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Journal of Psychiatric and Mental... Jun 2024
Review
'Throw me a life buoy, please': A systematic review and thematic synthesis of qualitative evidence regarding nurses' experiences of caring for inpatients with borderline personality disorder and/or non-suicidal self-injury.
PubMed: 38940193
DOI: 10.1111/jpm.13077 -
Journal of Affective Disorders Jun 2024Bipolar disorder (BD) has a high disease burden and the highest mortality risk in BD comes from suicide. Bipolar disorder type II (BD-II) has been described as a milder... (Review)
Review
BACKGROUND
Bipolar disorder (BD) has a high disease burden and the highest mortality risk in BD comes from suicide. Bipolar disorder type II (BD-II) has been described as a milder form of bipolar disorder; however, extant literature is inconsistent with this description and instead describe illness burden and notably suicidality comparable to persons with bipolar I disorder (BD-I). Towards quantifying the hazard of BD-II, herein we aim via systematic review and meta-analysis to evaluate the rates of completed suicide in BD-I and BD-II.
METHOD
We conducted a literature search on PubMed, OVID (Embase, Medline) and PsychINFO databases from inception to June 30th, 2023, according to PRISMA guidelines. Articles were selected based on the predetermined eligibility criteria. A meta-analysis was performed, comparing the risk of completed suicide between individuals diagnosed with BD-I to BD-II.
RESULTS
Four out of eight studies reported higher suicide completion rates in persons living with BD-II when compared to persons living with BD-I; however, two of the studies reported non-significance. Two studies reported significantly higher suicide completion rates for BD-I than BD-II. The pooled odds ratio of BD-II suicide rates to BD-I was 1.00 [95 % CI = 0.75, 1.34].
LIMITATIONS
The overarching limitation is the small number of studies and heterogeneity of studies that report on suicide completion in BD-I and BD-II.
CONCLUSION
Our study underscores the severity of BD-II, with a risk for suicide not dissimilar from BD-I. The greater propensity to depression, comorbidity and rapid-cycling course reported in BD-II are contributing factors to the significant mortality hazard in BD-II.
PubMed: 38901691
DOI: 10.1016/j.jad.2024.06.045 -
Addictive Behaviors Jun 2024Problematic gaming is particularly prevalent in adolescent and young adult populations. While numerous studies have investigated the psychiatric comorbidities of... (Review)
Review
Problematic gaming is particularly prevalent in adolescent and young adult populations. While numerous studies have investigated the psychiatric comorbidities of Internet Gaming Disorder in young adults, few have focused specifically on adolescents who might be especially at risk because developmental particularities related to this developmental period. Here, we conducted a review of the literature, in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in order to highlight the types of psychiatric comorbidities found in adolescents with problematic gaming.. We selected and analyzed 30 cross-sectional and longitudinal studies which correspond to 3683 adolescents (63,27% of boys) worldwide with problematic gaming. Our results highlight the high prevalence of Attention Deficit Hyperactivity Disorder (ADHD) in adolescents with problematic gaming and the links between this addiction and inattention, anxiety, depression, behavioural and emotional problems. These psychiatric comorbidities interact with problematic gaming and predict it throughout the adolescent's development. Moreover, this interaction involves personality profile and environment, including parental education. The complexity of this interaction argues in favor of the multi-level assessment that we are promoting.
PubMed: 38901145
DOI: 10.1016/j.addbeh.2024.108091 -
Psychopathology Jun 2024Pathological narcissism (PN) can be defined as the compromised and fluctuating ability to regulate self-esteem, the latter depending on external validation, admiration,...
INTRODUCTION
Pathological narcissism (PN) can be defined as the compromised and fluctuating ability to regulate self-esteem, the latter depending on external validation, admiration, or enhancement, all resulting in grandiose (e.g., self-enhancement, aggressiveness, manipulation) or vulnerable (e.g., depression, anxiety, self-criticism, avoidance) dysfunctional reactions when confronting with self-esteem threats. A link has been suggested between PN and emotion dysregulation (ED), but to date, no systematic review has been conducted.
METHODS
We conducted a systematic review of the literature published until February 2024 studying the association between PN (with or without a diagnosis of narcissistic personality disorder) and ED, divided in two domains: emotion regulation difficulties and strategies.
RESULTS
Twenty-two studies were included in our analysis. Altogether, the available data are insufficient to conclude on the link between grandiose narcissism and emotion regulation difficulties in non-clinical population (notably due to different patterns of associations depending on the scale used to assess narcissism). However, the small number of studies conducted in clinical population seems to indicate a possible absence of association between the two constructs. On the other side, there is considerable evidence for the existence of a positive association between vulnerable narcissism and emotion regulation difficulties, regardless of the scale used to assess narcissism and the type of population considered. Finally, regarding emotion regulation strategies, data are too scarce to draw any conclusion, even though there seems to be a trend toward positive association between narcissistic vulnerability and expressive suppression.
CONCLUSION
ED seems to be highly associated with narcissistic vulnerability. Given that every patient suffering from PN may experience vulnerable states, we believe that ED should be considered as an important part of psychoeducation programs and psychotherapeutic treatments designed for this population.
PubMed: 38870915
DOI: 10.1159/000538546 -
Psychotherapy Research : Journal of the... Jun 2024There are significant temporal and financial barriers for individuals with personality disorders (PD) receiving evidence-based psychological treatments. Emerging...
OBJECTIVE
There are significant temporal and financial barriers for individuals with personality disorders (PD) receiving evidence-based psychological treatments. Emerging research indicates Group Schema Therapy (GST) may be an accessible, efficient, and cost-effective PD intervention, however, there has been no synthesis of the available evidence to date. This review therefore aimed to investigate the efficacy of GST for PDs by systematically synthesizing available literature.
METHOD
Five electronic databases were screened with resulting studies subjected to a specific eligibility criteria, which yielded fourteen relevant studies. Characteristics were extracted and methodological quality rigorously assessed.
RESULTS
Strong support was evidenced for GST's ability to reduce Cluster B and C symptomology, particularly for Borderline and Avoidant PD. GST appeared to improve global symptom severity, quality of life and functional capacity, as well as treatment targets such as schemas and modes.
CONCLUSION
Although not without limitations and a moderate risk of bias, the current body of evidence supports GST as a potential solution to current service deficits in economical and evidence-based care for individuals with PD. Implications for treatment and future research are discussed.
PubMed: 38862126
DOI: 10.1080/10503307.2024.2361451 -
Frontiers in Psychiatry 2024We conducted a systematic review to evaluate the quality and extent of evidence on associations between personality disorders (PDs) and musculoskeletal disorders (MSDs)...
INTRODUCTION
We conducted a systematic review to evaluate the quality and extent of evidence on associations between personality disorders (PDs) and musculoskeletal disorders (MSDs) in population-based studies, since these disorders are leading causes of disease burden worldwide.
METHODS
A search strategy of published, peer-reviewed and gray literature was developed in consultation with a liaison librarian and implemented for Embase, CINAHL Complete, Medline Complete, and PsycINFO via the EBSCOhost platform from 1990 to the present and CORDIS and ProQuest Dissertations & Theses Global, respectively. The inclusion criteria were as follows: I) general population participants aged ≥15 years; II) self-report, probable PD based on positive screen, or threshold PD according to the DSM-IV/5 (groupings: any, Clusters A/B/C, specific PD) or ICD-10/11; III) MSDs identified by self-report or ICD criteria (arthritis, back/neck conditions, fibromyalgia, osteopenia/osteoporosis) and III) cohort, case-control, and cross-sectional study designs. Two reviewers independently screened articles and extracted the data. Critical appraisal was undertaken using the Joanna Briggs Institute checklists for systematic reviews of etiology and risk. A descriptive synthesis presents the characteristics of included studies, critical appraisal results, and descriptions of the main findings. This review adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.
RESULTS
There were 11 peer-reviewed, published articles included in this review (n = 9 cross-sectional and n = 2 case-control studies); participants were ≥18 years in these studies. No published gray literature was identified. Semi-structured interviews were the most common method to ascertain PDs; all studies utilized self-reported measures to identify MSDs. Overall, we detected limited and conflicting evidence for associations between PDs and MSDs.
DISCUSSION
The main result may be explained by lack of population-based longitudinal evidence, heterogenous groupings of PD, and few comparable cross-sectional and case-control studies. Strengths of the review include a comprehensive search strategy and a discussion of mechanisms underlying possible associations between PDs and MSDs.
CONCLUSIONS
The quality of most studies included in this review that examined associations between PD and MSDs in general population adults was high. However, the results demonstrated limited and conflicting evidence for these associations, in part, due to lack of comparable evidence, which should be addressed in future research.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42021243094.
PubMed: 38835544
DOI: 10.3389/fpsyt.2024.1288874 -
Journal of Anxiety Disorders Jun 2024Given the growth in research examining the effects of psychotherapy on social anxiety disorder (SAD), an up-to-date comprehensive meta-analysis in this field is needed. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Given the growth in research examining the effects of psychotherapy on social anxiety disorder (SAD), an up-to-date comprehensive meta-analysis in this field is needed.
METHODS
We selected studies from a database of randomized trials (RCTs) on psychotherapies for anxiety disorders (last updated search of PubMed, PsycINFO, Embase, and Cochrane (CENTRAL): 1 January 2024) We included RCTs comparing psychotherapy to a control condition for adults with SAD and conducted random effects meta-analyses to examine the efficacy of psychotherapy compared to control conditions at post-treatment.
RESULTS
Sixty-six RCTs were included with 5560 participants and 98 comparisons between psychotherapy and control groups. Psychotherapy was effective in reducing SAD symptoms, with a large effect size (g = 0.88; 95 % CI: 0.76 to 1.0; I = 74 %; 95 % CI: 69 to 79, NNT = 3.8). Effects remained robust across sensitivity analyses. However, there was evidence for significant risk of bias in the included trials. The multivariable meta-regression indicated significant differences in treatment delivery formats, type of recruitment strategy, target group, and number of sessions.
CONCLUSION
Psychotherapy is an effective treatment for SAD, with moderate to large effect sizes across all treatment types and formats. Future research is needed to determine the long-term effects.
Topics: Humans; Phobia, Social; Psychotherapy; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 38815481
DOI: 10.1016/j.janxdis.2024.102881 -
Personality and Mental Health May 2024The potential efficacy of psychosocial interventions in the treatment of borderline personality disorder (BPD) is impacted by significant treatment non-completion (TNC),...
The potential efficacy of psychosocial interventions in the treatment of borderline personality disorder (BPD) is impacted by significant treatment non-completion (TNC), with meta-analytic studies reporting rates of attrition of between 25% and 28%. Increasing patient retention could facilitate outcomes and improve resource utilization, given limited healthcare services. A systematic search of PsycINFO, CINAHL, EMBASE, CENTRAL, and Web of Science Core Collection identified 33 articles that met the criteria for inclusion. Although substantial heterogeneity in terms of methodology and quality of analysis limited conclusions that could be drawn in the narrative review, a few consistent patterns of findings were elucidated, such as Cluster B personality disorder comorbidities and lower therapeutic alliance were associated with TNC. Interestingly, the severity of BPD symptoms was not a predictor of TNC. These findings are discussed in terms of their potential theoretical contribution to TNC. Clinically, there may be value in applying mindfulness and motivational interviewing strategies early on in treatment for individuals who present uncertainty about engaging in treatment. Further research to develop this empirical landscape includes focusing on high-powered replications, examining burgeoning lines of research, and investigating dynamic predictors of TNC.
PubMed: 38807472
DOI: 10.1002/pmh.1627 -
Frontiers in Aging Neuroscience 2024Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder characterized by diverse and prominent changes in behavior and personality. One of the...
Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder characterized by diverse and prominent changes in behavior and personality. One of the greatest challenges in bvFTD is to capture, measure and predict its disease progression, due to clinical, pathological and genetic heterogeneity. Availability of reliable outcome measures is pivotal for future clinical trials and disease monitoring. Detection of change should be objective, clinically meaningful and easily assessed, preferably associated with a biological process. The purpose of this scoping review is to examine the status of longitudinal studies in bvFTD, evaluate current assessment tools and propose potential progression markers. A systematic literature search (in PubMed and Embase.com) was performed. Literature on disease trajectories and longitudinal validity of frequently-used measures was organized in five domains: global functioning, behavior, (social) cognition, neuroimaging and fluid biomarkers. Evaluating current longitudinal data, we propose an adaptive battery, combining a set of sensitive clinical, neuroimaging and fluid markers, adjusted for genetic and sporadic variants, for adequate detection of disease progression in bvFTD.
PubMed: 38784446
DOI: 10.3389/fnagi.2024.1382593 -
Current Opinion in Psychiatry Jul 2024The ability to perform mental time travels and to develop representations of the past, the present, and the future is one of the distinctive capacities of the human...
PURPOSE OF REVIEW
The ability to perform mental time travels and to develop representations of the past, the present, and the future is one of the distinctive capacities of the human mind. Despite its pronounced consequences for motivation, cognition, affect, and subjective well being, time perspective (TP) has been outside mainstream psychiatry and clinical psychology. We highlight the role of psychological-temporal phenomena in various disorders and summarize the current research on TP and psychopathology.
RECENT FINDINGS
Our review ultimately comprised 21 articles, including 18 unique datasets. It revealed that persons with different psychiatric diagnoses (attention defict hyperactivity disorder (ADHD), alcohol dependence, anxiety disorders, depression, bipolar disorder, personality disorders, posttraumatic stress disorder, schizophrenia) display different temporal profiles than control groups. We also found marked associations between temporal features and psychiatric symptom severity. The effects of specific TPs vary across different psychiatric diagnoses and to some extent between various age groups, with a consistent, widespread, and nonspecific effect of past-negative and less balanced, inflexible TP profile.
SUMMARY
Based on the review, TP biases are crucial factors in symptom development, while adaptive temporal profiles can serve as protective features against mental disorders. Understanding cognitive-temporal processes can enhance comprehension of psychopathological conditions and facilitate the development of temporality-focused clinical interventions.
Topics: Humans; Mental Disorders; Time Perception
PubMed: 38770908
DOI: 10.1097/YCO.0000000000000942