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Borderline Personality Disorder and Psychosis: A Case Managed by Transference-Focused Psychotherapy. 边缘型人格障碍和精神病：一例以转移为中心的心理治疗。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220060
Peter Freed, Lois W Choi-Kain, Elizabeth Liebson
{"title":"Borderline Personality Disorder and Psychosis: A Case Managed by Transference-Focused Psychotherapy.","authors":"Peter Freed,&nbsp;Lois W Choi-Kain,&nbsp;Elizabeth Liebson","doi":"10.1176/appi.focus.20220060","DOIUrl":"10.1176/appi.focus.20220060","url":null,"abstract":"<p><p>Transient stress-related paranoia is the descriptive definition of psychotic phenomena associated with borderline personality disorder. Although psychotic symptoms usually do not qualify patients for a separate diagnosis in the psychotic spectrum, statistical probabilities predict the co-occurrence of cases with comorbid borderline personality disorder and major psychotic disorder. This article presents three perspectives on a complex case of borderline personality disorder and psychotic disorder: one from a medication prescribing psychiatrist who is a transference-focused psychotherapist responsible for care, one from the anonymous patient, and one from a specialist in psychotic disorder. A discussion of clinical implications concludes this multidimensional presentation of borderline personality disorder and psychosis.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490148","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}
引用次数: 0
Addressing Patient-Centered Care Through Mindful Listening and Mentalizing in Psychiatry. 通过精神病学中的正念倾听和心理化来解决以患者为中心的护理问题。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220046
Shahrzad Bazargan-Hejazi, Anaheed Shirazi, Denese Shervington, Sabrina Amani, William Shay
{"title":"Addressing Patient-Centered Care Through Mindful Listening and Mentalizing in Psychiatry.","authors":"Shahrzad Bazargan-Hejazi,&nbsp;Anaheed Shirazi,&nbsp;Denese Shervington,&nbsp;Sabrina Amani,&nbsp;William Shay","doi":"10.1176/appi.focus.20220046","DOIUrl":"10.1176/appi.focus.20220046","url":null,"abstract":"<p><p>This 21st-Century Psychiatrist column reflects the authors' perceptions of the importance of addressing patient-centered care through mindful listening and mentalizing in psychiatry. The authors maintain that adopting a mentalizing stance is a promising approach for clinicians with diverse backgrounds to humanize clinical practice, especially in today's dynamic high-speed, high-paced, and high-technology environment. Mindful listening and mentalizing are particularly consequential for the field of psychiatry since the COVID-19 pandemic prompted an abrupt transition from in-person to virtual platforms for education and clinical care.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492890","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}
引用次数: 0
Obsessive-Compulsive Personality Disorder: A Review of Symptomatology, Impact on Functioning, and Treatment. 强迫症：症状学、对功能的影响和治疗综述。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220058
Anthony Pinto, Jonathan Teller, Michael G Wheaton
{"title":"Obsessive-Compulsive Personality Disorder: A Review of Symptomatology, Impact on Functioning, and Treatment.","authors":"Anthony Pinto,&nbsp;Jonathan Teller,&nbsp;Michael G Wheaton","doi":"10.1176/appi.focus.20220058","DOIUrl":"10.1176/appi.focus.20220058","url":null,"abstract":"<p><p>Obsessive-compulsive personality disorder (OCPD) is a chronic condition that involves a maladaptive pattern of excessive perfectionism, preoccupation with orderliness and details, and the need for control over one's environment. It is one of the most common personality disorders in the general population, with an estimated prevalence ranging from 1.9% to 7.8%. Despite the fact that patients with OCPD often present for treatment, there is little empirical research on treatments for OCPD, and there is no definitive empirically supported treatment for the condition. This review provides an overview of OCPD, its core features, its common presentation style types, and its impact on functioning. We review the limited treatment research to date and focus on cognitive-behavioral approaches targeting core aspects of OCPD that directly affect functioning in these patients, emphasizing take-home points for clinicians. We also address questions and controversies related to OCPD and its treatment.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9483867","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}
引用次数: 0
How Will Clinicians Utilize the Alternative DSM-5-TR Section III Model for Personality Disorders in Their Clinical Work? 临床医生将如何在临床工作中利用DSM-5-TR第三节替代模型治疗人格障碍？
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220053
John M Oldham
{"title":"How Will Clinicians Utilize the Alternative <i>DSM-5-TR</i> Section III Model for Personality Disorders in Their Clinical Work?","authors":"John M Oldham","doi":"10.1176/appi.focus.20220053","DOIUrl":"10.1176/appi.focus.20220053","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490152","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}
引用次数: 0
Borderline Personality Disorder: Updates in a Postpandemic World. 边缘型人格障碍：疫情后世界的最新情况。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220057
Lois W Choi-Kain, Zeynep Sahin, Jenna Traynor
{"title":"Borderline Personality Disorder: Updates in a Postpandemic World.","authors":"Lois W Choi-Kain,&nbsp;Zeynep Sahin,&nbsp;Jenna Traynor","doi":"10.1176/appi.focus.20220057","DOIUrl":"10.1176/appi.focus.20220057","url":null,"abstract":"<p><p>Progress in understanding borderline personality disorder has unfolded in the last decade, landing in a new COVID-19-influenced world. Borderline personality disorder is now firmly established as a valid diagnosis, distinct from its co-occurring mood, anxiety, trauma-related, and behavioral disorders. Further, it is also understood as a reflection of general personality dysfunction, capturing essential features shared among all personality disorders. Neuroimaging research, representing the vast neurobiological advances made in the last decade, illustrates that the disorder shares frontolimbic dysfunction with many psychiatric diagnoses but has a distinct signature of interpersonal and emotional hypersensitivity. This signature is the conceptual basis of the psychotherapies and clinical management approaches proven effective for the disorder. Medications remain adjunctive and are contraindicated by some guidelines internationally. Less invasive brain-based therapeutics show promise. The most significant change in the treatment landscape is a focus on briefer, less intensive formats of generalist management. Shorter variants of therapies, such as dialectical behavior therapy and mentalization-based treatment, are in the process of being shown to be adequately effective. Earlier intervention and greater emphasis on functional improvement are needed to more effectively curb the disabilities and risks of borderline personality disorder for patients and their families. Remote interventions show promise in broadening access to care.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490153","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}
引用次数: 2
The Psychiatric Patient's Right to Effective Treatment: Implications of Osheroff v. Chestnut Lodge. 精神病患者获得有效治疗的权利：Osheroff诉Chestnut Lodge案的启示。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.22020018
Gerald L Klerman
{"title":"The Psychiatric Patient's Right to Effective Treatment: Implications of <i>Osheroff v. Chestnut Lodge</i>.","authors":"Gerald L Klerman","doi":"10.1176/appi.focus.22020018","DOIUrl":"10.1176/appi.focus.22020018","url":null,"abstract":"<p><p>Although <i>Osheroff v. Chestnut Lodge</i> never reached final court adjudication, the case generated widespread discussion in psychiatric, legal, and lay circles. The author served as a consultant to Dr. Osheroff and testified that Chestnut Lodge failed to follow through with appropriate biological treatment for its own diagnosis of depression, focusing instead on Dr. Osheroff's presumed personality disorder diagnosis and treating him with intensive long-term individual psychotherapy. The author suggests that this case involves the proposed right of the patient to effective treatment and that treatments whose efficacy has been demonstrated have priority over treatments whose efficacy has not been established. Reprinted from <i>Am J Psychiatry 1990; 147:409-418</i>, with permission from American Psychiatric Association Publishing. Publishing. Copyright © 1990.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9495466","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}
引用次数: 0
Engaging the "Difficult" Patient: Strengthening Empathic Communication Skills. 让“困难”患者参与进来：加强移情沟通技巧。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220067
Dorothy E Stubbe
{"title":"Engaging the \"Difficult\" Patient: Strengthening Empathic Communication Skills.","authors":"Dorothy E Stubbe","doi":"10.1176/appi.focus.20220067","DOIUrl":"10.1176/appi.focus.20220067","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9495468","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}
引用次数: 0
Defining Borderline Patients: An Overview. 定义临界病人：综述。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.22020017
John G Gunderson, Margaret T Singer
{"title":"Defining Borderline Patients: An Overview.","authors":"John G Gunderson,&nbsp;Margaret T Singer","doi":"10.1176/appi.focus.22020017","DOIUrl":"10.1176/appi.focus.22020017","url":null,"abstract":"<p><p>This review of the descriptive literature on borderline patients indicates that accounts of such patients vary depending upon who is describing them, in what context, how the samples are selected, and what data are collected. The authors identify six features that provide a rational means for diagnosing borderline patients during an initial interview: the presence of intense affect, usually depressive or hostile; a history of impulsive behavior; a certain social adaptiveness; brief psychotic experiences; loose thinking in unstructured situations; and relationships that vacillate between transient superficiality and intense dependency. Reliable identification of these patients will permit better treatment planning and clinical research. Reprinted from <i>Am J Psychiatry 1975; 132:1-10</i>, with permission from American Psychiatric Association Publishing. Copyright © 1975.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490146","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}
引用次数: 0
Personality Disorders: A Once and Future (Nonbinary) King/Queen. 人格障碍：曾经和未来（非二元）的国王/王后。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.20220066
Lois W Choi-Kain
{"title":"Personality Disorders: A Once and Future (Nonbinary) King/Queen.","authors":"Lois W Choi-Kain","doi":"10.1176/appi.focus.20220066","DOIUrl":"10.1176/appi.focus.20220066","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490149","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}
引用次数: 0
Borderline and Other Personality Disorders: New Directions in 2022. 边缘型和其他人格障碍：2022年的新方向。
Focus (American Psychiatric Publishing) Pub Date : 2022-10-01 Epub Date: 2022-10-25 DOI: 10.1176/appi.focus.22020013
{"title":"Borderline and Other Personality Disorders: New Directions in 2022.","authors":"","doi":"10.1176/appi.focus.22020013","DOIUrl":"10.1176/appi.focus.22020013","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490150","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}
引用次数: 0
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