To examine the 1-month prevalence of generalized anxiety disorder (GAD) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Diagnostic and Statistical Manual of Mental, Fifth Edition (DSM-V), and International Classification of Diseases, Tenth Revision (ICD-10), and the overlap between these criteria, in a population sample of 75-year-olds. We also aimed to examine comorbidity between GAD and other psychiatric diagnoses, such as depression.
During 2005-2006, a comprehensive semistructured psychiatric interview was conducted by trained nurses in a representative population sample of 75-year-olds without dementia in Gothenburg, Sweden (N = 777; 299 men and 478 women). All psychiatric diagnoses were made according to DSM-IV. GAD was also diagnosed according to ICD-10 and DSM-V.
The 1-month prevalence of GAD was 4.1% (N = 32) according to DSM-IV, 4.5% (N = 35) according to DSM-V, and 3.7% (N = 29) according to ICD-10. Only 46.9% of those with DSM-IV GAD fulfilled ICD-10 criteria, and only 51.7% and 44.8% of those with ICD-10 GAD fulfilled DSM-IV/V criteria. Instead, 84.4% and 74.3% of those with DSM-IV/V GAD and 89.7% of those with ICD-10 GAD had depression. Also other psychiatric diagnoses were common in those with ICD-10 and DSM-IV GAD. Only a small minority with GAD, irrespective of criteria, had no other comorbid psychiatric disorder. ICD-10 GAD was related to an increased mortality rate.
While GAD was common in 75-year-olds, DSM-IV/V and ICD-10 captured different individuals. Current definitions of GAD may comprise two different expressions of the disease. There was greater congruence between GAD in either classification system and depression than between DSM-IV/V GAD and ICD-10 GAD, emphasizing the close link between these entities.
There are at least two different criteria for assessing pedophilia in men: absolute ascertainment (their sexual interest in children is intense) and relative ascertainment (their sexual interest in children is greater than their interest in adults). The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) used relative ascertainment in its diagnostic criteria for pedophilia; this was abandoned and replaced by absolute ascertainment in the DSM-III-R and all subsequent editions. The present study was conducted to demonstrate the continuing need for relative ascertainment, particularly in the laboratory assessment of pedophilia. A total of 402 heterosexual men were selected from a database of patients referred to a specialty clinic. These had undergone phallometric testing, a psychophysiological procedure in which their penile blood volume was monitored while they were presented with a standardized set of laboratory stimuli depicting male and female children, pubescents, and adults.The 130 men selected for the Teleiophilic Profile group responded substantially to prepubescent girls but even more to adult women; the 272 men selected for the Pedophilic Profile group responded weakly to prepubescent girls but even less to adult women. In terms of absolute magnitude, every patient in the Pedophilic Profile group had a lesser penile response to prepubescent girls than every patient in the Teleiophilic Profile group. Nevertheless, the Pedophilic Profile group had a significantly greater number of known sexual offenses against prepubescent girls, indicating that they contained a higher proportion of true pedophiles. These results dramatically demonstrate the utility-or perhaps necessity-of relative ascertainment in the laboratory assessment of erotic age-preference.
The aim was to compare different scales capturing ADHD symptoms for older individuals' self-reports about childhood and current ADHD symptomatology. An additional aim was relating these results to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) ADHD criteria.
The 25-item Wender Utah Rating Scale (WURS) administered in a population-based sample of 1,599 individuals aged 65 to 80. Two subsamples each with 30 individuals were randomly drawn based on their Wender Utah Rating Scale (WURS) scores, and studied using the Wender Riktad ADHD Symtom Skala (WRASS), interview assessed Barkley Scales, and DSM-IV ADHD criteria.
Higher WURS and WRASS scores were related to higher Barkley Childhood and Current Symptoms Scales Scores. Also, reporting more symptoms on these scales was related to meeting DSM-IV criteria for childhood and current ADHD.
The results support significant persistence of ADHD symptoms when using different scales designed for the capture of childhood and current ADHD symptomatology. Further studies of ADHD in a lifespan perspective are encouraged.
Dysfunction in affect regulation is a prominent feature that grossly impairs behavioural and interpersonal domains of experience and underlies a great deal of the psychopathology in borderline personality disorder (BPD). However, no study has yet been published that evaluates the psychometric properties of the translated Danish version of self-report measures sensitive to the different aspects and dimensions of dysfunction in affect regulation prevalent in BPD.
This study comprised a group of women diagnosed with BPD (n = 29) and a comparison group of healthy subjects (n = 29) who reported psychopathology and levels of affective instability, aggression, impulsivity and alexithymia by self-report measures.
Our results demonstrated that women with BPD have significant psychopathology and report significantly higher levels of dysfunction in separate components of affect regulation by self-report measures than the comparison group of healthy subjects. Our results also provided partial support for the psychometric appropriateness and clinical relevance of the translated Danish version of affect regulation measures.
The normative reference range indicated by our results makes the measures useful as a practical assessment tool.
To study alcohol and drug addiction incidence in students exposed to the Dawson College shooting within the 18 months following the event, to identify the precursors of a psychoactive substance addiction development while considering the severity of event exposure, and to examine whether alcohol use, 18 months after the event, is related to any of the various posttraumatic stress disorder (PTSD) symptom groups.
The population of this study was comprised of all the Dawson College students at the time of the event. Analyses were conducted with 854 students enrolled in the college at the time of the shooting.
Five per cent of women and 7% of men showed, for the first time in their life, a problem with substance addiction following the shooting. In men, young age, lifetime suicidal ideation, and having seen the killer during the shooting are the main precursors of incident accident cases. None of the studied precursors were significant in women. Men and women were also different in terms of PTSD symptoms predicting alcohol use 18 months after the shooting.
The study highlights the importance of considering a person's sex when studying their psychoactive substance use following a trauma.
Drinking behavior among Russian women remains poorly described. We analyzed gender differences in alcohol use among 374 tuberculosis patients in Tomsk, Siberia. Twenty-six (28.3%) women had lifetime alcohol abuse or dependence, compared with 70.6% of men. Women with alcohol use disorders drank 12.7 +/- 14.0 standard drinks per day and > or = 34.6% drank 2 three days per week. Among individuals with a lifetime alcohol use disorder, age of onset and typical consumption did not differ significantly by gender. We conclude that Russian women with alcohol use disorders consume almost as much alcohol as men and may be at greater risk for negative social and medical consequences.
AIMS: To assess suicide risk associated with alcohol use disorder in elderly men and women, and to examine the role of social stressors in elderly suicides with and without alcohol use disorders. METHODS: This retrospective case-control study included 85 suicide cases aged 65 years and above (46 men, 39 women) and 153 randomly selected population controls (84 men, 69 women). Interviews were carried out with control persons and with informants for the suicide cases. Mental disorders were diagnosed in accordance to DSM-IV. RESULTS: A history of alcohol dependence or misuse was observed in 35% of the elderly men who died by suicide and in 18% of the women. This disorder was uncommon among persons in the control group (2% of the men and 1% of the women). Alcohol use disorder remained an independent predictor of suicide risk in the regression models for both sexes. Among suicide cases, those with alcohol use disorders were younger and less likely to be suffering from severe physical illness (35 vs 63%) than those without this disorder. CONCLUSION: Alcohol use disorder is associated with suicide in elderly men and women. Prevention programmes need to target this important subgroup.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013a) offers an alternative model for Personality Disorders (PDs) in Section III, which consists in part of a pathological personality traits criterion measured with the Personality Inventory for DSM-5 (PID-5). The PID-5 selfreport instrument currently exists in the original 220-item form, a short 100-item form, and a brief 25-item form. For clinicians and researchers, the choice of a particular PID- 5 form depends on feasibility, but also reliability and validity. The goal of the present study was to examine the psychometric qualities of all 3 PID-5 forms, simultaneously, based on a Danish sample (N = 1376) of 451 psychiatric outpatients and 925 community-dwelling participants. Scale reliability and factorial validity were satisfactory across all 3 PID-5 forms. The correlational profiles of the short and brief PID-5 forms with clinician-rated PD dimensions were nearly identical with that of the original PID-5 (rICC = .99 and .95, respectively). All 3 forms discriminated appropriately between psychiatric patients and community-dwelling individuals. This supports that all 3 PID-5 forms can be used to reliably and validly assess PD traits and provides initial support for the use of the abbreviated PID-5 forms in a European population. However, only the original 220-item form and the short 100-item form capture all 25 trait facets, and the brief 25-item form may be ideally limited to preliminary screening or situations with substantial time restrictions.
AIMS: To examine whether polymorphic variants of the HTR2C gene are associated with diagnosis of alcohol dependence. METHODS: We compared allele frequencies of five HTR2C promoter polymorphisms in a Nordic population of alcohol dependent individuals (Males: n = 309; Females: n = 127) and ethnically matched controls (Males: n = 83; Females: n = 190) in whom alcohol dependence was established, or any diagnosis of substance disorder was excluded, respectively. Patients were further subtyped into Type I (late onset) and Type II (early onset) alcoholics. RESULTS: None of the individual polymorphisms indicated significant association with alcohol dependence. A common promoter haplotype (GAGG) exhibited different distribution frequencies between males and females (Type I), however on Bonferroni's multiple-testing correction, this observation proved to be insignificant. CONCLUSIONS: Although we report a lack of association between alcohol dependence and five common promoter polymorphisms, and the constituted haplotypes, the analysis tends to indicate gender and sub-type differences. We suggest that a follow up study with larger sample numbers should be performed to improve the power to detect the genetic influences of HTR2C in alcohol dependence.
Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder (ADHD) and/or oppositional defiant disorder (ODD) during the last few decades. Group format has often been used for parent training but single-subject designs are more common in teacher training. More studies have focussed on pre-school children than on older children, and a minority have been conducted in public mental health settings.
This study aimed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden.
The intervention was a modified version of Barkley's programme. Children were randomized to an Intervention or a Control group. Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms, and about behavioural problems when the study started and at a 3-month follow-up.
RESULTS showed that the intervention resulted in a reduction of the number of children who met DSM-IV criteria for ADHD and/or ODD. Effects were more pronounced in the home setting than in the school setting, and were further accentuated when both parents and teachers of the same child took part in the intervention. Teachers with more problematic classroom situations benefited most from the intervention.
The programme, "Strategies in Everyday Life", has, in a regular clinical setting, demonstrated promising effects on children's disruptive behaviour, and a clinical implication was to recommend involving both parents and teachers in the programme.