Psychopathology最新文献

Purpose: Sex differences play an important role in depression prevalence, symptom profile, treatment response, and disease course. However, sex differences in factors associated with suicide attempts (SAs) in first-episode and drug-naïve (FEDN) patients with psychotic major depression (PMD) remain unclear.

Methods: In this study, 171 patients with FEDN PMD were recruited. Patients' symptoms were assessed using the Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale. In addition, metabolic parameters and thyroid hormone levels were measured.

Results: The prevalence of SA was remarkably high in both male and female PMD patients (53.19% vs. 50.81%), without significant differences between the two groups. In male PMD patients, the combination of marital status and thyroid-stimulating hormone (TSH) levels was found to effectively distinguish between SA and non-SA cases, with an AUC value of 0.87. In addition, the HAMD score and diastolic blood pressure (BP) were significantly associated with the frequency of SAs in this subgroup. For female PMD patients, the combination of positive score, diastolic BP, TSH, and antithyroglobulin was found to be an effective discriminator between SA and non-SA cases, with an AUC of 0.91. Furthermore, duration of illness, positive score, systolic BP, and thyroid peroxidase antibody were found to be significantly associated with the frequency of SAs in this subgroup.

Conclusions: Our results indicate a high incidence of SAs in both men and women with PMD. Several clinically relevant factors, metabolic parameters, and thyroid hormone function contribute to sex differences in SAs in FEDN PMD patients.

Introduction: The Examination of Autistic Intersubjective Experiences is a semi-structured interview aimed at a phenomenological exploration of experiential and subjective ways of dealing with sociality.

Methods: As a qualitative study, this work can be understood in continuity with Examination of Anomalous Self-Experience (EASE) and Examination of Anomalous World Experience (EAWE). While these models focus on anomalies of selfhood and experience of the external world, respectively, this semi-structured interview focuses instead on the divergent ways dealing with intersubjective experience and on the difficulties that people with a diagnosis of autism experience in the social domain.

Conclusion: The advantages are both theoretic and practical: from a philosophical perspective, it will be interesting to observe how intersubjectivity works. From a clinical perspective, the collected data will be useful both for clinicians and caregivers, allowing them to better understand and cope with the autistic subject, and favor the communication between different social styles.

Introduction: Overweight or obesity often co-occurs with depression among young adults. Major depressive disorder (MDD) frequently occurs alongside anxiety; nevertheless, research exploring the interaction between anxiety symptoms and MDD in young adults with overweight or obesity is limited. This study aimed to investigate the prevalence and clinical characteristics of comorbid anxiety among young adults with overweight/obesity concomitant with MDD. Additionally, it aimed to identify predictors of anxiety within this demographic.

Methods: This cross-sectional study involved 523 young adults with overweight/obesity concomitant with MDD (age 18-35 years). Their demographic characteristics, clinical variables, and fasting biochemical parameters were collected utilizing the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS).

Results: The prevalence of anxiety symptoms was 50.8%. Correlation analysis suggested strong associations between total HAMD scores and various factors, including total HAMA scores, body mass index, suicidal tendencies, and psychotic symptoms. Binary regression identified four clinical variables, namely, HAMD scores, thyroid-stimulating hormone levels, excitement levels, and fasting blood glucose, as significant risk factors for anxiety within this demographic.

Conclusion: In summary, this research highlights a substantial prevalence of anxiety symptoms among young adults with overweight/obesity concomitant with MDD. Furthermore, it elucidates four risk factors associated with concurrent anxiety symptoms among this demographic. These findings have significant clinical implications.

Background: Emotions are a key feature of human life. Despite intensive research, we still do not have a full grasp of the complexity of emotions, such as their peculiar combination of emotional feeling and behavioral motor manifestation. We also lack translational research that links the phenomenal (experiential) with the pre-phenomenal (neurological) levels.

Summary: Operating within the framework of embodiment on experiential and neural levels, we characterize different emotions by their different movements as well as by their distinct experiences of time and space, rather than externally observable behavior. This leads literally to a choreography of emotions and spatiotemporal phenomenology, that is, a characterization of emotions in terms of corporeality, particularly how persons feel that their body moves in space and time and interacts with its environment. That is complemented by an outlook of linking such views of emotions to the brain through what has recently been introduced as "Spatiotemporal Neuroscience," whose theoretical background is briefly sketched and outlined. This is accompanied by an example of the temporal changes, with abnormal slowness being shared by both, experience and brain, as their "common currency" during sadness.

Key message: We here introduce the outline of a choreography of emotions as a descriptive framework that makes reference to the direction and timing of the way persons experience their bodily movement, as well as to the matching of bodily movements and the surrounding lived space, which carries high potential of being directly linked to the brain in a non-reductive way through spatiotemporal neuroscience.

Background: In recent times, adolescents with severe forms of psychopathology that do not unambiguously fit into a precise diagnostic category have come to clinical observation. The diagnoses attributed to these young patients range from borderline personality disorder, to affective disorders, ADHD, and others. These diagnoses are mainly based on behavioural abnormalities (e.g., social withdrawal, aggressiveness, self-injuring behaviour), but fail to capture the experiential core of their suffering.

Summary: Research in psychopathology, particularly that with a phenomenological approach, has long been committed to identifying early markers of schizophrenia in clinical pictures that precede the full onset of this pathology. In this paper, two case studies in transitional age youth (TAY) and additional material taken from our own clinical practice are presented where self-disorders and anomalies of common sense - originally developed to phenomenologically characterise the schizophrenic spectrum phenotype, and especially non-delusional forms of schizophrenia - are used to complement standard nosographic assessments.

Key message: We propose that using some of these phenomenological constructs can shed light on certain TAY pictures, in particular the most serious ones, helping us grasp their psychopathological core, and provide further elements for a fine-grained characterization and in-depth understanding. We propose as a work-in-progress a set of tentative criteria to differentiate such phenomena in TAY patients as compared to patients with a diagnosis of schizophrenia.

Introduction: This secondary analysis of quality control data assessed principal components of personality dysfunction and their relationship to mentalizing in a sample of treatment-seeking women with severe personality disorders.

Methods: The Schedule for Nonadaptive and Adaptive Personality (SNAP) and the Movie for the Assessment of Social Cognition (MASC) were administered to 37 females in routine quality assessments of a specialized residential treatment program. Principal component analysis (PCA) of SNAP scores was used to determine dimensions of personality most significantly contributing to overall maladaptive personality functioning. Bootstrapped stepwise regression tested the relationship of dimensional personality indices to hypermentalizing and hypomentalizing on the MASC controlling for general psychiatric severity.

Results: Four principal components (PCs) explained 71.4% of the variance in personality dysfunction, mapping onto antisocial, obsessive compulsive, borderline, and narcissistic personality constellations. The borderline and antisocial PCs were positively predictive of hypermentalizing. The obsessive-compulsive PC was positively predictive of hypomentalizing, while the antisocial PC was negatively predictive of hypomentalizing.

Conclusion: The study reiterates prior findings of a relationship between hypermentalizing and borderline and antisocial personality profiles. It also contributes evidence to the limited research on hypomentalizing as a clinical indicator and potential treatment target for obsessive-compulsive personality, and shows evidence of a negative relationship between antisocial personality disorder and hypomentalizing. These findings provide clinical indications for enhancing and regulating mentalizing via attention to and interpretations of internal and interpersonal events in individuals with personality disorders. Further research is needed to replicate these associations in larger, more representative clinical samples.

Introduction: Phenomenological qualitative research delves into the essence and meaning of phenomena through subjects' lived experiences. Despite its widespread use in humanities disciplines, its integration with psychopathology is rare in China.

Methods: We systematically reviewed phenomenological studies on schizophrenia in China to assess their content and quality and offer insights for future research. Following PRISMA guidelines, we reviewed 28 articles. Quality assessment focused on adherence to theoretical principles, transparency, coherence, and evidence.

Results: Topics covered various illness-related experiences, including treatment seeking, medication, hospitalization, rehabilitation, relapse, sexuality, and reproduction. Some studies also explored caregiver experiences. However, only 5 articles were rated excellent, with most lacking theoretical depth.

Conclusion: Phenomenological research related to schizophrenia in China is mostly peripheral to the psychopathology of schizophrenia, and the qualification rate is low. Researchers should keep in mind the nature of phenomenological attitudes, delving into the essence and meaning of phenomena.

Background: Research in the field of psychotherapy suggests that emotional arousal (EA) might be a key element to therapeutic success. However, its relevance depends on a situation-bound complex process, requiring its assessment at the right time and in relation to significant personal themes.

Methods: This article is a secondary analysis of a 4-month treatment RCT with two arms (General Psychiatric Management and Treatment As Usual) for borderline personality disorder (BPD). Fifty-five clients with BPD (GPM group: n = 28; TAU group: n = 27) as well as healthy controls (n = 29) participated in the study. We assessed them (intake, 2 months and discharge for the BPD group and intake and at consistent intervals for the healthy controls) using an experiential two-chair dialogue focused on the client's self-criticism, ensuring the idiosyncratic relevance of the aroused state. We evaluated EA during the two-chair dialogue at three time points (two for the controls) over the course of treatment via self-reported (Self-Assessment Manikin) and observer-rated (Client Emotional Arousal Scale-III) scales as well as borderline symptomatology (ZAN-BPD) and general psychological distress (Outcome Questionnaire 45).

Results: In line with our expectations, we find that participants with diagnosed BPD show higher EA variance compared to controls. This heightened EA variance changes range over the course of the 4-month psychiatric treatment, with participants in the control and BPD groups showing levels of EA variance that are not significantly different at T3. There is no evidence that lower EA variance is associated with reduced symptoms.

Discussion: In the treatment of BPD, change in EA variance may be a key element as it normalizes throughout the brief intervention. However, more research is needed to clarify the relationship between this normalization and symptom reduction.

Introduction: The mechanisms of change in psychological therapies have not yet been sufficiently empirically validated. In particular, the time course of their effects on patients' symptom distress is unknown. Therefore, the aims of the present study were (1) to examine the effects of 4 patient experiences, namely, interpersonal experience (IE), coping experience (CE), affective experience (AE), and resource-related experience (RE), on symptom distress within and between patients; (2) to consider the temporal development of the within-patient effects; and (3) to examine their associations with the final treatment outcome.

Methods: Within- and between-patient effects of IE, CE, AE, and RE on session-level symptom distress were calculated for n = 2,208 outpatients treated by n = 253 therapists. Patient experiences were measured after each session using session reports, and outcome was assessed with the HSCL-11 at the beginning of each session and with the OQ-30 after treatment. Linear mixed models (LMMs) were used to examine the within- and between-patient associations. Temporal changes in the within-patient effects were modeled using rolling windows and three-level LMMs (sessions nested in windows and patients).

Results: Within-patient components of all 4 patient experiences were significantly associated with symptom distress (b = -0.006 to b = -0.057), while none of the between-patient components were. The effects of all 4 patient experiences diminished over time (b = 0.000 to b = 0.001). The effects of IE, CE, and RE remained negative and significant, but the effect of AE crossed zero and became significantly positive with an increasing window number. A greater decrease in the within-patient effects of IE (b = -0.001) and CE (b = -0.001) on HSCL-11 was associated with better final treatment outcomes.

Conclusion: The results suggest that all four change factors are drivers of successful therapy, particularly in the early sessions. Over the course of treatment, their impact on symptom distress diminishes, which appears to be beneficial for the final treatment outcome. In the future, differences between patients in the temporal dynamics of change factors should be investigated to inform transtheoretical and process-based treatments that support therapists in personalizing their treatments to individual patients.