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PubMed1995

DSM-III-R brief reactive psychosis and personality disorders.

DSM-III and DSM-III-R defined the diagnostic criteria of brief reactive psychosis (BRP) identifying some personality disorders (PDs) as predisposing factors: up to now no experimental data support this hypothesis. In this research, the authors studied the link between BRP and PDs, assessing axis II diagnosis (SIDP-R), after recovery of BRP in a group of 23 patients. Eighty-seven percent of the patients (n = 19) received at least one diagnosis of PDs. The widespread presence of PDs and, particularly, the high prevalence of cluster C (n = 11, 47.8%), are only partially in accordance with the hypothesis of DSM-III. A possible alternative model of interaction is suggested.

Adult↗

PubMed1995

Comorbidity of obsessive-compulsive disorder and personality disorders. A Brazilian controlled study.

The aim of this study was to evaluate the presence of personality disorders (PDs) in 40 patients with obsessive-compulsive disorder (DSM-III-R criteria) from the Medical School of Botucatu (UNESP), São Paulo, Brazil. It is a case-control study. Patients were 24 women and 16 men, 16-68 years old, referred to our outpatient psychiatric service for treatment. Controls were 40 nonpsychiatric outpatients matched to the cases by sex, age and marital status. The instrument used was the Portuguese version of the Structured Interview for DSM-III-R Personality Disorders (SIDP-R). All interviews (n = 80) were made simultaneously by 2 raters, with independent scoring, so that the interrater reliability of the instrument could also be assessed (kappa statistics). The consensual axis II diagnoses in the OCD group were: avoidant (52.5%, kappa = 0.80), dependent (40%, kappa = 0.84), histrionic (20%, kappa = 0.83), paranoid (20%, kappa = 0.74), obsessive-compulsive (17.5%, kappa = 0.86), narcissistic (7.5%, kappa = 1.00), schizotypal (5%, kappa = 0.65), passive-aggressive (5%, kappa = 0.79) and self-defeating (5%, kappa = 0.55). At least one PD diagnosis was made in 70% of the patients, while only 6 controls had a PD diagnosis (p < 0.01). A great deal of diagnostic overlap was found in the OCD group (57.5% had two or more PDs), especially between avoidant and dependent PDs. The features of these two PDs may be secondary to the OCD. The study also suggests that there is not a close relationship between OCD and obsessive-compulsive personality disorder (OCPD). Patients with OCPD or even 3 or 4 O-C traits had significantly less insight into their obsessions and compulsions (p < 0.01).

Adolescent↗

PubMed1997

Diagnostic agreement between the DSM-IV and ICD-10-DCR personality disorders.

The SCID-II Personality Questionnaire, modified for DSM-IV and ICD-10 Diagnostic Criteria for Research (ICD-10-DCR), was administered to 58 consecutive patients with agoraphobia with panic disorder in order to screen for personality disorders (PDs) and assess diagnostic agreement between DSM-IV and ICD-10-DCR. The diagnostic agreement, as expressed by kappa values, was 0.78 for the presence of any personality disorder (PD), but it ranged from 0.51 for schizoid PD to 0.83 for dependent PD. There was a tendency for ICD-10-DCR to overdiagnose PDs, except for borderline and dependent PDs. The sources of disagreement can be traced to differences in the conceptualization of some PDs and differences in diagnostic criteria and diagnostic thresholds; these are further examined in an effort to improve diagnostic criteria and attain greater compatibility between the two diagnostic systems.

Adult↗

PubMed2005

Microarray analysis of cytokine and chemokine gene expression after prednisolone treatment in murine experimental autoimmune uveoretinitis.

PURPOSE: The purpose of this study was to investigate changes in gene expression of cytokines and chemokines and their receptors after systemic prednisolone treatment in experimental autoimmune uveoretinitis (EAU). METHODS: EAU mice received one intravenous injection of 7.5 mg/kg prednisolone (PDS) sodium phosphate at the peak of inflammation. EAU mice treated with only solvent served as the control. Total RNA was extracted from the whole eyes 1, 2, and 3 days after treatment. Gene expression analysis was conducted with a cDNA microarray, which contains 117 individual transcripts encoding the genes of the cytokines and chemokines and their receptors (29 cytokines and 34 cytokine receptors; 33 chemokines and 21 chemokine receptors). Comparisons of expression between PDS-treated and placebo-treated EAU mice at each time point were performed. The genes were sorted into clusters based on expression profiles, to clarify the gene regulation pattern after treatment. RESULTS: Forty-seven genes had a significant decrease in expression 1 day after treatment, 10 genes on day 2, and 46 genes on day 3. Ten genes were upregulated on day 1, but no gene was upregulated thereafter. Hierarchical cluster analysis of the microarray demonstrated that gene expression changes in EAU after treatment with PDS showed four patterns: flat, mountain, steep downhill, and less steep downhill. CONCLUSIONS: The implications of the clusters after treatment with PDS remain unclear. The results showed that hierarchical cluster analysis based on comprehensive gene expression profiles may provide a powerful tool for identifying genes not previously associated with the therapeutic targets in ocular inflammation.

Animals↗

PubMed2000

Laryngeal histologic findings in infants with palatal defects with or without craniofacial malformations.

The objective of this study was to determine whether specimens from infants with palatal defects (PDs) with or without craniofacial malformations (CFMs) exhibit aberrant laryngeal histologic findings compared with specimens from normal infants. Ten laryngeal specimens from infants with PDs with or without CFMs were histologically compared with 7 laryngeal specimens defined as normal from the same collection. Both groups were similar in terms of demographics and airway manipulation. All infants were prelingual. Comparisons were made at 3 levels: supraglottic, glottic, and subglottic. Histologically, no significant differences in primary laryngeal structures were found between the PD with or without CFM group and the group defined as normal. Acquired and intubation-type injuries, such as inflammation, ulceration, capillary congestion, and scar tissue, were more prevalent and severe in the study group. The primary laryngeal histologic findings of specimens from individuals with PDs with or without CFMs do not differ substantially from those from normal individuals; however, individuals with PDs do appear to be somewhat more susceptible to intubation injury and other acquired laryngeal injury. Meticulous airway management is essential.

Craniofacial Abnormalities↗

PubMed1996

The impact of perfusionist education programme characteristics on programme directors' responsibilities.

The purpose of this study was to measure the effect of four programme characteristics (curriculum design, type of degree offered, length of programme and number of students per class) on perfusionist education programme directors (PDs) in the USA in terms of the number of hours worked per week, number of cases pumped per year and workload mix. Descriptive and statistical analyses were performed on the responses to questionnaires sent to all perfusionist programmes between March 1993 and April 1994. PDs reported working an average of 51.8 h/week and pumping an average of 68.8 cases per year. All but one respondent reported spending more than 50% of his/her time (mean 74.5% +/- 19%) on programme-related issues such as administration, classroom teaching and clinical instruction. This level of commitment, as well as the total number of hours worked per week, were not found to be influenced by the programme's length, duration, class size or type of degree awarded. However, PDs of baccalaureate programmes, and programmes with more than nine students spent a significantly greater proportion of their time on administrative issues than their colleagues in other types of programmes. The bureaucratic demands of baccalaureate and large programmes require PDs to devote an average of 39.5% of their time to administration, compared to 27.2% in the other programmes. The results of this study show that the operation of all perfusionist education programmes requires a major commitment of time on the part of the individual designated as PD.

Education, Nursing↗

PubMed1998

Peer assessment of personality traits and pathology in female college students.

Assessment procedures for personality disorders (PDs) typically rely on self-reports, even though some people with PDs may be unable to view themselves realistically or are unwilling to report socially undesirable traits. Close associates may provide important information regarding the presence of PD traits. Peer nomination is a reliable and valid assessment procedure that can be adapted to the study of PDs for research purposes. This study focused on characteristic features that define narcissistic, dependent, and obsessive-compulsive PDs using information collected from both self and others in a nonclinical sample of women. It was designed to identify specific areas of agreement and discrepancy between self-report and peer assessment in the measurement of characteristic features of these disorders.

Adult↗

PubMed2004

Morphological brain differences between adult stutterers and non-stutterers.

BACKGROUND: The neurophysiological and neuroanatomical foundations of persistent developmental stuttering (PDS) are still a matter of dispute. A main argument is that stutterers show atypical anatomical asymmetries of speech-relevant brain areas, which possibly affect speech fluency. The major aim of this study was to determine whether adults with PDS have anomalous anatomy in cortical speech-language areas. METHODS: Adults with PDS (n = 10) and controls (n = 10) matched for age, sex, hand preference, and education were studied using high-resolution MRI scans. Using a new variant of the voxel-based morphometry technique (augmented VBM) the brains of stutterers and non-stutterers were compared with respect to white matter (WM) and grey matter (GM) differences. RESULTS: We found increased WM volumes in a right-hemispheric network comprising the superior temporal gyrus (including the planum temporale), the inferior frontal gyrus (including the pars triangularis), the precentral gyrus in the vicinity of the face and mouth representation, and the anterior middle frontal gyrus. In addition, we detected a leftward WM asymmetry in the auditory cortex in non-stutterers, while stutterers showed symmetric WM volumes. CONCLUSIONS: These results provide strong evidence that adults with PDS have anomalous anatomy not only in perisylvian speech and language areas but also in prefrontal and sensorimotor areas. Whether this atypical asymmetry of WM is the cause or the consequence of stuttering is still an unanswered question.

Adult↗

PubMed2004

Electrocardiogram interpretation training and competency assessment in emergency medicine residency programs.

OBJECTIVES: To determine the type of electrocardiogram (ECG) interpretation instruction in emergency medicine (EM) residency programs, the use and perceived value of teaching modalities and resources, and the methods used to assess competency of ECG interpretation. METHODS: An interactive survey instrument was posted on the Internet using SurveySuite, Inc., software and e-mailed to program directors (PDs) of all 125 Accreditation Council for Graduate Medical Education-approved U.S. EM residency programs. Responses are reported in total numbers and percentages. RESULTS: Ninety-nine of 125 PDs completed the online survey (response rate, 79.2%). Emergency department instruction (99%), case-based lectures (98%), and didactic lectures (98%) were most commonly used to teach interpretation of ECGs, followed by computer-based instruction (34%) and ECG laboratory (12%). The majority of programs (53%) spent more than eight hours on formal ECG lectures per year, while 11% spent less than three hours. Observation during clinical time (99%), lecture time (76%), and hypothetical cases (57%) were the most common ways to determine competency in reading ECGs, while clinical observation and hypothetical cases were perceived as the most valuable. The most commonly used resource was personal or departmental ECG files (91%), and this had the highest perceived value. The majority of PDs were comfortable with residents' abilities to read ECGs by the third year (96%) and fourth year (91%) of residency. CONCLUSIONS: These data suggest that EM PDs believe that EM residency is adequately preparing graduates to interpret ECGs. This goal is achieved through a variety of methods.

Clinical Competence↗

PubMed1998

DNA mismatch repair and O6-alkylguanine-DNA alkyltransferase analysis and response to Temodal in newly diagnosed malignant glioma.

PURPOSE: We evaluated the response to Temodal (Schering-Plough Research Institute, Kenilworth, NJ) of patients with newly diagnosed malignant glioma, as well as the predictive value of quantifying tumor DNA mismatch repair activity and O6-alkylguanine-DNA alkyltransferase (AGT). PATIENTS AND METHODS: Thirty-three patients with newly diagnosed glioblastoma multiforme (GBM) and five patients with newly diagnosed anaplastic astrocytoma (AA) were treated with Temodal at a starting dose of 200 mg/m2 daily for 5 consecutive days with repeat dosing every 28 days after the first daily dose. Immunochemistry for the detection of the human DNA mismatch repair proteins MSH2 and MLH1 and the DNA repair protein AGT was performed with monoclonal antibodies and characterized with respect to percent positive staining. RESULTS: Of the 33 patients with GBM, complete responses (CRs) occurred in three patients, partial responses (PRs) occurred in 14 patients, stable disease (SD) was seen in four patients, and 12 patients developed progressive disease (PD). Toxicity included infrequent grades 3 and 4 myelosuppression, constipation, nausea, and headache. Thirty tumors showed greater than 60% cells that stained for MSH2 and MLH1, with three CRs, 12 PRs, three SDs, and 12 PDs. Eight tumors showed 60% or less cells that stained with antibodies to MSH2 and/or MLH1, with 3 PRs, 3 SDs, and 2 PDs. Eleven tumors showed 20% or greater cells that stained with an antibody to AGT, with 1 PR, 2 SDs, and 8 PDs. Twenty-five tumors showed less than 20% cells that stained for AGT, with 3 CRs, 12 PRs, 4 SDs, and 6 PDs. CONCLUSION: These results suggest that Temodal has activity against newly diagnosed GBM and AA and warrants continued evaluation of this agent. Furthermore, pretherapy analysis of tumor DNA mismatch repair and, particularly, AGT protein expression may identify patients in whom tumors are resistant to Temodal.

Adult↗

PubMed2003

Personality disorders, coping strategies, and posttraumatic stress disorder in women with histories of childhood sexual abuse.

Using a treatment-seeking sample of adult female survivors of childhood sexual abuse, the relationships between coping strategies, personality disorders (PD) and Posttraumatic Stress Disorder (PTSD) were explored. A variety of PDs were found to exist in this population, with avoidant, antisocial, dependent PDs having higher frequencies than borderline PD. Avoidant coping and PTSD severity significantly correlated with many of these PDs. PTSD severity and avoidant coping were also significantly correlated. Additionally, women with PTSD displayed higher rates of avoidant and dependent PDs, as well as more avoidant coping, than did women without PTSD. Results support a more complex conceptualization of the trauma-related symptoms that occur in adult survivors of childhood sexual abuse that incorporate the relationships between avoidant coping, personality disorders, and PTSD.

Adaptation, Psychological↗

PubMed1992

Fixation of osteochondral fractures in rabbit knees. A comparison of Kirschner wires, fibrin sealant, and polydioxanone pins.

We compared fibrin sealant, polydioxanone (PDS) pins and Kirschner wires in the fixation of osteochondral fractures in rabbit knees. Standardised osteochondral fractures of the right medial femoral condyle were made in 56 adult New Zealand white rabbits. There were equal groups of control knees, and those which had Kirschner-wire, fibrin-sealant or PDS-pin fixation. No external immobilisation was used. One animal from each group was killed at two, three and four weeks. The remaining rabbits were killed at six weeks. A fracture which healed with less than 1 mm of displacement was considered a success. There was successful healing in 29% of the control group, in all of the Kirschner-wire group, in 50% of the fibrin-sealant group, and in 86% of the PDS-pin group. The use of PDS pins appears to be a reliable alternative to the use of metal in the fixation of osteochondral fractures in rabbits.

Animals↗

PubMed2002

Aberrant social relations in the personality disorders.

Research on the interpersonal aspects of personality disorders (PDs) has generally sought to describe them in terms of behavioural dispositions, often mapping these dispositions onto the interpersonal circumplex. The present study, in contrast, tested a theory that accounts for PDs as systematic disturbances in relationships between people. Self-reports of 57 participants experiencing significant interpersonal difficulties showed many predicted associations between PD symptoms and aberrant enactment of four elementary forms of social relationships (Fiske, 1991). Symptoms were associated with aberrant motivations for, and cognitive implementations of, these 'relational models', and with difficulties conducting them. These associations were comparable in strength to, but largely independent of, those obtained with a circumplex measure. Aberrations of authority- and equality-based relationships were central to many PDs, but not captured well by the circumplex. A relational analysis affords a fruitful and largely unexplored perspective on PDs.

Adolescent↗

PubMedDate not supplied

Comparison of carotenoid content, gene expression and enzyme levels in tomato (Lycopersicon esculentum) leaves.

Physiological conditions which lead to changes in total carotenoid content in tomato plantlets were identified. Carotenoid levels were found to increase after the onset of a dark period during a normal 24 h cycle. This rapid initial increase is followed by a steady decrease in carotenoid content throughout the night. A decrease in the expression of several carotenogenic genes, namely pds, zds (carotenoid desaturases) and ptox (plastid terminal oxidase), was observed following the removal of the light (when carotenoid content is at its highest). An increase in gene expression was observed before the return to light for pds and zds (when carotenoid levels were at their lowest), or following the return to light for ptox. The phytoene desaturation inhibitor norflurazon leads to a decrease coloured carotenoid content and, in the light, this correlated with pds and zds gene induction. In the dark, norflurazon treatment led to only a weak decrease in carotenoid content and only a small increase in pds and zds gene expression. The striking absence of phytoene accumulation under norflurazon treatment in the dark suggests a down-regulation of carotenoid formation in darkness However, prolonged dark conditions, or treatment with photosynthetic inhibitors, surprisingly led to higher carotenoid levels, which correlated with decreased expression of most examined genes. In addition to light, which acts in a complex way on carotenoid accumulation and gene expression, our results are best explained by a regulatory effect of carotenoid levels on the expression of several biosynthetic genes. In addition, monitoring of protein amounts for phytoene desaturase and plastid terminal oxidase (which sometimes do not correlate with gene expression) indicate an even more complex regulatory pattern.

Base Sequence↗

PubMed2002

Authority conflicts and personality disorders.

We investigated personality disorders (PDs) of young men with chronic authority conflicts using the Millon Clinical Multiaxial Inventory-I (MCMI-I; Millon, 1983). PDs occurred considerably more often in the young men with chronic authority conflicts (62%) compared with a clinical control group of young men with acute authority conflicts (39%). The prevalence of PDs in a normal control group was considerably lower (11%). The passive-aggressive PD is over-represented among young men with chronic authority conflicts; there is hardly any antisocial PD. Millon's conceptualization of these disorders could have influenced these results. The high prevalence of passive-aggressive PDs complicates a good psychotherapeutic outcome in young men with chronic authority conflicts. Our results underscore the clinical utility of the controversial PAPD diagnosis.

Adolescent↗

PubMed2002

Cross-system concordance of personality disorder diagnoses of DSM-IV and diagnostic criteria for research of ICD-10.

The aim in this study was to examine the cross-system concordance between the personality disorders (PDs) of DSM-IV and Diagnostic Criteria for Research of ICD-10 Classification of Mental and Behavioral Disorders, 10th rev. (ICD-10) PD diagnoses were made by a structured interview in a clinical psychiatric sample of 138 individuals. Both categorical and dimensional scores for each PD were established. The frequency of patients with a PD diagnosis on either classification who were also positive on the other varied from 26% for the schizoid PDs to 88% for the histrionic PDs. The chance-corrected agreement (Cohen's kappa) ranged from .37 to .94. The dimensional correlation (Pearson's r) between pairs of PD criteria sets was in the range of .79 to .98. In conclusion, when analyzed categorically, some of the PDs of DSM-IV and ICD-10-DCR were only moderately concordant. The reasons appear to be different criteria formulations and arbitrary thresholds for diagnoses. In contrast to categorical diagnoses, dimensional agreement was high, implicating similar trait-concept definitions. The least concordant pair of PD was antisocial (DSM-IV)-dissocial (ICD-10).

Adolescent↗

PubMed2002

Dependency, impulsivity, and self-harm: traits hypothesized to underlie the association between cluster B personality and substance use disorders.

Cluster B personality disorders (PDs) (i.e., antisocial, borderline, histrionic, and narcissistic) typically show a high degree of comorbidity with substance use disorders (SUDs). Previous research suggests that the broad-based personality domains of Disinhibition and Negative Temperament/Neuroticism may be common factors to both types of disorders. Using a two-phase process (i.e., screening and follow-up), this study examined three lower-order personality traits (i.e., dependency, impulsivity, and self-harm) that fall within the Disinhibition and Neuroticism domains. The study evaluated the hypotheses that these traits (a) are related both to cluster B PDs and to SUDs; and (b) underlie the association between the two types of disorders. Results indicate that impulsivity and self-harm play a significant role in cluster B PDs and SUDs, as well as in their association with each other. However, dependency was not associated with either type of disorder. These results indicate that sets of individual traits can be of significant utility in understanding the comorbidity between PDs and SUDs.

Adolescent↗

PubMed2003

Outpatient group psychotherapy following day treatment for patients with personality disorders.

This prospective, naturalistic study evaluated the practice and effectiveness of an outpatient group therapy program following day treatment for patients with personality disorders (PDs). One hundred and eighty-seven patients (86% patients with PDs and 14% with no PDs), were treated in outpatient psychodynamic group therapy. Outcome was assessed by Global Assessment of Functioning, Symptom Check List 90-R, and Inventory of Interpersonal Problems-Circumplex, short version, at admission and discharge from day treatment, and at the end of outpatient group therapy. Average length of outpatient therapy was 24 months. Forty-three percent terminated in an irregular manner. Outcome of the continuation therapy was satisfactory for patients without PDs. For PD patients, the improvement from the day treatment was maintained during outpatient therapy, but further improvements were modest for symptoms and interpersonal distress, somewhat better for global functioning. Implications for further treatment development are discussed.

Adult↗