General hospital psychiatry最新文献

{"title":"Pharmacological interventions for antipsychotic-induced weight gain in schizophrenia: A network meta-analysis","authors":"Naveen Chandrashekar Hegde ,&nbsp;Archana Mishra ,&nbsp;Rituparna Maiti ,&nbsp;Biswa Ranjan Mishra ,&nbsp;Debadatta Mohapatra ,&nbsp;Anand Srinivasan","doi":"10.1016/j.genhosppsych.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><p>Antipsychotic-induced weight gain (AIWG) is a significant but frequently neglected adverse effect of first- and second-generation antipsychotic therapy, which may lead to cardiovascular disturbances. The present network meta-analysis (NMA) was conducted to evaluate and compare the effects of available treatment options in antipsychotic-induced weight gain (AIWG).</p></div><div><h3>Methods</h3><p>The data was extracted from 68 relevant clinical trials after a literature search on MEDLINE/PubMed, Embase, Scopus, Cochrane databases and clinical trial registries. Random-effects Bayesian NMA was done to pool the effects across the interventions for the change in body weight from baseline. A network graph was built, a consistency model was run, node split analysis was performed, treatments were ranked as per the SUCRA score and meta-regression was done for the duration of therapy, baseline body weight and treatment strategy as the predictor variables. Finally, the results were sorted based on the certainty of evidence.</p></div><div><h3>Results</h3><p>The drugs showing significant reduction in body weight in order of magnitude of effect size include sibutramine 10 mg (−8.0 kg; −16. to −0.21), metformin 750 mg + lifestyle modification (−7.5 kg; −12 to −2.8), topiramate 200 mg (−7 kg; −10 to −3.4), metformin 750 mg (−5.7 kg; −9.3 to −2.1), topiramate 100 mg (−5.7 kg; −8.8 to −2.5), topiramate 50 mg (−5.2 kg; −10 to −0.57), liraglutide 1.8 mg (−5.2 kg; −10., −0.080), sibutramine 15 mg (−4.5 kg; −8.9 to −0.59), nizatidine 300 mg (−3.0 kg; −5.9 to −0.23) and metformin 1000 mg (−2.3 kg; −4.6 to −0.0046). There was no effect of duration of follow-up, baseline body weight and, preventive versus therapeutic strategy on weight reduction in AIWG.</p></div><div><h3>Conclusion</h3><p>Metformin 750 mg with lifestyle modification was the most effective treatment for AIWG, followed by topiramate 200 mg, metformin 750 mg, and topiramate 100 mg with moderate certainty of evidence.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"90 ","pages":"Pages 12-21"},"PeriodicalIF":7.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141324489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives for improving treatment initiation for new episodes of depression in historically minoritized racial and ethnic groups","authors":"Vanessa Simiola ,&nbsp;Lisa R. Miller-Matero ,&nbsp;Catherine Erickson ,&nbsp;Sixiang Nie ,&nbsp;Rowyda Kazan ,&nbsp;Jordan Gootee ,&nbsp;Gregory E. Simon","doi":"10.1016/j.genhosppsych.2024.05.011","DOIUrl":"10.1016/j.genhosppsych.2024.05.011","url":null,"abstract":"<div><h3>Objective</h3><p>Depression is one of the costliest and most prevalent health conditions in the U.S. with 21 million adults having experienced at least one major depressive episode. Despite the availability of evidence-based treatments for depression, a large proportion of people with new diagnoses fail to initiate formal mental health treatment. Although individuals across all racial and ethnic groups fail to initiate treatment for depression, historically minoritized racial/ethnic groups are at even greater risk.</p></div><div><h3>Method</h3><p>Thirty-four participants representing historically underserved racial and ethnic populations from two large health care systems in the U.S. participated in qualitative interviews or focus group to identify factors that impede and facilitate depression treatment initiation in primary care settings.</p></div><div><h3>Results</h3><p>Participants identified individual and systemic barriers and facilitators of treatment initiation for depression and suggested several ideas for increasing treatment engagement (i.e., increased communication and education from providers, community events, information on social media).</p></div><div><h3>Conclusion</h3><p>Novel interventions are needed to improve treatment initiation following initial diagnosis of depression in primary care settings. Findings from this study offer suggestions for improving treatment initiation in traditionally underserved communities.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"89 ","pages":"Pages 69-74"},"PeriodicalIF":7.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Warning signs in a period of acute risk for suicide attempt: The utility of count- and combination-based classification","authors":"Andrew K. Littlefield ,&nbsp;Katie P. Himes ,&nbsp;Kenneth R. Conner ,&nbsp;Courtney L. Bagge","doi":"10.1016/j.genhosppsych.2024.05.009","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.05.009","url":null,"abstract":"<div><h3>Objective</h3><p>This study sought to establish if models involving the specific combinations of identifiable behavioral warning signs (WS; i.e., alcohol use, suicidal communications, preparation of personal affairs, experiencing negative interpersonal life events) for a suicide attempt outperformed a simpler count model of WS to distinguish an acute risk period (the six hours prior to a suicide attempt) from a control period (a matched six-hour period the day prior).</p></div><div><h3>Method</h3><p>Generalized linear mixed models tested all logical combinations of four behavioral WS in addition to a count variable of the number of behavioral warning signs. For the count variable, receiver operating characteristic curve analysis was utilized to determine the optimal cut point for the number of endorsed WS.</p></div><div><h3>Results</h3><p>Area under the curve (AUC) compared classification across all models, with the count model demonstrating similar classification performance to the best multivariate model (AUCs of 0.72 and 0.73, respectively), with an optimal cut point of endorsing one or more WS.</p></div><div><h3>Conclusion</h3><p>Although determinations of acute risk should be informed by multiple sources of information, this study suggests a relatively simple count-based approach that considers the presence of one (or more) behavioral WS may be used as a potential indication of increased acute risk for suicide attempt.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"89 ","pages":"Pages 55-59"},"PeriodicalIF":7.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141090983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes following hip fracture surgery in adults with schizophrenia in Ontario, Canada: A 10-year population-based retrospective cohort study","authors":"Hina Ansari ,&nbsp;Kinwah Fung ,&nbsp;Angela M. Cheung ,&nbsp;Susan Jaglal ,&nbsp;Earl R. Bogoch ,&nbsp;Paul A. Kurdyak","doi":"10.1016/j.genhosppsych.2024.05.010","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.05.010","url":null,"abstract":"<div><h3>Objective</h3><p>To understand immediate and long-term outcomes following hip fracture surgery in adults with schizophrenia.</p></div><div><h3>Methods</h3><p>Retrospective population-based cohort study leveraging health administrative databases from Ontario, Canada. Individuals aged 40–105 years with hip fracture surgery between April 1, 2009 and March 31, 2019 were included. Schizophrenia was ascertained using a validated algorithm. Outcomes were: 30-day mortality; 30-day readmission; 1-year survival; and subsequent hip fracture within 2 years. Analyses incorporated Generalized Estimating Equation models, Kaplan-Meier curves, and Fine-Gray competing risk models.</p></div><div><h3>Results</h3><p>In this cohort study of 98,126 surgically managed hip fracture patients, the median [IQR] age was 83[75–89] years, 69.2% were women, and 3700(3.8%) had schizophrenia. In Fine-Gray models, schizophrenia was associated with subsequent hip fracture (_sdRH, 1.29; 95% CI, 1.09–1.53), with male patients with schizophrenia sustaining a refracture 50 days earlier. In age- and sex-adjusted GEE models, schizophrenia was associated with 30-day mortality (OR, 1.31; 95% CI, 1.12–1.54) and readmissions (OR, 1.40; 95% CI, 1.25–1.56). Kaplan-Meier survival curves suggested that patients with schizophrenia were less likely to be alive at 1-year.</p></div><div><h3>Conclusions</h3><p>Study highlights the susceptibility of hip fracture patients with schizophrenia to worse outcomes, including refracture, with implications for understanding modifiable processes of care to optimize their recovery.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"89 ","pages":"Pages 60-68"},"PeriodicalIF":7.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0163834324000914/pdfft?md5=dd9b4e0654516d56eed9baa9b4931f7a&pid=1-s2.0-S0163834324000914-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097815","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":"Three safety indices for the fourteen most prescribed antidepressants in the US, 2013–2020","authors":"Zachary Poliacoff","doi":"10.1016/j.genhosppsych.2024.05.002","DOIUrl":"10.1016/j.genhosppsych.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><p>This study provides three prevalence-based metrics of potential harm, the fatal toxicity index (FTI), serious morbidity index (SMI) and healthcare utilization index (HUI) for fourteen of the most prescribed antidepressants in the US.</p></div><div><h3>Method</h3><p>For the years 2013–2020, adverse events for single drug exposures were obtained from the National Poison Data System. Prescription estimates were taken from the Agency for Healthcare Research and Quality's Medical Expenditure Survey. 95% confidence intervals were calculated using a Poisson distribution. Chi-square testing was used where significance was not clear.</p></div><div><h3>Results</h3><p>SSRIs and SNRIs had the lowest overall indices (FTI 0.02–0.26). Bupropion's FTI (0.27–0.43) was not statistically significantly different from that of imipramine (FTI 0–1.3, <em>p</em> = .62) or nortriptyline (FTI 0.25–0.78, <em>p</em> = .22), though its SMI and HUI were significantly greater. There was a statistically significant difference in all indices between TCAs (<em>p</em> &lt; .0047). The difference between the FTI of all SSRIs did not remain significant after correction (<em>p</em> = .045).</p></div><div><h3>Conclusion</h3><p>SSRIs and SNRIs are safer than alternative agents on all measures. Bupropion exposure was as likely to cause mortality, and more likely to cause morbidity or require treatment in a healthcare facility, than TCAs nortriptyline and imipramine.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"90 ","pages":"Pages 1-5"},"PeriodicalIF":7.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141132555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional relationship between chronic pain and depressive symptoms in middle-aged and older adults","authors":"André O. Werneck ,&nbsp;Brendon Stubbs","doi":"10.1016/j.genhosppsych.2024.05.007","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the bidirectional association between chronic pain and depressive symptoms among middle-aged and older adults from two prospective cohort studies.</p></div><div><h3>Methods</h3><p>We used prospective data (12y of follow-up) from the English Longitudinal Study of Ageing (<em>n</em> = 9149, 5018 women, 65.0 ± 10.2y) and the Health and Retirement Study (<em>n</em> = 16,883, 9810 women, 66.9 ± 10.3y), including data from seven waves of each cohort between 2006 and 2018/2019. Depressive symptoms were assessed using the Centre of Epidemiological Studies Depression scale, while chronic pain was estimated using questions about the frequency of being troubled with pain. We used random-intercept cross-lagged panel models to assess the bidirectional association between pain and depressive symptoms, adjusting for potential confounders.</p></div><div><h3>Results</h3><p>There was a cross-lagged effect of chronic pain on depressive symptoms (ELSA: β: 0.038; 95%CI: 0.011–0.066. Standardized coefficient (B): 0.021. SHARE: β: 0.044; 95%CI: 0.023–0.065. B: 0.023–0.024) as well as depressive symptoms on pain (ELSA: β: 0.010; 95%CI: 0.002–0.018. B: 0.017–0.019. SHARE: 0.011; 95%CI: 0.005–0.017. B: 0.020–0.021). Moreover, there were auto-regressive effects of both chronic pain (ELSA: β: 0.149; 95%CI: 0.128–0.171. SHARE: β: 0.129; 95%CI: 0.112–0.145) and depressive symptoms (ELSA: β: 0.149; 95%CI: 0.130–0.168. SHARE: β: 0.169; 95%CI: 0.154–0.184).</p></div><div><h3>Conclusion</h3><p>We identified a modest bidirectional association between depressive symptoms and chronic pain, using two large prospective ageing cohorts.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"89 ","pages":"Pages 49-54"},"PeriodicalIF":7.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140951646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statins as an adjuvant therapy for patients with schizophrenia: An up-to-date systematic review and meta-analysis","authors":"Tzu-Rong Peng ,&nbsp;Hung-Hong Lin ,&nbsp;Ming-Chia Lee ,&nbsp;Shih-Ming Chen","doi":"10.1016/j.genhosppsych.2024.05.001","DOIUrl":"10.1016/j.genhosppsych.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Evidence suggests that inflammatory processes play a role in the pathophysiology of schizophrenia. Statins exert anti-inflammatory and antioxidant effects and may be effective in improving the symptoms of schizophrenia. This study explored whether statins, as an adjunctive therapy, can alleviate the symptoms of schizophrenia.</p></div><div><h3>Methods</h3><p>PubMed, EMBASE, and the Cochrane Library were searched for articles published up to March 2023. The risk-of-bias tool for randomized trials was used to assess study quality. Two researchers independently assessed the risks of bias and extracted data. Pooled data on Positive and Negative Syndrome Scale (PANSS) scores were analyzed. A random-effects model was employed to calculate pooled effect sizes. Statistical heterogeneity across studies was assessed using the <em>I</em>² statistic. All analyses were performed using RevMan5 and Comprehensive Meta-Analysis software.</p></div><div><h3>Results</h3><p>Nine trials enrolling 533 patients in total were included. Add-on statin therapy was found to be associated with a significantly better total PANSS score [standardized mean difference (SMD) = −0.42, 95% confidence interval (CI) −0.75 to −0.09, <em>I</em>² = 72%; <em>P</em> = 0.01] and PANSS negative subscale score (SMD = −0.26, 95% CI −0.45 to −0.07, <em>I</em>² = 0%; <em>P</em> = 0.009) in comparison with placebo. However, add-on statin therapy did not appear to improve scores for the PANSS positive and general subscales at the study-defined endpoint (6–24 weeks).</p></div><div><h3>Conclusions</h3><p>Our meta-analysis indicates that adjunctive statin therapy may confer benefits in ameliorating PANSS negative and total scores. It needs more solid data to confirm the results are related to clinical improvement and functioning.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"89 ","pages":"Pages 75-83"},"PeriodicalIF":7.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141029900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capgras syndrome in children and adolescents: A systematic review","authors":"Ron Walfisch ,&nbsp;Polina Perlman Danieli ,&nbsp;Mariela Mosheva ,&nbsp;Yehonathan Hochberg ,&nbsp;Tal Shilton ,&nbsp;Doron Gothelf","doi":"10.1016/j.genhosppsych.2024.05.003","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.05.003","url":null,"abstract":"<div><h3>Objectives</h3><p>To improve understanding of Capgras syndrome (CS) in the pediatric population, this study investigates its clinical features and discerns similarities and differences compared to CS in adults.</p></div><div><h3>Methods</h3><p>We conducted a descriptive systematic review of case reports following PRISMA guidelines, including cases of pediatric patients with CS. Patient demographics, medical and psychiatric history, imposter identity, underlying diagnosis, clinical manifestation, treatments, and outcomes were extracted and analyzed.</p></div><div><h3>Results</h3><p>We included 37 articles comprising 38 cases. The median age of patients was 15, with 23 (60.5%) being male. The most prevalent underlying diagnoses were schizophrenia spectrum and other psychotic disorders (47.3%). Imposter identity involved parents in 32 cases (84.2%). Associated symptoms included persecutory delusions (63.1%), auditory hallucinations (42.1%), aggression (31.5%), and depression (21.0%).</p></div><div><h3>Conclusion</h3><p>There is a significant gap in our understanding of CS, particularly in pediatric patients. This is the first systematic review of CS in pediatric patients, encompassing all cases found in English literature since 1923.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"89 ","pages":"Pages 32-40"},"PeriodicalIF":7.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps between current practice in perinatal depression screening and guideline recommendations: a systematic review","authors":"Yating Yang,&nbsp;Ting Wang,&nbsp;Di Wang,&nbsp;Miaomiao Liu,&nbsp;Shi Lun,&nbsp;Shuang Ma,&nbsp;Juan Yin","doi":"10.1016/j.genhosppsych.2024.04.011","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.04.011","url":null,"abstract":"<div><h3>Objective</h3><p>Screening for perinatal depression is recommended by many guidelines to reduce the disease burden, but current implementation practices require clarification.</p></div><div><h3>Method</h3><p>Fifteen databases were searched for observational studies using a pre-tested search strategy. In addition, the websites of academic organizations were searched for guidelines, recommendations, and reports. Literature published between January 1, 2010, and December 19, 2021, in either English or Chinese, was included. The standard form of the Joanna Briggs Institute (JBI) was used to assess risk of bias of the included studies.</p></div><div><h3>Results</h3><p>The data analysis covered 103 studies, 21 guidelines, 11 recommendations, five position statements, three reports, two committee opinions, three consensuses, one consultation, and one policy statement. All but one guideline recommended that mothers be routinely screened for perinatal depression at least once during the perinatal period. In addition, 39 documents recommended that perinatal mothers at risk of perinatal depression be provided with or referred to counseling services. In original studies, however, only 8.7% of the original studies conducted routine screenings, and only one-third offered referral services after the screening process. The EPDS emerged as the most frequently used screening tool to measure perinatal depression. 32% (<em>n</em> = 33) of studies reported the technology used for screening. The most commonly used method was face-to-face interviews (<em>n</em> = 22). Screening personnel the agents conducting the screening comprised researchers (<em>n</em> = 26), nurses (<em>n</em> = 15), doctors (<em>n</em> = 11).</p></div><div><h3>Conclusions</h3><p>A significant disparity was observed between the recommendations and implementation of perinatal depression screening, highlighting the need to integrate routine screening and referral processes into maternal care services.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"89 ","pages":"Pages 41-48"},"PeriodicalIF":7.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140901095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical multimorbidity in psychiatric patients with personality disorders: Insights within the ICD-11 framework","authors":"Ivona Šimunović Filipčić ,&nbsp;Nenad Jakšić ,&nbsp;Sarah Levaj ,&nbsp;Marija Ćopo ,&nbsp;Zrinka Vuksan-Ćusa ,&nbsp;Filip Luka Mikulić ,&nbsp;Majda Grah ,&nbsp;Milena Skočić Hanžek ,&nbsp;Marina Šagud ,&nbsp;Igor Filipčić ,&nbsp;Darko Marčinko","doi":"10.1016/j.genhosppsych.2024.04.013","DOIUrl":"https://doi.org/10.1016/j.genhosppsych.2024.04.013","url":null,"abstract":"<div><h3>Objective</h3><p>Recent research has revealed poor physical health among individuals with personality disorders (PDs). We aimed to compare chronic physical illnesses (CPI) and chronic physical multimorbidity (CPM) prevalence between the general population (GEP) and PD patients, and to explore the relationship between CPM and various aspects of PD, predominantly within the ICD-11 framework.</p></div><div><h3>Methods</h3><p>This cross-sectional study included 126 PD patients and 126 matched controls from the GEP. Patients were evaluated for the ICD-11 PD severity and maladaptive personality domains, subjective emptiness, and reflective functioning. CPI was assessed using a standardized self-report questionnaire.</p></div><div><h3>Results</h3><p>PD patients had a higher mean number of CPIs (2.05 vs. 1.02) and a more frequent CPM occurrence (49.2% vs. 26.2%) compared to the matched controls (<em>p</em> &lt; .001). The ICD-11 PD severity (OR = 1.143, <em>p</em> = .007) and maladaptive domain Negative affectivity (OR = 4.845, <em>p</em> = .002), and poor reflective functioning (OR = 1.694, p = .007) were significant predictors of CPM, independent of sociodemographic, clinical and lifestyle factors. Negative affectivity showed the most robust effect on CPM, while smoking did not significantly mediate these relationships.</p></div><div><h3>Conclusion</h3><p>Our study found increased CPM burden in PD patients and a link between CPM and various PD aspects under the ICD-11 framework, highlighting the need for more integrated healthcare.</p></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"89 ","pages":"Pages 16-22"},"PeriodicalIF":7.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}