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Temperament Traits in Pediatric Obsessive-Compulsive Disorder in Relation to Tourette Syndrome and Attention-Deficit Hyperactivity Disorder. 小儿强迫症的气质特征与图雷特综合征和注意力缺陷多动障碍的关系。
IF 1.9 3区 医学 Q3 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-01-29 DOI: 10.1159/000535658
Jessica Szu-Chi Cheng, Elissa Khalil, Masoud Salehi, Lauren Mulcahy, Isabella Yiru Xie, Hasti Hadizadeh, Marco A Grados

Introduction: Pediatric obsessive-compulsive disorder (OCD), attention-deficit hyperactivity disorder (ADHD), and Tourette syndrome (TS) are often concurrent. This study explores the temperament profile of complex OCD phenotypes.

Methods: A clinical registry recorded demographic data, psychiatric diagnoses, and temperament traits, including novelty seeking (exploratory behaviors), harm avoidance (fear of uncertainty), reward dependence (sentimentality), and persistence (perseverance). Temperament data were accrued from the Junior Temperament and Character Inventory (JTCI). Participants were divided into (1) OCD only; (2) OCD+ADHD or TS; and (3) OCD+ADHD+TS to compare temperament.

Results: Participants include 126 youths with OCD (61.9% male, 88.9% white) between the ages 6 and 18 years (12.7 ± 3.1). Among the three groups, the complex neurodevelopmental disorder group OCD+ADHD+TS expresses the highest novelty seeking and lowest persistence. Harm avoidance is increased in all groups compared to reference controls, irrespective of concurrent ADHD or TS. For the OCD+ADHD+TS group, contamination and washing symptoms have higher novelty seeking (p < 0.01), while counting and ordering have lower novelty seeking (p < 0.05). Harm avoidance is increased with aggressive, somatic, and checking symptoms in OCD only (p < 0.01), while persistence is increased with repeating and counting symptoms in the comorbid groups (OCD+ADHD or TS, OCD+ADHD+TS).

Discussion/conclusion: The complex subtype, OCD+ADHD+TS, is associated with high novelty seeking and low persistence, while high harm avoidance is linked to pediatric OCD irrespective of ADHD or TS co-occurrence. In sum, pediatric OCD with ADHD and TS confers a unique temperament profile, further refining complex phenotypes of pediatric OCD for future research.

导言:小儿强迫症(OCD)、注意力缺陷多动障碍(ADHD)和抽动秽语综合征(TS)常常同时存在。本研究探讨了复杂强迫症表型的气质特征:临床登记册记录了人口统计学数据、精神病诊断和气质特征,包括求新(探索行为)、避害(对不确定性的恐惧)、奖励依赖(多愁善感)和坚持(毅力)。气质数据来自青少年气质和性格量表(JTCI)。将参与者分为:(1) 强迫症患者;(2) 强迫症+ADHD或TS患者;(3) 强迫症+ADHD+TS患者,以比较他们的气质:参与者包括126名患有强迫症的青少年(61.9%为男性,88.9%为白人),年龄在6至18岁之间(12.7 ± 3.1)。在三个组别中,复杂神经发育障碍组 OCD+ADHD+TS 表现出最高的新奇寻求性和最低的持久性。与参照对照组相比,无论是否同时患有多动症(ADHD)或创伤后应激障碍(TS),所有组别的伤害回避都有所增加。在强迫症+多动症+TS组中,污染和清洗症状具有较高的寻求新奇性(p <0.01),而计数和排序具有较低的寻求新奇性(p <0.05)。仅在强迫症组中,攻击性、躯体性和检查症状会增加伤害回避(p <0.01),而在合并症组(强迫症+多动症或TS,强迫症+多动症+TS)中,重复和计数症状会增加持续性:讨论/结论:复杂亚型(强迫症+ADHD+TS)与高求新和低持续性相关,而高伤害回避与小儿强迫症相关,与ADHD或TS共存无关。总之,伴有多动症和TS的小儿强迫症具有独特的气质特征,为今后的研究进一步完善了小儿强迫症的复杂表型。
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引用次数: 0
Are Traumatic Disintegration, Detachment, and Dissociation Separate Pathogenic Processes Related to Attachment Trauma? A Working Hypothesis for Clinicians and Researchers 创伤性解体、分离和解离是与依恋创伤相关的独立致病过程吗?临床医生和研究人员的工作假设
IF 3.6 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-12-08 DOI: 10.1159/000535191
B. Farina, Claudio Imperatori
Background: Despite its high prevalence in all psychiatric disorders and its widely demonstrated clinical relevance as a marker of both clinical severity and poorer treatment response, a scientifically validated definition of dissociation remains controversial, and the understanding of its pathogenesis is still somewhat lacking. Furthermore, although most clinicians commonly refer to dissociation as a single unitary concept, the empirical evidence strongly supports the paucity of a one-dimensional approach to dissociation. Summary: Resonating with the clinical and neuroscientific data on this topic, this article aimed to provide a working hypothesis, suggesting that the wide variety of psychopathological phenomena that are currently improperly lumped into the category of dissociation are in fact produced by at least three different pathogenic processes involved in developmental trauma, namely, traumatic disintegration, detachment responses, and dissociation. Key Messages: This hypothesis should, therefore, be considered a starting point for a better understanding of the complex manifestations and processes that currently overly, attributed to dissociation per se.
背景:尽管它在所有精神疾病中都有很高的患病率,并且作为临床严重程度和治疗反应较差的标志被广泛证明具有临床相关性,但对分离的科学验证定义仍然存在争议,对其发病机制的理解仍然有所欠缺。此外,尽管大多数临床医生通常将分离作为一个单一的概念,但经验证据强烈支持一维分离方法的缺乏。摘要:根据关于这一主题的临床和神经科学数据,本文旨在提供一个有效的假设,表明目前被不恰当地归为分离类别的各种精神病理现象实际上是由至少三种不同的与发育性创伤有关的致病过程产生的,即创伤性解体、脱离反应和分离。因此,这一假设应该被视为一个起点,以便更好地理解目前过度归因于解离本身的复杂表现和过程。
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引用次数: 0
Automatic diagnosis of schizophrenia and attention deficit hyperactivity disorder in rs-fMRI modality using convolutional autoencoder model and interval type-2 fuzzy regression. 基于卷积自编码器模型和区间2型模糊回归的rs-fMRI模式自动诊断精神分裂症和注意缺陷多动障碍
IF 1.9 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-12-01 Epub Date: 2022-11-12 DOI: 10.1007/s11571-022-09897-w
Afshin Shoeibi, Navid Ghassemi, Marjane Khodatars, Parisa Moridian, Abbas Khosravi, Assef Zare, Juan M Gorriz, Amir Hossein Chale-Chale, Ali Khadem, U Rajendra Acharya

Nowadays, many people worldwide suffer from brain disorders, and their health is in danger. So far, numerous methods have been proposed for the diagnosis of Schizophrenia (SZ) and attention deficit hyperactivity disorder (ADHD), among which functional magnetic resonance imaging (fMRI) modalities are known as a popular method among physicians. This paper presents an SZ and ADHD intelligent detection method of resting-state fMRI (rs-fMRI) modality using a new deep learning method. The University of California Los Angeles dataset, which contains the rs-fMRI modalities of SZ and ADHD patients, has been used for experiments. The FMRIB software library toolbox first performed preprocessing on rs-fMRI data. Then, a convolutional Autoencoder model with the proposed number of layers is used to extract features from rs-fMRI data. In the classification step, a new fuzzy method called interval type-2 fuzzy regression (IT2FR) is introduced and then optimized by genetic algorithm, particle swarm optimization, and gray wolf optimization (GWO) techniques. Also, the results of IT2FR methods are compared with multilayer perceptron, k-nearest neighbors, support vector machine, random forest, and decision tree, and adaptive neuro-fuzzy inference system methods. The experiment results show that the IT2FR method with the GWO optimization algorithm has achieved satisfactory results compared to other classifier methods. Finally, the proposed classification technique was able to provide 72.71% accuracy.

如今,世界上有许多人患有脑部疾病,他们的健康处于危险之中。迄今为止,已经提出了许多诊断精神分裂症(SZ)和注意缺陷多动障碍(ADHD)的方法,其中功能磁共振成像(fMRI)模式被医生认为是一种流行的方法。本文提出了一种采用新的深度学习方法的静息状态功能磁共振成像(rs-fMRI)模式的SZ和ADHD智能检测方法。加州大学洛杉矶分校的数据集包含SZ和ADHD患者的rs-fMRI模式,已用于实验。FMRIB软件库工具箱首先对rs-fMRI数据进行预处理。然后,使用具有所提出层数的卷积自编码器模型从rs-fMRI数据中提取特征。在分类步骤中,引入区间2型模糊回归(IT2FR)方法,并采用遗传算法、粒子群算法和灰狼优化(GWO)技术对其进行优化。此外,将IT2FR方法的结果与多层感知器、k近邻、支持向量机、随机森林和决策树以及自适应神经模糊推理系统方法进行了比较。实验结果表明,与其他分类器方法相比,结合GWO优化算法的IT2FR方法取得了满意的结果。最后,所提出的分类技术能够提供72.71%的准确率。
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引用次数: 0
Contents Vol. 56, No. 6, 2023 目录 第 56 卷第 6 期,2023 年
IF 3.6 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-12-01 DOI: 10.1159/000535111
Joachim Klosterkötter, L. Fleck, A. Fuchs, M. H. Kaess, Bern, M. Kaur, NC Greensboro, M. Sanches, TX Houston, P.K.H. Mo, G.Y.K. So, Z. Lu, W. W. Mak, Hong Kong
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引用次数: 0
Front & Back Matter 正面和背面
IF 3.6 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-05-31 DOI: 10.1159/000531326
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引用次数: 0
Prelims 预备考试
IF 3.6 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-03-03 DOI: 10.1159/000529565

Psychopathology 2023;56:1–4
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引用次数: 0
Front & Back Matter 正面和背面
IF 3.6 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-03-01 DOI: 10.1159/000529990
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引用次数: 0
Homo œconomicus: A Key for Understanding Late Modernity Narcissism? Homo œconomicus:理解晚期现代性自恋的一把钥匙?
IF 3.6 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1159/000525678
Giovanni Stanghellini

This paper describes the form that narcissism takes in contemporary society in the light of Homo œconomicus - a concept developed by philosopher Foucault to describe a key figure of late modernity: the entrepreneur of himself whose core values are utility (every action must be directed towards production) and optimization (what costs more than it produces is a dead branch to be cut). Homo œconomicus is the subject of so-called "achievement society." Its imperative is summed up in the formula "You can!" that generates heavy constraints because it is introjected as "If I can, then I must!," and self-coercion is more fatal than hetero-coercion because no resistance can be put up against oneself. He is also the subject of the "society of the spectacle" in which a part of the world represents itself in front of the rest of the world and shows itself to be superior to it. The spectacle is not simply a set of images, but a type of social relationship between people mediated by images, generating alienation from oneself and from the Other. Using Homo œconomicus as a grid for understanding contemporary pathological forms of narcissism, I describe the values and the life-world of narcissistic persons including the ways they experience time, space, others, and their own body. I finally suggest a therapeutic of this form of existence based on the recognition of its value-structure.

本文从Homo œconomicus的角度描述了自恋在当代社会中的表现形式。Homo œconomicus是哲学家福柯(Foucault)提出的一个概念,用来描述晚期现代性的一个关键人物:自我企业家,其核心价值观是效用(每一个行动都必须以生产为导向)和优化(成本大于产出的东西是一个可以砍掉的死枝)。Homo œconomicus是所谓的“成就社会”的主体。它的命令性可以用“你可以!”这个公式来概括,这个公式产生了很大的约束,因为它被注入了“如果我可以,那么我必须!”自我强迫比异性强迫更致命,因为你无法对自己进行抵抗。他也是“景观社会”的主体,在这个社会中,世界的一部分在世界其他部分面前表现自己,并表现出自己比世界其他部分优越。景观不仅仅是一组图像,而是一种以图像为媒介的人与人之间的社会关系,产生了与自我和他者的异化。以Homo œconomicus作为理解当代自恋病理形式的网格,我描述了自恋者的价值观和生活世界,包括他们体验时间、空间、他人和自己身体的方式。最后,我提出了一种基于对其价值结构认识的治疗方法。
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引用次数: 4
First-Episode Psychosis and Centrality in the Work of Psychiatrist Henri Grivois: A Dialog with Phenomenological Psychopathology. 精神病学家Henri Grivois作品中的首发精神病和中心性:与现象学精神病理学的对话。
IF 3.6 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1159/000525425
Sarah Troubé

The article traces the hypotheses of the contemporary French psychiatrist Henri Grivois, concerning what he calls nascent psychosis. In a perspective close to descriptive phenomenology, Grivois tries to identify the alteration of subjective experience specific to the first moments of a psychosis. He thus describes the experiences of concernment and centrality as consisting in a disruption of the tacit mechanisms of mimesis and interindividual attunement. Using the common points between Grivois's aim and that of the phenomenological approach, the article puts these two conceptions of first-episode psychosis into dialog, questioning in particular the prereflexive register of experience. The notion of centrality questions the conditions of the constitution of intersubjectivity: it places the question of the bodily and gestural incarnation that founds the relationship to the other at the center of our understanding of psychosis. Grivois's hypotheses and the phenomenology of psychoses together contribute to the questioning of the therapeutic methods employed in the early stages of treatment. Centrality, in particular, questions the limits of verbal descriptions of psychotic experiences and invites us to think about methods that are based more on the anchoring and bodily attunement of the patient and the therapist.

这篇文章追溯了当代法国精神病学家亨利·格里沃斯(Henri Grivois)关于他所谓的“新生精神病”的假设。在一个接近描述现象学的视角中,Grivois试图识别特定于精神病最初时刻的主观经验的变化。因此,他将关注和中心的体验描述为对模仿和个体间协调的隐性机制的破坏。本文利用格里沃斯的目的与现象学方法之间的共同点,将这两个首发精神病的概念放入对话中,特别是对经验的前自反域提出质疑。中心性的概念对主体间性构成的条件提出了质疑:它将身体和手势的化身问题置于我们对精神病的理解的中心,这些问题建立了与他人的关系。格里沃斯的假说和精神病现象学共同促成了对早期治疗阶段所采用的治疗方法的质疑。尤其是中心性,质疑了对精神病经历的语言描述的局限性,并邀请我们思考更多地基于病人和治疗师的锚定和身体调谐的方法。
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引用次数: 1
Seizures as a Struggle between Life and Death: An Existential Approach to the Psychosocial Impact of Seizures in Candidates for Epilepsy Surgery. 癫痫发作是生与死的斗争:从存在论角度探讨癫痫发作对癫痫手术候选者的社会心理影响》(An Existential Approach to the Psychosocial Impact of Seizures in Candidates for Epilepsy Surgery)。
IF 3.6 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-01-01 Epub Date: 2023-03-16 DOI: 10.1159/000528924
Prisca R Bauer, Marie L A Bronnec, Andreas Schulze-Bonhage, Dirk-Matthias Altenmüller, Thomas Fuchs

Introduction: Mental health comorbidities such as depression and anxiety are common in epilepsy, especially among people with pharmacoresistant epilepsy who are candidates for epilepsy surgery. The Psychology Task Force of the International League Against Epilepsy advised that psychological interventions should be integrated into comprehensive epilepsy care.

Methods: To better understand the psychological impact of epilepsy and epileptic seizures in epilepsy surgery candidates, we analysed interviews with this subgroup of patients using Karl Jaspers' concept of limit situations, which are characterised by a confrontation with the limits and challenges of life. These are especially chance, randomness, and unpredictability, death and finitude of life, struggle and self-assertion, guilt, failure, and falling short of one's aspirations.

Results: In 43 interviews conducted with 15 people with drug-resistant epilepsy who were candidates for epilepsy surgery, we found that these themes are recurrent and have a large psychosocial impact, which can result in depression and anxiety. For some people, epileptic seizures appear to meet the criteria for traumatic events.

Conclusion: Understanding epilepsy and seizures as existential challenges complements the neurobiological explanations for psychological comorbidities and can help tailor psychological interventions to the specific needs of people with epilepsy, especially those who are candidates for surgical treatment.

导言:抑郁和焦虑等心理健康合并症在癫痫患者中很常见,尤其是在作为癫痫手术候选者的药物耐药性癫痫患者中。国际抗癫痫联盟心理工作组建议,应将心理干预纳入癫痫综合护理中:为了更好地了解癫痫和癫痫发作对癫痫手术候选者的心理影响,我们使用卡尔-雅斯贝尔斯(Karl Jaspers)的 "极限情境"(limit situations)概念分析了对这部分患者的访谈。这些挑战尤其是偶然性、随机性和不可预测性、死亡和生命的有限性、挣扎和自我主张、内疚、失败和达不到自己的愿望:在对 15 名候选癫痫手术的耐药性癫痫患者进行的 43 次访谈中,我们发现这些主题反复出现,并对社会心理产生了巨大影响,可能导致抑郁和焦虑。对某些人来说,癫痫发作似乎符合创伤事件的标准:将癫痫和癫痫发作理解为生存挑战,是对心理并发症的神经生物学解释的补充,有助于根据癫痫患者(尤其是手术治疗的候选者)的具体需求定制心理干预措施。
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引用次数: 1
期刊
Psychopathology
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