Psychopathology

精神病理学
  • 文章类型: Case Reports
    避免性限制性食品摄入障碍(ARFID)是一种新分类的饮食障碍,需要对其表现进行进一步了解。以前没有关于儿童扁桃体切除术后ARFID的报道。ARFID可能是儿童口咽手术后的潜在负面结果。
    一名10岁零2个月的女性儿童出现与抑郁症相关的ARFID,扁桃体切除术后的焦虑和营养缺乏。她吞下固体比吞下液体更困难,咀嚼食物后反复呕吐和吐痰。她脱水和营养不良,BMI为10.5,并被误诊为重症肌无力。
    据我们所知,这是儿童扁桃体切除术后ARFID的首例报告.我们讨论了ARFID的病理生理学,仍然难以捉摸,并建议在评估儿童扁桃体切除术后进行精神病学评估。
    UNASSIGNED: Avoidant Restrictive Food Intake Disorder (ARFID) is a newly classified eating disorder that requires further understanding of its presentation. There is no previous report of ARFID in a child post-tonsillectomy. ARFID may be a potential negative outcome for children following oropharyngeal surgery.
    UNASSIGNED: A female child aged 10 years and 2 months presented with ARFID associated with depression, anxiety and nutritional deficiency following tonsillectomy. She had more difficulty in swallowing solids than fluids and had repeated vomiting and spitting food after chewing it. She became dehydrated and malnourished with a BMI of 10.5 and was misdiagnosed with myasthenic gravis.
    UNASSIGNED: To our knowledge, this is the first case report of ARFID in a child post-tonsillectomy. We discuss the pathophysiology of ARFID, which remains elusive, and recommend psychiatric assessment when evaluating children post operative tonsillectomy.
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  • 文章类型: Case Reports
    在精神病医生的实践中,Eidetic图像是一种相对罕见的现象。它们在感知障碍类别中被描述为图像或记忆,由于它们的可塑性,生动和细节,与目前经历的感官知觉非常相似。然而,应该记住,它们的发生与任何精神障碍无关,在一些健康人身上也能观察到。本文介绍了一例患者抱怨“发声”的病例报告,\“塑料图像-他的精神病住院和当时进行的心理诊断的过程。作者指出了区分的困难,首先,听觉假性幻觉,并尝试对患者的症状进行心理病理学分类。关于这种现象可能的疾病机制的讨论是基于对想象力和自觉性现象的报道以及研究,这项研究的目的是提请诊断学家注意具有深刻特征的心理现象类别,这可能使他们避免错误地认识到他们作为感知的精神病性障碍的一个因素。
    Eidetic images are a relatively rare phenomenon in the practice of a psychiatrist. They are described in the category of perception disorders as images or memories which, thanks to their plasticity, vividness and detail, are very similar to the currently experienced sensory perceptions. However, it should be remembered that their occurrence is not associated with any mental disorders, and they are also observed in some healthy people. This paper presents a case report of a patient with complaints about \"voiced,\" plastic images - the course of his psychiatric hospitalization and the psychological diagnostics carried out at that time. The authors point out the difficulties in differentiating, first of all, with auditory pseudo-hallucinations and make an attempt at psychopathological classification of the patient\'s symptoms. The discussion on possible disease mechanisms of this phenomenon is based on reports as well as research on the phenomenon of imagination and eidetic perceptions, and the aim of this study is to draw the attention of diagnosticians to the category of psychological phenomena with an eidetic character, which may allow them to avoid incorrect recognition of them as an element of psychotic disorders of perception.
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  • 文章类型: Journal Article
    Klinefelter综合征(KS),男性的特征是额外的X染色体,表现为广泛的神经内分泌和精神症状。患有KS的人经常面临荷尔蒙功能障碍的风险增加,导致抑郁和焦虑,尽管在儿科和青少年年龄的扩展研究仍然有限。这个关键阶段,对KS儿童来说是决定性的,受遗传因素的影响,环境和家庭因素,影响大脑可塑性。在这份报告中,我们回顾了,以叙事的形式,儿童中至关重要的KS精神病理学标志。为了更好地描述KS患儿的神经内分泌和神经精神结局,我们介绍了一个11岁的患有马赛克KS的青春期前儿童的案例,由于他的学习成绩下降,他被转诊到我们的发育精神病理学中心。在过去的几个月中,白天过度疲劳和分心增加。家族史显示一级和二级亲属患有精神疾病,包括最近离婚的父母和一个15岁的妹妹。诊断为早发性持续性抑郁症和焦虑特征。及时识别易感儿童,彻底检查家族精神病史,环境影响和神经认知特征,除了有针对性的干预措施,可能会减轻儿童和青少年KS病例中与精神病理学相关的终身残疾,包括那些马赛克KS。
    Klinefelter syndrome (KS), characterized by an additional X-chromosome in males, manifests in a wide range of neuroendocrine and psychiatric symptoms. Individuals with KS often face increased risks of hormonal dysfunction, leading to depression and anxiety, although extended research during pediatric and adolescent age is still limited. This critical phase, decisive for KS children, is influenced by a combination of genetic, environmental and familial factors, which impact brain plasticity. In this report, we reviewed, in a narrative form, the crucial KS psychopathological hallmarks in children. To better describe neuroendocrine and neuropsychiatric outcomes in children with KS, we presented the case of an 11-year-old prepubertal child with mosaic KS who was referred to our Center of Developmental Psychopathology due to a decline in his academic performance, excessive daytime fatigue and increased distractibility over the past few months. Family history revealed psychiatric conditions among first- and second-degree relatives, including recently divorced parents and a 15-year-old sister. Early-onset persistent depressive disorder and anxious traits were diagnosed. Timely identification of susceptible children, with thorough examination of familial psychiatric history, environmental influences and neurocognitive profile, alongside targeted interventions, could potentially mitigate lifelong psychopathology-related disabilities in pediatric and adolescent KS cases, including those with mosaic KS.
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  • 文章类型: Journal Article
    量化人内心理健康变化的能力是临床心理学使命的核心。通常,这是使用症状测量的总分或平均分来完成的;然而,这种方法假设度量量化了相同的结构,同样的方式,每次测量完成时。没有这种品质,称为纵向测量不变性,观察到的时间点之间的差异可能部分归因于测量特性的变化,而不是可比症状测量的变化.由于报告风格的潜在差异,这种担忧在研究中被放大,使用不同形式的测量跨发育期。项目措辞,和发展背景。本研究为焦虑量表的纵向测量不变性提供了最有力的支持,抑郁/情感问题:认知分量表,注意缺陷多动障碍(ADHD)量表;适度支持抑郁/情感问题量表和躯体量表,对抑郁/情感问题的支持不足:荷兰Achenbach基于经验的评估系统的躯体症状量表青年自我报告和成人自我报告,样本为1,309个人(N=1,090人群,在6波数据中,N=219基于诊所的/在11岁之前转诊到门诊诊所)(第1波中的平均年龄=11岁,第6波中的平均年龄=26岁)。
    The ability to quantify within-person changes in mental health is central to the mission of clinical psychology. Typically, this is done using total or mean scores on symptom measures; however, this approach assumes that measures quantify the same construct, the same way, each time the measure is completed. Without this quality, termed longitudinal measurement invariance, an observed difference between timepoints might be partially attributable to changing measurement properties rather than changes in comparable symptom measurements. This concern is amplified in research using different forms of a measure across developmental periods due to potential differences in reporting styles, item-wording, and developmental context. This study provides the strongest support for the longitudinal measurement invariance of the Anxiety Scale, Depression/Affective Problems: Cognitive Subscale, and the Attention Deficit Hyperactivity Disorder (ADHD) Scale; moderate support for the Depression/Affective Problems Scale and the Somatic Scale, and poor support for the Depression/Affective Problems: Somatic Symptoms Subscale of the Dutch Achenbach System of Empirically Based Assessment Youth Self-Report and Adult Self-Report in a sample of 1,309 individuals (N = 1,090 population-based, N = 219 clinic-based/referred to an outpatient clinic before age 11 years) across six waves of data (mean ages = 11 years at Wave 1 and 26 years at Wave 6).
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  • 文章类型: Journal Article
    目的:异常显色(AS)和精神病样经历(PLE)已被证明是相关的。此外,焦虑是精神病患者和大多数精神病患者的主要症状。我们提出了一个模型,试图解释在健康对照和精神病患者中,PLEs在AS和焦虑之间的关联中的作用。
    方法:人口统计学和心理测量数据(异常显著性量表,社区心理体验评估,收集了163名对照和44名精神病患者的症状检查表-90-修订版)。描述性统计,相关性,随后进行了线性回归模型和协变量中介分析.
    结果:在患者和对照组中,AS与更频繁的阳性PLE和更高的焦虑水平相关。然而,PLEs的阳性频率仅在对照组之间介导AS和焦虑之间的关系。
    结论:与AS相关的PLEs似乎在对照组中引起焦虑,但在精神病患者中没有。新颖性和洞察力的逐渐丧失,可能,分别,削弱了对PLE的躯体情绪反应,以及将某些身体现象识别为焦虑的内在关联的能力,被视为最可能的理论解释。
    OBJECTIVE: Aberrant salience (AS) and psychotic-like experiences (PLEs) have been proven to be linked. Moreover, anxiety is a key symptom in psychosis-prone subjects and most psychotic patients. We propose a model that attempts to interpret the role of PLEs in the association between AS and anxiety among healthy controls and psychotic patients.
    METHODS: Demographic and psychometric data (Aberrant Salience Inventory, Community Assessment of Psychic Experiences, Symptom Check List-90-revised) from 163 controls and 44 psychotic patients was collected. Descriptive statistics, correlations, a linear regression model and a mediation analysis with covariates were subsequently performed.
    RESULTS: AS correlated with more frequent positive PLEs and higher anxiety levels in both patients and controls. However, positive PLEs\' frequency mediated the relationship between AS and anxiety only among controls.
    CONCLUSIONS: PLEs linked to AS appear to induce anxiety among the control group but not among psychotic patients. The progressive loss of both novelty and insight, which may, respectively, impair the somatic emotional reactivity to PLEs and the ability to recognize some bodily phenomena as the embodied correlates of anxiety, is seen as the most probable theoretical explanation.
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  • 文章类型: Case Reports
    与介入程序有关的情绪混乱可能会加剧以前的精神疾病,甚至引发新的精神病理学。尽管众所周知,精神健康障碍对心脏预后的有害影响,心理障碍的研究相对不足,但对起搏后患者的整体健康至关重要.在本病例系列中,我们介绍了在坦桑尼亚国家转诊心脏中心接受永久性起搏器植入的一组患者中观察到的一系列精神疾病。5名年龄在58至81岁之间的非洲裔人被送往JakayaKikwete心脏研究所,其临床条件需要永久性起搏器植入。所有五个人都否认有精神病史,然而,经过彻底的精神病学审查;器质性脑综合征,恐慌症,短暂的精神病,达到了适应障碍和重度抑郁障碍的诊断。所有五个人都成功地接受了医学心理治疗。最后,这个案例系列说明了对植入式心脏设备的不良心理适应的各种后果,它强调了对此类患者进行持续心理评估的重要性。
    Emotional disarray linked to interventional procedures may potentially aggravate previous psychiatric conditions or even precipitate new psychopathologies. Despite of the well-known deleterious impact of mental health disorders on cardiac outcomes, psychological disturbances are relatively understudied yet of vital importance to the overall health of post-pacing patients. In this case series we present a spectrum of mental illnesses observed in a cohort of patients who underwent permanent pacemaker implantation in Tanzania\'s national referral cardiac centre. Five individuals of African origin aged between 58 and 81 years presented to Jakaya Kikwete Cardiac Institute with clinical conditions warranting permanent pacemaker implantation. All five denied prior history of mental illness, however, after thorough psychiatric reviews; organic brain syndrome, panic disorder, brief psychotic disorder, adjustment disorder and major depressive disorder diagnoses were reached. All five were successfully channeled for medical psychotherapy. To conclude, this case series illustrates variable consequences of poor psychological adaptation to implantable cardiac devices, and it underscores the importance of continued psychological evaluation to such patients.
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  • 文章类型: Journal Article
    边缘性人格障碍(BPD)是一种严重的精神疾病,其特征是情感不稳定,认知,和人际领域。BPD与几种精神障碍同时发生,与精神病理学(p因子)和人格障碍(g-PD)的一般因素呈正相关。因此,一些研究人员声称BPD是p的标记,因此,BPD的核心特征反映了精神病理学的普遍责任。这一论断在很大程度上源于横断面证据,迄今为止没有研究阐明BPD和p之间的发育关系。本研究旨在通过研究两个相反框架的预测来调查BPD特征和p因子的发展:动态共生理论和共同原因理论。对竞争理论进行了评估,以确定哪种观点最能说明从青春期到成年的BPD和p的关系。数据来自匹兹堡女孩研究(PGS;N=2,450),包括14至21岁的BPD和其他内在化和外在化指数的年度自我评估。使用随机截距交叉滞后面板模型(RI-CLPM)和网络模型对理论进行了检验。结果表明,动态互惠主义和共同原因理论都不能完全解释BPD和p之间的发展关系。相反,这两个框架都得到了部分支持,发现p能强烈预测几个年龄段BPD的人内变化。(PsycInfo数据库记录(c)2023年APA,保留所有权利)。
    Borderline personality disorder (BPD) is a serious mental illness characterized by instability in affective, cognitive, and interpersonal domains. BPD co-occurs with several mental disorders and has robust, positive associations with the general factors of psychopathology (p-factor) and personality disorders (g-PD). Consequently, some researchers have purported BPD to be a marker of p, such that the core features of BPD reflect a generalized liability to psychopathology. This assertion has largely stemmed from cross-sectional evidence and no research to date has explicated the developmental relationships between BPD and p. The present study aimed to investigate the development of BPD traits and the p-factor by examining predictions of two opposing frameworks: dynamic mutualism theory and the common cause theory. Competing theories were evaluated to determine which perspective best accounted for the relationship of BPD and p from adolescence into young adulthood. Data were drawn from the Pittsburgh Girls Study (PGS; N = 2,450) and included yearly self-assessments of BPD and other internalizing and externalizing indices from ages 14 to 21. Theories were examined using random-intercept cross-lagged panel models (RI-CLPMs) and network models. Results indicated that neither dynamic mutualism nor the common cause theory could fully explain the developmental relations between BPD and p. Instead, both frameworks were partially supported, with p found to strongly predict within-person change in BPD at several ages. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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  • 文章类型: Case Reports
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  • 文章类型: English Abstract
    围产期充满了深刻的剧变和生理和心理变化,并伴有频繁的精神病理学和精神疾病。因此,这一时期母子关系的早期管理是一个重大而复杂的问题,无论是专业人士还是患者。两个主要的陷阱是区分考虑到受试者遭受早期改变亲子关系的风险,并将危险的心理和生理维度分开。临床情况说明了身体和心理可以参与和设想联合护理的方式。
    The perinatal period is suffused with profound upheaval and physical and psychological changes, and is accompanied by frequent psychopathological and psychiatric disorders. The early management of mother-child relationships during this period is therefore a major and complex issue, both for professionals and for patients. Two main pitfalls would be to distinguish the taking into account of the subject\'s suffering from the risk of early alteration of the parent-baby relationship, and to separate the psychological and physical dimensions at stake. A clinical situation illustrates the way in which the body and the psyche can be engaged and envisaged in a joint care.
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  • 文章类型: Journal Article
    背景:边缘性人格障碍(PD)的精神病谱系特征是一个长期存在的现象,但值得注意的是,到目前为止,它们并不是许多实证研究的焦点。此外,承认他们与情感性精神病有联系的比较研究甚至更少。同样,DSM-5维度方法的实证研究对这一主题的贡献也不常见。本研究旨在确定最佳的病理性人格特征和/或症状,这些特征和/或症状是边缘性PD和双相情感障碍中精神病特征(精神病和观念偏执症状)的预测因子。基于DSM-5第三节人格特质的框架。
    方法:两个临床样本的横断面研究:1)63名参与者的边缘PD组;2)65名参与者的双相情感障碍组。自我报告评估:DSM-5人格量表(PID-5);简要症状量表(BSI)。计算了一系列线性和逻辑回归分析。
    结果:总体而言,作为常见预测因子出现的数据是分离的,消极情感,精神病,抑制性,宏伟,可疑和人际关系敏感症状。边界PD在BSI偏执观念中得分最高,作为其区别特征出现(NagelkerkeR2=.58):认知和感知失调(OR:13.02),限制性情感(OR:12.09),撤回(OR:11.70),快感缺失(OR:10.98)和情绪不稳定(OR:6.69)。
    结论:除了似乎与精神病超谱两种疾病重叠的共性外,作为精神病特征基础的病理性人格症状模式似乎加强了精神分裂症和双相情感障碍之间的位置,PD可能处于临界状态,强调其与分裂情感/精神病光谱相交的可能性。精神病特征的病态人格性质是现象学维度的潜在综合特征。
    BACKGROUND: Psychotic spectrum features in borderline personality disorder (PD) are a long-standing phenomenon, but remarkably, to date, they have not been the focus of many empirical studies. Moreover, the comparative studies that acknowledge their links to affective psychoses are even more scarce. Likewise, the contributions of empirical research on the DSM-5 dimensional approach to this topic are also uncommon. This study seeks to identify the best set of pathological personality traits and/or symptoms that are predictors of psychotic features (psychoticism and ideation paranoid symptoms) in borderline PD and in bipolar disorder, based on the framework of the DSM-5 section III personality traits.
    METHODS: A cross-sectional study of two clinical samples: 1) Borderline PD group of 63 participants; 2) Bipolar disorder group of 65 participants. Self-reported assessment: Personality Inventory for DSM-5 (PID-5); Brief Symptom Inventory (BSI). A series of linear and logistic regression analyses were computed.
    RESULTS: Overall, the data emerging as common predictors are detachment, negative affectivity, psychoticism, depressivity, grandiosity, suspiciousness and interpersonal sensitivity symptoms. Borderline PD has the highest score in BSI paranoid ideation which emerges as its discriminating trait (Nagelkerke R2 = .58): cognitive and perceptual dysregulation (OR: 13.02), restricted affectivity (OR: 12.09), withdrawal (OR: 11.70), anhedonia (OR: 10.98) and emotional lability (OR: 6.69).
    CONCLUSIONS: Besides the commonality that appears to overlap both disorders with a psychosis superspectrum, the patterns of the pathological personality-symptoms underlying the psychotic features appear to reinforce a position between schizophrenia and bipolar disorders that borderline PD may occupy, highlighting the possibility of its intersection with schizoaffective/psychosis spectra. The pathological personality nature of the psychotic features emerges as a potential comprehensive trait of the phenomenological dimensions.
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