent psychiatric patient aged 13–17 are associated with a diagnosis of personality disorder (PD) in young adulthood after discharge from psychiatric hospitalization. MethodsThe study sample consisted of 508 adolescents (ages 13–17) admitted to acute psychiatric impatient care between April 2001 and March 2006. DSM IV-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL). The information on hospital treatments either in out- or inpatient settings until the end of 2012 was extracted from the national Care Register for Health Care provided by the Finnish National Institute for Health and Welfare. The follow-up time was 9.2 years (mean, 95% CI 9.0–9.3 yrs). ResultsAltogether 57 (11.2%) of subjects were diagnosed PD in adulthood. Among girls with anxiety disorders in adolescence the risk for PD in adulthood increased to 4.39-fold (95% CI 2.02–9.53). Males with later PD were more likely to be admitted for hospital treatment from child welfare placements (OR 3.23, 95% CI 1.21–8.61). However, axis I disorders in adolescence was not associated with risk for PD among boys. ConclusionsThe results indicate that risk of PD developing later in life is increased among girls with anxiety disorders. A child welfare placement associated with PD in males later in life. These associations in adolescents should be considered in clinical work.

Positive Association Between Reported Childhood Peer Teasing and Adult Borderline Personality Disorder Symptoms

The link between Borderline Personality Disorder and childhood maltreatment is well established, although little research has explored abuse outside the familial environment. The purpose of this study was to investigate the relationship between adult borderline symptomatology and childhood peer teasing in a non-clinical sample. Two hundred and twelve participants (M = 30.64 years, range 18 to 73; 76 % female) completed questionnaires assessing levels of current borderline symptomatology and retrospectively reported childhood abuse and teasing. Regression supported the hypothesis that childhood peer teasing would be significantly associated with adult borderline symptomatology, even after controlling for depression and other forms of childhood abuse. This unique finding highlights the importance of looking beyond familial influences when investigating Borderline Personality Disorder risk factors. Further research is needed to corroborate these findings and explore other sources of toxic childhood experience.

Personality disorder risk factors for suicide attempts over 10 years of follow-up.

Identifying personality disorder (PD) risk factors for suicide attempts is an important consideration for research and clinical care alike. However, most prior research has focused on single PDs or categorical PD diagnoses without considering unique influences of different PDs or of severity (sum) of PD criteria on the risk for suicide-related outcomes. This has usually been done with cross-sectional or retrospective assessment methods. Rarely are dimensional models of PDs examined in longitudinal, naturalistic prospective designs. In addition, it is important to consider divergent risk factors in predicting the risk of ever making a suicide attempt versus the risk of making an increasing number of attempts within the same model. This study examined 431 participants who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study. Baseline assessments of personality disorder criteria were summed as dimensional counts of personality pathology and examined as predictors of suicide attempts reported at annual interviews throughout the 10-year follow-up period. We used univariate and multivariate zero-inflated Poisson regression models to simultaneously evaluate PD risk factors for ever attempting suicide and for increasing numbers of attempts among attempters. Consistent with prior research, borderline PD was uniquely associated with ever attempting. However, only narcissistic PD was uniquely associated with an increasing number of attempts. These findings highlight the relevance of both borderline and narcissistic personality pathology as unique contributors to suicide-related outcomes.

Retrospective Analysis of Risk Factors for Suicide Attempts in a Large Population of Psychiatric Inpatients

As opposed to suicide that is officially registered risk factors for suicide attempts are more difficult to establish. Therefore, a large data set of inpatients in a university hospital was transformed and analyzed for accompanying risk factors at admission of suicidal patients. Apart from standard hospital data additional items were also derived from medical records and follow-up entries. The initial data file consisted of 16,895 data sets (i.e., hospitalizations) from year 1985 until 2005 that was transformed into a final file with 5,146 consistent data sets covering 233 variables. The analysis is based on a main group classification into suicide attempts 'positive” and suicide attempts 'negative”. Statistical analysis was done with Mann-Whitney-U-Tests, CHI2, correlation coefficients (r and ϕCOLE) and logistic regression. Patients with suicide attempts were significantly younger and were at higher risk for personality disorder (RR=1.69, p By means of a large and elaborated data file of inpatients a profile of risk factors for attempted suicide was identified providing a basis for more close intervention during inpatient treatment and thereafter.

Neither too much, nor too little. The dilemma of identifying personality disorders in adolescents patients with self-reports

The study aimed to compare methods of identification of Personality Disorders (PD) in adolescent patients with psychiatric disorders. A sample of 120 Spanish adolescents with clinical disorders was assessed using the International Personality Disorder Examination (IPDE) interview, its Screening Questionnaires (IPDE-SQ) comprising the ICD-10 and DSM-IV modules, and also the Temperament Character Inventory (TCI) to identify risk of PD. The IPDE-SQ identified a risk of PD around 92–97% of the sample; 61.7% when adjusting the stricter cut-off points. The TCI showed a PD risk of 20%, whereas the prevalence of PD identified by the IPDE clinical interview was around 36–38%. The differences between the IPDE, IPDE-SQ and TCI were significant, and a low agreement among instruments was obtained. Large discrepancy between self-report instruments in identifying PD with regard to the clinical interview raises several questions concerning the use of these instruments in clinical settings on adolescents with psychiatric disorders.

SPOCK3, a risk gene for adult ADHD and personality disorders

Attention-deficit/hyperactivity disorder (ADHD) is the most frequent psychiatric disorder in children, where it displays a global prevalence of 5%. In up to 50% of the cases, ADHD may persist into adulthood (aADHD), where it is often comorbid with personality disorders. Due to a potentially heritable nature of this comorbidity, we hypothesized that their genetic framework may contain common risk-modifying genes. SPOCK3, a poorly characterized, putatively Ca(2+)-binding extracellular heparan/chondroitin sulfate proteoglycan gene encoded by the human chromosomal region 4q32.3, was found to be associated with polymorphisms among the top ranks in a genome-wide association study (GWAS) on ADHD and a pooled GWAS on personality disorder (PD). We therefore genotyped 48 single nucleotide polymorphisms (SNPs) representative of the SPOCK3 gene region in 1,790 individuals (n aADHD=624, n PD=630, n controls=536). In this analysis, we found two SNPs to be nominally associated with aADHD (rs7689440, rs897511) and four PD-associated SNPs (rs7689440, rs897511, rs17052671 and rs1485318); the latter even reached marginal significance after rigorous Bonferroni correction. Bioinformatics tools predicted a possible influence of rs1485318 on transcription factor binding, whereas the other candidate SNPs may have effects on alternative splicing. Our results suggest that SPOCK3 may modify the genetic risk for ADHD and PD; further studies are, however, needed to identify the underlying mechanisms.

Personality Disorder and Self-Rated Health: A Population-Based Cross-Sectional Survey

Little is known about the impact of personality disorder (PD) on the health of people living in the community. The authors set out to examine the association between PD and general health, using a cross-sectional survey of a representative community sample in London, UK. A total of 1,698 adults aged 16 years or over from 1,075 randomly selected households were recruited and interviewed face-to-face by trained interviewers. Using multivariable logistic regression, the authors examined the cross-sectional association between PD screen status, as assessed by the Standardised Assessment of Personality-Abbreviated Scale (SAPAS), and self-rated health, adjusting for demographic and health covariates. Of the participants, 14.5% screened positively for PD. A greater proportion of those scoring positively for PD reported poor self-rated health, compared to screen negative participants (41.3% versus 15.0%). This association was reduced, but remained significant, after adjustment for potential confounders (unadjusted odds ratio (OR) = 3.99, 95% CI [2.93, 5.42]; fully adjusted OR = 1.53, 95% CI [1.02, 2.29]. Of note, subthreshold symptoms of PD were significantly associated with poor self-rated health (unadjusted OR per unit SAPAS score increment = 1.53, 95% CI [1.40, 1.67]; fully adjusted OR = 1.19, 95% CI [1.07, 1.33]. Furthermore, people screening positive for PD were more likely to report multiple (three or more) long-standing illnesses. The authors conclude that in the general population, individuals who are at high risk for PD are independently at increased risk of poor general health.

1872 – Comorbidity between panic disorder with and without co-occurring depression and personality disorders: a systematic review

Panic disorder is an anxiety disorder characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms. The diagnosis frequently is associated to other comorbid axis-I psychiatric disorders, especially depressive disorders. Moreover panic disorder can also be comorbid with axis-II diagnosis of Personality Disorder 1 (PDs). The aim of this study was to evaluate the existing comorbidity between current DSM-IV axis I panic disorder with and without co-occurring depression and current DSM-IV axis II PDs. We review all database from 1987 until January 2012 of all relevant cross-sectional and case-control studies which evaluate the comorbidity between panic disorders and PDs. We found 97 possible papers, 20 entered in the review. Among patients with a current DSM-IV panic disorder 44.3% [34.6, 54.2] had any PDs; 6.3% [3.1, 10.4] had any cluster A-PDs; 17.9% [12.2, 24.2] any cluster B-PDs, and 34.9% [25.6, 44.7] had any cluster C-PDs. Among patients with a current DSM-IV panic disorder and co-occurring depression 61.8% [44.6, 77.7] had any personality disorder 7.2% [4.4, 10.5] had any cluster A-PDs; 24.0% [17.6, 30.9] any cluster B-PDs, and 38.6% [25.7, 52.2] had any cluster C-PDs. The comorbidity between Panic disorder and Personality disorders is common. Cluster C-PDs was the most frequent PDs subtype related to panic disorder. Personality disorders were more prevalent among individuals with panic disorder and co-occurring depression. Further evaluations including dimensional and characterial dimensions are needed.Goodwin RD, Brook JS, Cohen P. Panic attacks and the risk of personality disorder. Psychol Med. 2005;35:227-35.