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PubMed2000

[Psychotherapy research in psychiatry. Results of a survey of psychiatric clinics].

This paper concerns advances in the integration of psychotherapy in psychiatric education and clinical practice and whether they go along with increasing research activities. To find answers, a survey on psychotherapy research was carried out in all German psychiatric hospitals and departments by means of a questionnaire. The results indicate that psychotherapy research is done nearly exclusively in university hospitals. About half of them had already published psychotherapy studies and two thirds of them are presently carrying out studies, mostly including prospective, randomized clinical trials. These studies cover the whole spectrum of psychiatric disorders: substance abuse, schizophrenic and affective disorders, anxiety, and obsessive compulsive and personality disorders. To improve psychotherapy research conditions further, efforts are necessary to increase scientific exchange, financial support, and the integration of institutions outside the universities.

Curriculum↗
PubMed1965

PERFECTIONISM.

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Diagnosis, Differential↗
PubMed1975

A study of genetic factors, childhood bereavement, and premorbid personality traits in patients with anancastic endogenous depression.

From a sample of 1,005 patients admitted to the State Hospital in Aarhus for the first time during the period 1950-1959 and who had been diagnosed as suffering from manic-depressive psychosis or endogenous depression (affective psychoses), a subsample of 104 manic-depressive aptients with anancastic symptoms in the history were selected. The 104 probands were individually matched with 104 non-anancastic probands with affective psychoses. The anancastic probands and the controls who were still living were seen personally at the follow-up. Information concerning the psychiatric history of 945 first degree relatives of the anancastic probands and 1,000 first degree relatives of the controls were obtained. During the search for factors which could be used to distinguish affective psychoses with anancastic symptoms from affective psychoses without these traits, a positive correlation was found between the presence of anancasma and the following factors: (a) premorbid obsessive personality traits; (b) traumatic environmental factors in childhood; (c) a tendency to monopolarity; (d) a preponderance of monopolar depressions in the family; (e) the presence of secondary cases of anancastic endogenous depression. The findings are compatible with a theory which attributes a pathoplastic effect to the obsessive personality giving rise to anancastic symptomatology in the form of affective psychoses which tend to a unipolar course.

Affective Symptoms↗
PubMed1992

The relationship between personality and DSM-III axis I disorders in the population: results from an epidemiological survey.

OBJECTIVE: The aim of this study was to assess the relationships between specific personality disorders and DSM-III axis I conditions in a community sample. METHOD: A total of 810 subjects were examined by psychiatrists in the second stage of the Eastern Baltimore Mental Health Survey, part of the Epidemiological Catchment Area Program of the National Institute of Mental Health. A semistructured examination, the Standardized Psychiatric Examination, was employed to assess axis I and axis II conditions. Scales for compulsive and antisocial personality disorders were derived from DSM-III criteria. The relationships between scores on these personality disorder scales and the presence of generalized anxiety disorder, alcohol use disorders (alcohol abuse and alcohol dependence), and simple phobia were evaluated by using logistic regression. RESULTS: Higher compulsive personality scores were associated with a greater odds of generalized anxiety disorder and simple phobia but a smaller odds of alcohol use disorders. In contrast, higher antisocial personality scores were associated with a greater odds of alcohol use disorders but a smaller odds of generalized anxiety disorder. There was no relationship between antisocial personality scores and simple phobia. CONCLUSIONS: Personality disorders have specific relationships to axis I conditions, which suggests different vulnerabilities but also different protective influences.

Adolescent↗
PubMed1991

Obsessive-compulsive disorder and schizophrenia in three identical twin pairs.

Three monozygotic twin pairs are described who are concordant for DSM-III-R obsessive-compulsive disorder while being discordant for schizophrenia or schizoaffective disorder. Follow-up interview showed the non-psychotic co-twins to have schizotypal personality disorder. It is concluded that obsessive-compulsive and schizophrenia-spectrum disorders can truly co-exist, thus supporting diagnostic changes introduced into DSM-III-R, and may in some cases be inherited together.

Adult↗
PubMed2004

Essential fatty acids and their role in the treatment of impulsivity disorders.

Essential fatty acids (EFAs) have been shown to benefit patients with depression, schizophrenia and dementia. More recently, their role in disorders characterised by impulsivity has attracted some attention. The psychiatric conditions of attention-deficit hyperactivity disorder and borderline personality disorder as well as the phenomena of deliberate self-harm and violence have been ameliorated by the supplementation of EFAs in a number of recent clinical trials. This paper summarises the burgeoning clinical and basic research indicating the existence of significant deficits of EFAs in impulsivity disorders and the supplementation studies of EFAs in these diverse conditions, all of which remain a major therapeutic challenge.

Aggression↗
PubMed1980

Relations of obsessional traits to anxiety in patients with ulcerative colitis.

The obsessional personality traits and the "state" and "trait" anxiety, measured by means of self-rating inventories, were correlated in a group of patients with ulcerative colitis and a group of anxiety neurotics. The results suggest that patients with ulcerative colitis demonstrate strong positive trends, contrary to neurotics who show negative or very weak correlations, during the active period of their illness. These findings are discussed and some hypotheses concerning the different association of anxiety to obsessionality between the two groups are presented.

Adult↗
PubMed1991

The comorbidity of multiple personality disorder and DSM-III-R axis II disorders.

Our ability to differentiate MPD from DSM-III-R Axis I disorders has become increasingly refined. Differentiation of MPD from the Axis II personality disorders is an area of more recent clinical investigation. MPD can be found comorbidity with many other psychiatric conditions. It is found in association with each of the DSM-III-R personality disorders. At the present time, however, we lack research data that define the prevalence of the comorbidity of MPD with the personality disorders. Objective study of this area is complicated by the paucity of instruments available to assess personality dimensions in the presence of a DD. In addition, the currently available personality inventories tend to overdiagnose BPD in patients with a high level of distress and acuity of symptoms. The diagnosis of a personality disorder in a patient with MPD is made on the basis of the assessment of the "whole" human being. It is based on the presence of a pervasive and relatively inflexible pattern of behaviors that reflects the individual predominant mode of being. The diagnosis of a personality disorder is not made on the basis of personality traits contained within any single alternate personality or groups of personalities. The personality disorders defined by DSM-III-R are a heterogeneous group of conditions whose individual etiologies reflect a complex interplay of constitutional, genetic, environmental, interpersonal, and psychodynamic factors. The interplay is variable and diverse between these determinants of the personality disorders and the traumatic forces that result in the development of a DD. For the Cluster A personality disorders (schizoid, schizotypal, paranoid), there is evidence supporting a relationship with specific psychotic illnesses. The combination of dissociative pathology with these personality disorders commonly results in a greater impairment of reality testing than in either condition alone. The Cluster B personality disorders (histrionic, narcissistic, borderline, antisocial) and Cluster C personality disorders (avoidant, compulsive, dependent, passive-aggressive) are believed to be primarily developmental disturbances. Comorbidity of these personality disorders with MPD involves consideration of the interaction of many developmental processes with the psychological impact of severe childhood trauma. Many MPD patients present with an apparent mixed personality profile consisting of an array of avoidant, compulsive, borderline, narcissistic, dependent, and passive-aggressive features. Although this article explores comorbidity of MPD with each of the personality disorders defined in DSM-III-R individually, it seems likely that a number of posttraumatic personality organizations can be defined that commonly coexist with MPD.(ABSTRACT TRUNCATED AT 400 WORDS)

Borderline Personality Disorder↗
PubMed2005

MR-based in vivo hippocampal volumetrics: 2. Findings in neuropsychiatric disorders.

Magnetic resonance imaging (MRI) has opened a new window to the brain. Measuring hippocampal volume with MRI has provided important information about several neuropsychiatric disorders. We reviewed the literature and selected all English-language, human subject, data-driven papers on hippocampal volumetry, yielding a database of 423 records. Smaller hippocampal volumes have been reported in epilepsy, Alzheimer's disease, dementia, mild cognitive impairment, the aged, traumatic brain injury, cardiac arrest, Parkinson's disease, Huntington's disease, Cushing's disease, herpes simplex encephalitis, Turner's syndrome, Down's syndrome, survivors of low birth weight, schizophrenia, major depression, posttraumatic stress disorder, chronic alcoholism, borderline personality disorder, obsessive-compulsive disorder, and antisocial personality disorder. Significantly larger hippocampal volumes have been correlated with autism and children with fragile X syndrome. Preservation of hippocampal volume has been reported in congenital hyperplasia, children with fetal alcohol syndrome, anorexia nervosa, attention-deficit and hyperactivity disorder, bipolar disorder, and panic disorder. Possible mechanisms of hippocampal volume loss in neuropsychiatric disorders are discussed.

Anatomy, Cross-Sectional↗