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PubMed1995

The Edinburgh Primary Care Depression Study: personality disorder and outcome.

BACKGROUND: Little is known about the impact of personality pathology on the treatment outcome of major depressive illness in primary care in the UK. METHOD: Patients meeting criteria for DSM-III major depressive disorder were randomly allocated to one of four treatments each lasting 16 weeks, then followed up for 18 months. Assessments were made of depressive symptoms, personality and social functioning. Personality was assessed at maximum improvement or 16 weeks. RESULTS: The prevalence of personality disorder (PD) in the sample of 113 patients was 26%. Patients with a PD were significantly younger and rated more depressed at entry than patients with no personality disorder (NoPD). On completion of treatment patients with a PD were significantly more depressed and had poorer social functioning than the NoPD group. After 18 months there were no differences in ratings of depression or social functioning between the groups. CONCLUSIONS: There was substantial improvement in both the PD and NoPD groups. The presence of personality pathology delays recovery from major depressive illness.

Adolescent↗
PubMed2001

A two-factor model of disordered eating.

General psychopathology (i.e., personality disturbance, mood/affect dysregulation) has been identified as common and perhaps etiologically important in eating disorder (ED) patients. In this context, we examined a two-factor model of disordered eating which implicated the independent and interactive contribution of (a) general psychopathology (personality) and (b) eating-related psychopathology (body esteem) in explaining deviant eating patterns. A sample of 266 female college/university students (M age=22.1) and 76 women with a clinically diagnosed ED (M age=28.09) completed paper and pencil questionnaires of deviant eating patterns, body esteem, and personality pathology. First, a K-means cluster procedure revealed a compelling three-cluster solution among the nonclinical women based on deviant eating variables: < >(n=61), < > (n=92), and < > (n=103). The ED women were classified as Cluster 4; < > (n=76). Second, to evaluate our two-factor model, multinomial logistic regression (MLR) was used with cluster membership as the outcome variable and the following variables as predictors: body esteem, personality pathology, and all two-way interactions. In addition to several significant main effects, three interaction terms were marginally significant: Body esteem appearance x Narcissism (P=.047), Body esteem weight x Narcissism (P=.044), and Body esteem attribution x Stimulus seeking(P=.051). The overall extent of correct cluster classification was 63%. These results indicate that the presence of both low body esteem and maladaptive personality, and the interactive operation of these two factors, seems to contribute to the likelihood of having an eating disorder, beyond the independent contribution of either factor alone. Results are considered in the context of etiological models in which general psychopathology presents a vulnerability factor in ED development.

Journal Article↗
PubMed1994

Self-image and personality traits in gender identity disorders: an empirical study.

Self-image and personality traits, measured by SASB and SCID screen respectively, were compared between transsexuals, patients diagnosed as Gender Identity Disorders of Adolescence and Adulthood, Non-transsexual Type (GIDAANT), and normal controls. Transsexual and GIDAANT patients differed significantly in both their self-image and personality traits. While both the transsexuals' and controls' self-images were positive with self-love, the GIDAANT patients had a negative self-image. On the SCID screen, the GIDAANT group fulfilled 39.8% of all axis II criteria; transsexuals fulfilled 28.6% versus 17.1% for the control group. Mean GAF scores (axis V) were 62, 70, and 83, respectively. For all patients a more negative self-image was significantly related to lower social functioning according to GAF and to more personality pathology according to SCID screen. The prevalence of additional clinical axis I and II disorders was about twice as high among GIDAANT patients as among transsexuals. Although the two conditions are closely related, we found more differences than similarities in the studied aspects and a clear tendency that the GIDAANT patients had more psychopathology overall. Although the transsexuals also differed significantly in some aspects from the controls, they showed less personality pathology and they had a normal self-image. Negative self-image, high degree of fulfilled axis II criteria, and low GAF scores seem to be corresponding factors and in this study clearly differentiate transsexuals from GIDAANT patients.

Adult↗
PubMed1997

[Gynecologic surgery in geriatric patients].

UNLABELLED: To establish a precise definition for the geriatric patient, results difficult, since the age limits change constantly and arbitrary way, but given that women are living longer, supposedly the rate of gynecologic surgery is increasing. OBJECTIVE: To inform the experience obteined in our service, from geriatric patients, with surgical intervention, and compare the results with published articles from other national gynecology services. MATERIALS AND METHODS: In the gynecology service of Specialties Hospital "Dr. Miguel Dorantes Mesa" from the S.S., in Xalapa Veracruz, México, a retrospective study was performed, from 76 cases of patients with gynecologic surgery. The research variables were: 60 years old or older, personal pathologic data, gynecologic and obstetrics, occupation, preoperative diagnosis, type of intervention, anatomopathologic diagnosis, anesthesia employed, complications during of after surgery, days in the hospital, hemoglobin and hematocrit. RESULTS: Most of the patients were 65 to 70 years old, 100% housewives, pelvic statics alterations were present in most cases (53.9%), followed by pre-malignant and malignant diseases of the cervix, the abdominal hysterectomy was indicated in 29 cases, 65.7% had personal pathologic data, the anatomopathologic study confirmed 85% of the cases, days-hospital average was 5.8. CONCLUSION: Survivorship does not depend by type of surgery or age, if not to concomitant illness.

Age Factors↗
PubMed2006

[Improving self-control in substance dependent persons and pathological gamblers--a pilot study].

BACKGROUND: Impaired self-control is an important symptom of addictive diseases. The average number of factors improving self-control among 117 men dependent on alcohol, other substances and pathological gamblers was 5.55 (SD=3.5). METHODS AND RESULTS: We classified strategies how to improve self-control into following groups (their ordering reflects the frequency of their use in our sample): 1. The help of others (professional treatment, self-help groups, and family), 2. Distraction and similar techniques, 3. The use of motivation, 4. Life-style changes including appropriate rest, 5. Physical activity, sports, physical work, 6. The use of environments, 7. Mastering of social and other relevant skills, 8. Relaxation based approaches, 9. Techniques working with improved self-awareness, 10. Pharmacotherapy, 11. Acknowledgement of an addictive disease and abstinence, 12. Disrupting risky behavioral patterns. CONCLUSIONS: To improve of self-control in addictive diseases simple techniques are appropriate because of temporarily impaired cognitive functions during craving. Frequent repetition are also important.

Alcoholism↗
PubMed1989

[Plasma homocysteine, a risk factor for premature vascular disease. Plasma levels in healthy persons; during pathologic conditions and drug therapy].

Homocysteine is a branch-point metabolite, the biological fate of which is linked to vitamin B12, reduced folates and vitamin B6. Various inborn defects in homocysteine metabolism, among which cystathionine beta-synthase deficiency is most common, lead to the clinical condition homocystinuria. A central feature of this clinical state is premature arteriosclerosis. These patients benefit from agents serving as cofactors in homocysteine metabolism which both reduce the homocysteine levels in plasma and the incidence of vascular episodes. Experimental data point to homocysteine as an arteriosclerotic agent. Homocysteine in human plasma exists mainly as mixed disulfides with albumin (70 per cent) and cysteine. New methods determine total plasma homocysteine which includes all these species. Normal values for plasma homocysteine are lower in premenopausal women than in men and postmenopausal women. Impaired homocysteine metabolism seems to exist in 15-30 per cent of patients with premature cardiovascular disease. Moderate homocysteinemia is as a risk factor for cardiovascular disease, independent of conventional risk factors. Apart from homocystinuria, vitamin B12 deficiency causes the most extreme elevations of plasma homocysteine, and it has been established that plasma homocysteine is a more responsive parameter to impaired vitamin B12 function than serum cobalamin. Massive increase in plasma homocysteine level is also observed in folate deficiency, whereas renal failure, some malignant states and psoriasis cause a moderate homocysteinemia. High doses of folic acid reduce plasma homocysteine, and this innocuous mean should be considered as an intervention in patients with increased plasma level. Drugs like methotrexate, some anticonvulsants and 6-azauridine triacetate induce moderate elevation of plasma homocysteine, whereas a reduction is observed after penicillamine administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗