A comparison of thought and perception disorders in borderline personality disorder and schizophrenia: psychotic experiences as a reaction to impaired social functioning

BACKGROUND: Although previous studies suggest a high frequency of psychotic symptoms in DSM-IV Borderline Personality Disorder (BPD) there is currently no consensus on their prevalence and characteristics (type, frequency, duration, location etc.). Similarly, there are few papers addressing psychotic reactivity, the crucial aspect of BPD included in the ninth criterion for DSM-IV BPD, which remained unchanged in DSM-IV-TR and DSM-5. The purposes of the present study were to compare thought and perception disorders in patients with DSM-IV BPD and schizophrenia (SC), investigating their relationship with social functioning. METHODS: Thought and perception disorders and social functioning over the previous two years were assessed by the Diagnostic Interview for Borderline Revised (DIB-R) and Personal and Social Performance scale (PSP) respectively in outpatients with DSM-IV BPD (n = 28) or DSM-IV SC (n = 28). RESULTS: Quasi-psychotic thought (i.e. transient, circumscribed and atypical psychotic experiences) was more frequent in BPD (BPD = 82.1%, SC = 50%, p = 0.024); whereas true psychotic thought (i.e. Schneiderian first-rank, prolonged, widespread and bizarre psychotic symptoms) was more frequent in SC (SC = 100%, BPD = 46.4%, p < 0.001). However both types of psychotic features were prevalent in both groups. Non-delusional paranoia (e.g. undue suspiciousness and ideas of references) was ubiquitous but was more severe in BPD than SC patients (U(54) = 203.5, p = 0.001). In the BPD group there was a strong negative correlation between personal and social functioning and non-delusional paranoia (τ(28) = 0.544, p = 0.002) and level of personal and social functioning was a significant predictor of the severity of non-delusional paranoia only in the BPD group (β = −0.16, t(23) = 2.90, p = 0.008). CONCLUSIONS: BPD patients reported less severe psychotic experiences with more frequent quasi-psychotic thought, less frequent true psychotic thought and more severe non-delusional paranoia than SC patients. Interpersonal functioning seems to predict non-delusional paranoia in BPD, which would validate the “stress-related paranoid ideation”, included in the ninth diagnostic criterion for DSM-IV and DSM-5 BPD. PBD patients had higher scores on the psychotic experiences subscale that support the use of a dimensional assessment of the severity of thought and perception disorders, for example the Clinician-Rated Dimensions of Psychosis Symptom Severity introduced in DSM-5, Section III

Gender Differences in Anxiety and Depression before and after Alcohol Detoxification: Anxiety and Depression as Gender-Related Predictors of Relapse

The aim of this prospective study was to estimate gender differences in anxiety, depression, and alcohol use severity among patients with alcohol use disorder (AUD) before and after detoxification program and within 12 months after discharge

Efficacia, target e contesti dei trattamenti per gli autori di reati sessuali

In the present study, the most recent meta-analyses concerning the much debated topic of the effectiveness of in-prison treatment programs for sex offenders are investigated. Both strengths and weaknesses of each analysis are analysed. Empirical evidence regarding treatment effectiveness is underlined with the latter being measured in terms of reduction of sexual recidivism. Noteworthy are the treatment programs based on the principles of the Risk/Need/Responsivity Theory which seems to provide the best guarantee of treatment effectiveness.In questo articolo vengono prese in esame le più recenti meta-analisi al riguardo del dibattuto problema dell’efficacia dei trattamenti intra-carcerari rivolti agli autori di reati sessuali. Di ognuna di esse sono analizzati i punti di forza e le debolezze. Vengono sottolineate le evidenze empiriche riguardanti l’efficacia dei trattamenti, misurata nei termini di riduzione della recidiva. Viene evidenziato che la formulazione di interventi teoricamente indirizzati secondo i principi della teoria Rischio/ Bisogni/ Responsività sembra, ad oggi, fornire le migliori garanzie di efficacia dei trattamenti

Disorder Post-Traumatic Stress, sleep quality, anxiety, depression and quality of life in cancer patients undergoing chemotherapy

Objectives: To assess the prevalence of disorder Posttraumatic Stress (DPTS), anxiety and depression, quality of sleep and quality of life in cancer patients consecutively during chemotherapy compared to the general population, the prevalence of benchmarking Disorder Post Traumatic Stress (DPTS), anxiety and depression, quality of sleep and quality of life in cancer patients during adjuvant treatment versus cancer patients in treatment for metastatic disease. Methods: We surveyed consecutive patients undergoing chemotherapy treatment for neoplastic disease in accordance with the following instruments: the disorder Posttraumatic Stress was assessed by questionnaire Impact of Event Scale (IES), the levels of anxiety and depression through the Hospital Anxiety and Depression Scale (HADS); sleep quality with the help of the Pittsburgh Sleep Quality Index (PSQI), the quality of life through the Functional Assessment of Cancer Therapy - General (FACT-G). Results: We evaluated 173 patients, of whom 61 (35.3%) treated with adjuvant chemotherapy and 112 (64.7%) in chemotherapy for metastatic disease. In the overall population, the supremacy of Disorder Posttraumatic Stress was 8%, a sleep disorder 30%; anxiety to 15 - 20%, 15% from depression. The prevalence in the study population Disorder Posttraumatic Stress was higher compared to data in the literature (45.1% versus 8%), the largest of sleep disorders (62.8% versus 30%) of the anxiety higher (40% vs. 15-20%), the major depression (15% versus 31.1%). No significant differences were found with regard to the prevalence of disorder Posttraumatic Stress (P = 0.768), sleep disorders (P = 0.978), anxiety (p = 0.351), depression (P = 0.958) and quality of  life (P = 0.675) in patients undergoing chemotherapy treatment for metastatic disease compared to patients treated adjuvante.Conclusões: The prevalence of psychological disorders in the study population appears significantly higher than in the general population; This finding confirms the need for psychiatric intervention consultation and liaison (liaison) in neoplastic patients undergoing chemotherapy. This need not differ between patients in the adjuvant treatment and those receiving treatment for metastatic disease, with no significant differences in the incidence of the disorders assessed between the two groups above

A Legislação Psiquiátrica e a Reforma da Psiquiatrica

Introducción: La reforma psiquiátrica en Italia es el resultado de un gran movimiento en el primer lugar y luego sociocultural grupo político que estalló espontáneamente su indignación por la degradación de manicomiais estructuras. Objetivo: analizar reflexivamente historia de la legislación psiquiátrica y la reforma psiquiátrica en la ciudad de Turín, Italia. Métodos: Se realizó un análisis de la implementación de los servicios territoriales de atención psicosocial del Departamento de Salud Mental creó la Facultad de Medicina y Cirugía de San Luis Gonzaga. Resultados: promover y coordinar la prevención, atención y rehabilitación en salud mental. Debe tener un alcance bien definido, que comprende una superficie de 100.000 y 200.000 habitantes, lo que garantiza todas las acciones, incluidas las de emergencia. Debe contar con un equipo multidisciplinario - con al menos un profesional responsable por cada 1.500 habitantes, integrados por psiquiatras, enfermeros y enfermeras, terapeutas de rehabilitación psiquiátrica, educadores, trabajadores sociales, auxiliares y personal administrativo, tienen una clínica, camas en los hospitales, residencias y semirresidencial. La primera intervención pasa entonces a petición del médico de cabecera que indica la "visita psicológico o psiquiátrico". Un equipo multidisciplinario realiza un examen para evaluar la gravedad de las intervenciones situación psicopatológicos y terapéuticos necesarios para la rehabilitación. Por otra parte, escribe el Proyecto Terapéutico Individual (ITP) con el fin de determinar el tratamiento, medicación y rehabilitación ruta / orientación del paciente, teniendo en cuenta sus necesidades personales y de salud. Conclusión: la mejora de la calidad del tratamiento se logra a través de un enfoque integrado de la farmacoterapia, la psicoterapia, la psicoeducación y la rehabilitación realizada en los servicios territoriales y, sobre todo, la creencia de que todas las enfermedades mentales pueden tener el beneficio del tratamiento y la asistencia

Age of Onset of Mood Disorders and Complexity of Personality Traits

Objective. The aim of the present study is to evaluate the link between the age of onset of mood disorders and the complexity of the personality traits. Methods. 209 patients with major depressive or manic/hypomanic episodes were assessed using the Structured Clinical Interview for DSM Axis I diagnoses and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. 17.2% of the patients had no elevated MCMI-III scores, 45.9% had one peak, and 36.9% had a complex personality disorder with two or more elevated scores. Mood disorders onset of 29 years or less was the variable most related to the complexity of personality disorders as indicated from a recursive partitioning analysis. Conclusions. The relationship between mood disorders and personality traits differ in reference to age of onset of the mood disorder. In younger patients, maladaptive personality traits can evolve both in a mood disorder onset and in a complex personality disorder, while the later development of a severe mood disorder can increase the personality symptomatology. Our results suggest a threshold of mood disorder onset higher compared to previous studies. Maladaptive personality traits should be assessed not only during adolescence but also in young adults to identify and treat potential severe mood disorders