Comprehensive psychiatry
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Comprehensive psychiatry · Mar 2005
The childhood-onset neuropsychiatric background to adulthood psychopathic traits and personality disorders.
Childhood conduct disorder (CD) and adult psychopathic traits according to the Psychopathy Checklist Revised (PCL-R) were the closest psychiatric covariates to repeated violent crimes and aggression among offenders under forensic psychiatric investigation in Sweden. As psychopathy is not included in the present psychiatric diagnostic systems, we compared total and factor PCL-R scores to Axis I disorders, including childhood-onset neuropsychiatric disorders, and to Axis II personality disorders, to establish the convergence of psychopathic traits with other psychiatric diagnoses, and to identify possible unique features. ⋯ The total PCL-R scores as well as the Factor 2 (unemotionality) and Factor 3 (behavioral dyscontrol) scores were significantly correlated with attention-deficit/hyperactivity disorder, Asperger's syndrome/high-functioning autistic traits, CD, substance abuse, and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Cluster B personality disorders. The interpersonal Factor 1 showed none of these correlations and may capture features that are specific to psychopathy, distinguishing core psychopathy from other diagnostic definitions.
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Comprehensive psychiatry · Sep 2004
DSM-IV obsessive-compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects.
The relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has not yet been fully clarified. The aim of the present study was to analyze DSM-IV OCPD prevalence rates in OCD and panic disorder (PD) patients to test for the specificity of the OCPD-OCD link, and to compare them to OCPD prevalence in a control group of subjects without any psychiatric disorder. A total of 109 patients with a principal diagnosis of DSM-IV (SCID-I) OCD and 82 with PD were interviewed using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) in order to assess the prevalence of OCPD. ⋯ A significant difference was found between the prevalence of OCPD in OCD (22.9%) and in PD (17.1%) on one hand, and that in the comparison sample (3.0%) on the other. No differences were found between the two psychiatric groups, even when splitting the samples according to gender. Our study failed to support the hypothesis of a specific relationship between OCPD and OCD; we confirmed the higher prevalence rate of this personality disorder in OCD subjects with regard to the general population, but we also confirmed the higher rate of OCPD in another anxiety disorder which is phenomenologically well characterized and different from OCD, such as PD.
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Comprehensive psychiatry · Jan 2004
Cincinnati criteria for mixed mania and suicidality in patients with acute mania.
The association between suicidality and diagnoses of mixed mania, as defined using both DSM-IV and Cincinnati criteria, was studied in 576 consecutive manic inpatients. Of the whole sample, 51 (8.9%) had suicidal ideation and 13 (2.3%) attempted suicide during the index episode. Suicidality was significantly more frequent in patients with a diagnosis of mixed mania, whether the diagnosis was made by DSM-IV or Cincinnati criteria. ⋯ Our finding that suicidality was more strongly associated with Cincinnati mixed mania than with DSM-IV mixed mania is probably due to that suicidal patients who do not meet DSM-IV criteria for mixed mania are classified into mixed mania, or/and that the depressive syndrome, related to suicidality, is more appropriately assessed among manic patients, when using the Cincinnati criteria. There was no evidence that marital status, employment, a lifetime history of alcohol or substance abuse, or a history of suicide attempts before the index episode was significantly associated with suicidality in the sample. Manic patients with suicidality may have a greater severity of residual depressive symptoms at discharge.
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Comprehensive psychiatry · May 2002
Randomized Controlled Trial Clinical TrialThe effect of cognitive-behavioral therapy for bulimia nervosa on temperament and character as measured by the temperament and character inventory.
Cognitive-behavioral therapy (CBT) is a successful treatment method for reducing symptomatology associated with bulimia nervosa (BN). Less is known regarding the impact of CBT on measures of temperament and character across treatment. We explore changes on the Temperament and Character Inventory (TCI) from pretreatment to 1-year follow-up in a sample of women with bulimia nervosa (BN). ⋯ We conclude that self-directedness and harm avoidance scores are positively affected by CBT. Higher scores on self-directedness not only predict treatment outcome for BN, but overall self-directedness is improved with CBT in women with BN. These results suggest that the elements of CBT affecting self-directedness may hold promise for enhancing the effectiveness of treatment for BN.
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Comprehensive psychiatry · Jan 2002
Comparative StudyThe impact of torture on post-traumatic stress symptoms in war-affected Tamil refugees and immigrants.
The present study examines the effect of torture in generating post-traumatic stress disorder (PTSD) symptoms by comparing its impact with that of other traumas suffered by a war-affected sample of Tamils living in Australia. Traumatic predictors of PTSD were examined among a subsample of 107 Tamils (refugees, asylum seekers, and voluntary immigrants) who had endorsed at least one trauma category on the Harvard Trauma Questionnaire. ⋯ The torture factor identified by the PCA was found to be the main predictor of PTSD in a multiple regression analysis. Although limited by sampling constraints and retrospective measurement, the present study provides support for the identification of torture as a particularly traumatic event, even when the impact of other war-related trauma is taken into account.