The purpose of the study was to review prescribing guidelines and clinical practices for EUPD.

MEDLINE and PsycINFO were searched for all English-language articles published 2000-2016 and containing the keywords “emotionally unstable personality disorder”, “borderline personality disorder”, “pharmacotherapy”, “drug treatment” and “treatment guidelines”.

NICE guidelines (2009) recommend pharmacotherapy should not be used for EUPD but for comorbid conditions only. In line with the American Psychiatric Association practice guideline, the Dutch and German guidelines recommend antipsychotics for cognitive-perceptual symptoms. However, in contrary to mood stabilisers they question the efficacy of antidepressants on impulsivity and affective dysregulation.

Studies on clinical practice showed 68% of borderline patients without comorbid disorder in UK were using antidepressants, 59% antipsychotics, 59% sedatives and 23% mood stabilizers. Similar results reported Paolini et al with polypharmacy in 83.5% of cases.

All international guidelines recommend psychological therapies as the first-choice in EUPD treatment but diverge with respect to pharmacotherapy use. NICE and Australian guidelines abstain from psychotropics what may prevent to some degree counterproductive polypharmacy, but also can refrain from temporary pharmacological support when needed. More RCTs for pharmacotherapy use in EUPD are needed but meanwhile using pharmacotherapeutic algorithms for specific symptom domains might be the way forward.

The author has not supplied his/her declaration of competing interest.

As more or less stable personality traits of the person, temperament, intellect and body is what makes an individual unique compatibility with the environment.

The purpose of this research was standardizing the questionnaire of personality disorder cluster A. On the basis of realizing criterion standard, DSM- 5.

1303 people from universities of Tehran and Alborz provinces (753 females and 550 males) were examined by using the randomized sampling method. The questions of the questionnaire were conformed Dr. ShahramVaziri on the basis of Iran s population and culture. Then the reliability was tested and accomplished simultaneously Millon(MCMI-III) questionnaire.

After computing the correlation scales of Millon test with each of the questions, 20 questions that showed the highest correlation and diagnosis coefficient were chosen and scored again in next stage.

Investigating the psychometric component of three scales (Paranoid 60%, Schizoid 66%, Schizotypal 59%) shows that they are reliable and defensibly valid. It can be said that questions related to all three measures paranoid, schizoid and schizotypal of acceptable psychometric properties and reliability are desirable.

The authors have not supplied their declaration of competing interest.

Narcissistic personality disorder influences relationships and beliefs in different life spheres.

We aimed to measure narcissism among Bulgarian adults by establishing validity of two scales measuring narcissism, specifying some social and demographic factors and differentiating narcissistic features.

One hundred and thirty-four Bulgarians (17–62 years old, M = 31; SD = 11) were examined with two scales measuring narcissism. Higher score on Narcissistic personality disorder scale from the Personality Diagnostic Questionnaire-4 correlated positively (r = .346; P < .001) with higher score on A. T. Beck and J. S. Beck's scale measuring Narcissistic beliefs from Personality Belief Questionnaire that indicated their validity.

No significant gender differences in narcissism were found, with female participants prevailing in the sample (n = 118). Family status (FPDQ−4(4,128) = 0.593; pPDQ-4 = 569; FPBQ(4,128) = 0.295; pPBQ = .881), occupational status – student, employed or unemployed (FPDQ−4(4,128) = 0.593; pPDQ−4 = .569; FPBQ(4,128) = 0.295; pPBQ = .881), secondary or university education (tPDQ−4(112) = 1.809; pPDQ−4 = .073; tPBQ(112) = 1.338; pPBQ = .184), and the length of work experience did not differentiate narcissism (RPDQ−4 = .168; tPDQ−4 = −1.853; pPDQ−4 = .066; RPBQ = .063; tPBQ = −0.681; pPBQ = .497). Advance in age was related to diminished levels of narcissism (RPDQ−4 = .21; R2PDQ−4 = .044; BPDQ−4 = −0.034; tPDQ−4 = −2.463; pPDQ−4 = .015). Higher narcissism was related to the belief of being a special person (70.8%) and to the perceptions of other people as being envy of one's personality–own achievements (60.9%).

Narcissistic personality disorder is rare in the studied Bulgarian adult population – 4.5% of the subjects (n = 6) had the highest levels of narcissism on both scales that corresponded to the proportion of 6% prevalence of lifetime narcissism in USA, according to Stinson et al.

The authors have not supplied their declaration of competing interest.

H&F Multidimensional Perfectionism Scale is a widely used measure of perfectionism developed to measure Self-oriented perfectionism (SOP), Socially-prescribed perfectionism (SPP) and Other-oriented perfectionism (OOP) dimensions. The original scale comprises 45-likert items. We have previously developed a short version of The H&F-MPS, with 13 items, showing adequate validity in a sample of university students, using principal component analyses method with factors varimax rotation.

To examine the factor structure of the H&F-MPS13 with confirmatory factor analysis (CFA), using a different sample of Portuguese university students.

The sample comprises 245 university students (68.9% females), with a mean age of 20.95 years (SD= 2.19; range= 17–33) who completed the H&F-MPS13. CFA was used to test the model suggested by prior exploratory factor analyses of H&F-MPS13.

After correlated errors, we obtained a good fit for the second-order factor (X2/d= 2.577; CFI= 0.928; GFI= 0.915, RMSEA= 0.080; P[rmsea ≤ 0.05] = 0.001). The H&F-MPS13 showed acceptable internal consistency (α= 0.77) and the three dimensions presented Cronbach's alphas ranging between acceptable and good (α OOP = 0.67; SPP = 0.73; SOP = 0.89).

The H&F-MPS13 obtained through CFA is a reliable and valid measure to assess perfectionism in Portuguese university students.

The authors have not supplied their declaration of competing interest.

The purpose of this study was to investigate relationship between personality traits and mental health in athlete students. This study was a descriptive and correlation design.

Sixty athletes students were randomly selected and responded to NEO-PIR inventory and General Health Questionnaire (GHQ 28). NEO assesses five personality traits: Neuroticism (N), Extroversion (E), Agreeableness (A), Openness to new experience (O) and Conscientiousness (C), and GHQ assesses four dimensions: Somatic symptoms (A), Anxiety (B), Social withdrawal (C) and Depression (D). NEO assesses five personality traits: Neuroticism, Extroversion, Agreeableness, Conscientiousness, Openness to experience. The data were analyzed with Pearson correlation test.

The findings showed that there was positive significant correlation between neuroticism with somatic symptoms and depression, and negative significant correlation between extroversion, agreeableness, openness to new experience and conscientiousness with depression.

Based on findings, it is concluded that physical exercises and sport plans have positive effects on mood and affect of students, and decrease physical and mental diseases in athletes students.

The authors have not supplied their declaration of competing interest.

To study the association of dissociative symptoms and specific psychopathological dimensions in a sample of patients with Borderline Personality Disorder (BPD).

An observational analytic study was conducted. Patients with BPD were administered the Diagnostic Interview for Borderline (DIB-R) and Dissociative Experience Scale (DES–II).

Participants were 34 adult patients with BPD. The majority presented with dissociative symptoms (65.6%; n = 21). A statistical significant correlation was found between DES total score and DIB-R subscales: depression (P = 0.04), feeling of loneliness and emptiness (P = 0.005), sexual deviation (P = 0.002) and intolerance to loneliness (P = 0.01). Furthermore, depersonalization was statistically correlated with the severity of borderline psychopathology (DIB-R total score- P = 0.04), suicidal behavior (P = 0.001) and interpersonal problems (P = 0.04). Derealization was significantly correlated with cognition (P = 0.02), psychotic thought (P = 0.004) and intolerance to loneliness (P = 0.02).

Dissociative symptoms are not easy to detect in the clinical daily work. More than a half of patients with BPD presented with dissociative symptoms detected with a specific rating scale. Particularly, only some specific psychopathological dimensions are correlated with dissociation and need to be assessed in patients with BPD.

The authors have not supplied their declaration of competing interest.

Patients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown a high risk to develop a DSM cluster B (i.e., Borderline, OR = 13.16; Antisocial, OR = 3.03; Narcissistic, OR = 8.69) and DSM Avoidant personality disorder (OR = 9.77). Similarly, higher rates of DSM cluster B personality disorder were found among adult ADHD patients (6-25%) than general population. Although some authors investigated the prevalence of personality traits and disorders among adult ADHD patients, no studies have been yet reported about the assessment of Millon's Evolution-Based Personality profiles in adult ADHD patients.

To explore the prevalence of personality traits and disorders among adult ADHD patients.

Millon's personality traits and disorders were assessed in a consecutive sample of 35 adult ADHD outpatients accessing the Service for Adult ADHD of the AOU San Luigi Gonzaga (Orbassano, TO) using the Millon Clinical Multiaxial Inventory–III (MCMI-III).

According to the MCMI-III manual, ADHD patients in our sample showed more frequently both Cluster C and Cluster A traits and disorders, with a high prevalence of avoidant/depressive (8.6%/14.3%) and negativistic/self-defeating (20%/5.7%) personality disorders. Conversely, we found a low prevalence of Narcissistic (5.7%) and Histrionic (5.7%) traits, and no patient showed Borderline personality traits or disorder.

Unexpectedly, the dimensional assessment of adult ADHD personality reveals a high prevalence of cluster C and cluster A personality traits and disorders, and a low prevalence of cluster B personality disorders.

The authors have not supplied their declaration of competing interest.

Personality plays a crucial role in a person's behavior, emotions and cognitive patterns and shows an important relationship with several variables such as marital status, mental disorders or parenting models. However, little is known about the relation between the parental Big Five personality traits (Neuroticism, Extraversion, Openness, Conscientiousness and Agreeableness) and children psychopathology regardless of the diagnostic of their offspring.

To analyze the correlation between parents’ Big Five personality traits and their children categorical diagnosis and psychopathology score.

The authors recruited 105 children in the outpatient unit of the child and adolescent psychiatry department of the pediatric hospital of Coimbra and their 117 parents. Parents were assessed using the Portuguese version of Neo Five-Factor Inventory and children psychopathology scores were rated by child and adolescent psychiatrists using the Brief Psychiatric Rating Scale for Children.

Forty-nine children (46.7%) were male and 56 (53.3%) were female, with a mean age of 12.5 ± 3.2 and 13.6 ± 2.9, respectively. Twenty parents (17.1%) were male and 97 (82.9%) were female, with a mean age of 45.8 ± 4.1 and 41.2 ± 5.4, respectively. After excluding children diagnosed with Schizophrenia, bipolar disorder, autism spectrum disorders and intellectual developmental disorder, Pearson's correlation coefficients were significant between: parents’ neuroticism and children Uncooperativeness (0.211), Manipulativeness (0.238), Hallucinations (0.257), Sleep difficulties (0.296) and Disorientation (0.204); parents’ agreeableness and children hostility (−0.228); and parent's conscientiousness and children disorientation (−0.231), all P < 0.05.

These preliminary results suggest that parental personality traits may influence psychopathological outcomes in their children. Data are still being collected to clarify the nature of this relationship.

The authors have not supplied their declaration of competing interest.

Correlations between psychiatric disorders and overweight/obesity are reported in the literature. The study aimed at detecting correlations between psychiatric disorders, temperamental traits and body image perception in overweight and obese patients who seek surgical lipostructuring treatments.

28 overweight/obese patients (age 18–60 yrs, BMI 25 to 34.9 at recruitment) were enrolled in the period March 2008–June 2011 between those referring to the outpatient service for Obesity-related lipodystrophisms of the Institute of Plastic Surgery. Presence of psychiatric disorders, temperamental traits and body image perception were evaluated, and compared to a control group (n = 25) from general population sharing clinical/demographic features. Psychiatric evaluation was based on acquisition of clinical history, Mini-International Neuropsychiatric Interview, Beck Depression Inventory, Yale Brown Scale (YBOCS), Paykel Life Events Scale, NEO Five Factory Inventory, Tridimensional Personality Questionnaire (TPQ), Body Shape Questionnaire (BSQ).

The patients group presented higher scoring in lifetime depression and BSQ with moderate/mild concern with body shapes. With regard to personality traits, TPQ revealed higher score in subscale RD4 (dependence/independence) in the patients, while controls scored higher in “openness to experience” NEO-FFI sub-scale. At YBOCS obese patients presented higher prevalence of obsessive characters.

The affective sphere is a relevant feature in obese patients, but also obsessive traits, as negative body shape perception and temperamental and personality characteristics appear to be involved in leading patients to seek surgical consultation. These aspects are implicated in medical/surgical outcome and compliance to treatments.

The authors have not supplied their declaration of competing interest.

Essential hypertension (EH) is one of the most common diseases of the cardiovascular system. Today scientists discover more and more patients whose blood pressure values during work appear to be higher than those values during free time. This form of EH is called “hypertension at work”.

To indicate psychological defense mechanisms in patients with “hypertension at work”, as compared with ‘classical’ EH and healthy individuals.

Defense mechanisms were evaluated by the survey “The Life Style Index”. Eighty-five patients with ‘Hypertension at work’ (mean age was 45.9 ± 2.8) and 85 patients with ‘classical’ EH (mean age was 47.4 ± 4.5 years) took part in the study.

The results showed the dominance of low level psychological defences. The most common mechanisms were denial, projection and regression. More mature defense processes included reaction formation and rationalization. The patients with ‘Hypertension at work’ significantly (P < 0.05) differs from second group by more frequent representation of displacement, denial, projection and reaction formation. Comprehensive interpretation of our findings suggested that affection of EH patients (specifically ‘Hypertension at work’) can be characterized by dominance of negative emotions and aggressive tendencies which would be projected, denied or suppressed. Such a complex of defense mechanisms is typical for those, who knows, based on own experience, that uncontrolled negative emotional reactions could be unsafe in social environment.

Our findings can be considered as a basis to define a “risk group” amongst EH patients by an attribute of “emotional well-being” disorder and to develop psychological recommendations for them.

The authors have not supplied their declaration of competing interest.

The DSM-5 Section III proposes a dimensional-categorical model of conceptualizing personality and its disorders, which includes assessment of impairments in personality functioning (criterion A) and maladaptive personality traits (criterion B). The Personality Inventory for DSM-5 (PID-5) is a self-report, composed of 220 items, organized into 25 facets nested in five domains of personality differences, and was developed to operationalize criterion B.

This study explores the factor structure of the Portuguese adaptation of the PID-5.

The five-factor structure that has emerged in previous studies with the PID-5 (cf. Krueger & Markon) is expected to be replicated in the current study.

Exploratory factor analyses with varimax oblique rotation were conducted on a sample of Portuguese adults from the general population (n = 379, Mage = 31.49, SD = 14.16, 25.3% males, 74.7% females).

A six factor structure was retained in which the first 5 factors resemble the PID-5 domains. The model showed good fit indices (KMO = 0.897). The total explained variance was 68.25%. All the facets but four had primary loadings on the expected factor.

The similarity of results across studies and nationalities contributes to the validation of the Portuguese translation of the PID-5 and highlights the structural resemblance among the DSM-5 model and the five factor model (FFM) and the personality psychopathology-five model (PSY-5), drawing attention to the relevance of these models for the diagnosis of Personality Disorders.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Hyperprolactinemia is a common endocrinological disorder. Some data suggest that psychological factors (e.g. personality traits) may play a role in hyperprolactinemia genesis.

Increased prolactin level (PRL) is described as clinical observations in some patients, usually with a diagnosis of borderline personality disorder. In the international literature there is lack of broader description and information of clinical implications of this phenomenon.

The aim of the study is to evaluate the prevalence of hyperprolactinemia in patients with diagnoses F40-F69 according to ICD-10 and an evaluation of the changes in PRL after psychotherapy.

The study population comprised 64 patients, mainly females (73%), with primary diagnosis of neurotic or personality disorder. Prolactin level was measured during the first and last week of the psychotherapy. Between the measurements patients underwent intensive short-term (12 weeks) group psychotherapy in a day hospital for neurotic and behavioural disorders.

Hyperprolactinemia was found in 41% of males and 42.4% of females in the study group. After psychotherapy significant reduction in prolactin level was observed in 80% of woman with hyperprolactinemia.

Hyperprolactinemia is observed in almost 40% of patients with neurotic and personality disorders. Psychodynamic psychotherapy can be a significant factor improving PRL level in patients with neurotic and personality disorders, specifically women.

The authors have not supplied their declaration of competing interest.

Dialectical behavior therapy has demonstrated effectiveness for patients suffering from co-morbid borderline personality and substance use disorder. The current study tries to replicate results of previous studies in a mixed gender sample of Egyptian outpatients.

The aim of the current study was to examine the effectiveness of DBT without drug replacement relative to treatment as usual “TAU” in improving behavioral outcomes related to SUD and BPD, and improving emotional regulation.

Forty outpatients with co-morbid BPD and SUD in Alexandria and Cairo were assigned for one year either to comprehensive DBT program (20 patients), or TAU defined as ongoing outpatient psychotherapeutic treatment from referring center (20 patients). Patients were assessed at baseline and follow up assessment at 4, 8, 12 and 16 months was done using Arabic version of Difficulties in Emotion Regulation Scale (DERS), urine multidrug screen and time line follow-back method for assessment of alcohol and substance use history.

Following one year of treatment, DBT group showed significantly lower doses of drugs used, DERS score, rates of hospital admission, ER visits, suicidal attempts and episodes of NSSI. Also, DBT patients showed markedly increased retention in treatment and longer duration of total alcohol abstinence and other drugs of abuse. Positive outcomes were maintained for four months post-treatment.

DBT demonstrated superior efficacy in comparison to TAU for treatment of Egyptian patients suffering from co-morbid borderline personality and substance use disorder across behavioral domains of SUD, BPD and reduction hospital admission, emergency room visits and DERS score.

The authors have not supplied their declaration of competing interest.

Burnout and depression are ordinarily assessed within different time frames. Burnout is most frequently assessed on an annual or a monthly basis whereas depression is generally assessed over a one- or two-week period. This state of affairs may have partly obscured the burnout-depression relationship in past research and contributed to an underestimation of burnout-depression overlap.

We investigated burnout-depression overlap using time-standardized measures of the two constructs. We additionally examined whether burnout and depression were differently associated with work-related effort and reward, occupational social support, and intention to quit the job.

We enrolled 257 Swiss schoolteachers (76% female; mean age: 45). Burnout was assessed with the Shirom-Melamed Burnout Measure and depression with a dedicated module of the Patient Health Questionnaire. Work-related effort and reward were measured with a short version of the Effort-Reward Imbalance Scale and occupational social support with a subscale of the Job Content Questionnaire. Intention to quit the job was assessed with 3 generic items (e.g., “I plan on leaving my job within the next year”).

We observed a raw correlation of .82 and a disattenuated correlation of .91 between burnout and depression. Burnout's dimensions (physical fatigue; cognitive weariness; emotional exhaustion) did not correlate more strongly with each other (mean r = .63) than with depression (mean r = .69). Burnout and depression showed similar associations with the job-related factors under scrutiny.

Burnout and depression may be empirically-redundant constructs. Measurement artifacts probably contributed to an underestimation of burnout-depression overlap in many studies.

The authors have not supplied their declaration of competing interest.

The concept of the Dark Triad (DT) consists of the dimensions of Machiavellianism, narcissism, and psychopathy, and has gained increased interest within the last 15 years for its predictive power to explain success in the fields of economy, politics, and professional sport. However, recent research suggests that the associations between DT and behavior are not as uniform as expected.

Investigating the associations between DT traits and vulnerable narcissism, mental toughness, sleep quality, and stress perception.

A total of 720 participants between 18 and 28 years took part in the study. The sample consisted of military cadres in the US (n = 238), Switzerland (n = 220), and of students from the university of Basel (n = 262). Participants completed self-rating questionnaires covering DT traits, mental toughness, vulnerable narcissism, sleep quality, and perceived stress.

Irrespective of the sample, participants scoring high on vulnerable narcissism also reported higher DT traits, lower mental toughness, poor sleep quality, and higher scores on perceived stress.

The present pattern of results suggests a more fine-grained association between DT traits and further behavior, calling into question to what extent DT traits might be a predictor for greater success in the fields of economy, politics or elite sports. Specifically, vulnerable narcissism seems to be key for more unfavourable behavior.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Systemic lupus erythemataus is a chronic inflammatory disease of the multimedia system that appear on renal involvement, cortical-mucous, bloody, and neurotic.

The target of this study is to examine the effect of treatment recognition based on mental conscious on decreasing depression intensity on lupus disease and three month follow up.

The method of study is semi test by targeted random selection in access in which we have used of pre-test by observe group. Volume of sample includes 200 women afflicted by lupus and among them about 20 ones were ready to cooperate and in study duration were in related improvement situation and has been evaluated. They have been grouped in the two test group (ten persons) and observe one (10 persons) in which two persons has been excluded from test group and we have excluded two persons from observe group, too. Test group have received eight MBCT treatment sessions but observe group has not received any treatment. Beck depression questionnaire (BDI-II) and brief signs of psychology questionnaire (BSI-53) has been performed as pre-test and after clinical test, post-test and three-month-follow up has been done. We have used of descriptive statics and co-variance for analysis.

Findings has shown that treatment recognition based on mental consciousness, meaningfully have an effect on decreasing remained signs of depression.

Three-month-follow up has shown that treatment recognition based on mental consciousness, had an effect on depression disorder, anxiety disorder, and lupus patients.

The authors have not supplied their declaration of competing interest.

Multi-systemic family therapy is a type of psychotherapy that base on the assumption that all kinds of difficulties in individuals are at least partly explained by dysfunctions in the family system and other systems to which the individual belongs.

This study examined associations between bullying behavior and family ethos, and provides data for changes after treatment with Multi-systemic family therapy-Integrative model, as a culturally sensitive approach.

Thirty-six adolescents with bullying behavior and their families were evaluated. Participants were randomly assigned into two groups: Family therapy group (FT-G) and Control group (CG). The FT-G was treated with integrative model for 6 months; the focus of FT sessions was on proximity-control goals and plans, bugs in the plans, emotive, and types of relations between family members programs. The CG was treated with the same frequency as the FT-G, but with interventions consisting of a detailed survey of their mental health, adolescents’ feelings, daily routines and life events. Every month, data were collected through interviews, questionnaires, observation facilitating techniques and observations of a family play therapy.

In the study participated 36 outpatient adolescents ages 14–16. Seventeen adolescents were male and 19 female (Fig. 1).

At baseline, 70 percent of participants met criteria for more than one of the following disorders, by ICD-10: conduct disorder, substance use, bulimia, borderline personality disorder, and attention deficit/hyperactivity disorder. Six months after the baseline measurement, there was a significant decrease in bullying behavior, substance use, smoking, excessive social media use, and anger control for the FT-G compared with the CG.

The author has not supplied his/her declaration of competing interest.