Psychometric Properties of the Persian Structured Clinical Interview for Personality Disorders of DSM-5-Personality Version (SCID-5-PD)

Background: The aim of this study was to investigate the psychometric properties of the Persian version of a structured clinical interview for personality disorders based on DSM-5 (R) (SCID-5-PD) in the population of patients with psychiatric disorders in Tehran.Method: The study population includes all outpatients and inpatients referred to three psychiatric centers in Tehran, including Iran Psychiatric Hospital, Rasoul Akram Hospital and Clinic of Behavioral Sciences and Mental Health (Tehran Psychiatric Institute). Inclusion criteria were age between 16 and 70 years, written Informed consent and the ability to understand and speak in Persian and no special physical problems that interfere with the interview process. Sampling in this study was done by Convenience sampling. In this study, in addition to the demographic questionnaire, the Persian version of SCID-5-PD was used. Finally, in order to evaluate the information, the methods of face and content validity and diagnostic validity, test-retest reliability and inter-rater reliability were used.Results: the diagnoses related to obsessive-compulsive personality disorder, paranoid, schizotypal, schizoid, histrionic, narcissistic, borderline and antisocial kappa were higher than 0.4 and the diagnoses related to avoidant personality disorder were dependent and in other certain disorders are below 0.4. Regarding borderline personality disorder with kappa 0.839, the highest agreement was reported between the two reports of the psychiatrist and the SCID interviewer. Also, the specificity results were mostly better than the sensitivity results, and in all diagnoses except obsessive-compulsive and paranoid personality disorder, the specificity was higher than 0.9 and in these two diagnoses, the specificity was higher than 0.85, which indicates the desired characteristic. SCID-5-PD. The sensitivity of all diagnoses except avoidant and dependent personality disorder was also reported to be higher than 0.8; But the susceptibility of avoidant and dependent personality disorder was 0.66. Also, the study of LR + / LR- ratio showed that this tool has the best diagnosis for histrionic, antisocial and schizotypal personality disorder. It is also suitable for other personality disorders except schizoid personality disorder and certain other disorders.Conclusion: According to the findings of the present study, SCID-5-PD can be used in psychiatric clinics and hospitals as a diagnostic tool. In general, this version is suitable for most diagnoses; but with regard to diagnoses of schizoid personality disorder and certain other disorders, this should be done with more caution.

Double filicide for extended suicide (frustrated) of a subject with major psychotic depression and dependent personality disorder

ABSTRACT: A case of frustrated extended suicide is illustrated, where the perpetrator can’t commit her own suicide, but having perpetrated the murder of her own 2 children due to suffering from a severe major depressive disorder with psychotic symptoms and dependent personality traits. The case is illustrated with the psychometric tests administered and also, the forensic psychometry of the case is analyzed. RESUMEN: Se ilustra un caso de suicidio ampliado frustrado, en el que la autora no puede suicidarse, pero ha perpetrado el asesinato de sus propios 2 hijos debido a que padece un trastorno depresivo mayor grave con síntomas psicóticos y rasgos de personalidad dependiente. El caso se ilustra con las pruebas psicométricas administradas y además, se analiza la psicometría forense del caso.

Unexpected cancellation on a catatonic patient’s electroconvulsive therapy due to the coronavirus pandemic

We report a case of a 39-year-old woman with a psychiatric history of schizoaffective disorder with catatonia, dependent personality disorder and substance use disorder whose symptoms have been very difficult to control. During her most recent inpatient admission, she was treated with electroconvulsive therapy (ECT) for catatonia. Our treatment team was hopeful that ECT was making a difference for this patient. However, she was only able to receive two sessions of treatment due to new hospital protocols related to the coronavirus pandemic. Although the patient was not suspected to have the coronavirus, she could no longer undergo ventilation with a bag and mask during the procedure. Bag–mask ventilation is known to aerosolise the coronavirus and other diseases and potentially put healthcare workers at risk. Although orotracheal intubation also aerosolises the coronavirus, this was the only means of airway management still allowed by anaesthesia providers at this time. Our psychiatry team estimated that the risks of intubation outweighed the benefits of treatment, and ECT was cancelled.Without additional ECT treatments, the patient again decompensated for several weeks before being stabilised on clozapine, haloperidol and lorazepam. Although she eventually had a positive treatment outcome, her hospital course was likely prolonged due to unforeseen events related to the novel coronavirus. We feel that the current medical climate is unprecedented and is interfering with necessary psychiatric treatment in an unanticipated way. Anaesthesiologists will need to be flexible while working with psychiatrists and identify safe ways to provide this necessary psychiatric treatment for patients.