1,721,020 research outputs found
Borderline personality disorder and early psychosis: a narrative review
Full text linkAbstract Background The purpose of the present review was to summarize the main literature contribution on the relationship between borderline personality disorder (BPD) and early psychosis. While retracing the historical path of the term “borderline”, specific attention was paid to psychotic and psychotic-like symptoms in BPD. Its relationship with At Risk Mental State was evaluated, as well. Methods This search was conducted on PUBMED/MEDLINE and PsycInfo, looking for “Borderline personality disorder, First Episode Psychosis, Early Psychosis, Ultra-High Risk AND/OR Clinical High Risk” for psychosis. Results Eight pertinent papers were identified on this topic. Their main findings were then discussed. The term “borderline” has undergone different changes in meaning and use, despite always referring to states considered on the fence between neurosis and psychosis. However, considering the history of psychopathology and its relationship with diagnostic manuals, little attention has been given to its psychotic features. Being those symptoms highly burdensome, this neglect has often led to misdiagnosis and under-treatment. Conclusions Psychotic symptoms in BPD can be severe and distressing. Nonetheless they can be easily neglected, and when found they challenge clinicians in defining a differential diagnosis to distinguish between BPD and Psychosis Spectrum Disorders. Given specific needs and interventions for these different conditions, a dimensional, rather than categorical, approach should be considered, as well as specific care pathways and monitoring should be advised
Antipsychotic Treatment in People at Clinical High Risk for Psychosis A Narrative Review of Suggestions for Clinical Practice
No full textPurpose: The “early intervention” paradigm in psychiatry holds significant
promise for preventing psychosis. Recent evidence showed that individuals at
clinical high risk for psychosis (CHR-P) with antipsychotic (AP) prescription
at baseline have higher psychosis transition rates compared with those without
AP, although the underlying cause remains unclear. In this article, we reviewed
international guidelines on early intervention in CHR-P people, paying specific
attention to clinical recommendations on AP treatment. Then, we comment on
these suggestions in the light of recent empirical evidence examining AP prescription in CHR-P populations within “real-world” clinical settings.
Methods: This search was conducted on PubMed/MEDLINE, PsycINFO,
EMBASE, and Google, looking for both “Guidelines AND CHR-P OR
UHR OR Early Psychosis.”
Results: International guidelines generally recommend not using AP as
first-line treatment, but only when psychosocial interventions have failed.
CHR-P people with AP drug showed high prevalence rates and had more
severe clinical picture at entry. Is this a “warning signal” for potentially
higher psychosis transition risk? Is it a direct AP iatrogenic effect? Is it possible to detect specific CHR-P subgroup that may benefit from AP? These
are the questions that this article seeks to explore.
Conclusions: The current framework for identifying CHR-P subjects has
defined psychometric criteria mainly based on positive symptoms. In our
opinion, this is reductive, especially for evaluating therapeutic outcomes
and prognosis. A more comprehensive assessment considering quality of life,
psychiatric comorbidity, persistent negative symptoms, subjective experience of CHR-P psychopathology, and social/personal recovery is thus needed
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Borderline personality disorder vs. mood disorders: clinical comparisons in young people treated within an “Early Intervention” service for first episode psychosis
No full textBackground and Objective: BorderlinePersonalityDisorder(BPD)isunder-investigatedinFirstEpisodePsychosis(FEP).BPDpsychoticmanifestationsandmoodchangesarealsodifficulttodif-ferentiatefromfirstepisodeaffectivepsychosis.Theaimofthisstudywastocomparesociode-mographicandclinicalfeaturesbetweenFEPpatientswithBPDvs.BipolarDisorder(BD)orMajorDepressiveDisorder(MDD)bothatbaselineandacrossa2-yearfollow-upperiod.Methods:224FEPparticipants(49withBPD,93withBDand82withMDD)completedtheHealthoftheNationOutcomeScale(HoNOS),thePositiveAndNegativeSyndromeScale(PANSS)andtheGlobalAssessmentofFunctioning(GAF)scale.Psychiatricdiagnosiswasreformulatedattheendofourfollow-up.Inter-groupcomparisonswereanalyzedusingtheKruskal-WallisortheChi-squaretest.Amixed-designANOVAmodelwasalsoperformedtoassessthetemporalstabilityofclinicalscoreswithinandbetweenthe3subgroups.Results:ComparedtoFEP/BDsubjectsatbaseline,FEP/BPDpatientsshowedhigherdepressivesymptomseverityandlowerexcitementseverity.ComparedtoFEP/MDDatentry,theyhadahigherprevalencerateofsubstanceabuse,alowerinterpersonalimpairmentandashorterDUP
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Rates and predictors of service disengagement in adolescents with first episode psychosis: results from the 2‐year follow‐up of the Pr‐EP program.
Full text linkService disengagement is a major concern for “Early Intervention in Psychosis” (EIP). Indeed, understanding predictors of engagement is important for the efectiveness of mental health interventions, to improve outcome and quality of life, also in adolescents with frst episode psychosis (FEP). No specifc European investigation on this topic in adolescence has been reported in the literature to date. The aim of this study was to investigate service disengagement rate and predictors in an Italian sample of FEP adolescents treated within an EIP program during a 2-year follow-up period. All participants were adolescents help-seekers (aged 12–18 years) enrolled in the “Parma Early Psychosis” (Pr-EP) program. At baseline, they completed the Positive and Negative Syndrome Scale (PANSS) and the global Assessment of Functioning (GAF) scale. Univariate and multivariate Cox regression analyses were performed. 71 FEP adolescents were recruited in this research. During the 2 years of our follow-up, a 25.4% prevalence rate of service disengagement was found. Particularly robust predictors of disengagement were lower baseline acceptance of psychosocial interventions, substance abuse at entry, and lower baseline PANSS “Disorganization” factor score. Approximately, 1/4 of our FEP adolescents disengaged from the Pr-EP program during the frst 2 years of treatment. A possible solution to decrease disengagement and to favor re-engagement of these young individuals might be to provide the option of low-intensity monitoring and support, also via remote technology
Short‐term disengagement from early intervention service for first‐episode psychosis: findings from the “Parma Early Psychosis” program.
Full text linktors
of engagement is crucial to maximize mental healthcare interventions in first-episode psychosis (FEP). No Italian study
on this topic has been reported to date. Thus, the aims of this investigation were: (1) to examine short-term disengagement
rate in an Italian population of FEP patients treated within an EIP service across a 1-year follow-up period, and (b) to assess
the most relevant predictors of disengagement in the first year of treatment.
Methods All participants were young FEP help-seeking patients, aged 12–35 years, enrolled within the “Parma Early Psychosis”
(Pr-EP) protocol. At baseline, they completed the Positive And Negative Syndrome Scale (PANSS), the Health of
the Nation Outcome Scale (HoNOS) and the Global Assessment of Functioning (GAF) scale. Univariate and multivariate
Cox regression analyses were used.
Results 496 FEP individuals were enrolled in this research. Across the follow-up, a 16.5% prevalence of short-term disengagement
was found. Particularly robust predictors of service disengagement were poor baseline treatment non-adherence,
living with parents and the presence of brief psychotic disorder or schizophreniform disorder at entry.
Conclusion About 16% of FEP patients disengaged the Pr-EP program within the first year of treatment. A solution to reduce
disengagement and/or to favor re-engagement of these subjects might be to remain on EIP program caseloads allowing the
option for low-intensity support and monitoring, also via remote technology
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Persistent negative symptoms in young people at clinical high risk of psychosis treated with an Italian early intervention program: a longitudinal study
Full text linkNegative symptoms in CHR-P people are generally not responsive to treatments and commonly related to poorer functional
outcome. However, less research attention has been dedicated to Persistent Negative Symptoms (PNS), defined as clinically
stable negative symptoms of moderate severity evident for at least 6 months. This study aims to (a) determine the prevalence
of PNS in a sample of young people at CHR-P; (b) investigate any association of PNS with functioning and clinical features;
(c) examine longitudinal course of PNS across 2 years of follow-up and changes in PNS severity levels with specialized
treatments. One Hundred Eighty CHR-P participants were recruited and were divided into CHR-P/PNS + and CHR-P/PNS−
subgroups. The clinical assessments were based on the PANSS and the GAF and were conducted at baseline and every
12 months during the follow-up. Twenty four participants showed PNS at entry. Of them, 21 concluded the 2-year followup
period. At baseline, the CHR-P/PNS + participants showed more educational and employment deficits, and more social
and functioning impairment. During the follow-up, the CHR-P/PNS + subgroup had a significant longitudinal decrease in
negative symptoms, which was specifically related to antidepressant treatment. CHR-P/PNS + subjects also showed a higher
incidence of new hospitalization and a lower functional recovery over time. Our findings support that the persistence of
negative symptoms in CHR-P people is longitudinally related to worse daily functioning and more severe clinical conditions
that are at higher risk of hospitalization and are less responsive to specialized treatments
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