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There are only a few epidemiology studies of personality disorders in the general population related with gender distribution. Due the important relevated actually increase in the clinic and non clinic environment of this type of disorders, the intention of this work is to study the prevalence of the personality disorder (PD) by gender in a sample of 684 students of the city of Barcelona (Spain).
It has been administrate the questionnaire Personality Diagnostic Questionnaire-4+ (PDQ-4+) Spanish version. That assessed the 12 PD following DSM-IV criteria (the 10 PD specifics of the axis II and the 2 PD of the appendix) (Huang and cols., 2007).
The analysis obtained, there are the comparison of dimensional scores (t test of Student) and the prevalence's by gender (test χ2).
In general, the totally scores of the PDQ-4+ show that the woman obtain higher scores of PD presence than the man. Related with the specific scales, the scores of the woman is significantly in the two analysis paranoide, avoidant, obsessive-compulsive and depressive; on the contrary the man in the antisocial.
Research on personality and substance use has shown that some traits of personality might be involved in the onset and later development of addictions. According to Gray's Reinforcement Sensitivity Theory (RST; Gray, 1981), there are two basic brain systems that control behaviour and emotions (Corr, 2004): the Behavioural Inhibition System (BIS) and the Behavioural Activation System (BAS). It has been suggested that high levels of BAS sensitivity predispose psychopathological conditions that are characterized by a pathological engagement in approach behaviours, such as alcohol and drug abuse (Franken, Muris, Georgieva, 2006)
The aim of the present research was to analyse individual differences in the BIS and BAS in a sample of cocaine dependent patients in comparison to a non-clinical population group.
To carry on this study a number of BIS/BAS related scales were administered in a sample of 30 cocaine dependent patients and in a non-consumers control group of 30 participants recruited from general population.
Cocaine addict patients showed higher BAS scores, specifically in Sensitivity to Reward, Non-planning Impulsivity, Motor Impulsivity and Cognitive Impulsivity in comparison to the control group. Moreover, the Disinhibition scale, of the Sensation Seeking Scale, a measure also related to BAS activity, predicted age of onset of cocaine consumption.
These results suggest that BAS might be a vulnerability factor of cocaine misuse, while BIS might be a protector factor.
Psychotherapy is considered the primary treatment for Borderline Personality Disorder (BPD) and Dialectical Behavior Therapy (DBT) is one of the most effective, based on empirical data (Lieb et al.,2004). Pharmacotherapy strategies have been successful in decreasing some core symptoms like impulsivity (Oldham,2005). Topiramate has been effective against BPD anger, considered as an expression of affective instability and a proxy measure of impulsivity (Nickel et al.,2004;2005).
To analyze the topiramate contribution in the aggressive impulsivity decrease with BPD patients treated by DBT.
23 BPD patients, treated with DBT, participated in the study. Patients were evaluated with SCID-I and SCID-II. Topiramate dosage was adapted to the frequency and severity of self-aggressive impulsive behaviors.
The influence of topiramate in behavior outcomes was analysed using step by step multivariated regression analysis.
Topiramate didn't decrease suicidal attempts number, but had strong influence in parasuicidal behaviors (Standarized Betha=0.57;t=3.16,p<0.05) and in the reduction of emergencies visits (Standarized Betha=0.22;t=2.151, p<0.05). The medium topiramate dosage was 200 mg UID (100-500mg).
Topiramate can be helpful, as a symptom-targeted pharmacotherapy, for self-aggresive impulsive behavior with BPD patients treated by DBT.
The available information on the cost of illness of Borderline Personality Disorder (BPD) is overtly insufficient for policy planning. Our aim was to estimate the costs of illness for BPD in Catalonia (Spain) for 2006.
This is a multilevel cross-design synthesis study combining a qualitative nominal approach, quantitative ‘top-down’ analysis of multiple health databases, and ‘bottom-up’ data of local surveys. Both direct and indirect costs have been estimated from a governmental and societal perspective.
Estimated year-prevalence of BPD was 0.7% (41,921 cases), but only 9.6% of these cases were treated in the mental health system (4033 cases). The baseline of the total cost of BPD in Catalonia was 45.6 million €, of which 15.8 million € (34.7%) were direct costs related to mental health care. The cost distribution was 0.4% in primary care; 4% in outpatient mental health care; 4.7% in hospitalisation; 0.7% in emergency care; and 24.9% in pharmacotherapy. Additionally, the cost of drug addiction treatment for persons with BPD was 11.2%; costs associated with sheltered employment were 23.9% and those of crime and justice were 9.7%. Indirect costs – including temporary sick leave and premature death (suicide) – represented 20.5% of total costs. The average annual cost per patient was 11,308 €.
An under-reporting of BPD was identified by the experts in all health databases and official registries. Most of the BPD costs were not related to mental health care. Amongst the direct cost categories, pharmacotherapy had the largest proportion despite the lack of specificity for BPD. This distribution of costs reinforces the idea of BPD complexity related to an inadequate and inefficient use of health resources.
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