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Continuum (Minneapolis, Minn.) Jun 2015Psychosis is a common and functionally disruptive symptom of many psychiatric, neurodevelopmental, neurologic, and medical conditions and an important target of... (Review)
Review
PURPOSE OF REVIEW
Psychosis is a common and functionally disruptive symptom of many psychiatric, neurodevelopmental, neurologic, and medical conditions and an important target of evaluation and treatment in neurologic and psychiatric practice. The purpose of this review is to define psychosis, communicate recent changes to the classification of and criteria for primary psychotic disorders described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and summarize current evidence-based approaches to the evaluation and management of primary and secondary psychoses.
RECENT FINDINGS
The DSM-5 classification of and criteria for primary psychotic disorders emphasize that these conditions occur along a spectrum, with schizoid (personality) disorder and schizophrenia defining its mild and severe ends, respectively. Psychosis is also identified as only one of several dimensions of neuropsychiatric disturbance in these disorders, with others encompassing abnormal psychomotor behaviors, negative symptoms, cognitive impairments, and emotional disturbances. This dimensional approach regards hallucinations and delusions as arising from neural systems subserving perception and information processing, thereby aligning the neurobiological framework used to describe and study such symptoms in primary psychotic disorders with those used to study psychosis associated with other neurologic conditions.
SUMMARY
This article provides practicing neurologists with updates on current approaches to the diagnosis, evaluation, and treatment of primary and secondary psychoses.
Topics: Adult; Antipsychotic Agents; Delusions; Hallucinations; Humans; Male; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia
PubMed: 26039850
DOI: 10.1212/01.CON.0000466662.89908.e7 -
American Family Physician Dec 2011Personality disorders have been documented in approximately 9 percent of the general U.S. population. Psychotherapy, pharmacotherapy, and brief interventions designed... (Review)
Review
Personality disorders have been documented in approximately 9 percent of the general U.S. population. Psychotherapy, pharmacotherapy, and brief interventions designed for use by family physicians can improve the health of patients with these disorders. Personality disorders are classified into clusters A, B, and C. Cluster A includes schizoid, schizotypal, and paranoid personality disorders. Cluster B includes borderline, histrionic, antisocial, and narcissistic personality disorders. Cluster C disorders are more prevalent and include avoidant, dependent, and obsessive-compulsive personality disorders. Many patients with personality disorders can be treated by family physicians. Patients with borderline personality disorder may benefit from the use of omega-3 fatty acids, second-generation antipsychotics, and mood stabilizers. Patients with antisocial personality disorder may benefit from the use of mood stabilizers, antipsychotics, and antidepressants. Other therapeutic interventions include motivational interviewing and solution-based problem solving.
Topics: Antipsychotic Agents; Combined Modality Therapy; Family Practice; Humans; Motivational Interviewing; Personality Disorders; Primary Health Care; Problem Solving
PubMed: 22150659
DOI: No ID Found -
Clinical Psychology Review Jun 2023The aim of this systematic review and meta-analysis was to investigate the diagnostic, the dimensional mean-level, and rank-order stability of personality disorders... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review and meta-analysis was to investigate the diagnostic, the dimensional mean-level, and rank-order stability of personality disorders (PDs) and PD criteria over time. EMBASE, PsycInfo, PubMed, and Web of Science were searched for peer-reviewed studies published in either English, German, or French between the first publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 and December 20, 2022. Inclusion criteria were a prospective longitudinal study design, assessing the stability of PDs or PD criteria over at least two measurement occasions at least one month apart, and using the same assessment at baseline and follow-up. Effect sizes included proportion of enduring cases (i.e., diagnostic stability), test-retest correlations (i.e., dimensional rank-order stability), and within-group standardized mean differences (i.e., dimensional mean-level stability), based on the first and last available measurement occasion. From an initial pool of 1473 studies, 40 were included in our analyses, covering 38,432 participants. 56.7% maintained the diagnosis of any PD, and 45.2% maintained the diagnosis of borderline PD over time. Findings on the dimensional mean-level stability indicate that most PD criteria significantly decreased from baseline to follow-up, except for antisocial, obsessive-compulsive, and schizoid PD criteria. Findings on the dimensional rank-order stability suggested moderate estimates, except for antisocial PD criteria, which were found to be high. Findings indicated that both PDs and PD criteria were only moderately stable, although between study heterogeneity was high, and stability itself depended on several methodological factors.
Topics: Humans; Longitudinal Studies; Prospective Studies; Personality Disorders; Diagnostic and Statistical Manual of Mental Disorders
PubMed: 37116251
DOI: 10.1016/j.cpr.2023.102284