Personalized Medicine in Psychiatry最新文献

{"title":"Mindfulness-based cognitive therapy as an adjunctive treatment for treatment-resistant depression: A systematic review","authors":"Michele F Rodrigues,&nbsp;Larissa Junkes,&nbsp;Jose Appolinario,&nbsp;Antonio E Nardi","doi":"10.1016/j.pmip.2025.100148","DOIUrl":"10.1016/j.pmip.2025.100148","url":null,"abstract":"<div><h3>Background</h3><div>Treatment-Resistant Depression is a significant mental health challenge characterized by an inadequate response to standard treatments. Mindfulness-Based Cognitive Therapy has shown promise for depression, but its effectiveness for Treatment-Resistant Depression remains unclear.</div></div><div><h3>Objective</h3><div>This systematic review evaluated the effectiveness and safety of Mindfulness-Based Cognitive Therapy as an adjunctive treatment for Treatment-Resistant Depression.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, Embase, Web of Science, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, and PsycInfo up to June 15, 2024, without language restrictions. Randomized controlled trials comparing Mindfulness-Based Cognitive Therapy plus treatment as usual to treatment as usual alone in individuals with Treatment-Resistant Depression were included. The primary outcome was depressive symptom severity. Secondary outcomes included quality of life, rumination, mindfulness skills, and self-compassion.</div></div><div><h3>Results</h3><div>The review included 13 studies with a total of 864 participants. Preliminary evidence suggests that Mindfulness-Based Cognitive Therapy significantly may help reduce depressive symptoms compared to treatment as usual or active controls, with effect sizes ranging from moderate to large (Cohen’s d = 0.54 to 1.04) in well-designed studies. Some improvements were also noted in quality of life (d = 0.36 to 0.51), rumination (d = 0.39), mindfulness skills (d = 0.73), and self-compassion (d = 0.21 to 0.64).</div></div><div><h3>Conclusions</h3><div>While encouraging, the current evidence suggests that Mindfulness-Based Cognitive Therapy maybe a promising intervention for Treatment-Resistant Depression However, methodological limitations, including heterogeneity in study designs and TRD definitions, preclude definitive conclusions. Future research should prioritize well-designed randomized controlled trials to establish its efficacy and optimal implementation.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"49 ","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of meta-cognitive and emotional beliefs, and negative repetitive thinking in the relationship between emotional abuse and psychological distress in psychiatric outpatients: A serial multiple mediation model","authors":"Mehdi Rezaei ,&nbsp;Hadi Samadieh ,&nbsp;Mohammad Mahdi Shariat Bagheri ,&nbsp;Ezatolah Ghadamour","doi":"10.1016/j.pmip.2024.100146","DOIUrl":"10.1016/j.pmip.2024.100146","url":null,"abstract":"<div><h3>Background</h3><div>Although meta-cognitive and emotional beliefs are linked to higher psychological distress, little is known about the potential antecedents of these beliefs. On the other hand, the emotional schema model and metacognitive therapy posit that negative meta-cognitive and emotional beliefs generate negative repetitive thinking (NRTs) that lead to the development of psychological distress. In a meta-cognitive integrative model, we examined: (a) whether the link between emotional abuse and psychological distress was mediated serially by meta-cognitive beliefs (MCBs) and NRTs; (b) whether the relationship between emotional abuse and psychological distress was mediated serially by negative beliefs about emotional (NBEs) and NRTs.</div></div><div><h3>Methods</h3><div>Between 2021 and 2024, 514 outpatients (<em>M</em> _age = 29.29; <em>SD</em> = 10.88) completed the Emotional Abuse Questionnaire (EAQ), Metacognitions Questionnaire (MCQ-30), Leahy Emotional Schema Scale (LESS), Perseverative Thinking Questionnaire (PTQ), and Kessler Psychological Distress Scale (<em>K</em>10). The PROCESS SPSS macro was used to conduct serial multiple mediation analysis.</div></div><div><h3>Results</h3><div>The multilevel mediation model demonstrated that the positive relationship between emotional abuse and psychological distress was partially mediated by MCBs, NBEs, and NRTs, and serially mediated by MCBs and then NRTs. The results also showed that the link between emotional abuse and psychological distress was mediated serially by NBEs and NRTs after controlling for age and gender. The model explained much of the variance in psychological distress (R² = 0.52).</div></div><div><h3>Conclusion</h3><div>The current study contributes to the literature by validating a conceptual model to confirm the association between emotional abuse and psychological distress. The hypothesized model in the present study also suggested the salience of the emotional schema model and metacognitive model in predicting psychological distress. Our results also support that NRTs are strategies utilized to cope with MCBs and NBEs.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"49 ","pages":"Article 100146"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BDNF blood levels as a potential biomarker Predictor of treatment response and remission in bipolar depression","authors":"Anton Shkundin ,&nbsp;James Sinacore ,&nbsp;Angelos Halaris","doi":"10.1016/j.pmip.2024.100144","DOIUrl":"10.1016/j.pmip.2024.100144","url":null,"abstract":"<div><h3>Background</h3><div>Immune dysfunction and inflammation play critical roles in the pathophysiology of bipolar disorder. Treatment-resistant bipolar depressive disorder (TRBDD) poses significant challenges in psychiatric practice, often unresponsive to standard treatment strategies. Celecoxib, a selective Cyclooxygenase-2 (COX-2) inhibitor, has shown promise as an add-on treatment for bipolar depression, potentially influencing brain-derived neurotrophic factor (BDNF) levels.</div></div><div><h3>Methods</h3><div>We assessed the effects of treatment on BDNF levels in 43 patients with Treatment-Resistant Bipolar Depressive Disorder (TRBDD), diagnosed with Bipolar Disorder I or II, and compared their baseline BDNF levels with those of 13 healthy control (HC) individuals. TRBDD participants were randomized to receive either Escitalopram plus Placebo (ESC + PBO) or Escitalopram with Celecoxib (ESC + CBX) for 8 weeks. BDNF levels in serum were measured at baseline, week 4, and week 8. The HC group only provided samples at baseline. Statistical analyses were conducted to compare BDNF levels between TRBDD and HC groups, as well as between TRBDD participants in the ESC + PBO and ESC + CBX groups, in relation to treatment response and remission.</div></div><div><h3>Results</h3><div>The TRBDD group demonstrated significantly lower baseline mean BDNF levels compared to the HC group (p = 0.015), suggesting a potential role for BDNF in the pathophysiology of TRBDD. However, BDNF levels at baseline, week 4, and week 8 did not differ significantly between responders and non-responders, or between remitters and non-remitters, within the TRBDD group, regardless of whether they were receiving ESC + PBO or ESC + CBX treatment.</div></div><div><h3>Conclusions</h3><div>The significant difference in baseline BDNF levels between TRBDD patients and healthy controls highlights the potential importance of BDNF in the pathophysiology of TRBDD. Our study suggests that Escitalopram with Celecoxib did not produce significant changes in BDNF levels over the study period. Further research with larger sample sizes and extended follow-up periods is necessary to explore the effects of these treatments on BDNF levels in TRBDD patients and to evaluate the use of BDNF levels as biomarkers for treatment response and remission.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"47 ","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low handgrip strength is a risk factor for symptoms of anxiety and depression in survivors breast cancer patients","authors":"Mirella de P.L. Oliveira ,&nbsp;Jéssika M. Siqueira ,&nbsp;Amanda N. Santos ,&nbsp;Emilly B. Lemos ,&nbsp;Evelly B. Lemos ,&nbsp;Eldom M. Soares ,&nbsp;Gustavo D. Pimentel","doi":"10.1016/j.pmip.2024.100143","DOIUrl":"10.1016/j.pmip.2024.100143","url":null,"abstract":"<div><div>To evaluate the association of anxiety and depression symptoms with handgrip strength in women undergoing post-treatment for breast cancer. A cross-sectional study conducted with 146 adult women undergoing post-treatment for breast cancer. The patients were evaluated and answered the self-administered questionnaire Hospital Anxiety and Depression Scale (HADS) to assess symptoms of anxiety (HADS-anxiety ≥ 9) and depression (HADS-depression ≥ 9). Handgrip strength (HGS) was measured with a digital dynamometer and was considered low when &lt;16 kg. Descriptive analyses, such as mean and standard deviation, relative frequency, Spearman’s correlation test, and logistic regression were performed to evaluate the difference and correlation and association between anxiety and depression symptoms and HGS, respectively. The incidence of anxiety symptoms was 43.15 % and depression was 32.19 %. In the bivariate analysis, there was an association (p &lt; 0.05) between breast surgery on the dominant hand, greater body weight, and lower HGS are often observed in women with symptoms of depression. Women who presented symptoms of anxiety had 3 times less time in minutes of physical activity per week and lower HGS. A significant association was found in the adjusted model (Anxiety vs. HGS = OR: 2.64, % CI (1.07 – 6.54), p = 0.035; Depression vs. HGS = OR: 5.68, % CI (2.15 – 16.66), p &gt; 0.001). In conclusion, low HGS in breast cancer survivors is an important risk factor for symptoms of anxiety and depression.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"47 ","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum regarding missing ethical statements in previously published articles","authors":"","doi":"10.1016/j.pmip.2024.100142","DOIUrl":"10.1016/j.pmip.2024.100142","url":null,"abstract":"","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"47 ","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quetiapine-induced peripheral oedema: A case report and review of the literature","authors":"Christoff Geldenhuys,&nbsp;Anthea Payne Maziena,&nbsp;Petrus Steyn","doi":"10.1016/j.pmip.2024.100141","DOIUrl":"10.1016/j.pmip.2024.100141","url":null,"abstract":"<div><div>Quetiapine is an atypical antipsychotic and is commonly prescribed in the treatment of psychiatric conditions. Quetiapine has been associated with peripheral oedema but it is considered a rare side effect. Cases however suggest it may occur more frequently than reported in clinical trials. The exact mechanism of quetiapine-induced oedema remains unclear. We report the first documented case in Africa of quetiapine-induced oedema. We also do a brief review of other case reports related to the same side effect. We suggest particular caution when prescribing in the elderly and patients on concomitant valproate therapy, with close monitoring of physical condition and cardiovascular state. Peripheral oedema is an important side effect that may influence treatment adherence and quality of life. By having an increased awareness of this problematic adverse effect of quetiapine, one can avoid unnecessary investigations as well as relapses, which may have a particularly profound impact on resource limited settings and low-to-middle income countries.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"47 ","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of stepped care for mental health disorders: An umbrella review of meta-analyses","authors":"Anthony Jeitani ,&nbsp;Paul P. Fahey ,&nbsp;Michael Gascoigne ,&nbsp;Abha Darnal ,&nbsp;David Lim","doi":"10.1016/j.pmip.2024.100140","DOIUrl":"10.1016/j.pmip.2024.100140","url":null,"abstract":"<div><h3>Background</h3><div>Stepped care offers patients the least intensive intervention required for their mental health needs, with advancements to more intensive treatments as necessary. This umbrella review synthesized existing <em>meta</em>-analyses on the effectiveness of stepped care for mental health disorders.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Web of Science Core Collection, and PsycINFO were systematically searched for published <em>meta</em>-analyses on the effectiveness of stepped care for mental health disorders since the databases’ inception until August 2023. Protocol was preregistered with PROSPERO (CRD42023461710) and followed the JBI umbrella review methodology.</div></div><div><h3>Results</h3><div>Ten systematic reviews incorporating 38 primary studies on depression, anxiety and posttraumatic stress disorder were the source of data. In spite of the different models of stepped care, the treatment appeared to improve depression response (3–6 months RR = 1.52 [1.30, 1.78]; I² = 74 %, N = 14. 9–12 months RR = 1.47 [1.23, 1.77], I² = 80 %, N = 13) and remission rate (4–6 months RR = 1.57 [1.30, 1.90]; I² = 79 %, N = 14. 12 months RR = 1.60 [1.23, 2.07]; I² = 94 %, N = 13) as well as anxiety (post-treatment SMD = −0.29 [−0.48, −0.10]; I² = 0 %, N = 3. 12 months SMD = −0.57 [−0.53, −0.06]; I² = 37 %, N = 2).</div></div><div><h3>Limitations</h3><div>Systematic reviews without <em>meta</em>-analyses and reviews published in languages other than English were not accounted for in this umbrella review.</div></div><div><h3>Conclusions</h3><div>Our results support the implementation of stepped care, particularly for the pooled effectiveness in depression treatment.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"47 ","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain-derived neurotrophic factor and stress perception","authors":"Anton Shkundin ,&nbsp;Heather E. Wheeler ,&nbsp;James Sinacore ,&nbsp;Angelos Halaris","doi":"10.1016/j.pmip.2024.100139","DOIUrl":"10.1016/j.pmip.2024.100139","url":null,"abstract":"<div><h3>Background</h3><div>Bipolar disorder (BD) is a severe and chronic mental health condition. Stress is a significant risk factor for BD onset and exacerbation, often triggering depressive symptoms. Perceived stress, reflecting an individual’s subjective experience of stress, is elevated in BD patients. Brain-Derived Neurotrophic Factor (BDNF), crucial for neuronal plasticity and neurotransmitter modulation, decreases under stress conditions. The variation in stress response, with some individuals developing stress-related disorders while others remain resilient, suggests that genetic variations may alter the impact of stress on the risk of psychopathology. The present work was undertaken to investigate the correlations between stress perception (PSS-14) scores and BDNF serum levels and explore their relationship with the minor allele carrier status of specific single nucleotide polymorphisms (SNPs) in patients with treatment-resistant bipolar disorder depression (TRBDD).</div></div><div><h3>Methods</h3><div>Our cohort included 41 patients diagnosed with BD experiencing treatment resistant depression. Participants, aged 21 to 65, met DSM-IV criteria for BD I or II. Treatment resistance was defined as persistent depression despite adequate antidepressant trials or breakthrough depressive episodes while on a mood stabilizer, an antidepressant and/or an atypical antipsychotic. Patients completed the Perceived Stress Scale-14 (PSS-14) and provided blood samples for BDNF measurement and genotyping. Three SNPs (rs10835210, rs6265, and rs1519480) were selected based on their reported associations with affective disorders. Carriers were identified as individuals with at least one A allele for rs6265, A allele for rs10835210, and G allele for rs1519480.</div></div><div><h3>Results</h3><div>There was a significant negative Pearson correlation (p = 0.014) between baseline BDNF serum levels and PSS-14 scores. Multiple regression analyses revealed complex patterns involving the SNPs rs10835210, rs6265, and rs1519480. All three SNPs showed a negative correlation between PSS-14 scores and BDNF levels. Both rs10835210 and rs6265 exhibited crossover interactions between carriers and non-carriers at approximately 5 and 10 points, respectively. Additionally, rs6265 demonstrated an inverted directional effect compared to rs10835210 and rs1519480.</div></div><div><h3>Conclusions</h3><div>Our study highlights a complex relationship between stress, BDNF levels, and BDNF SNPs. The findings suggest two interpretations: perceived stress may reduce BDNF levels, or elevated BDNF levels may protect against stress. The unique roles of these SNPs in modulating BDNF activity are crucial for understanding the biological processes involved in mood disorders and may aid in the implementation of personalized diagnostic and therapeutic interventions.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"47 ","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediating effect of emotional distress on the relationship between noncommunicable diseases and lifestyle among Brazilian academics during the COVID-19 pandemic","authors":"Siqueira Rafael Pena ,&nbsp;Cunha Carla de Magalhães ,&nbsp;Costa Priscila Ribas de Farias ,&nbsp;De Santana Mônica Leira Portela ,&nbsp;Oliveira Lucivalda Pereira Magalhaes ,&nbsp;Conceição-Machado Maria Ester Pereira da","doi":"10.1016/j.pmip.2024.100138","DOIUrl":"10.1016/j.pmip.2024.100138","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the association between noncommunicable diseases (NCDs) and lifestyle, and to examine the mediating effect of emotional distress on this relationship, among university professors and students during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis was conducted using baseline data from a larger cohort study involving 671 professors and 1652 students from Brazilian universities. Participants were recruited via emails, social media, and messaging apps. The study included individuals over 18 who were registered in a university course or were active university professors during the pandemic isolation restrictions. Data were collected through virtual questionnaires covering health, mental health, dietary habits, smoking, alcohol consumption, physical activity, and sleep. Structural equation models (SEM) were used to test the associations of interest.</div></div><div><h3>Results</h3><div>The presence of NCDs among students was observed to be associated with greater emotional distress (<em>β</em>: 0.12; <em>p</em>: 0.003). Furthermore, both professors (<em>β</em>: −0.59, <em>p</em>: &lt;0.001) and students (<em>β</em>: −0.82, <em>p</em>: &lt;0.001) demonstrated an inverse association between emotional distress and a healthy lifestyle, which indicates that higher emotional distress was linked to a poorer healthy lifestyle. Additionally, an indirect inverse association was observed between NCDs and healthy lifestyle, when mediated by emotional distress in the student’s group (<em>β</em>: −0.10, <em>p</em>: 0.004).</div></div><div><h3>Conclusion</h3><div>This study provides new insights into the complex interplay between NCDs, emotional distress, and lifestyle among university professors and students during the pandemic. The results underscore the importance of integrating mental health support into interventions aimed at improving lifestyle and managing NCDs during health crises.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"47 ","pages":"Article 100138"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of dextroamphetamine/amphetamine to treat attention-deficit/hyperactivity disorder comorbid with borderline personality disorder: A case report","authors":"Stacy Ellenberg,&nbsp;Sutanaya Pal,&nbsp;Lianne De La Cruz,&nbsp;Faiz Kidwai,&nbsp;Seethalakshmi Ramanathan","doi":"10.1016/j.pmip.2024.100137","DOIUrl":"10.1016/j.pmip.2024.100137","url":null,"abstract":"<div><h3>Background</h3><div>30–60 % of patients with borderline personality disorder (BPD) also meet criteria for attention-deficit/hyperactivity disorder (ADHD). However, because symptoms of BPD tend to “overshadow” those of ADHD, clinicians frequently fail to diagnose, and therefore treat, comorbid BPD and ADHD (BPD+ADHD) appropriately. Psychostimulants such as dextroamphetamine/amphetamine (AMP) are considered the “gold standard” treatment for ADHD. Because BPD and ADHD share a number of clinical features – deficits in affect regulation, impulsivity, low self-esteem, interpersonal, educational, and occupational dysfunction – the current case report investigates the ability of AMP to mediate these variables in comorbid BPD+ADHD. The literature base on the treatment of BPD+ADHD is significantly limited, warranting the need for the current case report.</div></div><div><h3>Case presentation</h3><div>A 30-year-old cisgender female diagnosed with BPD and ADHD with history of multiple psychiatric inpatient hospitalizations, longstanding involvement in outpatient dialectical-behavior therapy, and marked functional impairment was treated with AMP. Significant improvements in functional outcome (gaining and maintaining employment, caring for self, maintaining financial stability) and decreases in functional impairment (no instances of psychiatric hospitalizations) occurred across a 1.5-year follow-up period after being treated with AMP.</div></div><div><h3>Conclusions</h3><div>We suggest that pharmacological treatment of comorbid BPD and ADHD with AMP may have been responsible for the overall improvement in functional outcome in this patient. We postulate that AMP allowed for increased ability to adopt and implement dialectical-behavior therapy skills that had previously been unable to be adopted and implemented prior to AMP administration. We hypothesize that increased ability to implement skills may have been attributable to improved overall cognitive and behavioral control induced by the administration of AMP.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"47 ","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}