Comprehensive psychiatry最新文献

{"title":"Identifying factors strongest associated with clinical, societal and personal recovery in people with psychosis with a long duration of illness","authors":"Stynke Castelein ,&nbsp;Ellen Visser ,&nbsp;PHAMOUS-investigators ,&nbsp;Maarten F. Brilman ,&nbsp;Klaas J. Wardenaar ,&nbsp;Jojanneke Bruins","doi":"10.1016/j.comppsych.2024.152540","DOIUrl":"10.1016/j.comppsych.2024.152540","url":null,"abstract":"<div><h3>Introduction</h3><div>Most studies on recovery of psychotic disorders focus on first-episode populations using premorbid and baseline data to predict recovery. However, many patients experience a long duration of illness and many factors are dynamic and change during life.</div></div><div><h3>Aims</h3><div>To investigate factors strongest associated with clinical, societal and personal recovery, and recovery change scores in people with a long duration of illness using current data measured at the same assessment.</div></div><div><h3>Methods</h3><div>Least absolute shrinkage and selection operator regression analyses with cross-validation were used to identify the correlates of (changes in) clinical (<em>N</em> = 1054), societal (<em>N</em> = 1145) and personal recovery (<em>N</em> = 1187) in people with psychotic disorders. Subsequently, the identified associated factors were included in separate linear regression models, examining the associative strength of the identified variables and overall fit of the models.</div></div><div><h3>Results</h3><div>Better clinical recovery was associated with better societal and personal recovery, experiencing fewer problems with daily functioning and social relations. Participants had a better societal recovery when they were employed, had fewer problems in daily life, less negative symptoms, had a life partner and better clinical recovery. Personal recovery was associated with greater satisfaction with life in general, no depressive mood and increased clinical recovery. Change scores were small with minimal fluctuation and no significant associations with change scores were detected.</div></div><div><h3>Conclusions</h3><div>Recovery domains strongly influence each other in people with a long illness duration of psychosis and should therefore have an equally important focus during treatment.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152540"},"PeriodicalIF":4.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of risk-taking behaviour and suicidality among humanitarian aid workers","authors":"Frédérique Vallières ,&nbsp;Hamed Seddighi ,&nbsp;Áine Travers ,&nbsp;Peter Varah ,&nbsp;Nana Wiedemann ,&nbsp;Cecilie Dinesen ,&nbsp;Kinan Aldamman ,&nbsp;James Lee ,&nbsp;Bonnix Kayabu ,&nbsp;Philip Hyland","doi":"10.1016/j.comppsych.2024.152541","DOIUrl":"10.1016/j.comppsych.2024.152541","url":null,"abstract":"<div><div>In an era of high need for humanitarian assistance, humanitarian aid workers face increased exposure to potentially traumatic events and, correspondingly, a greater risk of psychological distress (e.g., anxiety, depression, posttraumatic stress disorder [PTSD], and burnout). Less studied among humanitarian workers, however, are other known correlates of trauma-exposure: complex PTSD, risk-taking behaviours, and suicidality. The current study examined levels of trauma exposure and rates of trauma-related mental health disorders, risk-taking behaviour, and levels of suicidality among a sample (<em>N</em> = 232) of humanitarian workers located across 52 countries. Multiple linear regression analysis was used to determine which demographic (i.e., sex, age, cadre, years working as an aid worker), psychological (i.e., social support, personality traits), and trauma-related (trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, and dissociation) variables were uniquely associated with risk-taking behaviours and suicidality. Overall, 12.9 % (95 % CI = 8.5 %, 17.2 %) of humanitarian workers met the diagnostic requirements for PTSD, and 8.6 % (95 % CI = 5.0 %, 12.2 %) met requirements for CPTSD. Higher risk-taking behaviours were significantly associated with being male, an international worker, greater trauma exposure, extraversion, neuroticism, and CPTSD symptoms. Suicidality was significantly associated with being an international staff member and higher levels of dissociation. Results are consistent with previous studies citing a high risk of psychological distress among humanitarian workers. Humanitarian aid agencies have a duty of care to their workers - both professional and volunteer - and greater safeguarding measures are necessary to mitigate the risk to mental health brought on by humanitarian work-related stressors.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152541"},"PeriodicalIF":4.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prospective associations between problematic gaming and phubbing among Chinese adolescents: Insights from a cross-lagged panel network model","authors":"Yingying Su ,&nbsp;Yan Chen ,&nbsp;Qian Gai ,&nbsp;Xiangfei Meng ,&nbsp;Tingting Gao","doi":"10.1016/j.comppsych.2024.152542","DOIUrl":"10.1016/j.comppsych.2024.152542","url":null,"abstract":"<div><h3>Background and aims</h3><div>Previous studies are limited in addressing the directionality of temporal relationships between problematic gaming and phubbing symptoms by exploring cross-sectional studies. Therefore, we estimated the longitudinal relationships between individual behavioral addictive symptoms including problematic gaming and phubbing in adolescence, and explored potential sex differences in these relationships.</div></div><div><h3>Methods</h3><div>This study included 3296 participants in Shandong Province, China. Data were collected from November 2021 (mean [SD] age: 15.17 [1.44] years) to May 2023 (mean [SD] age: 17.50 [1.18] years), with females comprising 54.5 % of the sample. Problematic gaming and phubbing were assessed using validated scales at each wave. We construct cross-sectional networks and cross-lagged panel networks (CLPN) to explore the contemptuous and temporal relationships between problematic gaming and phubbing.</div></div><div><h3>Results</h3><div>Contemporaneous networks revealed significant differences in problematic gaming and phubbing networks between males and females. Additionally, temporal network analyses indicated that among male adolescents, feeling anxious when unable to play games was the most influential predictor of subsequent behavioral addictive symptoms. For female adolescents, fantasizing about gaming had the most significant associations with future addictive behaviors. The strongest bridge symptom linking problematic gaming and phubbing for both sexes was focusing on phones rather than engaging in conversation.</div></div><div><h3>Discussion and conclusions</h3><div>The study applied network modeling to panel data from a large, population-based cohort of adolescents, identifying unique longitudinal relationships between problematic gaming and phubbing across symptom domains. It provides valuable insights into the characterization of behavioral addictive symptoms among adolescents and the potential predictive relationships among these symptoms among different sexes, guiding sex-specific targeted interventions for adolescents.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152542"},"PeriodicalIF":4.3,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal thoughts and behaviors in adults with hoarding disorder","authors":"Dariana Gil-Hernández ,&nbsp;Elizabeth McCarthy ,&nbsp;Tatevik Avanesyan ,&nbsp;Pavithra Mukunda ,&nbsp;Marcos Ortiz ,&nbsp;Randy O. Frost ,&nbsp;Peter J. van Roessel ,&nbsp;Michele S. Berk ,&nbsp;Carolyn I. Rodriguez","doi":"10.1016/j.comppsych.2024.152539","DOIUrl":"10.1016/j.comppsych.2024.152539","url":null,"abstract":"<div><h3>Background</h3><div>Hoarding disorder (HD) is characterized by difficulty discarding possessions and clutter that impairs daily functioning. Previous research has demonstrated a high correlation between hoarding behaviors and suicidal thoughts and behaviors; however, there is limited research on suicidal thoughts and behaviors in individuals meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for HD. Our aim in this study was to report our findings about suicidal thoughts and behaviors in a HD sample.</div></div><div><h3>Methods</h3><div>We used existing data from participants meeting DSM-5 criteria for HD (<em>n</em> = 99). Data about suicidal thoughts and behaviors was collected using a structured instrument, the Columbia-Suicide Severity Rating Scale (C-SSRS).</div></div><div><h3>Results</h3><div>Among the 99 participants, 49.5 % and 26.3 % had passive and active suicidal ideation (SI), respectively. Of those with active ideation, 11 participants endorsed thinking about overdose during their most severe SI. 13 participants reported attempting suicide at least once in their lifetime.</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the first study examining suicidal thoughts and behaviors in HD using the structured assessment C-SSRS. In this HD data set, participants reported suicidal thoughts and behaviors at higher rates than the general U.S. population. Our study highlights the importance of screening for suicidal thoughts and behaviors in individuals with HD.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152539"},"PeriodicalIF":4.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role models in gaming: Wishful identification and maladaptive daydreaming mediate the association between desire for fame and game engagement","authors":"Rita Horváth ,&nbsp;Ágnes Buvár ,&nbsp;Róbert Urbán ,&nbsp;Zsolt Demetrovics ,&nbsp;Ágnes Zsila","doi":"10.1016/j.comppsych.2024.152538","DOIUrl":"10.1016/j.comppsych.2024.152538","url":null,"abstract":"<div><h3>Background</h3><div>The popularity of video games has considerably increased in recent years, with approximately 3.24 billion players worldwide in 2021. Empirical evidence suggests that the quality of engagement in video games can determine whether a gaming activity is associated with psychological distress (i.e., problematic gaming) or self-enhancing outcomes (i.e., esports career pursuits). This study investigates the role of influential gaming role models and other external factors relating to fame appeal in gamers' different ways of engagement.</div></div><div><h3>Methods</h3><div>A total of 803 adolescent and adult gamers (89.29 % male, <em>M</em>age = 24.90 years, <em>SD</em> = 6.13) were recruited through an online questionnaire.</div></div><div><h3>Results</h3><div>A path analysis was constructed demonstrating that wishful identification partially mediated the relationship between desire for fame and esports career planning. Moreover, maladaptive daydreaming fully mediated the association between desire for fame and gaming disorder symptoms. Wishful identification with gaming role models predicted both esports career planning and gaming disorder symptoms.</div></div><div><h3>Conclusions</h3><div>The findings shed light on the importance of considering the role of gaming role models in predicting healthy and problematic gaming patterns.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"135 ","pages":"Article 152538"},"PeriodicalIF":4.3,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenting and mental health in protracted refugee situations: a systematic review","authors":"Qusai Khraisha ,&nbsp;Nadeen Abujaber ,&nbsp;Sadhbh Carpenter ,&nbsp;Robert J. Crossen ,&nbsp;Johanna Kappenberg ,&nbsp;Ronan Kelly ,&nbsp;Cameron Murphy ,&nbsp;Orla Norton ,&nbsp;Sophie Marleen Put ,&nbsp;Kate Schnoebelen ,&nbsp;Azza Warraitch ,&nbsp;Stella Roney ,&nbsp;Kristin Hadfield","doi":"10.1016/j.comppsych.2024.152536","DOIUrl":"10.1016/j.comppsych.2024.152536","url":null,"abstract":"<div><h3>Background</h3><div>Refugees' parenting behaviour is profoundly influenced by their mental health, which is, in turn, influenced by their situation of displacement. Our research presents the first systematic review on parenting and mental health in protracted refugee situations, where 78% of all refugees reside.</div></div><div><h3>Methods</h3><div>We pre-registered our protocol and screened documents in 22 languages from 10 electronic databases, reports by 16 international humanitarian organisations and region-specific content from the top 100 websites for each of the 72 countries that ‘host’ protracted refugees. Our criteria were empirical papers reporting parenting and parental mental health data on refugees who are in a protracted refugee situation. Studies including only internally displaced or stateless persons were excluded.</div></div><div><h3>Results</h3><div>A total of 18,125 documents were screened and 30 studies were included. We identified a universal pathway linking macro-level stressors in protracted refugee situations, such as movement restrictions and documentation issues, to symptoms of depression and anxiety, which, in turn, led to negative parenting practices. Addtionally, culture-specific pathways were observed in the way parental mental health and parenting were expressed. Situational (e.g., overcrowding) and relational factors (e.g., spousal dynamics) modulated both of these pathways. Biases in the research included the over-representation of specific protracted refugee situations, overreliance on self-reported data, and a heavy focus on mothers while neglecting fathers and other caregivers. Longitudinal research is needed to clarify the directionality and causality between specific macro-level stressors in a given protracted refugee situation and parental mental health and practices. Refugees were rarely consulted or involved in the design of research about their parenting and parental mental health.</div></div><div><h3>Conclusion</h3><div>In recognising the existing links between protracted refugee situations, parental mental health, and parenting, our systematic review calls for a shift in thinking: from focusing solely on the micro aspects that affect ‘refugee parenting’ to understanding and tackling the broader macro-level stressors that drive them. We urge for larger and long-term research efforts that consider diverse protracted refugee situations, greater investment in science communication and diplomacy with governments, and stronger implementation of durable solutions by states to alleviate the roots of refugee parents' distress and negative parenting practices.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"135 ","pages":"Article 152536"},"PeriodicalIF":4.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Item response theory analysis of the Chinese version compulsive shopping scale","authors":"Shuang Gao ,&nbsp;Xinyan Ma ,&nbsp;HoiKi Tsui ,&nbsp;Jie Wang ,&nbsp;Xueqin Zhang","doi":"10.1016/j.comppsych.2024.152535","DOIUrl":"10.1016/j.comppsych.2024.152535","url":null,"abstract":"<div><div>Compulsive shopping, a behavioral disorder with significant personal and social repercussions, necessitates reliable assessment tools, especially within different cultural contexts. While several scales exist to measure compulsive buying behavior, there is a lack of validated instruments tailored to the Chinese population. This study aimed to examine the psychometric properties of the Chinese version of the Compulsive Shopping Scale (CSS) using Item Response Theory (IRT). A total of 637 young healthy participants (42.5 % males and 57.5 % females), with a mean age of 21.32 years (<em>SD</em> = 2.06), both undergraduate and postgraduate students, were recruited from various cities in China. Sixty-four participants were retested after a two-week interval to assess test-retest reliability. The results indicated that a one-dimensional factor structure was appropriate. The reliability analyses, including test-retest reliability, ω, α, and λ₆ tests, demonstrated good internal consistency. The rating scale model analysis showed infit and outfit MNSQ values between 0.6 and 1.4, indicating a good fit. The item information curve and test information curve indicated a normal distribution of scores. Differential item functioning was observed in two items, suggesting potential gender-related differences. These findings indicate that the Chinese version of the CSS is a reliable and valid instrument for measuring compulsive shopping behaviors in Chinese populations.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"135 ","pages":"Article 152535"},"PeriodicalIF":4.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay of personality pathology and treatment outcome in psychosomatic psychotherapy: A longitudinal analysis using latent change score modelling","authors":"Antonie Louise Bierling ,&nbsp;Stephan Doering ,&nbsp;Kerstin Weidner ,&nbsp;Magdalena Pape ,&nbsp;Henrik Kessler ,&nbsp;Tobias Hofmann ,&nbsp;Matthias Rose ,&nbsp;Katrin Imbierowicz ,&nbsp;Franziska Geiser ,&nbsp;Jörg Rademacher ,&nbsp;Silke Michalek ,&nbsp;Eva Morawa ,&nbsp;Yesim Erim ,&nbsp;Johanna Sophie Schneider ,&nbsp;Martin Teufel ,&nbsp;Armin Hartmann ,&nbsp;Claas Lahmann ,&nbsp;Eva Milena Johanne Peters ,&nbsp;Johannes Kruse ,&nbsp;Dirk von Boetticher ,&nbsp;Ilona Croy","doi":"10.1016/j.comppsych.2024.152532","DOIUrl":"10.1016/j.comppsych.2024.152532","url":null,"abstract":"<div><h3>Introduction</h3><div>While ample data demonstrate the effectiveness of inpatient psychosomatic treatment, clinical observation and empirical evidence demonstrate that not all patients benefit equally from established therapeutic methods. Especially patients with a comorbid personality disorder often show reduced therapeutic success compared to other patient groups. Due to the heterogeneous and categorical personality assessment, previous studies indicated no uniform direction of this influence. This complicates the derivation of therapeutic recommendations for mental disorders with comorbid personality pathology.</div></div><div><h3>Methods</h3><div>Analyzing <em>n</em> = 2094 patients from German university hospitals enrolled in the prospective “MEPP” study, we tested the dynamic interaction between dimensionally assessed personality functioning and psychopathology of anxiety and depression.</div></div><div><h3>Results</h3><div>Longitudinal structural equation modelling replicated the finding that the severity of symptoms at admission predicts symptom improvement within the same symptom domain. In addition, we here report a significant coupling parameter between the baseline level of personality function and the change in general psychopathology - and vice versa.</div></div><div><h3>Discussion and conclusion</h3><div>These results imply that personality pathology at admission hinders the therapeutic improvement in anxiety and depression, and that improvement of personality pathology is hindered by general psychopathology. Furthermore, the covariance between both domains supports the assumption that personality functioning and general psychopathology cannot be clearly distinguished and adversely influence each other. A dimensional assessment of the personality pathology is therefore recommendable for psychotherapy research and targeted therapeutic treatment.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"135 ","pages":"Article 152532"},"PeriodicalIF":4.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142326451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender and trait rumination moderates the link between trait impulsivity and gambling problems severity in young adults","authors":"Natália Kocsel ,&nbsp;Borbála Paksi ,&nbsp;Andrea Eisinger ,&nbsp;Katalin Felvinczi ,&nbsp;Andrea Czakó ,&nbsp;Zsolt Demetrovics ,&nbsp;Gyöngyi Kökönyei","doi":"10.1016/j.comppsych.2024.152533","DOIUrl":"10.1016/j.comppsych.2024.152533","url":null,"abstract":"<div><h3>Aims</h3><div>Trait impulsivity and trait rumination appear to uniquely contribute to problem gambling. However, only a limited number of studies have investigated their relationship with each other, and no study has tested whether their interplay could explain problem gambling. In this study, we aimed to examine these associations, especially focusing on the putative moderator role of gender.</div></div><div><h3>Methods</h3><div>The present study utilized data from the first wave of the Budapest Longitudinal Study, representatively surveying young adults. The final, weighted sample consisted of <em>N</em> = 1202 (649 men; mean age = 28.04 years; SD = 4.31) participants who reported gambling in the past year. Gambling severity was assessed by the Problem Gambling Severity Index (PGSI), trait impulsivity was measured by Barratt Impulsiveness Scale short form (BIS-R-10), while rumination was assessed by the short version of Ruminative Response Scale (RRS).</div></div><div><h3>Results</h3><div>Multiple linear regression analysis showed significant positive association between impulsivity and problematic gambling, and we found that both trait rumination and gender moderated this association, even after controlling for depressed mood, age, level of education, and subjective relative wealth. For men, when the level of trait rumination was high, higher levels of trait impulsivity were associated with an increase in gambling problems. However, these associations were not found among women.</div></div><div><h3>Conclusions</h3><div>Our results suggested that the interplay of trait rumination and trait impulsivity might contribute to problem gambling, potentially by the impulsive desire to alleviate negative mood states. Our results also revealed that these associations could be stronger among men than in women.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"135 ","pages":"Article 152533"},"PeriodicalIF":4.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quo vadis DSM-6? An expert survey on the classification, diagnosis, and differential diagnosis of body-focused repetitive behaviors","authors":"Steffen Moritz ,&nbsp;Luca Noemi Hoyer ,&nbsp;Noam Sarna ,&nbsp;Amitai Abramovitch ,&nbsp;Cristian Curran ,&nbsp;Alessandro S. De Nadai ,&nbsp;Stella Schmotz","doi":"10.1016/j.comppsych.2024.152534","DOIUrl":"10.1016/j.comppsych.2024.152534","url":null,"abstract":"<div><h3>Background</h3><div>Many conditions we now call body-focused repetitive behaviors (BFRBs) have been subject to research for several decades, most notably trichotillomania and skin picking. However, the American Psychiatric Association did not combine these conditions into a single category, body-focused repetitive behavior disorders (BFRBDs), until the fifth edition of the DSM (2013). Several aspects of the disorder remain uncertain and controversial. For example, ongoing debate surrounds which specific conditions fall under this diagnostic category and how to best differentiate BFRBs from conditions such as nonsuicidal self-injury (NSSI). The current article presents results from a survey of experts' opinions on diagnostic criteria, with the goal of refining the diagnostic criteria.</div></div><div><h3>Method</h3><div>We contacted experts on BFRB via various sources and invited them to complete an online survey on the phenomenology, classification, and differential diagnosis of BFRB. We also inquired about possible alternative syndrome labels (e.g., body-focused habit).</div></div><div><h3>Results</h3><div>Data from the final sample of 50 experts demonstrates that most experts agree with the present classification of BFRB/BFRBD as an obsessive-compulsive and related disorder and recommend retaining the labels BFRB or BFRBD. The experts considered the following conditions BFRB, with an agreement of over 60%: trichotillomania, skin picking, dermatophagia, nail biting, and lip-cheek biting. Mixed results emerged for awake bruxism and thumb sucking in adults. Only a minority regarded night bruxism and knuckle cracking as BFRB. To differentiate BFRB from NSSI, the experts noted that the motive behind the urge (self-harm/injury versus release of tension) should be considered. Analyses of a sub-sample of experts with at least six years of clinical and/or research experience yielded results compatible with those of the entire sample.</div></div><div><h3>Discussion</h3><div>The survey supports the usefulness of the BFRBD diagnostic entity. However, some criteria require further refinement. Future editions of the DSM should more explicitly delineate which conditions qualify as BFRB. Furthermore, it is important to give more attention to the primary motivation behind BFRB to distinguish it from NSSI and potentially from stereotypic movement behavior.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152534"},"PeriodicalIF":4.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}