personality disorders (PDs)

  • 文章类型: Editorial
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  • 文章类型: Journal Article
    癫痫学家和精神病医生长期以来在临床实践中观察到癫痫与人格障碍(PD)之间的相关性。我们进行了全面的PubMed搜索,以寻找癫痫患者(PwE)的PD证据。在没有任何时间限制的情况下获得的600多个结果中,我们只选择了仅限于英语的相关研究(包括分析性和描述性研究),意大利语,法语和西班牙语,特别关注PD,而不是特征或症状,因此,我们的搜索范围缩小到23个符合条件的研究。PD已在局灶性癫痫(主要是颞叶癫痫-TLE)中进行了研究,青少年肌阵挛性癫痫(JME)和心因性非癫痫发作(PNES),具有异构的方法论。在手术候选人或手术后个体中,局灶性癫痫的PDs患病率为18%至42%,C群人格障碍或相关特征和症状最常见。在JME,患病率从8%到23%,与任何特定的PDs亚型没有强相关性。在PNES中,患病率从30%到60%不等,与B群人格障碍有显著关联,尤其是边缘性人格障碍。PwE中有一个PD,不管子类型,使治疗管理复杂化。然而,关于神经生物学底物的知识存在很大的差距,抗癫痫药物和癫痫手术对伴随PD的影响,所有这些都是未来研究的潜在途径。
    Epileptologists and psychiatrists have long observed a correlation between epilepsy and personality disorders (PDs) in their clinical practice. We conducted a comprehensive PubMed search looking for evidence on PDs in people with epilepsy (PwE). Out of over 600 results obtained without applying any time restriction, we selected only relevant studies (both analytical and descriptive) limited to English, Italian, French and Spanish languages, with a specific focus on PDs, rather than traits or symptoms, thus narrowing our search down to 23 eligible studies. PDs have been investigated in focal epilepsy (predominantly temporal lobe epilepsy - TLE), juvenile myoclonic epilepsy (JME) and psychogenic non-epileptic seizures (PNES), with heterogeneous methodology. Prevalence rates of PDs in focal epilepsy ranged from 18 to 42% in surgical candidates or post-surgical individuals, with Cluster C personality disorders or related traits and symptoms being most common. In JME, prevalence rates ranged from 8 to 23%, with no strong correlation with any specific PDs subtype. In PNES, prevalence rates ranged from 30 to 60%, with a notable association with Cluster B personality disorders, particularly borderline personality disorder. The presence of a PD in PwE, irrespective of subtype, complicates treatment management. However, substantial gaps of knowledge exist concerning the neurobiological substrate, effects of antiseizure medications and epilepsy surgery on concomitant PDs, all of which are indeed potential paths for future research.
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  • 文章类型: Journal Article
    UNASSIGNED:随着2022年初第11版国际疾病分类(ICD-11)的实施,诊断人格障碍(PD)的框架和过程将发生根本变化,指示从分类模型到维度模型的过渡。尽管越来越多的证据表明PD不像以前假设的那样稳定,PD的长期稳定性仍存在重大争议。本文的目的是研究高风险样本中从青春期到成年期的PDs的分类和维度平均水平和等级顺序稳定性。
    未经批准:总共,本研究包括115名在瑞士有居住儿童福利和少年司法安置史的年轻人。在基线和10年随访时评估PDs。在绝对层面上,通过从基线到随访的持久病例比例评估平均稳定性.通过科恩κ和四声相关系数评估排序稳定性。在维度层面上,基线和随访时PD性状评分之间的变化幅度通过Cohen'sd测量。通过Spearman'sρ评估排序稳定性。
    UNASSIGNED:任何PD的患病率在基线时为20.0%,在随访时为30.4%。最常诊断的疾病是反社会的,边界线,和强迫性PD,基线和随访时。在绝对层面上,任何PD的平均水平稳定性都只有中等,特定PD的平均水平稳定性较低,除了分裂样PD.同样,任何PD类别的排序稳定性都是中等的,而从低到高的个人PD诊断。在维度层面上,大多数PD的分数显著增加,除了组织学特征,从基线到随访显着下降。效应大小通常较低。维度得分的等级顺序稳定性从低到中等。
    UNASSIGNED:研究结果表明,从青春期到成年期,Pds和Pd性状的稳定性低至中等,这支持了越来越多的证据表明,对Pds的分类诊断非常不稳定。这反过来,强调即将到来的ICD-11的使用,承认pds只是“相对”稳定。
    UNASSIGNED: With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) in early 2022, there will be a radical change in the framework and process for diagnosing personality disorders (PDs), indicating a transition from the categorical to the dimensional model. Despite increasing evidence that PDs are not as stable as previously assumed, the long-term stability of PDs remains under major debate. The aim of the current paper was to investigate the categorical and dimensional mean-level and rank-order stability of PDs from adolescence into young adulthood in a high-risk sample.
    UNASSIGNED: In total, 115 young adults with a history of residential child welfare and juvenile-justice placements in Switzerland were included in the current study. PDs were assessed at baseline and at a 10-year follow-up. On a categorical level, mean-level stability was assessed through the proportion of enduring cases from baseline to follow-up. Rank-order stability was assessed through Cohen\'s κ and tetrachoric correlation coefficients. On a dimensional level, the magnitude of change between the PD trait scores at baseline and at follow-up was measured by Cohen\'s d. Rank-order stability was assessed through Spearman\'s ρ.
    UNASSIGNED: The prevalence rate for any PD was 20.0% at baseline and 30.4% at follow-up. The most frequently diagnosed disorders were antisocial, borderline, and obsessive-compulsive PDs, both at baseline and at follow-up. On a categorical level, the mean-level stability of any PD was only moderate, and the mean-level stability of specific PDs was low, except of schizoid PD. Likewise, the rank-order stability of any PD category was moderate, while ranging from low to high for individual PD diagnoses. On a dimensional level, scores increased significantly for most PDs, except for histrionic traits, which decreased significantly from baseline to follow-up. Effect sizes were generally low. The rank-order stability for dimensional scores ranged from low to moderate.
    UNASSIGNED: The findings indicate low to moderate stability of Pds and Pd traits from adolescence to adulthood, which supports the growing evidence that categorical diagnoses of Pds are quite unstable. This in turn, emphasizes the use of the upcoming ICD-11 that Acknowledgments Pds to be only \"relatively\" stable.
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  • 文章类型: Journal Article
    酒精使用障碍(AUDs)代表了严重的,世界性的问题,通常与精神疾病并存,合并症增加了与AUDs相关的风险,并对患者造成更严重的后果。然而,目前AUDs合并精神疾病的潜在机制尚不清楚.调查合并症的研究可以帮助我们理解AUDs的神经机制。在这次审查中,我们在AUDs中探索三种合并症,包括精神分裂症,抑郁症(MDD),和人格障碍(PD)。它们都是AUDs的合并症,比率为33.7、28和50-70%,分别。发病率明显高于其他疾病。因此我们回顾和分析相关文献,探讨这三种疾病是否是AUDs的危险因素,专注于评估认知功能和使用神经成像的研究。我们发现记忆缺陷,认知控制受损,负面情绪,冲动性可能会增加个人对AUD的脆弱性。这种合并症可能表明AUD的神经基础,并揭示与不同类型合并症相关的特征。导致AUDs新治疗方法的进一步发展。
    Alcohol use disorders (AUDs) represent a severe, world-wide problem, and are usually comorbid with psychiatric disorders, comorbidity increases the risks associated with AUDs, and results in more serious consequences for patients. However, currently the underlying mechanisms of comorbid psychiatric disorders in AUDs are not clear. Studies investigating comorbidity could help us understand the neural mechanisms of AUDs. In this review, we explore three comorbidities in AUDs, including schizophrenia, major depressive disorder (MDD), and personality disorders (PDs). They are all co-morbidities of AUDs with rate of 33.7, 28, and 50-70%, respectively. The rate is significantly higher than other diseases. Therefore we review and analyze relevant literature to explore whether these three diseases are the risk factors of AUDs, focusing on studies assessing cognitive function and those using neural imaging. We found that memory deficits, impairment of cognitive control, negative emotion, and impulsivity may increase an individual\'s vulnerability to AUDs. This comorbidity may indicate the neural basis of AUDs and reveal characteristics associated with different types of comorbidity, leading to further development of new treatment approaches for AUDs.
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