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1.
The role of anxious and hyperthymic temperaments in mental disorders: a national epidemiologic study
ELIE G. KARAM MARIANA M. SALAMOUN JOUMANA S. YERETZIAN ZEINA N. MNEIMNEH AIMEE N. KARAM JOHN FAYYAD ELIE HANTOUCHE KAREEN AKISKAL HAGOP S. AKISKAL 《World psychiatry》2010,9(2):103-110
Temperament has been demonstrated clinically to be linked to mental disorders.
We aimed to determine the possible role of temperament in mental disorders
in a national epidemiologic study. A nationally representative sample of adults
(n=1320) was administered the Lebanese-Arabic version of the Temperament Evaluation
of the Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A), and
the Arabic CIDI 3.0, as part of the LEBANON study. The association among temperaments
and DSM-IV mood, anxiety, and impulse control disorders was assessed. The
anxious temperament was shown to be a robust predictor of most disorders,
especially within the anxiety and depressive clusters. The hyperthymic temperament
had a uniquely protective effect on most mental disorders, with the exception
of separation anxiety, bipolar, substance abuse and impulse control disorders.
These effects were moderated by age and education. Temperaments, previously
largely neglected in epidemiologic studies, could play a major role in the
origin of mental disorders. 相似文献
2.
Christina M. Lamertz Ph.D. Corinna Jacobi Alexander Yassouridis Klaus Arnold Andreas W. Henkel 《Obesity (Silver Spring, Md.)》2002,10(11):1152-1160
Objective: Associations between body mass index (BMI) and mental disorders meeting Axis-I diagnoses according to the Diagnostic and Statistical Manual for Mental Disorders IV (DSM-IV) were investigated in The Early Developmental Stages of Psychopathology Study in a large population-based sample, which included adolescents and young adults of both genders for the first time. Research Methods and Procedures: A total of 3021 German subjects ranging from 14 to 24 years of age were assessed for specific DSM-IV diagnoses derived from a modified version of the standardized Composite International Diagnostic Interview, and general psychological disturbances, using the Symptom Checklist-90-Revised. BMI percentiles for age and gender were calculated to avoid systematic bias in the BMI distribution resulting from the young age range represented in the sample. Additionally, subjects with a lifetime diagnosis of any eating disorder were excluded from statistical analysis to control the confounding effect of body weight-related eating disorders on associations between BMI and psychopathology. Results: The results based on logistic regression analyses and MANOVAs demonstrate that the BMI is not associated with mental disorders or general psychopathologies. There were no significant associations between BMI and mood, anxiety, substance, and somatoform disorders, a result that contrasts with almost all previous clinical studies. Additionally, in contrast to clinical investigations and most epidemiological studies, neither obesity nor underweight was significantly associated with any kind of general psychopathology. Discussion: The overall finding that obesity is not significantly related to marked psychopathology in the general German population of adolescents and young adults has important clinical implications. 相似文献
3.
The constructs of atypical depression, bipolar II disorder and borderline
personality disorder (BPD) overlap. We explored the relationships between
these constructs and their temperamental underpinnings. We examined 107 consecutive
patients who met DSM-IV criteria for major depressive episode with atypical
features. Those who also met the DSM-IV criteria for BPD (BPD+), compared
with those who did not (BPD-), had a significantly higher lifetime comorbidity
for body dysmorphic disorder, bulimia nervosa, narcissistic, dependent and
avoidant personality disorders, and cyclothymia. BPD+ also scored higher on
the Atypical Depression Diagnostic Scale items of mood reactivity, interpersonal
sensitivity, functional impairment, avoidance of relationships, other rejection
avoidance, and on the Hopkins Symptoms Check List obsessive-compulsive, interpersonal
sensitivity, anxiety, anger-hostility, paranoid ideation and psychoticism
factors. Logistic regression revealed that cyclothymic temperament accounted
for much of the relationship between atypical depression and BPD, predicting
6 of 9 of the defining DSM-IV attributes of the latter. Trait mood lability
(among BPD patients) and interpersonal sensitivity (among atypical depressive
patients) appear to be related as part of an underlying cyclothymic temperamental
matrix. 相似文献
4.
Dvornik-Radica A Rudan V Juresa V Ivanković D Rumboldt M Smoje E Vrdoljak D Mrduljas-Dujić N 《Collegium antropologicum》2006,30(3):489-493
The aim of the study was to examine patients in adolescent crisis at the beginning of treatment and after a period of 12 months in order to evaluate the relative diagnostic and therapeutic validity. The study included 153 Split University students in adolescent crisis; 90 of them were treated by counseling and 63 served as controls. For diagnosis, Hampstead index and Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) multiaxial evaluation were used, allowing a wider insight into personal functioning. The study sample was split in 7 significantly different diagnostic subgroups. The counseling-treated examinees had better personality functioning after 12 months, but did not differ significantly from the control group. Some of their single functions were more severely disturbed at the very beginning. Counseling is a valuable therapeutic and diagnostic tool for adolescent crisis. The assessment must evaluate the entire person, because looking at only one aspect, due to different development and its place, a wrong conclusion may be reached. The "adolescents crisis" entity is clinically relevant. 相似文献
5.
The use of structured psychiatric interviews performed by non-clinicians
is frequent for research purposes and is becoming increasingly common in clini-cal
practice. The validity of such interviews has rarely been evaluated empirically.
In this study of a sample of 100 diagnostically heterogeneous, first-admitted
inpatients, the results of an assessment with the Structured Clinical Interview
for DSM-IV (SCID), yielding a DSM-IV diagnosis and performed by a trained
non-clinician, were compared with a consensus lifetime best diagnostic estimate
(DSM-IV) by two experienced research clinicians, based on multiple sources
of information, which included videotaped comprehensive semi-structured narrative
interviews. The overall kappa agreement was 0.18. The sensitivity and specificity
for the diagnosis of schizophrenia by SCID were 19% and 100%, respectively.
It is concluded that structured interviews performed by non-clinicians are
not recommendable for clinical work and should only be used in research with
certain precautions. It is suggested that a revival of systematic theoretical
and practical training in psychopathology is an obvious way forward in order
to improve the validity and therapeutic utility of psychiatric diagnosis. 相似文献
6.
Bowden CL 《MedGenMed : Medscape general medicine》2002,4(3):17
Bipolar disorders are currently divided into 4 entities: bipolar I, bipolar II, cyclothymic disorder, and bipolar disorder not otherwise specified, as described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). These subtypes of bipolar disorders cover a spectrum of severities, frequencies, and durations of manic and depressive symptoms. The differential diagnosis among these and with regard to other disorders with similar symptom features remains the foundation for treatment of bipolar disorders. It is clear that much diversity exists within these major subtypes, such that designations like "rapid cycling" and "bipolar III" are being put forward and probed for clinical relevance. Some of the concerns and advantages of including these less-established manifestations of bipolar disorders in our diagnostic thinking are discussed here, and the utility and drawbacks of our current diagnostic protocols are considered. 相似文献
7.
SALIH ALHASNAWI SABAH SADIK MOHAMMAD RASHEED ALI BABAN MAHDI M. AL-ALAK ABDULRAHMAN YONIS OTHMAN YONIS OTHMAN NEZAR ISMET OSMAN SHAWANI SRINIVASA MURTHY MONAF ALJADIRY SOMNATH CHATTERJI NAEEMA AL-GASSEER EMMANUEL STREEL NIRMALA NAIDOO MOHAMED MAHOMOUD ALI MICHAEL J GRUBER MARIA PETUKHOVA NANCY A. SAMPSON RONALD C. KESSLER ON BEHALF OF THE IRAQ MENTAL HEALTH SURVEY STUDY GROUP 《World psychiatry》2009,8(2):97-109
Data on the prevalence and correlates of anxiety, mood, behavioral, and substance disorders are presented from a 2007-8 national survey of the Iraq population, the Iraq Mental Health Survey (IMHS). The IMHS was carried out by the Iraq Ministry of Health in collaboration with the Iraq Ministry of Planning and the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. Interviews were administered to a probability sample of Iraqi household residents by trained lay interviewers. The WHO Composite International Diagnostic interview (CIDI) was used to assess DSM-IV disorders. The response rate was 95.2%. The estimated lifetime prevalence of any disorder was 18.8%. Cohort analysis documented significantly increasing lifetime prevalence of most disorders across generations. This was most pronounced for panic disorder and post-traumatic stress disorder, with lifetime-to-date prevalence 5.4-5.3 times as high at comparable ages in the youngest (ages 18-34) as oldest (ages 65+) cohorts. Anxiety disorders were the most common class of disorders (13.8%) and major depressive disorder (MDD) the most common disorder (7.2%). Twelve-month prevalence of any disorder was 13.6%, with 42.1% of cases classified mild, 36.0% moderate, and 21.9% serious. The disorders most often classified serious were bipolar disorder (76.9%) and substance-related disorders (54.9%). Socio-demographic correlates were generally consistent with international epidemiological surveys, with the two exceptions of no significant gender differences in mood disorders and positive correlations of anxiety and mood disorders with education. Only 2.2% of IMHS respondents reported receiving treatment for emotional problems in the 12 months before interview, including 23.7% of those with serious, 9.2% with moderate, and 5.3% with mild disorders and 0.9% of other respondents. Most healthcare treatment, which was roughly equally distributed between the general medical and specialty sectors, was of low intensity. Further analyses of barriers to seeking treatment are needed to inform government efforts to expand the detection and treatment of mental disorders 相似文献
8.
Karam EG Mneimneh ZN Dimassi H Fayyad JA Karam AN Nasser SC Chatterji S Kessler RC 《PLoS medicine》2008,5(4):e61
Background
There are no published data on national lifetime prevalence and treatment of mental disorders in the Arab region. Furthermore, the effect of war on first onset of disorders has not been addressed previously on a national level, especially in the Arab region. Thus, the current study aims at investigating the lifetime prevalence, treatment, age of onset of mental disorders, and their relationship to war in Lebanon.Methods and Findings
The Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation study was carried out on a nationally representative sample of the Lebanese population (n = 2,857 adults). Respondents were interviewed using the fully structured WHO Composite International Diagnostic Interview 3.0. Lifetime prevalence of any Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) disorder was 25.8%. Anxiety (16.7%) and mood (12.6%) were more common than impulse control (4.4%) and substance (2.2%) disorders. Only a minority of people with any mental disorder ever received professional treatment, with substantial delays (6 to 28 y) between the onset of disorders and onset of treatment. War exposure increased the risk of first onset of anxiety (odds ratio [OR] 5.92, 95% confidence interval [CI] 2.5–14.1), mood (OR 3.32, 95% CI 2.0–5.6), and impulse control disorders (OR 12.72, 95% CI 4.5–35.7).Conclusions
About one-fourth of the sample (25.8%) met criteria for at least one of the DSM-IV disorders at some point in their lives. There is a substantial unmet need for early identification and treatment. Exposure to war events increases the odds of first onset of mental disorders. 相似文献9.
Falck RP Pot AM Braam AW Hanewald GJ Ribbe MW 《Tijdschrift voor gerontologie en geriatrie》1999,30(5):193-199
The prevalence and recognition of depression among physically frail patients living in an urban Dutch nursing home were estimated. To patients with Mini-Mental-Status-Examination (MMSE) scores of 15 or above, the Geriatric Depression Scale (GDS) was administered (N = 80). With this screen clinically relevant depressive symptoms can be established. For diagnosing major depression according to the DSM-IV criteria, the Diagnostic Interview Schedule (DIS) (N = 57) was administered using a MMSE cut-off of 20. 49% of the respondents showed a score above the GDS cut-off (> 11), which means having clinically relevant depressive symptoms. 16% met the criteria for major depression according to DIS. Nursing home physicians recognized 39% of the patients with clinically relevant depressive symptoms and 67% of those with a major depression. Nurses recognized depressive patients slightly better but they were less specific in their judgement (more false-positive rates). We also found that in situations in which physicians and nurses had the same opinion the recognition of depression improved. Therefore it is recommended that physicians and nurses exchange their judgements on patients' mood on a regular basis. 相似文献
10.
Fernando Navarro-Mateu Ma José Tormo Diego Salmerón Gemma Vilagut Carmen Navarro Guadalupe Ruíz-Merino Teresa Escámez Javier Júdez Salvador Martínez Ron C. Kessler Jordi Alonso 《PloS one》2015,10(9)
Background
To describe the lifetime and 12-month prevalence, severity and age of onset distribution of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) disorders and to explore the association between socio-demographic variables and economic stressors with mental disorders during the economic crisis in the general population of Murcia (Spain).Methods and Findings
The PEGASUS-Murcia Project is a cross-sectional face-to-face interview survey of a representative sample of non-institutionalized adults in Murcia administered between June 2010 and May 2012. DSM-IV disorders were assessed by the Composite International Diagnostic Interview (CIDI 3.0). Main outcome measures were lifetime and 12-month prevalence of Anxiety, Mood, Impulse and Substance Disorders, Severity and Age of Onset. Sociodemographic variables and stressful economic life events during the preceding 12 months were entered as independent variables in a logistic regression analysis. A total of 2,621 participants (67.4% response rate) were interviewed, 54.5% female, mean age 48.6 years. Twelve-month prevalence (95%CI) of disorders: anxiety 9.7% (7.6–12.2), mood 6.6% (5.5–8.1), impulse 0.3% (0.1–1.2) and substance use 1.0% (0.4–2.4) disorders. Lifetime prevalence: anxiety 15.0% (12.3–18.1), mood 15.6% (13.5–18.1), impulse 2.4% (1.4–4.0) and substance use 8.3% (6.2–11.0) disorders. Severity among 12-month cases: serious 29.2% (20.8–39.4), moderate 35.6% (24.0–49.1) and mild severity 35.2% (29.5–41.5). Women were 3.7 and 2.5 times more likely than men to suffer 12-month anxiety and mood disorders, respectively. Substance use was more frequent among men. Younger age and lower income were associated with higher prevalence. Respondents exposed to multiple and recent economic stressors had the highest risk of anxiety disorders.Conclusions
Mental disorders in the adult population of Murcia during the economic crisis were more prevalent and serious than those in previous estimates for Spain. Prevalence was strongly associated with exposure to stressors related to the economic crisis. 相似文献11.
12.
Clinical utility of ICD‐11 diagnostic guidelines for high‐burden mental disorders: results from mental health settings in 13 countries
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Geoffrey M. Reed Jared W. Keeley Tahilia J. Rebello Michael B. First Oye Gureje José Luis Ayuso‐Mateos Shigenobu Kanba Brigitte Khoury Cary S. Kogan Valery N. Krasnov Mario Maj Jair de Jesus Mari Pratap Sharan Dan J. Stein Min Zhao Tsuyoshi Akiyama Howard F. Andrews Elson Asevedo Majda Cheour Tecelli Domínguez‐Martínez Joseph El‐Khoury Andrea Fiorillo Jean Grenier Nitin Gupta Lola Kola Maya Kulygina Itziar Leal‐Leturia Mario Luciano Bulumko Lusu J. Nicolás I. Martínez‐López Chihiro Matsumoto Mayokun Odunleye Lucky Umukoro Onofa Sabrina Paterniti Shivani Purnima Rebeca Robles Manoj K. Sahu Goodman Sibeko Na Zhong Wolfgang Gaebel Anne M. Lovell Toshimasa Maruta Kathleen M. Pike Michael C. Roberts María Elena Medina‐Mora 《World psychiatry》2018,17(3):306-315
In this paper we report the clinical utility of the diagnostic guidelines for ICD‐11 mental, behavioural and neurodevelopmental disorders as assessed by 339 clinicians in 1,806 patients in 28 mental health settings in 13 countries. Clinician raters applied the guidelines for schizophrenia and other primary psychotic disorders, mood disorders (depressive and bipolar disorders), anxiety and fear‐related disorders, and disorders specifically associated with stress. Clinician ratings of the clinical utility of the proposed ICD‐11 diagnostic guidelines were very positive overall. The guidelines were perceived as easy to use, corresponding accurately to patients’ presentations (i.e., goodness of fit), clear and understandable, providing an appropriate level of detail, taking about the same or less time than clinicians’ usual practice, and providing useful guidance about distinguishing disorder from normality and from other disorders. Clinicians evaluated the guidelines as less useful for treatment selection and assessing prognosis than for communicating with other health professionals, though the former ratings were still positive overall. Field studies that assess perceived clinical utility of the proposed ICD‐11 diagnostic guidelines among their intended users have very important implications. Classification is the interface between health encounters and health information; if clinicians do not find that a new diagnostic system provides clinically useful information, they are unlikely to apply it consistently and faithfully. This would have a major impact on the validity of aggregated health encounter data used for health policy and decision making. Overall, the results of this study provide considerable reason to be optimistic about the perceived clinical utility of the ICD‐11 among global clinicians. 相似文献
13.
Margreet ten Have Marlous Tuithof Saskia van Dorsselaer Frederiek Schouten Annemarie I. Luik Ron de Graaf 《World psychiatry》2023,22(2):275-285
Up-to-date information on the prevalence and trends of common mental disorders is relevant to health care policy and planning, owing to the high burden associated with these disorders. In the first wave of the third Netherlands Mental Health Survey and Incidence Study (NEMESIS-3), a nationally representative sample was interviewed face-to-face from November 2019 to March 2022 (6,194 subjects; 1,576 interviewed before and 4,618 during the COVID-19 pandemic; age range: 18-75 years). A slightly modified version of the Composite International Diagnostic Interview 3.0 was used to assess DSM-IV and DSM-5 diagnoses. Trends in 12-month prevalence rates of DSM-IV mental disorders were examined by comparing these rates between NEMESIS-3 and NEMESIS-2 (6,646 subjects; age range: 18-64 years; interviewed from November 2007 to July 2009). Lifetime DSM-5 prevalence estimates in NEMESIS-3 were 28.6% for anxiety disorders, 27.6% for mood disorders, 16.7% for substance use disorders, and 3.6% for attention-deficit/hyperactivity disorder. Over the last 12 months, prevalence rates were 15.2%, 9.8%, 7.1%, and 3.2%, respectively. No differences in 12-month prevalence rates before vs. during the COVID-19 pandemic were found (26.7% pre-pandemic vs. 25.7% during the pandemic), even after controlling for differences in socio-demographic characteristics of the respondents interviewed in these two periods. This was the case for all four disorder categories. From 2007-2009 to 2019-2022, the 12-month prevalence rate of any DSM-IV disorder significantly increased from 17.4% to 26.1%. A stronger increase in prevalence was found for students, younger adults (18-34 years) and city dwellers. These data suggest that the prevalence of mental disorders has increased in the past decade, but this is not explained by the COVID-19 pandemic. The already high mental disorder risk of young adults has particularly further increased in recent years. 相似文献
14.
Jamie E. M. Byrne Ben Bullock Aida Brydon Greg Murray 《Chronobiology international》2019,36(2):265-275
The sleep, circadian rhythms, and mood (SCRAM) questionnaire (Byrne, Bullock et al., 2017) was designed to concurrently measure individual differences in three clinically important functions: diurnal preference, sleep quality, and mood. The 15-item questionnaire consists of three 5-item scales named Morningness, Good Sleep, and Depressed Mood. The overarching aim of the current project was to investigate the validity and reliability of the questionnaire. Here, we report on associations investigated in three data sets. Study 1 (N = 70, 80% females) was used to examine the test–retest reliability of the questionnaire, finding strong test–retest reliability of the three scales over a 2-week period (r’s ranging from 0.73 to 0.86). Study 2 (N = 183, 80% females) enabled us to examine the construct validity of the SCRAM scales against well-validated self-report measures of diurnal preference, sleep quality, and depression. Strong correlations were found between each SCRAM scale and their respective measure in bivariate analyses, and associations were robust after the inclusion of the remaining two SCRAM scales as predictors in regression analyses. Data from Study 3 (N = 42, 100% males) were used to measure the extent to which SCRAM scores correlated with objective measures of sleep–wake behavior using actigraphy. Morningness was found to be related to earlier sleep onset and offset times, and Good Sleep was related to higher sleep efficiency but to no other measures of sleep quality; Depressed Mood was not related to actigraphy measures. The findings provide provisional support for construct validity and reliability of the SCRAM questionnaire as a measure of diurnal preference, sleep quality, and depressed mood. Future research into the psychometrics of SCRAM should test the questionnaire’s discriminant and predictive validity in clinical samples. 相似文献
15.
RONALD C KESSLER MATTHIAS ANGERMEYER JAMES C ANTHONY RON DE GRAAF KOEN DEMYTTENAERE ISABELLE GASQUET GIOVANNI DE GIROLAMO SEMYON GLUZMAN OYE GUREJE JOSEP MARIA HARO NORITO KAWAKAMI AIMEE KARAM DAPHNA LEVINSON MARIA ELENA MEDINA MORA MARK A OAKLEY BROWNE JOSé POSADA-VILLA DAN J STEIN CHEUK HIM ADLEY TSANG SERGIO AGUILAR-GAXIOLA JORDI ALONSO SING LEE STEVEN HEERINGA BETH-ELLEN PENNELL PATRICIA BERGLUND MICHAEL J GRUBER MARIA PETUKHOVA SOMNATH CHATTERJI T. BEDIRHAN üSTüN 《World psychiatry》2007,6(3):168-176
Data are presented on the lifetime prevalence, projected lifetime risk,
and age-of-onset distributions of mental disorders in the World Health Organization
(WHO)''s World Mental Health (WMH) Surveys. Face-to-face community surveys
were conducted in seventeen countries in Africa, Asia, the Americas, Europe,
and the Middle East. The combined numbers of respondents were 85,052. Lifetime
prevalence, projected lifetime risk, and age of onset of DSM-IV disorders
were assessed with the WHO Composite International Diagnostic Interview (CIDI),
a fully-structured lay administered diagnostic interview. Survival analysis
was used to estimate lifetime risk. Median and inter-quartile range (IQR)
of age of onset is very early for some anxiety disorders (7-14, IQR: 8-11)
and impulse control disorders (7-15, IQR: 11-12). The age-of-onset distribution
is later for mood disorders (29-43, IQR: 35-40), other anxiety disorders (24-50,
IQR: 31-41), and substance use disorders (18-29, IQR: 21-26). Median and IQR
lifetime prevalence estimates are: anxiety disorders 4.8-31.0% (IQR: 9.9-16.7%),
mood disorders 3.3-21.4% (IQR: 9.8-15.8%), impulse control disorders 0.3-25.0%
(IQR: 3.1-5.7%), substance use disorders 1.3-15.0% (IQR: 4.8-9.6%), and any
disorder 12.0-47.4% (IQR: 18.1-36.1%). Projected lifetime risk is proportionally
between 17% and 69% higher than estimated lifetime prevalence (IQR: 28-44%),
with the highest ratios in countries exposed to sectarian violence (Israel,
Nigeria, and South Africa), and a general tendency for projected risk to be
highest in recent cohorts in all countries. These results document clearly
that mental disorders are commonly occurring. As many mental disorders begin
in childhood or adolescents, interventions aimed at early detection and treatment
might help reduce the persistence or severity of primary disorders and prevent
the subsequent onset of secondary disorders. 相似文献
16.
Karestan C Koenen Michael J Lyons Jack Goldberg John Simpson Wesley M Williams Rosemary Toomey Seth A Eisen William R True Marylene Cloitre Jessica Wolfe Ming T Tsuang 《Twin research》2003,6(3):218-226
Combat-related posttraumatic stress disorder (PTSD) is highly comorbid with other mental disorders. However, the nature of the relationship between PTSD and other mental disorders remains unclear. A discordant high-risk twin design was used on data from a sub-sample of the male-male twin pair members of the Vietnam Era Twin Registry to examine whether patterns of comorbidity are consistent with a psychopathological response to combat exposure or reflect familial vulnerability to psychopathology. Mental disorders were assessed via the Mental Health Diagnostic Interview Schedule Version III - Revised. Discordant monozygotic within-pair comparisons revealed that PTSD probands had higher symptom counts and diagnostic prevalences of mood and anxiety disorders than their non-combat exposed co-twins. Monozygotic co-twins of PTSD probands had significantly more mood disorder symptoms than monozygotic co-twins of combat controls or dizygotic co-twins of veterans with PTSD. These findings suggest that a) major depression, generalized anxiety disorder and panic disorder are part of a post-combat response syndrome; b) a shared familial vulnerability also contributes to the association between PTSD and major depression, PTSD and dysthymia, and c) this shared vulnerability is mediated by genetic factors. 相似文献
17.
There is considerable debate over whether bipolar and related disorders that share common signs and symptoms, but are currently defined as distinct clinical entities in DSM-IV and ICD-10, may be better characterized as falling within a more broadly defined "bipolar spectrum". With a spectrum view in mind, the possibility of broadening the diagnosis of bipolar disorder has been proposed. This paper discusses some of the rationale for an expanded diagnostic scheme from both clinical and research perspectives in light of potential drawbacks. The ultimate goal of broadening the diagnosis of bipolar disorder is to help identify a common etiopathogenesis for these conditions to better guide treatment. To help achieve this goal, bipolar researchers have increasingly expanded their patient populations to identify objective biological or endophenotypic markers that transcend phenomenological observation. Although this approach has and will likely continue to produce beneficial results, the upcoming DSM-IV and ICD-10 revisions will place increasing scrutiny on psychiatry's diagnostic classification systems and pressure to re-evaluate our conceptions of bipolar disorder. However, until research findings can provide consistent and converging evidence as to the validity of a broader diagnostic conception, clinical expansion to a dimensional bipolar spectrum should be considered with caution. 相似文献
18.
Ferdowsian HR Durham DL Kimwele C Kranendonk G Otali E Akugizibwe T Mulcahy JB Ajarova L Johnson CM 《PloS one》2011,6(6):e19855
Background
In humans, traumatic experiences are sometimes followed by psychiatric disorders. In chimpanzees, studies have demonstrated an association between traumatic events and the emergence of behavioral disturbances resembling posttraumatic stress disorder (PTSD) and depression. We addressed the following central question: Do chimpanzees develop posttraumatic symptoms, in the form of abnormal behaviors, which cluster into syndromes similar to those described in human mood and anxiety disorders?Methodology/Principal Findings
In phase 1 of this study, we accessed case reports of chimpanzees who had been reportedly subjected to traumatic events, such as maternal separation, social isolation, experimentation, or similar experiences. We applied and tested DSM-IV criteria for PTSD and major depression to published case reports of 20 chimpanzees identified through PrimateLit. Additionally, using the DSM-IV criteria and ethograms as guides, we developed behaviorally anchored alternative criteria that were applied to the case reports. A small number of chimpanzees in the case studies met DSM-IV criteria for PTSD and depression. Measures of inter-rater reliability, including Fleiss'' kappa and percentage agreement, were higher with use of the alternative criteria for PTSD and depression. In phase 2, the alternative criteria were applied to chimpanzees living in wild sites in Africa (n = 196) and chimpanzees living in sanctuaries with prior histories of experimentation, orphanage, illegal seizure, or violent human conflict (n = 168). In phase 2, 58% of chimpanzees living in sanctuaries met the set of alternative criteria for depression, compared with 3% of chimpanzees in the wild (p = 0.04), and 44% of chimpanzees in sanctuaries met the set of alternative criteria for PTSD, compared with 0.5% of chimpanzees in the wild (p = 0.04).Conclusions/Significance
Chimpanzees display behavioral clusters similar to PTSD and depression in their key diagnostic criteria, underscoring the importance of ethical considerations regarding the use of chimpanzees in experimentation and other captive settings. 相似文献19.
20.
We used a multi-round, two-party exchange game in which a healthy subject played a subject diagnosed with a DSM-IV (Diagnostic and Statistics Manual-IV) disorder, and applied a Bayesian clustering approach to the behavior exhibited by the healthy subject. The goal was to characterize quantitatively the style of play elicited in the healthy subject (the proposer) by their DSM-diagnosed partner (the responder). The approach exploits the dynamics of the behavior elicited in the healthy proposer as a biosensor for cognitive features that characterize the psychopathology group at the other side of the interaction. Using a large cohort of subjects (n = 574), we found statistically significant clustering of proposers' behavior overlapping with a range of DSM-IV disorders including autism spectrum disorder, borderline personality disorder, attention deficit hyperactivity disorder, and major depressive disorder. To further validate these results, we developed a computer agent to replace the human subject in the proposer role (the biosensor) and show that it can also detect these same four DSM-defined disorders. These results suggest that the highly developed social sensitivities that humans bring to a two-party social exchange can be exploited and automated to detect important psychopathologies, using an interpersonal behavioral probe not directly related to the defining diagnostic criteria. 相似文献