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Language disorders are criteria of psychopathology diagnostics listed both in the 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the Diagnostic and Statistic Manual of Mental Disorders (DSM). However, structure and grammar remain understudied in this aspect, which makes structural analysis a relevant research topic. A structural analysis of written narrative may objectivize particular language disorders, thus facilitating psychodiagnostics of different mental disorders. The research objective was to describe the structural features of written narratives obtained from 127 patients with schizophrenic, bipolar, and personality disorders. The narratives were subjected to structural and statistical analyses. Schizophrenic narratives demonstrated a poor vocabulary, a low volume, and a high degree of formality with a passive narrator. Bipolar texts tended to be long, detailed, egocentric, and active, with multiple participles. Patients with personality disorders emotionally relived their memories, producing reflective written narratives with a lot of actors. The final list of written speech indicators to be used to distinguish between schizophrenic, bipolar, and personality disorders included such variables as text volume, verb tense, non-finite verb forms, first-person singular pronoun, number of actors, passive / active narrator, and laconic / detailed narration.

This ethnographic work on the cultural behavior of anorexic women in a virtual communication space aimed to demonstrate the use of their verbalizations and images that support the motivations and guidelines of this practice. The methodology of writing from the leading role of this condition and having returned some time later to be able to document it was used. The main finding is a guide exposed in categories where it can be concluded that this pathology behaves as a spiritual cult where communication with ANA is vital, the deity of this practice that has its own symbols and imaginaries, all through a virtual forum. Este trabajo etnográfico sobre el comportamiento cultural de las mujeres anoréxicas en un espacio de comunicación virtual, tuvo como objetivo evidenciar el uso de sus verbalizaciones e imágenes que fundamentan las motivaciones y pautas de esta práctica. Se usó la metodología de escribir desde el protagonismo de este padecimiento y haber regresado tiempo después para poder documentarlo. Como principal hallazgo se presenta una guía expuesta en categorías donde se puede concluir que esta patología se comporta como culto espiritual donde es vital la comunicación con ANA, la deidad de esta práctica que tiene sus propios símbolos e imaginarios, todo a través de un foro virtual.

Abstract Objective: Previous publications have focused on a leading pop culture phenomenon, Star Wars, to teach several issues in psychiatry, which can make understanding challenging themes easier. This article delves into matters of differential diagnoses regarding two psychiatric disorders. Methods: We examine and compare the symptoms and specificities of borderline personality disorder and bipolar disorder in the light of the fictional villain of the films, Darth Vader/Anakin Skywalker. Results and Conclusion: Our considerations of his diagnosis should be interpreted as an academic exercise with two main goals: to discuss the differential diagnosis between borderline personality disorder and bipolar disorder in an illustrative, soft, and ludic way; and to teach how to connect one’s behaviors with diagnostic criteria - in this case, those related to borderline personality disorder.

Introduction: The institution of marital consent, which is the efficient cause of marriage and its annulment on the grounds of specified personality disorders. Aim of the study: The research objectives of this study are as follows: determining the proportion of cases on the sole ground of mental incapacity to other grounds of marriage annulment, the number of marriage annulment declarations among clients suffering from personality disorders with a differential diagnosis, age and gender determination of the person requesting marriage annulment – determining the average value and the standard deviation, the duration of marriage until its annulment – determining the average value and the standard deviation, the number of cases in which marriage annulment application is submitted by men and women as well as determining the proportion of cases concluding with the declaration of marriage annulment to those concluding with a negative judgement. In the research part of the study the following analysis has been carried out, personality disorders leading to the marriage annulment, distinguishing between gender, the etiology of particular disorders as well as dysfunctional areas demonstrated by court experts concerning both marital and family life. Material and methods: The analysis of psychological opinions extracted from the marriage annulment cases which were considered and judged by the Bishop’s Court in the Diocese of Toruń. The research period stretches over five years between 2012 and 2016,during which court experts in clinical psychology issued their opinions in 156 cases concerning 82 persons. Conclusions: On the basis of the analysis, the following conclusions can be drawn: the age of applicants requesting marriage annulment: Men – M=37,04; SD=7,90; Women – M=34,98; SD=8,07. Duration of marriage until annulment: – M=13,23; SD=8,24. Marriage annulment requests were submitted by 62 men and 94 women. Marriage was declared null and void in 122 cases whereas the negative judgment concerned 36 cases. The conclusions drawn indicate that the predominant disorders resulting in marriage annulment included antisocial personality disorder, narcissistic personality disorder as well as dependent personality disorder (DPD). The conclusions drawn clearly show that the predominant disorder resulting in the invalidation of marriage is antisocial personality disorder, closely followed by narcissistic personality disorder and finally by dependent personality disorder. Out of 189 cases processed by the court within the period of five years, 156 of them concern mental incapacities whereas the remaining ones concern other cases of marriage annulment.

The aim of the study was to verify the predictive capacity of the indicator of pathological personality (IPP) regarding work engagement, job satisfaction, and burnout. A total of 228 Brazilian workers answered the IDCP-SV, EEGT, EST, and MBI-HSS. Structural Equation Modeling was used to predict work engagement, job satisfaction, and burnout using the IPP. The results showed that the IPP can negatively predict work engagement and job satisfaction, and positively predict burnout. We observed that workers with high levels of pathological personality functioning are less engaged and satisfied with work and present higher levels of burnout, as hypothesized in this study. The findings indicate the importance of evaluating personality traits, especially pathological traits, in hiring processes and in promoting well-being at work.

The majority of teenagers benefit from scientific advances, whether pharmacological or technological, but the most vulnerable use them to their detriment. While only certain substances or activities are potentially "addictive", the psyche, personality and environment play a major role in the onset of an addiction. Pleasure-seeking motivates gambling and drug use. Suffering will drive the adolescent to pursue this practice, which provides pleasure and relief, to the detriment of any other activity. It becomes exclusive, toxic and alienating. The therapist must rise to the challenge., (Copyright © 2024. Published by Elsevier Masson SAS.)

It is often claimed that women abuse inevitably emanates from patriarchy. Using ancient Israel and Africa as contexts, this article assesses the correlation between patriarchy and violence against women. The article suggests in these contexts, it is not all men are who are perpetrators of women abuse; rather, there is evidence of female perpetrators of sexual violence against men; and that in the ancient and modern societies, there is also homosexual violence. Rather than patriarchy, the major cause of women abuse is a personality disorder characterised, among other traits, by aggression against women, alcoholism and drug abuse – the latter two traits are often responsible for women abuse. Being accustomed to domestic violence from youth and low socio-economic status are also causes of women abuse.

Suicide is a public health problem affecting majority of patients with psychiatric diseases, including bipolar disorder (BD). The purpose of this study was to estimate the prevalence of suicide attempts (SAs) and to identify different factors associated with it in a population of patients with bipolar disorder type I (BD I). We conducted a cross-sectional and descriptive study of 150 patients. We used a fact sheet, questionnaires assessing affective temperaments, alcohol addiction and drug addiction. A comparison between suicidal (23,3%, n = 35) and non-suicidal (76,7%, n = 115) subjects enabled the identification of the following risk factors for suicide: cannabis addiction, addiction to psychotropic drugs, advanced age, a family history of BD, depression, SA and suicide deaths, a personal somatic history, a personality disorder associated, in particular, with histrionic personality, depressive temperament, a first thymic depressive episode, recurrent thymic episodes and long-term disease progression. Two protective factors were also identified: valproic acid and a higher number of siblings. In a multivariate study risk factors included: age, a family history of BD, a family history of SA and cannabis addiction. Particular attention should be given to determinants associated with suicidal behavior in BD I patients in order to adopt effective preventive and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Early psychological factors, including childhood traumas and personality, play a crucial role in the emergence and persistence of painful symptoms and appears to be frequent in patients with nociplastic pain. Patient care involves validating the reality of their pain and identifying various facets of their suffering, taking into account their individual history and context. A multimodal therapeutic approach, within a bio-psycho-social model, emphasizing psychotherapeutic care, is recommended., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

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Objective: Mental illness is noted for being in one of the first places in global burden of disease in terms of years lived with disability (YLDs). Notably, absences due to mental health problems greatly affect the world of work, and mental illness is one of the most economically important diseases. However, there is a high rate of those not seeking care in mental health, both in the general population but also in workers in private and public sectors with significant economic impacts. The aim of our study was to identify factors associated with low access to specialized psychiatric care among French Public Sector employees referred to a psychiatric expertise upon request from the Departmental Medical Board of Martinique (Comité médical départemental [CMD] de Martinique), between 2000 and 2013., Methods: We carried out an observational and transversal study, analyzing sociodemographic and clinical data from psychiatric assessments done to help the CMD give notification on the medico-administrative situation of Public Sector employees, a large majority of whom had been on sick leave due to mental health for at least 6 months. The variable of interest - low access to psychiatric care - was defined as the absence of consultation at the time of the assessment provided by a psychiatrist since at least 12 months. Descriptive analyses were performed first, then univariate analysis using a non-adjusted binary logistic regression model, to identify factors associated with low access to psychiatric care. Finally, multivariate analyses using a binary logistic regression model were performed after excluding non-relevant factors (with significance level above 5%) during the univariate analysis. A significance threshold of 0.05 was adopted for all of the statistical analyses., Results: We retrospectively analysed the records of 516 Public Sector employees. Two hundred and ninety-three subjects (57% of the population) had a low access to psychiatric care as part of their regular clinical follow-up, even the 81% who were identified has having had psychiatric antecedents (55% with 'mood disorders', and 17% with 'neurotic, stress-related and somatoform disorders'). Moreover, psychiatric expertise found a psychiatric diagnostic in 96 % of cases, mostly 'mood disorders', 'neurotic, stress-related and somatoform disorders' and 'personality disorders'. For mood disorders, clinical characteristics of episodes were defined as 'severe' or 'with psychotic symptoms' in many cases. Suicidal thoughts were found in 96 subjects (18%) during the expertise. Fewer than half of the subjects (43%) had a specialized psychiatric care (mostly subjects with 'mood disorders' and 'psychotic disorders') and 41% only had care by a general practitioner (mostly subjects with 'neurotic, stress-related and somatoform disorders'). In most of the cases, psychotropic drugs were insufficiently and inadequately prescribed. Using multivariate analysis, we found a significant association between low access to psychiatric care and: being masculine, having had more than two children, having had personal life events (in particular chronic somatic diseases), and having had no history of mental illness or of psychiatric hospitalization. It appears that chronic somatic diseases are frequently associated with psychiatric diseases, and the association worsens the prognosis of the two disorders. However, even if employees with mental disorders associated with chronic somatic diseases are unfit for work, many of them do not have access to mental health care and only have care by a general practitioner., Conclusion: More than half of French Public Sector employees referred to the Departmental Medical Board of Martinique for a medico-administrative decision relevant to sick leave due to mental diseases, had low access to specialized psychiatric care. By identifying barriers to care and reasons for not seeking specialized mental health care, we would be able to prevent disability claims and days off work (predicting malaise in the workplace and health-related limitations). Our results demonstrate the need to strengthen existing partnerships, and thus enhancing cooperation between public psychiatric sectors and primary healthcare players, facilitating access to mental healthcare and decreasing the stigma about mental disorders., (Copyright © 2022 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Psychiatrists and psychotherapists specialising in the fields of addiction, personality disorders, ADHD and suicidal crisis, we questioned the ChatGPT artificial intelligence program in order to form an opinion on the quality of its answers to questions on these subjects. Our aim is to satisfy our curiosity about these emerging tools. On the other hand, we want to assess the relevance of the answers in order to know whether relatives and patients can use them safely. In this article, we comment on the question-and-answer dialogue with the artificial intelligence program in the light of the literature., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en lien avec cet article.

Background: We choose to examine the Personality Diagnostic Questionnaire-4+ (PDQ-4+), considered as one of the most used and representative measure for personality disorders as they are referenced in the DSM-IV. The PDQ-4+ is a self-report questionnaire assessing the ten personality disorders and the two additional personality disorders derived from the DSM-IV. Participants must answer by true or false to the 99 items, each item represents a personality disorder' criteria. Few researches have pointed out the psychometric properties of the original version of the PDQ-4+. Validating studies on the French version have been rarely conducted and only among students and teenagers. Clinical samples have been laid aside. Objective: Considering the importance of the assessment of personality disorders, the aim of the present study was to evaluate the main psychometric properties of the French version of the PDQ-4+ as a screening tool for borderline, antisocial, schizotypal, schizoid, obsessional-compulsive, narcissistic, histrionic, paranoid, dependent and avoidant personality disorders, in a psychiatric population. Materials and methods: A sample of 137 French psychiatric patients completed the French versions of the Structured Interview for DSM-IV Personality disorder-IV (SIDP-IV) and the PDQ-4+. Convergent validity, sensibility, specificity, positive and negative predictive values, and internal consistency have been evaluated. Results: The level of agreement between the PDQ-4+ and the SIDP-IV was very low for the majority of personality disorders and low for the dependent personality disorder. The sensitivity was high for antisocial and borderline personality disorders and moderate or low for the other. Only dependent (0.44) and borderline (0.39) personality disorders had a moderate predictive positive value, associated with a high negative predictive value (0.82 and 0.79). The other personality disorders had a low positive predictive value (ranged from 0.00 to 0.28) and a high negative predictive value (ranged from 0.76 to 1.00). The specificity was high for five disorders and moderate for the other. Internal consistency of the PDQ-4+ and its subscales was unsatisfying. Correlation coefficients between each PDQ-4+ subscales were low or moderate. Conclusions: As other self-report measure, the PDQ-4+ screened more personality disorders than the clinical interview. Besides, even if the two diagnostic methods evaluated more borderline and avoidant personality disorders, level of agreements for each personality disorder were generally low, in concordance with previous studies. Only dependent personality disorder emerged with low agreement, moderate specificity and positive predictive value, and high sensitivity and negative predictive value. The influence of the cut-off scores on these results could be raised. The internal consistency for each personality disorders was unsatisfying and lower than other French and international validating studies. The psychometric properties of the French version of the PDQ-4+ were overall unsatisfying. This tool allows a large screening of personality disorders and thus only appears as a useful method to screen a global personality disturbance. [ABSTRACT FROM AUTHOR]

The hospital management of patients experiencing a suicidal crisis and suffering from a personality disorder is complex for caregivers. The care model must be adapted and applied by a multidisciplinary team. The emotional charge of these crisis situations makes it difficult for caregivers to maintain their ability to treat mental states with curiosity and without necessarily experiencing them as they appear to them. In other words, it could be difficult to mentalize. For example, an expressed desire to die may be much more complex in reality. Mentalizing abilities are challenged differently depending on our role with the patient. In this article we explore the specifics of interdisciplinary crisis work through the lens of mentalization-based therapy., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

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Résumé: Objectifs: Depuis la publication de la troisième édition du Manuel diagnostique et statistique des troubles mentaux de la classification américaine (DSM-III), les syndromes cliniques psychiatriques et les troubles de la personnalité figurent sur deux axes distincts, les axes I et II. Dans la cinquième révision du manuel (DSM-5), publiée en mai 2013, cette distinction est supprimée et les troubles de la personnalité figurent désormais parmi les autres troubles mentaux. L’objectif de ce travail est de tenter d’en repérer les enjeux cliniques et épistémologiques. Méthode: Cette distinction a surtout eu l’intérêt d’attirer l’attention des praticiens sur la personnalité des patients indépendamment de leurs diagnostics psychiatriques. Sa justification scientifique paraît cependant actuellement insuffisante. De nombreux arguments plaident en faveur d’une continuité entre les deux axes et de remaniements nosographiques des troubles anxieux, des troubles dépressifs et des troubles de la personnalité. Cette mise au point résume les principales tendances qui se sont fait jour dans les dix dernières années à propos de la classification des troubles de la personnalité, avec une insatisfaction grandissante vis-à-vis du modèle catégoriel traditionnel et un intérêt croissant pour une perspective dimensionnelle. Ces tendances sont illustrées par les recommandations rédigées par le groupe de travail sur la personnalité et les troubles de la personnalité pour le DSM-5. Résultats: Les critiques du monde scientifique vis-à-vis de ces recommandations ont été vives. L’article résume les principaux arguments développés de part et d’autre et l’évolution de la réflexion du groupe de travail jusqu’aux décisions finales rendues publiques en décembre 2012. Il n’existe pas de véritable consensus sur le meilleur modèle dimensionnel à retenir, même si le système le mieux étudié est sans conteste le modèle à cinq facteurs, dit des Big Five. Discussion: Ce système a surtout été testé en psychologie et son applicabilité à la psychopathologie, certainement envisageable, nécessite des aménagements et des travaux complémentaires de validation avant d’être définitivement adopté. Conclusion: Le retour à une perspective mono-axiale pour les troubles de la personnalité justifie aussi une réflexion approfondie sur les limites de la normalité et sur la définition générale d’un trouble mental qui n’a jamais fait l’objet d’un réel consensus dans notre profession. [ABSTRACT FROM AUTHOR]

Objective Personality disorders and intimate partner violence (IPV) are two problems recognized as major public health issues associated with serious individual and societal repercussions. Several studies have documented the links between borderline personality disorder (BPD) and IPV; however, we know very little about the specific pathological traits contributing to IPV. The study aims to document the phenomenon of IPV committed and suffered in persons with BPD and to draw profiles from the personality facets of the DSM-5 Alternative Model for Personality Disorders (AMPD). Method One hundred and eight BPD participants (83.3% female; Mage = 32.39, SD = 9.00) referred to a day hospital program following a crisis episode completed a battery of questionnaires including the French versions of the Revised Conflict Tactics Scales, evaluating physical and psychological IPV committed and suffered, and the Personality Inventory for the DSM-5- Faceted Brief Form, evaluating 25 pathological facets of personality. Results Among the participants, 78.7% report having committed psychological IPV, while 68.5% have been victims, which is more than the estimates published by the World Health Organization (27%). In addition, 31.5% would have committed physical IPV, while 22.2% would have been victims. IPV appears to be bidirectional since 85.9% of participants who are perpetrators of psychological IPV also report suffering from it and 52.9% of participants who are perpetrators of physical IPV report being also victims. Nonparametric group comparisons indicate that Hostility, Suspiciousness, Duplicity, Risk-Taking, and Irresponsibility facets distinguish physically and psychologically violent participants from nonviolent participants. High results on Hostility, Callousness, Manipulation, and Risk-taking facets characterize participants who are victims of psychological IPV, while an elevation in Hostility, Withdrawal, Avoidance of intimacy, and Risk-taking facets and a low result on the Submission facet distinguish participants who are victims of physical IPV from non-victims. Regression analyzes show that the Hostility facet alone explains a significant variance in the results of IPV perpetrated, while the Irresponsibility facet contributes substantially to the variance of the results of IPV experienced. Conclusion Results show the high prevalence of IPV in a sample of persons with BPD, as well as its bidirectional nature. Beyond the diagnosis of BPD, certain specific facets of the personality (including Hostility and Irresponsability) make it possible to target persons at greater risk of committing and suffering from psychological and physical IPV.

Competing Interests: M. Speranza déclare n’avoir aucun lien d’intérêts.

Résumé: Pour approfondir la connaissance du facteur de risque suicidaire constitué par le trouble de la personnalité dépendante (TPD), nous avons évalué l’association de ce facteur avec différentes variables dans une population de suicidants. Le TPD est un facteur de risque suicidaire important à considérer puisqu’il est fréquent (48 %), associé à une insertion socioprofessionnelle de moins bonne qualité et à une fréquence de récidive suicidaire deux fois plus élevée. L’association de l’épisode dépressif majeur (EDM) avec les différentes variables a également été évaluée. Chez les patients présentant un EDM, l’intentionnalité de l’acte est plus forte et l’hospitalisation plus fréquente. Cette étude permet de définir deux profils de population très différents suivant que le patient présente un TPD ou un EDM. Replacer la question du lien entre EDM et TPD dans une perspective diachronique amène à considérer ces deux identités comme des constructions différentes, la dépression s’apparentant davantage à un état réversible et la dépendance à un trait. [ABSTRACT FROM AUTHOR]

Abstract: The link between sexual risk-taking and substance use, on one hand, and the link between sexual risk-taking and life events, on the other hand, is well established in the literature. Novelty seeking has been identified as a risk factor in these relationships. However, a few studies have examined simultaneously the link between sexual-related risk behavior, personality attributes, substance use and life events. The current study assessed the relationship between personality attributes (personality disorder and novelty seeking), substance use and life events in sexual risk-taking in a sample of college students. Results showed that substance use, antisocial and impulsive behaviours and novelty seeking contribute to the self-reported sexual risk-taking. Implications of these data and the existing literature on personality, substance use, life events and sexual risk-taking are discussed with regards to the direction of future research. [Copyright &y& Elsevier]

Résumé: La question de troubles de la personnalité est « centrale » en matière de responsabilité pénale ; c’est donc un problème qu’il faut analyser soigneusement du point de vue des concepts validés et dont il faut revoir les fondements au vu des conséquences qu’ils peuvent avoir dans les expertises psychiatriques et psychologiques. Le « trouble de la personnalité » questionne tout d’abord la pertinence du concept de personnalité même et de son utilisation comme vecteur d’exclusion et de normalisation des différences interpersonnelles. Les troubles de la personnalité posent la question de la maladie mentale au sein de laquelle le concept de troubles de la personnalité représente une lacune non négligeable. L’utilisation au quotidien de ce concept par les cliniciens renvoi souvent à une interprétation de leur part pouvant refléter une incompréhension de l’Autre ; l’Autre qui ne partage pas les mêmes valeurs et normes sociales. Il faut donc être attentif à ne pas instrumentaliser un phénomène psychologique dont la validité reste à établir afin qu’il ne puisse être un outil d’interprétation à charge et travailler à des recommandations consensuelles. [ABSTRACT FROM AUTHOR]

The psychobiological model of personality developed by Cloninger, including four dimensions of temperament and three dimensions of character, allows to explore personality factors associated with depressive disorders. METHODS: The study was conducted on 35 major depressive patients (29 women et 6 men) who filled out the questionnaire (TCI) during a medical consult. Eleven patients had personality disorders, sixteen had family antecedent of depression, and twelve had chronic depression. RESULTS: This study confirms higher Harm Avoidance (HA) scores and lower Self-Directedness (SD) and Cooperativeness (C) scores for depressed patients. In this present study, the patients with personality disorders showed lower scores for Self-Directness (SD) and Resourcefulness (SD3), Congruent second nature (SD5), Compassion (C4). This study also showed lower scores for Exploratory (NS1) for the patients with family antecedent of depression. Finally, this study showed lower scores for Reward dependence (RD) and attachment (RD2) for the patients with chronic depression. [ABSTRACT FROM AUTHOR]

Abstract: In a first part, we presented the results of a literature review of these treatments among patients referred from the Emergency Department after a suicide attempt. As patients with borderline personality disorder have a significantly higher suicidality and as they deserve a special care for their special suicidal risk, we also reviewed the randomized controlled trials of treatments to improve the suicidality of such patients. Several trials support the effectiveness of structured interventions such as Dialectic and Behavioral Therapy, Mentalisation-Based-Treatment, Transference-Focused-Psychotherapy, Schema-Focused-Therapy, various cognitive-behavioral therapies, etc. However, one of the main limitations seemed to be the lack of study on patients with borderline personality disorder recruited in emergencies departments after a suicide attempt. This review highlights the need to better assess patients from the Emergency Services, by targeting risk factors, and to develop specific care according to risk of recidivism, and in particular to develop therapeutic modalities for acute suicidal patients with a borderline personality disorder. [Copyright &y& Elsevier]

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Abstract: The Psychodynamic Diagnostic Manual (PDM), published in 2006 by the Alliance of Psychoanalytic Organisations, had for goal to complement the Diagnostic and Statistical Manual (DSM) published by the American Psychiatric Association. The main complement brought by the PDM is the addition of psychological and psychodynamic dimensions into the DSM''s diagnostics. These addictions are all empirically based, and for this latter reason the PDM seems a sound attempt to articulate the richness of psychodynamic point of view and the reliability of empirically based researches. The goal of this article is, first: present to French professionals the PDM, and, second: to discuss his theoretical and technical choices and his articulation with DSM-IV-R. These discussions are illustrated by the diagnostic of psychotic disorders and the schizoid personality disorders. The PDM''s limits are discussed too, specifically the ambiguity of his relation with the DSM: complement or concurrent? A discussion about the evolution of the DSM-V (publication planned for 2013), some of these evolutions take into account the psychodynamic point of view of the PDM, and their consequences on PDM conclude this article. [Copyright &y& Elsevier]

Abstract: Context: Although psychiatric research uses clear diagnostic criteria to describe bipolar disorders, therapists in clinical practice are often confronted with patients presenting a number of symptoms with different degrees of intensity and belonging to more than one diagnostic category. With respect to this actual clinical complexity, there is an increasing interest in a dimensional approach of psychopathological traits to gain better understanding of mental disorders. In the 1980s, Robert Cloninger elaborated on a psychobiological model to explain personality in clinical groups as well as in general population. His model was then operationalised with a questionnaire evaluating temperament (harm avoidance, novelty seeking, reward dependence and persistence) and character (self-directeness, cooperativeness, self-transcendence): the Temperament and Character Inventory (TCI). Objective: To review all studies conducted in adult bipolar samples on temperament and character according to Cloninger''s psychobiological model. Materials and methods: A search was conducted on MedLine and PsycInfo for all articles written in English or French, between 1986 and September 2008, on temperament and character in bipolar disorder. The words bipolar disorder or mania had to be associated with the following keywords temperament, TCI, Cloninger, TPQ, harm avoidance, novelty seeking, reward dependence. Results: Across studies, compared to the general population, bipolar subjects have significantly higher harm avoidance, higher novelty seeking and lower self-directness. Some studies have investigated differences between bipolar disorders and other psychopathologies like depression, and borderline personality disorder. Among studies on depression and bipolar disorder, there is no consensus on the findings. Compared to borderline personality disorder patients, bipolar disorder subjects have lower harm avoidance and higher self-directness and cooperativeness. This finding is consistent with Cloninger''s hypothesis that all personality disorders have lower self-directness than any axis I disorder. With respect to other temperament and character traits, studies yielded results either contradictory or non-significant. No difference was found when the bipolar group was subdivided according to the clinical presentation (type I vs II) and the suicidal risk, apart from harm avoidance. Bipolar subjects with substance related disorders displayed higher novelty seeking and lower persistence, which might be explained by a low dopaminergic activity that had to be compensated with drug intake. Low persistence causes greater difficulties to overcome substance dependence. However, it is not possible to determine whether these temperament characteristics are specifically linked to bipolar disorder, substance related disorders, or both. Similar limitations apply to bipolar patients with comorbid anxiety disorders, who presented higher harm avoidance and lower self-directness. Conclusions: Across studies, there are limitations which impede the generalization of the findings to other clinical populations. Age, gender, cultural characteristics, mood status during evaluation, group size, versions of the TCI questionnaire, suicidal risk, clinical type (BP I vs II) and comorbidity differ from one study to another. These methodological variables should be controlled in future studies. Nevertheless, adult bipolar patients appear to present a different temperamental profile than other clinical groups and general population. Therefore, Cloninger''s psychobiological model of temperament remains an interesting avenue for future researches in bipolar disorder. [Copyright &y& Elsevier]

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Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Objectif: L’objectif principal de ce travail est d’évaluer l’impact de la transformation hormonochirurgicale sur les différents domaines importants de la vie quotidienne des transsexuels. Le second objectif est de rechercher l’influence de différents facteurs susceptibles d’influencer la qualité de vie tels que le sexe et la personnalité des sujets. Méthode: Une étude de la personnalité sera ainsi effectuée grâce à l’inventaire de personnalité d’Eysenck (EPI) afin d’analyser deux dimensions de la personnalité (l’extraversion et le névrosisme). Trente-huit sujets ayant suivi une transformation hormonochirurgicale sont inclus dans cette étude. Résultats: Les résultats montrent que l’opération de changement de sexe améliore la qualité de vie des transsexuels dans différents domaines pertinents (les transsexuels sont tous satisfaits de leur conversion sexuelle, [28/30] satisfaits et [2/30] moyennement satisfaits, leur qualité de vie s’améliore après chirurgie sur le plan social [21/30] et sexuel [25/30]). Cependant, il existe des différences entre les transsexuels masculins et féminins en ce qui concerne la qualité de vie (les transsexuels FM ont une meilleure vie sociale, professionnelle, amicale et un bien-être psychologique plus important que les transsexuels MF). Enfin, les résultats de cette étude ne mettent pas en évidence l’influence de certains facteurs de personnalité tels que l’extraversion et le névrosisme sur le niveau de qualité de vie des sujets transsexuels opérés. [Copyright &y& Elsevier]

Abstract: In addition to the clinical factors of the diagnoses of mental pathology in general and schizophrenia in particular, and in addition to the social factors being able to precipitate or contextualise the recourse to the violence of these patients, the question of the comorbidity appears to have to be raised. Indeed, personality disorders, in particular antisocial personality disorder, substances abuse and the comorbidities raise the relevance to wonder about the existence of typologies of patients violent one, understand, envisage and also direct the assumption of responsibility. [Copyright &y& Elsevier]

Abstract: Objectives: Using complementary methods, Gard et al. (2007) reported that schizophrenia patients reported as much pleasure in the moment as controls in their daily lives and on a measure of trait consummatory pleasure (consummatory subscale of the Temporal Experience of Pleasure Scale [TEPS-CONS]) but the schizophrenia patients reported experiencing less trait pleasure in anticipation of future events (anticipatory subscale of the TEPS [TEPS-ANT]) compared to healthy controls. The aim of the present study was to replicate the Gard et al. (2007) study using the French version of the TEPS. Patients and method: Hundred and twenty-five university students were recruited as well as 162 inpatients with either schizophrenia or mood, neurotic or personality disorders. All participants completed the French versions of the following rating scales: the 18-item TEPS, the 61-item revised Physical Scale (PAS) and the 41-item Social Anhedonia Scale (SAS), the 14-item Snaith Hamilton Pleasure Scale (SHAPS) and the 21-item Beck Depression Inventory-II (BDI-II). We also created PAS anticipatory (PAS-ANT) and PAS consummatory (PAS-CONS) scales from the university student sample. Firstly, we examined the construct, concurrent validities and reliability of the TEPS using respectively confirmatory factorial analyses (CFA) to test the two-factor structure of the TEPS, Pearson''s correlations between the ten-item TEPS-ANT or eight-item TEPS-CONS and the other anhedonia scales and Cronbach''s alpha coefficients. Secondly, we compared the three groups (university students, schizophrenia subjects, other psychiatric subjects) using analyses of variance (ANOVA) on the measures of anticipatory and consummatory anhedonias. Results: For the results of the CFA, we used three parameters to test the adequacy of the data to the model: the normed chi-square, the root mean square residual and the root mean square error of approximation. The three parameters were respectively for the university and psychiatric samples: 1.66, 0.09, 0.074 and 2.19, 0.09, 0.087. Cronbach''s alpha coefficients were satisfactory (>0.7) for the TEPS-ANT. Significant correlations were observed between either the TEPS-CONS or the TEPS-ANT and the anhedonia scales suggesting satisfactory concurrent validities. Analyses of Variance (ANOVA) reported significant difference between groups for the TEPS-ANT but not for the TEPS-CONS. Similar results were observed using the PAS-ANT and PAS-CONS. Conclusion: The French version of the TEPS had satisfactory psychometric properties and replicated the Gard et al. (2007) study reporting that schizophrenic subjects had low anticipatory pleasure than healthy controls but did not differ on consummatory pleasure. Moreover, the difference on anticipatory pleasure between healthy and schizophrenic subjects was independent of depression and there was no difference between schizophrenic subjects and non-schizophrenic psychiatric controls concerning anticipatory pleasure. Further studies are needed to explore the hypothesis that specific subgroups of schizophrenic subjects (for exemple, deficit schizophrenic subjects) could be more anhedonic in either form of anhedonia (anticipatory and/or consummatory anhedonia), additionally comparisons should be further made with psychiatric controls without a schizophrenia diagnosis. [Copyright &y& Elsevier]

Abstract: Alexithymia has been described in several psychiatric disorders as well as in borderline personality but there is no study that explores this emotional deficiency in dependent personality. The aim of the study was to test the hypothesis that dependent personalities were more alexithymic than nondependent personality disorders. Methods: Three hundred and five subjects were recruited among a population of patients requesting descriptive certificates of assault and battery after aggressions have occurred. The subjects filled out three questionnaires: the Toronto Alexithymia Scale (TAS-20), the Beck Depression Inventory (BDI), the questionnaire of the Structured Clinical Interview for DSM-IV (SCID-II). Using the SCID-II, the 305 subjects were divided into three subgroups: 179 without personality disorders, 108 with nondependent personality disorders and 18 with dependent personality disorders. Analyses of variance and chi square tests were done to compare the TAS-20 scores or the rates of alexithymic subjects among the three subgroups. To control the potential effect of depression analysis of covariance (ANCOVA) was also done using the BDI score as covariate. Results: Dependent personalities had higher scores on the TAS-20 than nondependent personality disorders or controls. The means (m) and standard deviations (S.D.) of the TAS-20 scores were respectively: m =61.17 (S.D.=11.28), m =52.53 (S.D.=12.44), m =43.62 (S.D.=12.5). Moreover, this difference remains significant when depressive severity was controlled using analysis of covariance (F (2, 301)=5.28, p <0.001). The rates of alexithymic subjects among the three groups were respectively: 19.4% (without personality disorders), 40.8% (nondependent personality disorder), 77.8% (dependent personality disorder). The difference was significant (χ2 =28.42, df=2, p <0.001). Discussion: Dependent personalities were significantly more alexithymic than other personality disorders and these differences cannot be explained by depression. One of the main limitations of the study was the use of questionnaires rather than clinical interviews to diagnose personality disorders. Moreover, anxiety and stress were not rated although they can explain elevated levels of alexithymia. Our results must be confirmed using prospective methodology to test the hypothesis that alexithymia constitutes a stable characteristic in dependent personality disorders. [Copyright &y& Elsevier]

Abstract: This study examines relations between emotional factors (anxiety and depression), normal and pathological personality, and risk-taking behavior in 11 BASE-jumpers comparing to a control group (n =11). Method: All the subjects have been evaluated with self-report questionnaires measuring their emotional states before and after the jump, their involvement in risk-taking behavior, sensation seeking, personality disorders, anxious and depressive symptomatology. Results show a significant effect of BASE-jump practice on emotional state. They have higher scores on the thrill and adventure seeking subscale, they show more drug consumption and more accidents than control group. We found also clinical elements of pathological personality solely from cluster B of the DSM-IV-TR classification among BASE-jumpers. Emotional factors are correlated with borderline personality in this same group. Discussion: We analyzed those results depending on emotional and behavioral dysregulation, and their specifics involvement in borderline personality, risk-taking behaviors, and also addiction. Sensation seeking could be especially reinforced on the base of a borderline personality with the possibility of a build-up of risk which may put individuals addict to it. [Copyright &y& Elsevier]

Abstract: Detention for reasons of public safety, an exceptional measure created by the French law of February 25, 2008, concerns individuals sentenced for certain major crimes who have a serious personality disorder and who present a very high risk of re-offending after their release. This measure involves placing the individual in a special socio-medicolegal center after the sentence has been served. The system raises several forensic issues: was it necessary, considering the already numerous repressive measures available in France? What can be considered as a serious personality disorder? How is the supposed considerable dangerousness of the individual to be evaluated? In their critique of the increasing complexity of the French system of repression, the authors propose a unique law on the safeguarding of society and social rehabilitation, which involves periodic scientific assessment of criminal dangerousness: before sentencing, during the detention, before the criminal''s release and, if necessary, in the community. The new regulations concerning the declaration of criminal irresponsibility for mental disorder provide little progress except for the possibility for certain judges to order forensic placement of criminals as well as conditions (prohibitions and obligations) concerning them after their confinement in a psychiatric establishment. Finally, the recent procedures of the February 25, 2008 law continue to refer to the practice of the legal psychiatric report, whereas this method no longer meets the requirements of the modern scientific practice of criminology and is incapable of correctly assessing serious criminal behaviour. [Copyright &y& Elsevier]

Abstract: Carbon monoxide intoxication (COI) can result in severe neuropsychiatric lesions that are however granted little attention in literature. Following the description of affective and neurological symptoms in a 37-year-old female patient five years following COI, we will review, across the literature (Medline1974–2006), the long-term neuropsychiatric consequences, etiopathogenic hypotheses, prognoses and treatments to apply. Subjective symptoms are reported by the quasi-totality of patients for over more than 30 years following COI. More than half of patients are diagnosed as suffering from cognitive impairments and other neurological symptoms after years following COI. Affective disorders are observed in almost three-fourths of patients and personality disorders in more than half. Numerous cerebral lesions and perfusion disorders can be observed through IRM, PET scan and SPECT and related to the clinical symptomatology of the patient. COI may constitute a risk factor in the waking of long-term neuropsychiatric disorders in a context of environmental and neurobiological complex factor interaction. A close follow-up must be envisaged with neuropsychiatric assessments and regular neuroimagery in order to adapt at best therapeutic interventions to the patient''s clinical status. First and foremost prevention and education remain the key solution to the reduction of morbidity and mortality of COI. [Copyright &y& Elsevier]

Abstract: Although serial killers have always existed, individualizing this concept as well as giving a consensual definition and universal typology is still a problem nowadays. The authors present an overview based on the current literature, more specifically on definitions, categorization, epidemiology and clinical area. Psychopathological aspects are also developed and focused on different topics: psychopathy, sexual sadism, fantasies, and childhood. Serial murder is a world-wide phenomenon which has an increasing incidence even in the countries where the global criminality rate is decreasing, as for example in the United-States. The reasons are numerous and often lead to inconvenient explanations. A serial killer is generally a Caucasian, aged between 20 and 40, who is often socially and familiarly well integrated, often suffering from personal and especially familial psychiatric conditions. Many serial killers act alone, and plan their crime a long time in advance. They choose their next victims with highly precise criteria, approached then and win their trust. Few serial killers act in an impulsive way and do not select their victims. In this precise case, these are very often psychotic. Generally, serial killers have a psychopathic personality disorder with a sexual sadistic dimension. Psychopathy implies a lack of affection and a loss or a total absence of empathy. A gravely offended childhood with physical and psychological violence, a chaotic familial dynamic, and lot of sexual, violent and dead fantasies are the common denominator of these murderers. Nowadays, even if they are regularly on the highlights of the media, serial killers still remain an enigma. Neurobiological and neurophysiological approaches, through the functional neuroimagery for example, could be interesting paradigms in order to try to understand and decode how these people work and, in this way, prevent their emergences. [Copyright &y& Elsevier]