Personality disorders

人格障碍
  • 文章类型: Journal Article
    使用经过验证的法语版人格组织清单(IPO-fr)收集了法国年轻人的人格障碍数据。受访者还完成了人格诊断问卷-第4版(PDQ-4+)。样本包括607名年龄在18-26岁之间的学生,他们在法国的昂热大学(AngersUniversity)参加了各种课程。其中,根据PDQ-4+,170患有人格障碍,他们的数据被用来定义A组的IPO截止分数,B或C型人格障碍。数据以逗号分隔的值格式存储,可以从Mendeley数据存储库轻松下载(https://data。mendeley.com/datasets/tv6w6yyfy8/4)。本文涉及的数据可以在该地址以“研究3”的名称标识。
    Data on personality disorders in young French adults were collected using the validated French version of the Inventory of Personality Organization (IPO-fr). Respondents also completed the Personality Diagnostic Questionnaire-4th Edition (PDQ-4+). The sample comprised 607 students aged 18-26 years enrolled on a variety of courses at Angers University (France). Of these, 170 had a personality disorder according to the PDQ-4+, and their data were used to define IPO cut-off scores for Cluster A, B or C personality disorders. The data are stored in a comma-separated value format that can be easily downloaded from a Mendeley data repository (https://data.mendeley.com/datasets/tv6w6yyfy8/4). The data concerned by this article can be identified at this address under the name \"Study 3\".
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  • 文章类型: Journal Article
    现有精神疾病的经前恶化是指在经前阶段该状况固有的症状恶化。研究一致表明,月经周期中的荷尔蒙波动是精神症状发作或恶化的独特时期,影响诊断,风险评估,和治疗。这篇综述试图阐明经前恶化的现象及其对一系列精神疾病的影响,包括情绪,焦虑,精神病患者,强迫症,个性,和创伤相关的疾病。尽管近年来对经前烦躁不安症和经前综合征的研究有所扩大,经前恶化仍未充分开发且定义不清。这篇综述为精神疾病的诊断和管理提供了重要贡献,倡导在经前恶化的背景下提高认识和新的治疗方法。
    Premenstrual exacerbation of an existing psychiatric disorder refers to the worsening of symptoms inherent to the condition during the premenstrual phase. Research consistently indicates that hormonal fluctuations during the menstrual cycle present a unique period of vulnerability for the onset or exacerbation of psychiatric symptoms, impacting diagnosis, risk assessment, and treatment. This review sought to elucidate the phenomenon of premenstrual exacerbation and its impact across a spectrum of psychiatric illnesses, including mood, anxiety, psychotic, obsessive-compulsive, personality, and trauma-related disorders. Despite the expanded research in recent years on premenstrual dysphoric disorder and premenstrual syndrome, premenstrual exacerbation remains underexplored and poorly defined. This review offers significant contributions to the diagnosis and management of psychiatric conditions, advocating for heightened awareness and novel treatment approaches in the context of premenstrual exacerbation.
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  • 文章类型: Journal Article
    功能性癫痫(FS)在DSM-5中被分类为转换障碍,在ICD-11中被分类为分离障碍,显示出具有各种精神病合并症的多因素精神病理学。比如抑郁和焦虑。一些研究发现FS和人格障碍之间存在相关性,主要是集群B中的那些,在这个集群中,边缘性人格障碍(BPD)或边缘性人格特质在FS中最普遍。情绪失调是BPD的标志,通常在FS患者中报道。C群人格障碍,如回避或强迫症,在FS中也有报道。在这次审查中,我们旨在评估FS与人格障碍之间的关系。在FS背景下评估人格障碍与确定最合适的干预措施有关。认知行为疗法(CBT)被认为是治疗FS的一线方法。在各种CBT策略中,辩证行为疗法,专门针对情绪失调,可能对BPD患者有帮助。未来的研究应该评估系统性评估FS中人格障碍的优势,以解决特定的治疗计划,并评估其对癫痫复发的有效性。心理合并症,和生活质量。
    https://www.crd.约克。AC.英国/PROSPEROFILES/509286_STRATEGY_20240203。pdf,标识符CRD42024509286。
    Functional seizures (FS) are classified as conversion disorders in the DSM-5 and dissociative disorders in the ICD-11, showing a multifactorial psychopathology with various psychiatric comorbidities, such as depression and anxiety. Several studies have found a correlation between FS and personality disorders, mainly those in cluster B. Within this cluster, borderline personality disorder (BPD) or borderline personality traits are the most prevalent in FS. Emotion dysregulation is a hallmark of BPD and is commonly reported in individuals with FS. Cluster C personality disorders, such as avoidant or obsessive-compulsive disorders, have also been reported in FS. In this review, we aim to evaluate the relationship between FS and personality disorders. Assessing personality disorders in the context of FS is relevant for determining the most appropriate intervention. Cognitive-behavioral therapy (CBT) is considered the first-line approach to treating FS. Among various CBT strategies, dialectical behavior therapy, which specifically targets emotion dysregulation, may be helpful for individuals with BPD. Future research should assess the advantages of systematically evaluating personality disorders in FS to address specific treatment planning and evaluate its effectiveness on seizure recurrence, psychological comorbidities, and quality of life.
    UNASSIGNED: https://www.crd.york.ac.uk/PROSPEROFILES/509286_STRATEGY_20240203.pdf, identifier CRD42024509286.
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  • 文章类型: Journal Article
    很大比例的人格障碍患者不能从治疗中获益。监测治疗进展有助于调整无效治疗。这项研究检查了在第一阶段治疗期间症状和人格功能障碍的早期变化是否可以预测治疗结果。分析了841例接受人格障碍专门治疗的患者的数据。这项研究的重点是结果问卷-45.2(OQ-45.2)症状困扰量表(SD)的变化,人格障碍的一般评估(GAPD),和严重程度指数的人格问题(SIPP)在治疗的早期阶段预测治疗后的人格功能障碍,由SIPP和GAPD测量。特定SIPP域内的早期变化是同一域中治疗后结果的最强预测因子。症状的早期变化显着预测自我控制的结果,关系功能,和身份整合,而GAPD预测了SIPP在自我控制和社会协调方面的结果。对于GAPD,GAPD本身的早期变化,其次是OQ-45SD和SIPP领域社会地位的早期变化,是重要的预测因子。因此,当涉及到人格障碍时,特定领域或措施的早期变化是同一领域结果的最佳预测因素.虽然OQ-45预测了人格障碍的某些方面,它不应该取代针对无序的措施。此外,SIPP结构域和GAPD不应互换用于相互预测.总之,考虑到这些因素,监测早期变化有助于评估人格障碍患者的治疗进展.
    A significant proportion of patients with a personality disorder do not benefit from treatment. Monitoring treatment progress can help adjust ineffective treatments. This study examined whether early changes in symptoms and personality dysfunction during the first phase of therapy could predict treatment outcomes. Data from 841 patients who received specialized treatment for personality disorders were analyzed. The study focused on whether changes in the Outcome Questionnaire-45.2 (OQ-45.2) symptom distress scale (SD), the General Assessment of Personality Disorder (GAPD), and Severity Indices of Personality Problems (SIPP) in the early phase of therapy predicted post-treatment personality dysfunction, as measured by the SIPP and GAPD. Early changes within a specific SIPP domain were the strongest predictors of post-treatment outcomes in that same domain. Early changes in symptoms significantly predicted outcomes in Self-Control, Relational Functioning, and Identity Integration, while the GAPD predicted outcomes in Self-Control and Social Attunement on the SIPP. For the GAPD, early changes on the GAPD itself, followed by early changes on the OQ-45 SD and the SIPP domain Social Attunement, were significant predictors. Thus, when it comes to personality dysfunction, early changes in a specific domain or measure are the best predictors of outcomes in that same domain. While the OQ-45 predicted some aspects of personality dysfunction, it should not replace disorder-specific measures. Additionally, the SIPP domains and the GAPD should not be used interchangeably to predict each other. In sum, considering these factors, monitoring early change can be useful in assessing progress in the treatment of patients with personality disorders.
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  • 文章类型: Journal Article
    背景:创伤后应激障碍(PTSD)与C型人格障碍(PD)的高发率相关,这可能会对PTSD治疗产生负面影响。尚不清楚PTSD和PD合并症的同时治疗是否会导致更好的治疗效果,与标准的创伤聚焦治疗相比。目的:目的是测试将人格障碍治疗(团体图式治疗;GST)添加到以个人创伤为重点的治疗(图像脚本;ImRs)中的功效。方法:2018年至2023年,在荷兰一家精神卫生机构的两个地点进行了一项双臂随机临床试验(分配比例为1:1)。评估者对治疗分配视而不见。患有PTSD和合并症C型人格障碍的成年门诊患者被随机分配接受ImRs(12-18个疗程)或ImRsGST(12-18ImRs52-58GST)。主要结果是PTSD严重程度开始治疗一年后,用DSM-5的临床医师-管理的PTSD量表测量。结果:130例患者(平均[SD]年龄=40.6[11.2],110[85%]女性),66个分配给ImRs,64个分配给ImRs+GST。12个月时,创伤后应激障碍严重程度大幅下降(dImRs=2.42,95CI=1.97-2.87;dImRs+GST=2.44,95CI=1.99-2.90),但条件之间没有显着差异(d=0.02,95CI=-0.33-0.36,p=.944)。在这两种情况下都观察到人格障碍症状和所有其他次要结果的减少。在12个月时,任何次要结局的条件之间没有显着差异。结论:对于PTSD和共病CPD患者,更密集的并发创伤聚焦和人格障碍治疗(ImRsGST)并不优于单独的创伤聚焦治疗(ImRs)。这表明创伤集中治疗是内在化人格障碍和创伤后应激障碍患者的首选主要治疗方法。保留加强针对人格障碍的更深入的心理治疗作为二线治疗。试用注册:ClinicalTrials.gov标识符:NCT03833531。
    对于患有创伤后应激障碍(PTSD)和合并症C型人格障碍的患者,并发创伤集中和人格障碍治疗并不优于仅创伤集中治疗。PTSD严重程度的大幅降低和所有次要结局的中等到大的降低,包括人格障碍症状,在两个治疗组中都观察到。这些发现是惊人的,考虑到联合治疗组人格障碍合并症的较高治疗剂量和专门治疗。
    Background: Posttraumatic stress disorder (PTSD) is associated with high rates of cluster C personality disorders (PD), which may negatively affect PTSD treatment. It is unknown whether concurrent treatment for PTSD and comorbid PD leads to superior treatment effects, compared to standard trauma-focused treatment.Objective: The objective was to test the efficacy of adding personality disorder treatment (group schema therapy; GST) to individual trauma-focused treatment (imagery rescripting; ImRs).Method: A two-arm randomized clinical trial (1:1 allocation ratio) was conducted between 2018 and 2023 at two sites of a mental health institution in the Netherlands. Raters were blind to treatment allocation. Adult outpatients with PTSD and comorbid cluster C personality disorders were randomized to receive either ImRs (12-18 sessions) or ImRs + GST (12-18 ImRs + 52-58 GST). The main outcome was PTSD severity one year after start of treatment measured with the Clinician-Administered PTSD Scale for DSM-5.Results: Of 130 patients (mean [SD] age = 40.6 [11.2], 110 [85%] females), 66 were assigned to ImRs and 64 to ImRs + GST. At 12 months, there were large decreases in PTSD severity (dImRs = 2.42, 95%CI = 1.97-2.87; dImRs + GST = 2.44, 95%CI = 1.99-2.90), but there was no significant difference between conditions (d = 0.02, 95%CI = -0.33-0.36, p = .944). Reductions in personality disorder symptoms and all other secondary outcomes were observed in both conditions. There were no significant differences between conditions on any of the secondary outcomes at 12 months.Conclusion: The more intensive concurrent trauma-focused and personality disorder treatment (ImRs + GST) was not superior to trauma-focused treatment alone (ImRs) for patients with PTSD and comorbid CPD. This suggests that trauma-focused treatment is the preferred primary treatment in patients presenting with both internalizing personality disorder and PTSD, reserving the stepping up to more intensive psychotherapy aimed at the personality disorder as a second line of treatment.Trial registration: ClinicalTrials.gov identifier: NCT03833531.
    Concurrent trauma-focused and personality disorder treatment was not superior to only trauma-focused treatment for patients with posttraumatic stress disorder (PTSD) and comorbid cluster C personality disorders.Large reductions in PTSD severity and medium-to-large reductions in all secondary outcomes, including personality disorder symptoms, were observed in both treatment arms.These findings are remarkable, given the higher therapy dosage and specialized treatment for personality disorder comorbidity in the combined treatment arm.
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  • 文章类型: Journal Article
    神经退行性疾病是一个主要的全球健康问题,预计到2050年将有1.5亿人患有痴呆症。遗传因素,环境因素,人口统计,一些疾病与痴呆症有关。除了高血压、脑血管疾病和痴呆等疾病之间的关联,新发现将一些精神疾病与痴呆相关。由于痴呆症的全球患病率高且不断增加,以及精神疾病的全球患病率高,这篇叙述性综述的主要目的是评估已发表的评估双相情感障碍之间关联的研究结果,抑郁症,焦虑,创伤后应激障碍,强迫症,注意力缺陷/多动障碍,自闭症谱系障碍,精神分裂症和其他精神病综合征,人格障碍和人格特质和偶发性痴呆。这里,我们重点介绍了这些精神疾病与随后的痴呆之间可能存在关联的研究结果,并提示某些精神疾病可能是偶发痴呆的危险因素.进一步研究,包括更大规模的纵向研究和额外的荟萃分析,然而,需要更好地描述精神疾病和痴呆症之间的联系,为了确定这些推定关联的可能机制,并确定精神疾病中的危险因素,这些危险因素使某些患有精神疾病的人容易患上痴呆症,而其他人则不容易患上痴呆症。其他重要问题涉及精神疾病的治疗如何影响痴呆的风险。
    Neurodegenerative disease is a major global health problem with 150 million people predicted to have dementia by 2050. Genetic factors, environmental factors, demographics, and some diseases have been associated with dementia. In addition to associations between diseases such as hypertension and cerebrovascular disease and dementia, emerging findings associate some psychiatric disorders with incident dementia. Because of the high and increasing global prevalence of dementia and the high worldwide prevalence of psychiatric disorders, the primary objective of this narrative review was to evaluate published findings that evaluate the association between bipolar disorder, depression, anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, schizophrenia and other psychosis syndromes, and personality disorders and personality traits and incident dementia. Here, we highlight findings indicating possible associations between these psychiatric disorders and subsequent dementia and suggest that some psychiatric disorders may be risk factors for incident dementia. Further research, including more large longitudinal studies and additional meta-analyses, however, is needed to better characterize the associations between psychiatric disorders and incident dementia, to identify possible mechanisms for these putative associations, and to identify risk factors within psychiatric disorders that predispose some people with a psychiatric disorder but not others to subsequent dementia. Additional important questions concern how the treatment of psychiatric disorders might affect the risk of incident dementia.
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  • 文章类型: Journal Article
    精神病学病理学在当代社会中脱颖而出,不仅是独立的,而且还通过其与其他医学合并症如肿瘤疾病的关联。专业文献证实了随着时间的推移这些疾病的共存。有一种趋势是发展各种精神表现,如情绪障碍和躯体形式障碍,以及现有的潜在精神疾病(焦虑症和精神障碍)或人格障碍的代偿失调(一个很好的例子是强迫性人格障碍中焦虑的加剧)。乳腺癌,像任何致残疾病一样,影响人的心理和行为作为一个整体。科学证明,心理平衡影响患者的生活质量,也影响疾病的演变和预后,心理过程能够调节肿瘤过程的活动。有必要扩大临床实践和研究,超越简单的症状评估,治疗的目标不仅应该是减轻症状,而且应该在身体和精神上改善癌症患者的生活质量。
    Psychiatric pathology stands out in contemporary society not only as independent but also through its association with other medical comorbidities such as neoplastic diseases. Specialized literature confirms over time the coexistence of these diseases. There is a tendency to develop various psychiatric manifestations such as mood disorders and somatoform disorders, as well as decompensation of underlying existing psychiatric pathologies (anxiety disorders and psychotic disorders) or personality disorders (a good example is the exacerbation of anxiety in obsessive-compulsive personality disorder). Breast cancer, like any disabling disease, affects the person\'s psyche and behaviors as a whole. It is scientifically proven that mental balance influences the quality of life of patients and also the evolution and prognosis of the disease, psychological processes being able to modulate the activity of the tumor process. It is necessary to expand clinical practice and research beyond the simple evaluation of symptoms, and the goal of treatment should not only be to reduce symptoms but also to improve in terms of both physically and mentally the quality of life of cancer patients.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    COVID-19大流行导致了多种具有社会限制性的公共卫生措施,并报告了对青少年的负面心理健康影响。很少有研究按性别评估发病率,区域,以及整个人口的社会决定因素。
    为了估计精神健康状况住院的发生率,按性别分层,区域,和社会决定因素,在儿童和青少年(以下简称青年)和年轻人中,比较流行和流行期。
    这项基于加拿大人口的重复生态横断面研究使用了卫生行政数据,从2016年4月1日延长至2023年3月31日。包括加拿大各省和地区的所有6至20岁的年轻人和年轻人。加拿大卫生信息研究所提供了除魁北克以外所有省份的数据;国家卓越研究所提供了魁北克的汇总数据。
    COVID-19流行时期,定义为2020年4月1日至2023年3月31日。
    主要结局指标是因焦虑症住院的前流行率和COVID-19流行率,情绪障碍,饮食失调,精神分裂症或精神病,人格障碍,物质相关疾病,和自我伤害。次要指标包括按性别分列的住院差异,年龄组,和剥夺以及急诊科访问相同的精神健康状况。
    在研究期间的加拿大青年和年轻人中,有218101例精神健康状况住院(6至11岁:5.8%,12至17年:66.9%,18至20岁:27.3%;66.0%女性)。在流行前和COVID-19流行年之间,精神健康住院率从每10,000人年51.6降至47.9。然而,大流行与焦虑症住院人数增加有关(发病率比[IRR],1.11;95%CI,1.08-1.14),人格障碍(IRR,1.21;95%CI,1.16-1.25),自杀和自我伤害(IRR,1.10;95%CI,1.07-1.13),和饮食失调(IRR,1.66;95%CI,1.60-1.73),女性和饮食失调(IRR,1.47;95%CI,1.31-1.67)男性。在两性中,因情绪障碍而住院的人数有所减少(IRR,0.84;95%CI,0.83-0.86),物质相关疾病(IRR,0.83;95%CI,0.81-0.86),和其他精神健康障碍(IRR,0.78;95%CI,0.76-0.79)。
    这项针对加拿大年轻人和年轻人的横断面研究发现,焦虑情绪有所上升,人格障碍,在COVID-19流行期,女性自杀和两性饮食失调的增加。这些结果表明,在未来的大流行中,政策制定者应支持在公共卫生限制期间特别容易受到精神健康状况恶化影响的年轻人和年轻人,包括饮食失调,焦虑,和自杀。
    UNASSIGNED: The COVID-19 pandemic resulted in multiple socially restrictive public health measures and reported negative mental health impacts in youths. Few studies have evaluated incidence rates by sex, region, and social determinants across an entire population.
    UNASSIGNED: To estimate the incidence of hospitalizations for mental health conditions, stratified by sex, region, and social determinants, in children and adolescents (hereinafter referred to as youths) and young adults comparing the prepandemic and pandemic-prevalent periods.
    UNASSIGNED: This Canadian population-based repeated ecological cross-sectional study used health administrative data, extending from April 1, 2016, to March 31, 2023. All youths and young adults from 6 to 20 years of age in each of the Canadian provinces and territories were included. Data were provided by the Canadian Institute for Health Information for all provinces except Quebec; the Institut National d\'Excellence en Santé et en Services Sociaux provided aggregate data for Quebec.
    UNASSIGNED: The COVID-19-prevalent period, defined as April 1, 2020, to March 31, 2023.
    UNASSIGNED: The main outcome measures were the prepandemic and COVID-19-prevalent incidence rates of hospitalizations for anxiety, mood disorders, eating disorders, schizophrenia or psychosis, personality disorders, substance-related disorders, and self-harm. Secondary measures included hospitalization differences by sex, age group, and deprivation as well as emergency department visits for the same mental health conditions.
    UNASSIGNED: Among Canadian youths and young adults during the study period, there were 218 101 hospitalizations for mental health conditions (ages 6 to 11 years: 5.8%, 12 to 17 years: 66.9%, and 18 to 20 years: 27.3%; 66.0% female). The rate of mental health hospitalizations decreased from 51.6 to 47.9 per 10 000 person-years between the prepandemic and COVID-19-prevalent years. However, the pandemic was associated with a rise in hospitalizations for anxiety (incidence rate ratio [IRR], 1.11; 95% CI, 1.08-1.14), personality disorders (IRR, 1.21; 95% CI, 1.16-1.25), suicide and self-harm (IRR, 1.10; 95% CI, 1.07-1.13), and eating disorders (IRR, 1.66; 95% CI, 1.60-1.73) in females and for eating disorders (IRR, 1.47; 95% CI, 1.31-1.67) in males. In both sexes, there was a decrease in hospitalizations for mood disorders (IRR, 0.84; 95% CI, 0.83-0.86), substance-related disorders (IRR, 0.83; 95% CI, 0.81-0.86), and other mental health disorders (IRR, 0.78; 95% CI, 0.76-0.79).
    UNASSIGNED: This cross-sectional study of Canadian youths and young adults found a rise in anxiety, personality disorders, and suicidality in females and a rise in eating disorders in both sexes in the COVID-19-prevalent period. These results suggest that in future pandemics, policymakers should support youths and young adults who are particularly vulnerable to deterioration in mental health conditions during public health restrictions, including eating disorders, anxiety, and suicidality.
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  • 文章类型: Journal Article
    患有严重精神疾病(SMI)的人面临的职业挑战与被诊断为人格障碍(PD)的人不同。支持就业(SE)已得到SMI患者的验证,但其对PD患者的有效性尚不清楚。这种潜在差异的原因还没有被探索。这项研究旨在确定SMI客户和PD客户在SE实践方面的差异。
    采访了六名SE工作教练,了解了他们的经历。进行了专题分析。
    与其他SMI的客户相比,与PD的客户相比,提到了更多的困难和促进因素。对于两者来说,据报道,患者的症状对他们(重新)融入就业市场产生负面影响。然而,与SMI的客户相比,PD患者的症状与SE成功之间的关系涉及困难行为及其对治疗关系的负面影响。
    总之,SE实践似乎受到PD的破坏,可以从适应中受益,例如对SE团队进行特定培训,以帮助他们管理患有这种疾病的客户。
    UNASSIGNED: People with severe mental illnesses (SMI) face different occupational challenges than those diagnosed with personality disorders (PD). Supported employment (SE) has been validated for SMI patients but its effectiveness for individuals with PD remains unclear, and the reasons for this potential difference have not been explored. This study aimed to identify differences in SE practice for clients with SMI and those with PD.
    UNASSIGNED: Six SE job coaches were interviewed about their experiences. A thematic analysis was run.
    UNASSIGNED: More difficulties and facilitators were mentioned regarding clients with PD than regarding clients with other SMI. For both, patients\' symptoms were reported to negatively affect their (re)integration into the job market. However, in contrast to that of clients with SMI, the relation between symptoms and SE success for clients with PD involved difficult behaviors and their negative impact on the therapeutic relationship.
    UNASSIGNED: In summary, SE practice seems to be undermined by PD and could benefit from adaptations, such as specific training for SE teams to help them in managing clients with this disorder.
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