scholarly journals Thought disorder in the meta-structure of psychopathology

2012 ◽  
Vol 43 (8) ◽  
pp. 1673-1683 ◽  
Author(s):  
K. M. Keyes ◽  
N. R. Eaton ◽  
R. F. Krueger ◽  
A. E. Skodol ◽  
M. M. Wall ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Personality Disorders ◽  
Thought Disorder ◽  
Patient Treatment ◽  
Treatment Needs ◽  
Co Morbidity ◽  
The Us ◽  
Axis I ◽  
Dsm Iv

BackgroundDimensional models of co-morbidity have the potential to improve the conceptualization of mental disorders in research and clinical work, yet little is known about how relatively uncommon disorders may fit with more common disorders. The present study estimated the meta-structure of psychopathology in the US general population focusing on the placement of five under-studied disorders sharing features of thought disorder: paranoid, schizoid, avoidant and schizotypal personality disorders, and manic episodes as well as bipolar disorder.MethodData were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a face-to-face interview of 34 653 non-institutionalized adults in the US general population. The meta-structure of 16 DSM-IV Axis I and Axis II psychiatric disorders, as assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version (AUDADIS-IV), was examined using exploratory and confirmatory factor analysis.ResultsWe document an empirically derived thought disorder factor that is a subdomain of the internalizing dimension, characterized by schizoid, paranoid, schizotypal and avoidant personality disorders as well as manic episodes. Manic episodes exhibit notable associations with both the distress subdomain of the internalizing dimension as well as the thought disorder subdomain. The structure was replicated for bipolar disorder (I or II) in place of manic episodes.ConclusionsAs our understanding of psychopathological meta-structure expands, incorporation of disorders characterized by detachment and psychoticism grows increasingly important. Disorders characterized by detachment and psychoticism may be well conceptualized, organized and measured as a subdimension of the internalizing spectrum of disorders. Manic episodes and bipolar disorder exhibit substantial co-morbidity across both distress and thought disorder domains of the internalizing dimension. Clinically, these results underscore the potential utility of conceptualizing patient treatment needs using an approach targeting psychopathological systems underlying meta-structural classification rubrics.

scholarly journals Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions

2005 ◽  
Vol 35 (12) ◽  
pp. 1747-1759 ◽  
Author(s):  
BRIDGET F. GRANT ◽  
DEBORAH S. HASIN ◽  
FREDERICK S. STINSON ◽  
DEBORAH A. DAWSON ◽  
W. JUNE RUAN ◽  
...  
Keyword(s):  
Substance Use ◽  
Anxiety Disorder ◽  
Mood Disorder ◽  
Personality Disorders ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety ◽  
Epidemiologic Survey ◽  
Co Morbidity ◽  
Axis I ◽  
Dsm Iv

Background. This study addressed the prevalences, correlates, co-morbidity and disability of DSM-IV generalized anxiety disorder (GAD) and other psychiatric disorders in a large national survey of the general population, the National Institute on Alcohol Abuse and Alcoholism's (NIAAA) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The study presents nationally representative data, for the first time, on prevalence, correlates, co-morbidity, and comparative disability of DSM-IV GAD.Method. Data are taken from a large (n=43093) representative sample of the adult USA population.Results. Prevalences of 12-month and lifetime GAD were 2·1% and 4·1%. Being female, middle-aged, widowed/separated/divorced, and low income increased risk, while being Asian, Hispanic, or Black decreased risk. GAD was highly co-morbid with substance use, and other anxiety, mood, and personality disorders. Co-morbidity in GAD was not substantially greater than for most other Axis I and II disorders. Disability and impairment in pure GAD were equivalent to pure mood disorders, but significantly greater than in pure substance use, and other anxiety and personality disorders. Individuals co-morbid for GAD and each mood disorder were more disabled than those with pure forms of GAD or each mood disorder. When co-morbid with GAD, nicotine dependence and other anxiety and personality disorders were not associated with increased disability over that associated with pure GAD, but GAD did show increased disability over that due to each of these disorders in pure form.Conclusions. Associations between GAD and Axis I and II disorders were strong and significant, with variation among specific disorders. Results strongly support GAD as an independent disorder with significant impairment and disability.

Gender-related distribution of personality disorders in a sample of patients with panic disorder

2001 ◽  
Vol 16 (3) ◽  
pp. 173-179 ◽  
Author(s):  
G. Barzega ◽  
G. Maina ◽  
S. Venturello ◽  
F. Bogetto
Keyword(s):  
Personality Disorder ◽  
Panic Disorder ◽  
Personality Disorders ◽  
Structured Interview ◽  
Dependent Personality Disorder ◽  
Dependent Personality ◽  
Co Morbidity ◽  
Related Distribution ◽  
Axis I ◽  
Dsm Iv

SummaryObjectiveWe examined gender differences in the frequency of DSM-IV personality disorder diagnoses in a sample of patients with a diagnosis of panic disorder (PD).MethodOne hundred and eighty-four outpatients with a principal diagnosis of PD (DSM-IV) were enrolled. All patients were evaluated with a semi-structured interview to collect demographic and clinical data and to generate Axis I and Axis II diagnoses in accordance with DSM-IV criteria.ResultsMales were significantly more likely than females to meet diagnoses for schizoid and borderline personality disorder. Compared to males, females predominated in histrionic and cluster C diagnoses, particularly dependent personality disorder diagnoses. A significant interaction was found between female sex and agoraphobia on personality disorder (PD) distribution.ConclusionsMale PD patients seem to be characterized by more severe personality disorders, while female PD patients, particularly with co-morbid agoraphobia, have higher co-morbidity rates with personality disorders belonging to the ‘anxious-fearful cluster’.

Twelve-month prevalence and disability of DSM-IV bipolar disorder in an Australian general population survey

2004 ◽  
Vol 34 (5) ◽  
pp. 777-785 ◽  
Author(s):  
P. B. MITCHELL ◽  
T. SLADE ◽  
G. ANDREWS
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
National Survey ◽  
Large Scale ◽  
Well Being ◽  
Major Depressive ◽  
Co Morbidity ◽  
Dsm Iv ◽  
Days Out Of Role

Background. There have been few large-scale epidemiological studies which have examined the prevalence of bipolar disorder. The authors report 12-month prevalence data for DSM-IV bipolar disorder from the Australian National Survey of Mental Health and Well-Being.Method. The broad methodology of the Australian National Survey has been described previously. Ten thousand, six hundred and forty-one people participated. The 12-month prevalence of euphoric bipolar disorder (I and II) – similar to the euphoric-grandiose syndrome of Kessler and co-workers – was determined. Those so identified were compared with subjects with major depressive disorder and the rest of the sample, on rates of co-morbidity with anxiety and substance use disorders as well as demographic features and measures of disability and service utilization. Polychotomous logistic regression was used to study the relationship between the three samples and these dependent variables.Results. There was a 12-month prevalence of 0·5% for bipolar disorder. Compared with subjects with major depressive disorder, those with bipolar disorder were distinguished by a more equal gender ratio; a greater likelihood of being widowed, separated or divorced; higher rates of drug abuse or dependence; greater disability as measured by days out of role; increased rates of treatment with medicines; and higher lifetime rates of suicide attempts.Conclusions. This large national survey highlights the marked functional impairment caused by bipolar disorder, even when compared with major depressive disorder.

scholarly journals The genetic epidemiology of personality disorders

2010 ◽  
Vol 12 (1) ◽  
pp. 103-114 ◽  
Keyword(s):  
Personality Disorders ◽  
Genetic Factors ◽  
Association Studies ◽  
Molecular Genetic ◽  
Cluster Structure ◽  
Epidemiologic Studies ◽  
Axis Ii ◽  
Candidate Gene Association ◽  
Axis I ◽  
Dsm Iv

Genetic epidemiologic studies indicate that all ten personality disorders (PDs) classified on the DSM-IV axis II are modestly to moderately heritable. Shared environmental and nonadditive genetic factors are of minor or no importance. No sex differences have been identified, Multivariate studies suggest that the extensive comorbidity between the PDs can be explained by three common genetic and environmental risk factors. The genetic factors do not reflect the DSM-IV cluster structure, but rather: i) broad vulnerability to PD pathology or negative emotionality; ii) high impulsivity/low agreeableness; and iii) introversion. Common genetic and environmental liability factors contribute to comorbidity between pairs or clusters of axis I and axis II disorders. Molecular genetic studies of PDs, mostly candidate gene association studies, indicate that genes linked to neurotransmitter pathways, especially in the serotonergic and dopaminergic systems, are involved. Future studies, using newer methods like genome-wide association, might take advantage of the use of endophenotypes.

The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions

2007 ◽  
Vol 37 (7) ◽  
pp. 1047-1059 ◽  
Author(s):  
FREDERICK S. STINSON ◽  
DEBORAH A. DAWSON ◽  
S. PATRICIA CHOU ◽  
SHARON SMITH ◽  
RISE B. GOLDSTEIN ◽  
...  
Keyword(s):  
Low Income ◽  
Adult Population ◽  
Age At Onset ◽  
Specific Phobia ◽  
Increased Risk ◽  
Co Morbidity ◽  
The Usa ◽  
Axis I ◽  
Dsm Iv ◽  
The Mean

Background. There is a lack of current detailed national data on the prevalence, correlates, disability and co-morbidity of DSM-IV specific phobia (SP), the prevalence of specific objects and situations feared, and associations between impairment, treatment and co-morbidity and the number of specific situations and objects feared, among adults in the USA.Method. The data were derived from a large (43093) representative sample of the adult population in the USA.Results. Prevalences of 12-month and lifetime DSM-IV SP were 7·1% and 9·4% respectively. Being female, young, and low income increased risk, while being Asian or Hispanic decreased risk (p<0·05). The mean age at onset of SP was 9·7 years, the mean duration of episode was 20·1 years and only 8·0% reported treatment specifically for SP. Most specific phobias involved multiple fears, and an increasing number of fears, regardless of content, was associated with greater disability and impairment, treatment seeking and co-morbidity with other Axis I and II disorders.Conclusions. SP is a highly prevalent, disabling and co-morbid disorder in the US adult population. The early onset of SP and the disorders most strongly associated with it highlights the need for longitudinal studies beginning in early childhood. Results suggest the existence of a generalized subtype of SP much like social phobia, which, once revealed, may lead to a classification of SP that is more etiologically and therapeutically meaningful.

Cardiovascular drug use and mortality in patients with schizophrenia or bipolar disorder: a Danish population-based study

2013 ◽  
Vol 44 (8) ◽  
pp. 1625-1637 ◽  
Author(s):  
T. M. Laursen ◽  
P. B. Mortensen ◽  
J. H. MacCabe ◽  
D. Cohen ◽  
C. Gasse
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Drug Use ◽  
General Population ◽  
Cerebrovascular Disease ◽  
Severity Of Illness ◽  
Population Based ◽  
Danish Population ◽  
Co Morbidity ◽  
Rate Ratios

BackgroundCardiovascular (CV) co-morbidity is one of the major modifiable risk factors driving the excess mortality in individuals with schizophrenia or bipolar disorder. Population-based studies in this area are sparse.MethodWe used Danish population registers to calculate incidence rate ratios (IRRs) for CV drug use, and mortality rate ratios comparing subjects with schizophrenia or bipolar disorder with subjects with no prior psychiatric hospitalization.ResultsIRRs for CV prescriptions were significantly decreased in patients with schizophrenia or bipolar disorder compared with the general population. Among persons without previous myocardial infarction (MI) or cerebrovascular disease, persons with schizophrenia or bipolar disorder had an up to 6- and 15-fold increased mortality from all causes or unnatural causes, respectively, compared with the general population, being most pronounced among those without CV treatment (16-fold increase). Among those with previous MI or cerebrovascular disease, excess all-cause and unnatural death was lower (up to 3-fold and 7-fold increased, respectively), but was similar in CV-treated and -untreated persons.ConclusionsThe present study shows an apparent under-prescription of most CV drugs among patients with schizophrenia or bipolar disorder compared with the general population in Denmark. The excess of mortality by unnatural deaths in the untreated group suggests that the association between CV treatment and mortality may be confounded by severity of illness. However, our results also suggest that treatment of CV risk factors is neglected in these patients.

scholarly journals DSM-IV Axis II personality disorders and suicide and attempted suicide in China

2016 ◽  
Vol 209 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Kenneth R. Conner
Keyword(s):  
Personality Disorders ◽  
Suicidal Behaviour ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Control Group ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Increased Risk ◽  
Axis I ◽  
Dsm Iv

BackgroundThere are meagre data on Axis II personality disorders and suicidal behaviour in China.AimsTo describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders.MethodPeople who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders.ResultsAxis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7–8.0 for suicide and for suicide attempts.ConclusionsAxis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China.

The impact of premenstrual dysphoric disorder among 92 bipolar patients

2010 ◽  
Vol 25 (8) ◽  
pp. 450-454 ◽  
Author(s):  
M. Fornaro ◽  
G. Perugi
Keyword(s):  
Rating Scale ◽  
Post Partum ◽  
Premenstrual Dysphoric Disorder ◽  
Clinical Variable ◽  
Type I ◽  
Co Morbidity ◽  
Axis I ◽  
Dsm Iv ◽  
Bipolar Patients ◽  
The Impact

AbstractObjectivesTo evaluate the impact of Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV)-defined premenstrual dysphoric disorder (PMDD) lifetime co-morbidity among 92 bipolar patients.MethodNinety-two women with a lifetime diagnosis of DSM-IV-defined Bipolar Disorder (BD) either type I or type II were consecutively enrolled to determine co-morbidity rates with PMDD and associated clinical features. Measures included the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) and the Clinical Global Impression (CGI) rating scale.ResultsIn our sample, 25 (27.2%) patients reported a lifetime history of PMDD according to DSM-IV criteria (PMDD+). PMDD+ reported higher rates of Cyclothymia and BP-II than PMDD− (respectively 72% vs. 36% and 88% vs. 60%). On the contrary, the carbohydrate-craving feature was more represented among PMDD− than PMDD+ (25% vs. 4%). PMDD was also significantly associated with post-partum depression (36% vs. 15%), Obsessive-Compulsive (24% vs. 7.5%) and Body Dysmorphic Disorders (24% vs. 6%). Finally, PMDD+ reported higher total number of Axis I co-morbid disorders than PMDD−.ConclusionsIn our cohort of BD women, PMDD is a frequent co-morbid condition, in particular among patients with BD-II or Cyclothymia. Multiple co-morbidities also represent a clinical variable associated with PMDD. Further perspective studies are necessary to better define the relationships between PMDD and BD.

Spanish Consensus on Physical Health in Patients with Bipolar Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Saiz-Ruiz ◽  
J. Bobes ◽  
E. Vieta ◽  
J. Mostaza
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Physical Health ◽  
Psychosocial Functioning ◽  
General Medicine ◽  
Diagnostic Procedures ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Increased Risk ◽  
Co Morbidity

Background and objective:Bipolar disorder is a serious mental illness which may affect between 2% and 5% of the population. These patients present much higher morbidity and mortality rates than the general population. In addition to a higher mortality rate from suicide, they also have a higher prevalence of other physical disorders.The purpose of this consensus is to establish recommendations for diagnostic procedures and clinical interventions in order to control the risk factors which have repercussions on the physical health of the patients.Methods:After carrying out a systematic review of medical co-morbidity and mortality rates in bipolar disorder, two multidisciplinary consensus meetings were held in which 31 psychiatrists and 11 experts from other medical specialities participated.Working groups were formed for each speciality for the purposes of adapting the guidelines applied in the general population to these patients.Results:The bibliographical review revealed an increased risk of hypertension, obesity, smoking, pulmonary diseases, migraine and HIV infection. There is evidence of higher mortality rates from cardiovascular and respiratory diseases and infections, as well as from suicide. The expert group reached consensus on a series of basic measures for detecting medical co-morbidity. The resulting recommendations will be validated by Spanish Psychiatry and General Medicine Associations.Conclusion:The physical health of patients with bipolar disorder could be improved. It is hoped that the publication of this consensus will have an impact in terms of better psychosocial functioning, quality of life and life expectancy for these patients in Spain.

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