A Voxel-Based Morphometry Study of Frontal Gray Matter Correlates of Impulsivity

Impulsivity is a personality trait exhibited by healthy individuals, but excessive impulsivity is associated with some mental disorders. Lesion and functional, neuroimaging Studies indicate that the ventromedial prefrontal region (VMPFC), including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC) and medial prefrontal cortex, and the amygdala may modulate impulsivity and aggression. However, no morphometric study has examined the association between VMPFC and impulsivity. We hypothesized that healthy subjects with high impulsivity would have smaller volumes in these brain regions compared with those with low impulsivity. Sixty-two healthy Subjects were Studied (age 35.4 +/- 12.1 years) using a 1.5-T MRI system. The Barratt impulsiveness scale (BIS) was used to assess impulsivity. Images were processed using an optimized voxel-based morphometry (VBM) protocol. We calculated the correlations between BIS scale scores and the gray matter (GM) and white matter (WM) volumes of VMPFC and amygdala. GM volumes of the left and right OFC were inversely correlated with the BIS total score (P = 0.04 and 0.02, respectively). Left ACC GM Volumes had a tendency to be inversely correlated with the BIS total score (P = 0.05. Right OFC GM Volumes were inversely correlated with BIS nonplanning impulsivity, and left OFC GM volumes were inversely correlated with motor impulsivity. There were no significant WM volume correlations with impulsivity. The results Of this morphometry Study indicate that small OFC volume relate to high impulsivity and extend the prior finding that the VMPFC is involved in the circuit modulating impulsivity. HUM Brain Mapp 30:1188-1195, 2009. (C) 2008 Wiley-Liss, Inc.

Programa de competências pessoais e sociais para adultos em exclusão social

Trabalho apresentado em XIII Congreso Internacional Galego-Portugués de Psicopedagoxía, Área 8 Interculturalidad, inclusión social y educación. Universidad da Coruña, 3 de Setembro de 2015.

Avaliação de mudanças na personalidade no processo psicoterapêutico : Estudo de caso

Dissertação de Mestrado apresentada ao ISPA - Instituto Universitário

Prevalence of mental disorders among sexual offenders and non-sexual offenders

OBJECTIVE: To evaluate the prevalence of mental disorders in convicted sex offenders admitted to the Psychiatric Custody and Treatment Hospital (Forensic Psychiatric Facility). METHOD: 89 patient records of males admitted from March 2005 to August 2006 were analyzed. The analysis included evaluation of two study groups: Group I comprised subjects who had committed sex offenses (sexual offenders) while Group II contained subjects convicted for other crimes (non-sexual offenders). Variables studied were: age bracket, years of schooling, marital status, skin color, place of birth, previous psychiatric admissions and psychiatric diagnosis. RESULTS: Mental retardation and personality disorders were the mainly diagnoses in Group I (sexual offenders) (61,76% and 29,41% respectively). In the other hand, schizophrenic subjects predominated in Group II (non-sexual offenders) (82,93%). CONCLUSION: Different from international data, we have found low prevalence of personality disorders among Brazilian forensic population and we believe that it's due to a distinguishing characteristic of the Brazilian legal system, which does not consider personality disorder a mental disease, thus, not prompting these patients to civil commitment.

Presence of dual diagnosis between users and non-users of licit and illicit drugs in Brazil

ABSTRACT Objective Investigate the occurrence of dual diagnosis in users of legal and illegal drugs. Methods It is an analytical, cross-sectional study with a quantitative approach, non-probabilistic intentional sampling, carried out in two centers for drug addiction treatment, by means of individual interviews. A sociodemographic questionnaire, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Mini-International Neuropsychiatric Interview (MINI) were used. Results One hundred and ten volunteers divided into abstinent users (group 1), alcoholics (group 2) and users of alcohol and illicit drugs (group 3). The substances were alcohol, tobacco, crack and marijuana. A higher presence of dual diagnosis in group 3 (71.8%) was observed, which decreased in group 2 (60%) and 37.1% of drug abstinent users had psychiatric disorder. Dual diagnosis was associated with the risk of suicide, suicide attempts and the practice of infractions. The crack consumption was associated with the occurrence of major depressive episode and antisocial personality disorder. Conclusion It was concluded that the illicit drug users had a higher presence of dual diagnosis showing the severity of this clinical condition. It is considered essential that this clinical reality is included in intervention strategies in order to decrease the negative effects of consumption of these substances and provide better quality of life for these people.

Encoding dysfunctions in a dynamic-static paradigm for visuospatial working memory in first-episode psychosis patients: a 2-year follow-up study.

Aim: To investigate static and dynamic visuospatial working memory (VSWM) processes in first-episode psychosis (FEP) patients and explore the validity of such measures as specific trait markers of schizophrenia. Methods: Twenty FEP patients and 20 age-, sex-, laterality- and education-matched controls carried out a dynamic and static VSWM paradigm. At 2-year follow up 13 patients met Diagnostic and Statistical Manual (of Mental Health Disorders) - Fourth Edition (DSM-IV) criteria for schizophrenia, 1 for bipolar disorder, 1 for brief psychotic episode and 5 for schizotypal personality disorder. Results: Compared with controls, the 20 FEP patients showed severe impairment in the dynamic VSWM condition but much less impairment in the static condition. No specific bias in stimulus selection was detected in the two tasks. Two-year follow-up evaluations suggested poorer baseline scores on the dynamic task clearly differentiated the 13 FEP patients who developed schizophrenia from the seven who did not. Conclusions: Results suggest deficits in VSWM in FEP patients. Specific exploratory analyses further suggest that deficit in monitoring-manipulation VSWM processes, especially involved in our dynamic VSWM task, can be a reliable marker of schizophrenia.

Substance use and suicidal conduct: a study of adolescents hospitalized for suicide attempt and ideation.

AIM: To study the prevalence of psychoactive substance use disorder (PSUD) among suicidal adolescents, psychoactive substance intoxication at the moment of the attempt, and the association between PSUD at baseline and either occurrence of suicide or repetition of suicide attempt(s). METHODS: 186 adolescents aged 16 to 21 y hospitalized for suicide attempt or overwhelming suicidal ideation were included (T0); 148 of them were traced again for evaluations after 6 mo (T1) and/or 18 mo (T2). DSM-IV diagnoses were assessed each time using the Mini International Neuropsychiatric Interview. RESULTS: At T0, 39.2% of the subjects were found to have a PSUD. Among them, a significantly higher proportion was intoxicated at the time of the attempt than those without PSUD (44.3% vs 25.4%). Among the 148 adolescents who could be traced at either T1 or T2, two died from suicide and 30 repeated suicide attempts once or more times. A marginally significant association was found between death by suicide/repetition of suicide attempt and alcohol abuse/dependence at baseline (OR=3.3, 95% CI 0.7-15.0; OR=2.6, 95% CI 0.7-9.3). More than one suicide attempt before admission to hospital at T0 (OR=3.2, 95% CI 1.1-10.0) and age over 19 y at T0 (OR=3.2, 95% CI 1.1-9.2) were independently associated with the likelihood of death by suicide or repetition of suicide attempt. CONCLUSION: Among adolescents hospitalized for suicide attempt or overwhelming suicidal ideation, the risk of death or repetition of attempt is high and is associated with previous suicide attempts--especially among older adolescents--and also marginally associated with PSUD; these adolescents should be carefully evaluated for such risks and followed up once discharged from the hospital.

Interferència dels trastorns de personalitat en la capacitat parental. Comparació entre població normal i diagnosticada

En aquesta investigació, hem comparat tres mostres (amb diagnòstic de transtorn de la personalitat, amb trets disfuncionals de la personalitat i sans) per tal de valorar quina disposa d’un funcionament parental més acurat. Dels resultats obtinguts, malgrat el petit tamany de la mostra, podem afirmar que els progenitors sans obtenen millors resultats que els altres dos, i que els que disposen de trets disfuncionals tenen un funcionament més adequats que els que tenen un diagnòstic.

Quelle place pour la psychothérapie dans la psychiatrie publique [What place for psychotherapy in public psychiatry?].

The question of the place of psychotherapy in psychiatric public care is posed in this article. We will address this question first by presenting two clinical and research programmes which were implemented in a clinical psychiatric unit, section Karl Jaspers (Service of General Psychiatry) of the Department of Psychiatry CHUV, in Lausanne with the collaboration of the University Institute of Psychotherapy. The first one puts forward psychodynamic psychotherapy of depressed inpatients; the clinical programme and the research questions on efficacy of this treatment are discussed. The second focuses on the early treatment of patients with Borderline Personality Disorder, in particular in its research question on the effect of the motive-oriented therapeutic relationship in this process. We conclude by underlining the convergences of the two programmes.

International ADHD in substance use disorders prevalence study.

Dr Van Hout has been invited by the ICASA network and IASP research team [Drs Geurt van de Glind; Trimbos Institute, The Netherlands; Dr Pieter-Jan Carpentier, ICASA; Josep Antoni Ramos-Quiroga, University of Barcelona, Spain, Professor Dr Frances Levin, University of Columbia, New York, USA and Professor Dr. Wim van den Brink, University of Amsterdam, The Netherlands] to undertake the research protocol for Ireland as part of this European study of the prevalence of ADHD in adult patients referred for treatment of addiction problems. The research team at Waterford Institute of Technology, School of Health Sciences will undertake this national study as part of the International Collaboration on ADHD and Substance Abuse [ICASA] â?~International ADHD in Substance Use Disorders Prevalence Studyâ?T [IASP study]. The International Collaboration on ADHD and Substance Abuse [ICASA] will provide Dr Van Hout and her team with full support from ICASA of the measurement instruments available and a central database at the University of Amsterdam, and will undergo training for procedures for data capture from Dr van de Glind, Trimbos Institute, The Netherlands. Eight European countries (Norway, Sweden, the Netherlands, Belgium, France, Spain, Switzerland and Hungary) USA and Australia have already participated in the first phase of the IASP study, which will close in September 2011. Over 2500 Substance Use Disorder [SUD] patients were sampled with approximately 38% scoring positive on the ADHD screener (ASRS). Of these 2500 patients over 1000 patients were evaluated on ADHD, Depression, Bipolar Disorder, Anti-Social Personality and Borderline Personality Disorder. A preliminary estimate of the prevalence of ADHD in SUD treatment seeking patients was recorded at 20 %. The second phase of study [IASP 2011] will commence in September 2011 for countries including Ireland, South Africa, Egypt and Brazil. Dr Van Hout has also been invited to partake in a systematic review paper on the risk factors for development of SUD in children/adolescents with ADHD in collaboration with the ICASA foundation.This resource was contributed by The National Documentation Centre on Drug Use.

Mental health services for homeless: patient profile and factors associated with suicide and homicide.

This study aimed to establish a profile of users of the mental health service for homeless in Cork, comparing this group with those attending a General Adult Service. The homeless group were significantly more likely to be male (89% v 46%), unemployed (96% v 68%), unmarried (98% v 75%) and under 65 (94% v 83%). Diagnostically, there was a significantly higher prevalence of schizophrenia (50% v 34%); personality disorder (37% v 11%) and substance dependence (74% v 19%) in the homeless service users. They were more likely to have a history of deliberate self harm (54% v 21%) and violence (48% v 10%). Severe mental illness has a high prevalence in the homeless population, with particularly high levels of factors associated with suicide and homicide. Poor compliance and complexity of illness lead to a requirement for significant input from multidisciplinary mental health teams members.This resource was contributed by The National Documentation Centre on Drug Use.

Mental illness, offending and substance misuse.

This leaflet is for members of the public who want to know more about mental illness, offending and substance misuse. We describe what is meant by mental disorder, offending and substance misuse and how often they are seen together. Also we will talk about treatments and other sources of help. We examine whether people with mental illness are more likely to commit violent crimes. Offending and mental health: Mental illness is sometimes called a â?~mental disorderâ?T. This includes schizophrenia, bipolar disorder, drug-induced psychosis, personality disorder, depression, anxiety and post-traumatic stress disorder. These are just some examples of mental disorders. The branch of psychiatry dealing with the assessment and treatment of offenders with mental health problems is called â?~forensic psychiatryâ?T.This resource was contributed by The National Documentation Centre on Drug Use.

Dèficits neuromotors en trastorns de personalitat de l'espectre esquizofrènic : Una visió neuro-anatòmica

Aquest estudi pretén aprofundir, mitjançant tècniques de neuroimatge, en la cerca de diferències volumètriques, tant en volum de substància gris com blanca, que presenten els pacients de trastorns de personalitat esquizoide i esquizotípic amb relació amb un grup control.

Health risk behaviors in adolescents with chronic conditions

OBJECTIVE: The objective of this study was to compare the frequency of risk behaviors and to measure the extent of co-occurrence of these behaviors in chronically ill and healthy adolescents. METHODS: Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health database, a nationally representative survey of 7548 adolescents in postmandatory school aged 16 to 20 years. There were 760 subjects who reported a chronic illness and/or a disability. The comparison group consisted of 6493 subjects who answered negatively to both questions. We defined 8 risk behaviors: daily smoking, alcohol misuse, current cannabis use, current use of any other illegal drug, early sexual debut, eating disorder, violent acts, and antisocial acts. We analyzed each behavior and the sum of behaviors, controlling for age, gender, academic track, parents' education level, depression, and health status. Results are given as adjusted odds ratios using the comparison group as the reference category. RESULTS: Youth with a chronic condition were more likely to smoke daily, to be current cannabis users, and to have performed violent or antisocial acts. Youth with a chronic condition were also more likely to report 3 or >or=4 risk behaviors. CONCLUSIONS: These results indicate that having a chronic condition carries additional risks for engaging in health risk behaviors and emphasize the importance of health risk screening and preventive counseling for young people in general and among those suffering from chronic conditions in particular.

Cuando la mirada y la palabra del otro exigen respuesta: Reflexiones Éticas en el abordaje psicosocial de un caso con funcionamiento intelectual límite (FIL) y trastorno límite de personalidad (TLP)

Este trabajo de investigación pretende realizar una mirada ética “comprometida y crítica” a la realidad psicosocial de las personas que presentan inteligencia límite y trastorno de personalidad atendidas en la unidad de hospitalización especializada de salud mental para personas con discapacidad intelectual. La finalidad es ofrecer, a través del análisis de un caso clínico con problemática social, la pluralidad de situaciones que se dan desde el ámbito socio sanitario que comprometen su atención integral e integradora y que exigen una pluralidad de respuestas no sólo desde la práctica asistencial sino también desde la ética. Se realiza una descripción exhaustiva de su historia patobiográfica y se detiene en el análisis de aquellos problemas éticos más relevantes y significativos aparecidos durante estos dos años. Finaliza con una serie de conclusiones extrapolables a este perfil poblacional que deben realizar una estancia psiquiátrica de media estancia en la red especializada enumerando algunas consideraciones o recomendaciones a tener en cuenta para una atención ética