Personality, psychiatric disorders, and parental attitude among a community sample of adolescents.
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Adolescent↗
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An empirical study of borderline personality disorder and psychiatric suicides.
Borderline personality disorder (BPD) is closely related to suicidal behavior, and suicide attempts per se are considered a diagnostic criterion. However, there has been no previous study of completed suicides and BPD. The present study is based on a population of 134 consecutive psychiatric suicides from 1961 to 1980 in a catchment area of 250,000 inhabitants. Clinical records were retrospectively diagnosed according to the Diagnostic Interview for Borderlines and DSM-III. There was a progressive increase in proportion of borderline suicides during the time period. The overall proportion of BPD, however, was only 12%, indicating that borderline patients are not seriously overrepresented among patients committing psychiatric suicides. Demographic variables, earlier psychiatric care, and suicidal behavior in the borderline group are described and analyzed.
Adult↗
Toward a cultural history of the personality disorders.
Psychiatric categories in general, and the personality disorders in particular, remain problematic and contested. This is no where more clearly evident than in the case of the 'antisocial' and 'histrionic' personality disorders. In part, the problem is related to the observation of differences in gender distribution. Men are more likely to be diagnosed 'antisocial' than women, and women are more likely to be diagnosed 'histrionic' than men. Confusion results partly from the suspicion that these categories may be culturally conditioned and therefore spurious as medical labels true in some 'absolute' sense. This paper argues that the antisocial and histrionic disorders have cultural histories, representing (in extreme form) values strongly congruent with familiar cultural stereotypes: the 'independent' male and the 'dependent' female. The process by which these values were delegated to men and women is examined, and then shown to be at least partly determinative of later developments in the formation of psychiatric categories.
Adult↗
Cocaine use and dependence in young adults: associated psychiatric disorders and personality traits.
Current and lifetime prevalence of substance use and psychiatric disorders was determined by administering the NIMH-DIS, revised to cover DSM-III-R diagnoses, to a sample of 1007 young adults. Personality and affectivity were measured also. Increased rate of any Substance Use Disorder was related to use of cocaine more than 5 times over the lifetime regardless of whether or not criteria for Cocaine Dependence were met. Increased rate of any Affective Disorder was related to dependence in those who used cocaine more than 5 times. Cocaine use was associated with increased neuroticism, psychoticism and negative affect.
Adult↗
Sex distribution of DSM-III personality disorders in psychiatric outpatients.
The author determined the sex distribution of 170 outpatients with a DSM-III diagnosis of personality disorder measured by standardized instruments and compared his findings with DSM-III predictions. They confirmed the prediction of more women diagnosed as having histrionic personality disorder and more men diagnosed as having paranoid, compulsive, and antisocial personality disorders. The predicted excess of women diagnosed as having borderline and dependent personality disorders was not confirmed.
Ambulatory Care↗
Use of the ICD-10 version of the Standardized Assessment of Personality to determine the prevalence of personality disorder in psychiatric in-patients.
The Standardized Assessment of Personality (SAP) involves a short semi-structured interview with an informant. It was modified to accord with the 1987 draft of the tenth revision of the International Classification of Diseases (ICD-10) and used to assess the pre-morbid personality of first-admission patients in one London area over the period of one year. Of the 120 (84% of the total sample of first-admissions) patients included, 43 (36%) were found to satisfy the ICD-10 criteria for personality disorder and a further 17 (14%) to satisfy the criteria for personality trait accentuation.
Adult↗
Sensitivity to noise in a community sample: I. Measurement of psychiatric disorder and personality.
A sample of 77 women of high and low noise sensitivity, living in areas of high and low exposure to aircraft noise drawn from the 1977 West London Survey, were interviewed in the community in 1980. Women of high, intermediate and low noise sensitivity in 1980 were compared for measures of psychiatric disorder, personality and reactivity to the other sensory stimuli. In addition, the noise sensitivity measures defining the three groups in 1980 were compared with further measures of noise sensitivity. High noise sensitive women exhibited significantly more psychiatric symptoms, higher neuroticism scores, and greater reactivity to other sensory stimuli than intermediate and low noise sensitive women.
Adolescent↗
The frequency of multiple personality disorder among psychiatric inpatients.
OBJECTIVE: A 2-year study was undertaken to determine the frequency of multiple personality disorder among general adult psychiatric inpatients. METHOD: All individuals admitted to two 23-bed acute care wards in a teaching hospital in Winnipeg, Man., were screened with the Dissociative Experiences Scale. Individuals with prior diagnoses of multiple personality disorder were excluded. All subjects scoring 20 or higher on the Dissociative Experiences Scale were interviewed with the Dissociative Disorders Interview Schedule. Then subjects with a diagnosis of multiple personality disorder and comparison subjects were interviewed by a clinician who was blind to all research data. RESULTS: A total of 299 subjects completed the Dissociative Experiences Scale and 80 received a structured diagnostic interview. Ten subjects (3.3%) had clinically confirmed multiple personality disorder. CONCLUSIONS: If these results are replicated and accepted, multiple personality disorder will become a serious consideration in the differential diagnosis of many psychiatric patients.
Adult↗
Comorbidity of psychiatric disorders and personality profiles of American World War II prisoners of war.
To characterize the effects of trauma sustained more than 40 years ago, prevalence of psychiatric disorders and personality dimensions were examined in a sample of 62 former World War II POWs. The negative effects of their experiences are reflected in their multiple lifetime diagnoses and in their current personality profiles. Fifty percent met DSM-III posttraumatic stress disorder (PTSD) criteria within 1 year of release; 18 (29%) continued to meet the criteria 40 years later at examination (chronic PTSD). A lifetime diagnosis of generalized anxiety disorder was found for over half the entire sample; in 42% of those who never had PTSD, 38% of those with recovery from PTSD, and 94% of those with chronic PTSD. Ten percent of those without a PTSD diagnosis had experienced a depressive disorder, as had 23% of those with recovery from PTSD and 61% of the POWs with chronic PTSD. The combination of depressive and anxiety disorders also was frequent in the total sample (61%). Current MMPIs of three groups with psychiatric diagnosis were compared with those of POWs who had no diagnoses and with a group of Minnesota normal men. Profile elevations for the groups, from highest to lowest, were: POWs with chronic PTSD, POWs with recovery from PTSD, POWs with other psychiatric diagnoses, POWs with no disorders, and Minnesota normal men. Symptoms of anxiety, depression, and somatic concerns combined with the personality styles of suppression and denial characterize the current adjustment of negatively affected POWs.
Adaptation, Psychological↗
Diagnosing personality disorders in psychiatric inpatients.
This study investigated assumptions made by DSM-III and DSM-III-R regarding Axis I-Axis II associations and sex differences for the 11 personality disorders (PD). A total of 112 patients formed 4 Axis I diagnostic groups: recent-onset schizophrenia (n = 35); recent-onset mania (n = 26); unipolar affective disorder (n = 30); and a mixed diagnostic group (n = 21). The prevalence of PD was determined using the Structured Interview for DSM-III Personality Disorders (SIDP). Schizophrenia was associated with antisocial PD and schizotypal PD; manic disorder was associated with histrionic PD; and unipolar affective disorder was associated with borderline, dependent and avoidant PD. Some of these results were consistent with DSM-III/DSM-III-R postulates. However, there was little support for the DSM-III/DSM-III-R statements on sex differences in the prevalence of PD, except for antisocial PD. The implications of the results for DSM-III/DSM-III-R assumptions are discussed.
Adult↗
Genetic interconnections between personality-related phenotypes and psychiatric disorders.
BACKGROUND: Personality-related phenotypes are genetically correlated with psychiatric disorders, but whether these relationships reflect shared genetic loci and differ across individual phenotypes remains unclear. We investigated their shared genetic architecture at the level of specific phenotype-disorder pairs. METHODS: We analyzed genome-wide association study summary statistics for 13 personality-related phenotypes and eight psychiatric disorders in populations of European ancestry. Genetic correlations were evaluated separately for 104 phenotype-disorder pairs using linkage disequilibrium score regression and high-definition likelihood. For pairs supported by both methods, MTAG and CPASSOC were applied separately to identify pleiotropic signals, followed by linkage disequilibrium clumping, Bayesian colocalization, gene prioritization, functional enrichment and bidirectional two-sample Mendelian randomization analyses. No composite personality or psychiatric-disorder phenotype was constructed. RESULTS: Among the 104 evaluated pairs, 77 showed significant positive genetic correlations in both analyses. Joint screening of MTAG and CPASSOC results identified pleiotropic signals in 61 pairs, comprising 1088 independent lead SNV-pair associations and 776 unique SNVs. Bayesian colocalization supported 351 signals across 42 pairs and 284 unique lead SNVs. MAGMA identified 1293 unique genes, of which 379 were prioritized by PoPS and 151 were further supported by SMR. These genes were enriched in brain tissues and biological processes involving nervous system development, synaptic organization and intercellular connectivity. Inverse-variance weighted Mendelian randomization identified 41 forward and 32 reverse associations after false-discovery-rate correction, including 21 pairs with bidirectional evidence. CONCLUSION: These item-resolved analyses identify widespread but heterogeneous genetic sharing between personality-related phenotypes and psychiatric disorders. The findings provide a pair-specific map of shared loci and prioritized genes, while the Mendelian randomization results should be interpreted cautiously because of residual heterogeneity and potential horizontal pleiotropy. Further validation in diverse populations and functional studies is required.
Colocalization↗
Personality disorder assessment for psychiatric inpatients.
The standardised criteria for DSM-III personality disorders encouraged the development of numerous multidimensional instruments to make the diagnosis of such disorders more objective and reliable compared with clinical judgement. Yet, there is no published research on the concordance between these instruments when used with psychiatric inpatients. Two such measures, the Millon Clinical Multiaxial Inventory (MCMI) and the Structured Interview for DSM-III Personality (SIDP), were chosen for this study. The MCMI identified a significantly greater number of personality disorders than the SIDP for each subject. Despite overall high interrater reliability with the SIDP, low agreement was found between the two instruments for most of the 11 DSM-III Axis II (personality disorders) categories. Different normative populations on which the instruments were developed, method variance, and theoretical differences between Millon and DSM-III, were all likely to contribute to the low concordance. Systematic research of possible confounding factors is suggested.
Adult↗
Psychiatric disorders in persons with Down syndrome.
This study was designed to provide information on the prevalence and nature of psychiatric disorders in 497 individuals with Down syndrome. There were 261 patients under 20 years of age and 164 patients 20 years and older, with both groups followed as outpatients, and 72 residents from a state school. The overall frequency of psychiatric disorders in our study population was 22.1%. Patients under 20 years of age often displayed disruptive behaviors, anxiety disorders, and repetitive behaviors. Individuals with Down syndrome 20 years and older who were followed as outpatients more often exhibited major depressive disorders and state school residents were found to have an increased prevalence of dementia.
Adolescent↗
Personality disorder and psychiatric illness in general practice.
In a one-year prevalence study of conspicuous psychiatric morbidity in two group general practices, one urban and the other rural, personality disorder was diagnosed in 5.3% by the GP and in 5.6% by the psychiatrist, but this increased to 28% when personality disorder was assessed using a structured interview. The prevalence of personality disorder was higher in the urban practice than in the rural one but there was no consistent association between personality disorder and mental state disorder, with the exception of alcohol abuse and dependence. The high rate of personality disorder found using the interview schedule is likely to be a true finding, and failure to recognise this hidden morbidity is important in both general and psychiatric practice.
England↗
Concordance between two personality disorder instruments with psychiatric inpatients.
Eighty-two psychiatric inpatients received axis II diagnoses on the Millon Clinical Multiaxial Inventory (MCMI-1)--a self-report instrument--and the Structured Interview for DSM-III Personality (SIDP). Those two instruments were then compared in terms of personality disorder categories and trait-scores (dimensions). Essentially, with the exception of the borderline category, concordance between the two instruments was poor on all scales. Bayesian statistics confirmed the obtained results. The adequacy of the MCMI-I as an index of DSM-III personality disorders is questioned.
Adult↗
Care or convenience? On the medical-bureaucratic model of commitment of the mentally ill.
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Commitment of Persons with Psychiatric Disorders↗
Acute postdisaster psychiatric disorders: identification of persons at risk.
This study examined the prevalence of four psychiatric disorders--posttraumatic stress disorder, major depression, generalized anxiety disorder, and alcohol abuse/dependence--in survivors of a jet plane crash into a hotel. Forty-six subjects were interviewed with the Diagnostic Interview Schedule/Disaster Supplement within 4-6 weeks of the event. More than half of the subjects met criteria for a psychiatric disorder after the disaster. More than two-thirds of the cases of acute postdisaster psychiatric disorders were predicted by identifying the subjects who had predisaster psychiatric histories. Predisaster psychiatric disorder predicted postdisaster psychopathology with a sensitivity of 72% and a specificity of 90%.
Adult↗
How flexible are our civil commitment statutes?
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Commitment of Persons with Psychiatric Disorders↗