Personality disorder, formerly referred to as a Character Disorder, is a class of mental disorders characterized by rigid and on-going patterns of feeling, thinking, and behavior. The underlying belief systems informing these patterns are referred to as fixed fantasies or “dysfunctional schemata” (Cognitive modules). The inflexibility and pervasiveness of these behavioral patterns often cause serious personal and social difficulties, as well as a general functional impairment. So the study examined a new view in personality and mental disorders named “Rap” disorder. In the domain we compare the youngster with and without disorder. The Rap disorder people are known with unusual hair model, nihilistic and anarchistic thinking, unusual and bizarre behavior, reading of meaningfulness poet and sings, doing immoral behavior against society norms and so on.

Method research is Causative - Comparative (Ex post facto). 200 youngster, 100 with the disorder and 100 without the disorder, were randomly selected and Eysenc's Personality Questionnaire (EPQ) was administered on them.

Findings showed the Rap youngster are high in extroversion and emotional instability than normal youngster.

It is recommended that the appropriate behavior education specially moral and religious education can avoid tendency to this behavior disorder and reduce the bad effects of the behavior in society.

Identity disturbance is one of the DSM- IV criteria for borderline personality disorder, but there has been little attention to its nature. Four subset of identity disturbance (role absorption, painful incoherence, inconsistency, lack of commitment) have been assessed.

Assess the role of these subsets in patients with borderline personality disorder and examine the relation between identity disturbances with substance- dependency.

This case- control study was conducted on 40 patients with borderline personality disorder referring to Beheshti Hospital in Kerman during 2007-2008; and 40 healthy people who were matched with case group in term of gender, and educational level. Data gathering was done with three questionnaire including a demographic- related questionnaire, disturbance questionnaire (included 35 items), and a questionnaire related to substance- dependency and its related factors. Data analysis was performed using SPSS software (version 11) by mean calculation and t-test and ANOVA.

Mean score of 33 items of identity disturbance questionnaire were greater with significant difference in case group (p < 0.05). Means differences in two groups in all subsets were statistically significant except for role absorption (p < 0.05). Means differences in all subsets in substance- dependent subjects and substance- independent people in both groups were not statistically significant.

Identity disturbance is one of the major criteria for borderline personality disorder, but in different societies the role of its subsets are different. Assessing subsets of identity disturbance has no value in assessing substance- dependency in patients with borderline personality disorder.

This research was carried out to study the association between personality traits and work-family conflict among teachers.

The method of this research was a correlation study. Participants were 100 teachers that answered to NEO & family-work conflict questioners. For analysis the data were stem from the research applied statistical methods, included; mean, standard deviation, T-Test, correlation and multi variable regression.

The results indicated that there was negative and significant relationship between personality traits (included; extraversion, agreeableness, conscientiousness and openness) with family-work conflict. Furthermore, the results of T test did not showed significant difference in personality traits and family-work conflict in males and females teacher. The regression results indicated that two dimensions of traits, neuroticism and agreeableness could explanation %76 of family-work variation. Also, neuroticism dimension could explanation %48 of family work variation. Moreover, the other two dimensions of trait involving; neuroticism and openness could explain %92 of family-work variation.

The results suggested that family-work conflict characteristics had association with personality traits. In addition, the results showed that there was not significant relationship between personality traits and family-work conflicts in males and females teachers.

More than 15% of patients who present to a primary care clinic are considered “difficult” yet interprofessional members of primary care clinics receive little training on how to diagnose and manage these patients.

Become familiar with successful method of workshop development on how to diagnose and manage “difficult” patients to interprofessional audience of six community health centers.

The aim of the workshop was to enhance primary care providers’ capacity to diagnose and manage “difficult” patients as well as serve as a pilot program for a larger conference on managing “difficult” patients.

A half-day workshop was designed to fill this perceived need of community health providers to learn how to diagnose and manage “difficult” patients. The workshop consisted of didactic presentation and case based small group learning.

This workshop served as a pilot program for the development of larger conference for community providers on managing “difficult” patients.

The workshop was evaluated by participants. 100% of respondents agreed that the workshop was relevant to their work and 87.5% of respondents reported that the workshop will alter their clinical practice.

The workshop has met participants’ perceived learning needs as well as served as a pilot program for a larger conference on managing difficult patients.

Among personality disorders (PDs), antisocial and borderline personality disorder are well-studied. However, the remaining PDs (in the following called “minor PDs”) pose major problems in everyday-health care settings. People affected often present with additional axis-l disorders such as substance-related, mood or anxiety disorders, and are among those most difficult to treat.

To systematically review the current evidence of psychotherapeutic treatments for “minor” personality disorders

In the context of Cochrane Collaboration reviews for Cluster A, B and C PDs, exhaustive literature searches were done to identify the current RCT evidence for PD treatments. The electronic search strategies were extended to identify also non-RCT evidence for minor PD treatments. Retrievals were assessed and evaluated by two reviewers independently.

The current evidence for psychotherapeutic treatments of minor PDs is sparse and based on mixed PD samples with co-morbid axis-l disorders in the majority of cases. Reported outcomes focus on specific axis-l disorders or general measures such as overall functioning.

The current evidence is scarce and does not allow for distinct treatment recommendations but undermines the importance of meeting special demands of PD patients by PD-specific treatments. Possible reasons for the paucity of research in this regard will be discussed, also in the light of future developments after DSM-V.

Quality of life (QoL) research has increased during last decates. Psychiatric patients spend many days for their treatment so QoL is something that should be measured for these patients too.

To examine the relationship between dispositional optimism and Quality of life (QOL) among patients suffering from schizophrenia, schizoaffective disorder, bipolar disorder, depression, and other psychiatric conditions from a psychiatric department and to find out the existing correlations with other measures of personality characteristics.

To reveal the underlining correlation between QoL and dispositional optimism.

69 inpatients in a psychiatric ward in Athens-Greece took part in the study.31 (44.9%) of them were males and 38 (55.1%) females. The questionnaires that were used are the Short Form health questionnaire (SF12), the life orientation test-revised (GrLOT-R), the subjective well being scale (SWBC) and the Satisfaction with life Scale(SWLS).

Both Physical (M = 39,9 SD = ±7,2) and Mental (M = 29,4 SD = ±7,8) composite scores are lower than in the greek general population (M = 50 SD = ±6,8). Optimism (M = 14,8 SD = ±4.9) correlates significantly with both mental (p = ,571**) and physical (p = ,438**) health, well being (p = ,427**) and with the days of hospitalization (p = .,261**). Global happiness correlates significantly only with mental health (p = ,493**) and well being (p = ,573**).

Quality of life in mental patients seems to have a mediator and that is Optimism. Optimistic patients seems to have better health related quality of life and well being and stays more days in hospital for treatment needs.

Psychopathy comprises affective (eg lack of empathy, superficial charm, shallow emotions) and antisocial lifestyle features (eg criminal behaviour, impulsivity). The nature of the deficits in empathie responding remain poorly understood but recently authors have claimed that psychopaths know right from wrong but do not care.

To explore the relationship between moral judgement and psychopathic traits in a healthy population (n = 198 females and n = 103 males).

We used a number of online questionnaires to assess key features of psychopathy including primary and secondary psychopathy (Levenson's Psychopathy Scale), moral judgement (Moral Judgement Test), impulsivity (Barratt Impulsivity Scale), life history of aggression (Life History of Aggression questionnaire), and cognitive and affective empathy (Questionnaire of Cognitive and Affective Empathy) in a healthy student population. We explored relationships between moral judgement scores and the other constructs using correlational analysis and comparisons between upper and lower quartiles.

We found correlations that were consistent with current literature for example, total BIS scores correlated strongly with Secondary Psychopathy scores (r = 0.57, p < 0.01). Primary psychopathy correlated with cognitive empathy (r = 0.3, p < 0.01). However, we did not observe any significant correlations between moral judgement scores and psychopathy scores.

In this healthy control population moral judgment scores do not show a significant relationship with psychopathy scores. Low empathy and high impulsivity scores observed in individuals with high psychopathy scores may not be related to a lack of understanding of moral concepts. These findings will have to be confirmed in a clinical population.

Alcohol abuse and dependence are frequently associated with psychiatric disorders and Personality Disorders, with differences among genders. However, only few studies investigated gender differences in personality disorders among alcoholics.

The aim of our study is to investigate personality disorders in a sample of inpatient alcoholics applying Millon Clinical Multiaxial Inventory - III, and to describe gender differences in prevalence and comorbidity of personality disorders.

The study population consist of 206 alcohol dependent patients entering detoxification treatment in a specialized clinic in Italy. At enrollment, patients filled in the Millon Clinical Multiaxial Inventory - III for the assessment of personality disorders and the AUDIT Test for the evaluation of alcohol consumption.

The sample consisted of 150 men and 56 women. According to Millon assessment, 25% percent of men vs 12% of women had one PDs, 16% vs 23% had two PDs, and 46% vs 48% had more than three PDs. A statistically significant higher proportion of women got high scores on Avoidant (21.4% vs 9.3%, p = 0.020), Self-Defeating (50.0% vs 24.0%, p < 0.001), and Borderline scale (42.9% vs 25.3%, p = 0.015). Associations among PD are sporadic among men whilst are very frequent among women. Depressive, Self-Defeating and Borderline PDs are frequently associated both to other PDs and among each other, suggesting a possible female pattern.

Borderline PD is confirmed to be more frequent among alcoholic women than among men. More studies are needed to clarify prevalence and associations of PDs, prognosis, and gender differences in alcoholics patients.

The Borderline Personality (BP) disorder is defined as a limit state between neurosis and psychosis. The symptomatology observed in such disorder seems to be correlated with the dysfunction of specific areas of the human brain, such as cortical and sub-cortical ones.

This report aims to review the state of the art in order to better understand the correlation between the functional anatomy of the brain and the BP disorder, and its relevance to the symptomatic manifestation of this psychopathology.

The stress response of patients with BP disorder seems to be associated with a low-responsive pituitary gland. The frontolimbic abnormalities observed in recent studies seems associated with the difficulty in the emotional management and impulsivity. The findings suggest a reduction of parietal cortex metabolism which appears to be associated to lack of insight and easy hypnotic induction. The disfunction of the amygdala, hippocampus and prefrontal cortex was found to be lateralized on the left hemisphere, whether the structures with increased activation on the right hemisphere were the temporal lobe, ventrolateral prefrontal cortex and posterior parietal lobe. Finally, the aggressive and impulsive behavior of such patients seems to be related with low levels of cortical serotonin.

To our knowledge, some of the neurofunctional findings didn’t match the symptomatic pattern of the BP disorder. From all the relations found, the fronto-limbic deficit is the one with a more relevant influence for the consequent emotional disturbance, a major symptom of this disorder.

There have been numerous studies that reveal attitudes of different social groups in relation to mental illness, but have not been developed none in other chronic diseases such as fibromyalgia.

Our hypothesis is to demonstrate that there are certain beliefs about the disease that determine attitudes, and these beliefs may be related to certain personality patterns.

To determine the relationship between personality dimensions and attribution of causes fibromyalgia.

Evaluation of a sample of medical students, which were administered the following tests: demographic data (age, sex, year of study), Zuckerman-Kuhlman's Questionnaire of personality, level of concern about the disease and survey of possible causes in fibromyalgia.

A total of 34 students were interviewed, between 3rd and 6th grade of Medicine, with a mean age of 24.8 years (sd 5.5). 70.6% were women. 20.6% had contact with the disease (which in most cases a family member diagnosed with fibromyalgia), no statistically significant differences with respect to the concern about the disease, compared with the rest. There is a high level of agreement in the sample in the attribution of cause of fibromyalgia to a genetic predisposition, personality or sleep disorders.

In our study, Neuroticism stands between personality dimension. High scores on this dimension are associated with statistically significant differences (t-student), to attribute the cause “attract attention” (p = 0.02) or the “Influence of the mass media” (p = 0,03) in fibromyalgia.

There are dimensions of personality such as neuroticism, which may influence the attribution of causes of the disease Fibromyalgia.

This study investigated relationship among personality dimensions based on Jungian personality types and stress in university students.

The studied population included 200 students between ages of 19–26 were randomly selected from three universities and Coudron's Stress Inventory (CSI) and Hogan - Champagne's Personal Style Inventory (PSI) were administered on them. PSI assesses eight personality dimensions based on Jungian personality types (introversion-extroversion E/I, intuition- sensing N/S, thinking-feeling T/F, perceiving-judging P/J). The data were analyzed with Pearson correlation coefficient and independent T test.

Findings showed negative correlation between extroversion and stress and positive correlation between introversion and stress. Analysis of personality dimensions showed male are more intuition than female and female are more sensing than male.

Based on findings, considering that introverted are quiet, diligent at working alone, and socially reserved, they make decisions somewhat independently and prodding from situations, cultures, people, or things around them, so facing to stress factors interrupt their own world and reduce their function, cause to variability in situation and stress emerge.

Four psychotherapies have been recognized as effective with scientific evidence for the treatment of BPD, but are long term techniques. It is necessary to explore new time limited psychotherapies in order to be more accessible.

We have developed a specific manualized psychotherapy for BPD named Psychic Representation focused Psychotherapy (PRFP)

To assess the efficacy of the PRFP in BPD in an outpatient care setting compared to a control group receiving psychiatric treatment “as usual” in several specific symptoms and in diminishing the disability due to the illness.

60 subjects with BPD were randomized to one of the two treatment groups. The study group has received PRFP with 20 sessions on a weekly basis; the control group has received treatment “as usual”. Both groups may receive psychopharmacological treatment. The assessment is done in four time-points: at baseline, after the psychotherapy or conventional treatment (six months), and at a six and twelve month's follow-up period.

Preliminary results of the first 30 patients (control group 17, experimental group 13, without significant differences, Age 18–35 years; 70% women) assessed at the baseline and at the end of the intervention (six months). Experimental group reached a statistically significant clinical improvement over the controls in all measured variables: Scales: SCL-90; Zanarini ; MDRS; Barrat; STAI anxiety state; Rosemberg self-esteem and SASS social adaptation.

The preliminary results are encouraging and reveal that this method could be effective. This study state the interest in develop more studies about time limited psychotherapy for BPD.

The aim of research was comparisonal investigation of personality traits and mental health in people with artistic jobs and without artistic jobs.

The research sample was comprised by 70 people with artistic experiences and jobs such as musician, theatre player, poet, actors, local singer, and 70 people without artistic jobs and experiences. The sample's characteristics were measured by Revised NEO Personality Inventory (FFM PI-R) and Goldberg's general health questionnaire (GHQ). Data were analyzed with T independent test.

Findings showed significant differences between variables. People with artistic experiences and jobs were more extroverted, agreeable and conscientiousness in personality traits and were low in components of mental illness than people without artistic jobs and experiences.

Based on results it is concluded that art and its fields such as music, theatre, poem and singing have positive effect on mental health and well-being.

Borderline personality disorder (BPD) patients present a diffuse pattern of unstable interpersonal relations, self-image, affection and considerable impulsiveness.

Describe the circumstances related to prolonged hospitalization of a BPD patient; denote doubts, difficulties, polemics and feelings generated in the care team when managing this situation; and seeking scientific literature support on BPD.

Understand the circumstances related to prolonged hospitalization of a BPD patient and the effects of this situation on the care team.

An exploratory and descriptive research was carried out at the Psychiatric Ward at Ribeirão Preto Medical School Hospital of the University of São Paulo, Brazil. Interviews with five professionals were submitted to thematic content analysis and data from the patient's file were presented as a case report.

Two categories emerged from the interviews. “Team management in conducting the case”: divergencees in case conduction, bad feelings and counter-transference; the patient made demands and wanted to break rules. “Family abandonment”: although ready for discharge, the patient remained hospitalized due to lack of family and economic support. The only alternative was her transfer to a psychiatric hospital. Despite the difficulties, the team considered the experience gained in conducting the case was positive.

Investments are needed in programs aimed at better preparing the family to understand and welcome the patient after discharge from hospital. Moreover, greater cooperation is needed among the social structures of health care, patients and family members.

The peptic ulcer disease (PUD) is a paradigm of the mind body interaction. This model has been a source of much research until the rise of an infectious etiologic model and improvement in pharmacotherapy. To the best of our knowledge, there is no epidemiological data investigating the co-occurrence of PUD with personality disorders based on DSM-IV criteria.

To assess the association between peptic ulcer and a wide range of personality disorders in a large sample representative of the general population in the United States.

Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, on the basis of a face-to-face interview of more than 43,000 adults. Univariate and multivariate logistic regression were used to examine the relationship between self-reported “stomach ulcer” and personality disorders.

All seven personality disorders assessed in the National Epidemiologic Survey on Alcohol and Related Conditions (i.e., avoidant, dependent, obsessive-compulsive, paranoid, schizoid, histrionic, and antisocial personality disorders) were associated with stomach ulcer, with odds ratio ranging from 2.26 (obsessive compulsive personality disorder) to 5.54 (dependent personality disorder). Participants with ulcer were five times more likely to have more than three personality disorders than participants without ulcer. The relationship between ulcer and personality disorders was only slightly attenuated after adjusting for sociodemographic conditions, physical and psychiatric disorders, and addictions.

Self-reported peptic ulcer is associated with increased rates of personality disorders, beyond the influence of psychiatric disorders or addictions.

Psychosom Med. 2010 Aug 17. [Epub ahead of print]

The borderline personality disorder is the most frequent personality disorder in psychiatry.

It causes significant changes in social, family and professional functioning, wish can sometimes be severe enough to cause an alteration of quality of life for this patients.

To assess the quality of life among people with borderline personality in order to improve patients care.

A retrospective study on 25 patients hospitalized in our hospital during the period between 2006 and 2008.

In 92% of our sample, there is a social impact, represented by social and family isolation (64% of cases), separations, divorces (28%). 40% of patients are in a good economical level. 56% of the sample had no education beyond high school, only 36% were able to attend college. In 96% of cases, the symptoms have affected the education and occupation with dropout in 56% fragile employability in 28% and job loss in 12%.

BPD sounds significantly on the social and professional integration of patients, so consequently on the quality of life. Pharmacological treatment alone is not enough. Individual psychotherapy and group rehabilitation activities can contribute on improving the quality of life of borderline subjects.

There has been considerable interest internationally in the assessment and treatment of individuals who have a severe personality disorder and who might pose a high-risk of future recidivism. In the United Kingdom, the ‘Dangerous and Severe Personality Disorder’ (DSPD) programme was initiated to deal with just this group. It is important, however, that the DSPD service is filling a treatment void and not competing with already well-established and effective services for (non-DPSD) personality disordered patients. Objective: To establish whether those admitted to innovative DSPD services are different from those admitted to conventional personality disorder (PD) services.

To compare patients admitted to DSPD services with those admitted to personality disordered (non-DPSD) services.

Sixty patients admitted to DSPD services, under DSPD criteria, were compared with 44 patients admitted to personality disordered (non-DSPD) services within the same high secure psychiatric hospital, on risk measures, including

1. (1) an index of predicted future violence

2. (2) previous offending behaviour and

3. (3) pre-treatment levels of institutional risk-related behaviour.

DSPD patients do pose a greater clinical and management risk, have a higher number of pre-treatment risk-related behaviour, and have a greater number of convictions and imprisonments after age 18, relative to PD patients.

The findings broadly confirm the hypotheses as to the higher risk in DSPD patients and thus offer support for the main purpose of DSPD services: to provide treatment for those who represent the highest priority in terms of treatment need and risk to public protection. Implications are discussed.

Risperidone is an antipsychotic used as the first-line treatment of schizophrenia. Risperidone is metabolised by enzyme CYP2D6. Activity of this enzyme can be predicted by genotypization.

To explore the possibility of different response rate to risperidone in first-episode schizophrenia patients with different CYP2D6 genotype.

To asses the utility of CYP2D6 pharmacogenetic testing in patients with schizophrenia treated with risperidone.

CYP2D6 genotype was assessed in 22 first-episode schizophrenic patients by use of automatic sequencing of DNA isolated from peripheral leukocytes. PANSS score was assessed every week of treatment until the change in medication or patient release.

Response was defined as at least 30% reduction in total PANSS. Differences in response rate between groups were tested by Fisher's exact test.

10 CYP2D6 extensive metabolisers (EM), 8 intermediate metabolisers (IM) and 4 poor metabolisers (PM) were identified. Criteria for response met 4 EM, 4 IM and 1 PM. Differences in response rate between groups were not statistically significant.

Although group of IM had higher response rate than EM and PM, differences in response rate did not reach statistical significance. Further differences may be found by extending the sample size. An useful approach would be also to examine differences in occurrence of adverse effects and subjective tolerance of the treatment.

The study was supported by the grant of Czech Ministry of Health No. NS 9676-4/2008.