Second gene expression in bicistronic constructs using short synthetic intercistrons and viral IRES sequences

The authors addressed 5 issues bearing on the validity of the construct of depressive personality disorder (DPD): its relationship with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) mood and personality disorders and normal personality dimensions of negative and positive affectivity, its stability over 30-months, and its impact on the course of Axis I depressive disorders. Two samples were used: 156 outpatients with mood disorders, personality disorders, or both, and 267 of their 1st-degree relatives. The association between DPD and dysthymia was fairly modest, whereas the associations with major depression and the personality disorders were quite low. DPD was moderately correlated with both negative and positive affectivity; however, it contributed unique information beyond that available from the 2 emotional superfactors. Finally, DPD was moderately stable over a 30-month period and was associated with a poorer course of depression.     

Depressive personality: Associations with DSM-III-R mood and personality disorders and negative and positive affectivity, 30-month stability, and prediction of course of Axis I depressive disorders.

The authors addressed 5 issues bearing on the validity of the construct of depressive personality disorder (DPD): its relationship with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association. 1987) mood and personality disorders and normal personality dimensions of negative and positive affectivity, its stability over 30-months, and its impact on the course of Axis I depressive disorders. Two samples were used: 156 outpatients with mood disorders, personality disorders, or both, and 267 of their 1st-degree relatives. The association between DPD and dysthymia was fairly modest, whereas the associations with major depression and the personality disorders were quite low. DPD was moderately correlated with both negative and positive affectivity; however it contributed unique information beyond that available from the 2 emotional superfactors. Finally, DPD was moderately stable over a 30-month period and was associated with a poorer course of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiation of Axis I and Axis II disorders.

The revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III—R; American Psychiatric Association, 1987) distinguishes between Axis I and Axis II disorders: Axis II includes personality (and developmental) disorders, and all others are on Axis I. This distinction is often useful, but the reification of Axis I and II constructs through diagnostic criteria sets that demarcate categorically distinct entities is at times problematic. T. A. Widiger and T. Shea review the issues of differentiating personality from Axis I disorders, specifically illustrated by schizotypal and schizophrenic disorders, borderline and mood disorders, antisocial and substance use disorders, and avoidant personality from social phobia. The options for addressing their differentiation include adding exclusion criteria, shifting the placement of disorders, deleting overlapping criteria, adding differentiating criteria, and converting to a dimensional format. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The joint structure of DSM-IV Axis I and Axis II disorders.

The Diagnostic and Statistical Manual (4th ed. [DSM–IV]; American Psychiatric Association, 1994) distinction between clinical disorders on Axis I and personality disorders on Axis II has become increasingly controversial. Although substantial comorbidity between axes has been demonstrated, the structure of the liability factors underlying these two groups of disorders is poorly understood. The aim of this study was to determine the latent factor structure of a broad set of common Axis I disorders and all Axis II personality disorders and thereby to identify clusters of disorders and account for comorbidity within and between axes. Data were collected in Norway, through a population-based interview study (N = 2,794 young adult twins). Axis I and Axis II disorders were assessed with the Composite International Diagnostic Interview (CIDI) and the Structured Interview for DSM–IV Personality (SIDP–IV), respectively. Exploratory and confirmatory factor analyses were used to investigate the underlying structure of 25 disorders. A four-factor model fit the data well, suggesting a distinction between clinical and personality disorders as well as a distinction between broad groups of internalizing and externalizing disorders. The location of some disorders was not consistent with the DSM–IV classification; antisocial personality disorder belonged primarily to the Axis I externalizing spectrum, dysthymia appeared as a personality disorder, and borderline personality disorder appeared in an interspectral position. The findings have implications for a meta-structure for the DSM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social phobia: Axis I and II correlates.

The presence of Axis I and Axis II disorders in 71 social phobic patients was examined. Generalized anxiety disorder was the common secondary Axis I disorder, followed by simple phobia. Avoidant personality disorder and obsessive-compulsive personality disorder were the most common Axis II diagnoses, and 88% of the sample exhibited features of these 2 personality styles. Ss with additional Axis I diagnoses were more anxious and depressed than those with no additional Axis I disorder. Social phobics with additional Axis II disorders were more depressed but not more anxious than those with no Axis II diagnosis. Furthermore, those with an additional Axis I disorder had higher scores on measures of neuroticism, interpersonal sensitivity, and agoraphobia. The prevalence and impact of additional Axis I and II disorders on the etiology, maintenance, and treatment outcome for persons with social phobia are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality disorder subtypes among opiate addicts in methadone maintenance.

The Millon Clinical Multiaxial Inventory was administered to 196 men and 113 women newly admitted to methadone maintenance. The distribution of participants among Axis I subtypes was no elevation (18.8%), drug-alcohol abuse only (25.2%), affective disturbance (31.7%), and psychotic symptoms(l7.2%); among Axis II subtypes it was no elevation (10.4%), narcissistic-antisocial (36.2%), dependent (16.2%), withdrawn-negativistic (12.6%), histrionic (7.4%), and severe personality disorder (8.4%). Women were more likely to be assigned to histrionic, dependent, and severe personality disorder subtypes. Proportionately more Black participants were assigned to drug-alcohol only, psychotic symptoms, narcissistic-antisocial, and severe personality disorder subtypes. The proportion retained in treatment at 18 mo was higher for withdrawn (.51) and histrionic (.33) than other Axis II subtypes (range?=?.13–.22). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Axis II psychopathology as a function of Axis I disorders in childhood and adolescence

OBJECTIVE: To examine the occurrence of elevated personality disorder (PD) dimensional scores in a community sample of young adults as a function of the occurrence of Axis I disorders through age 18 years. METHOD: 299 individuals who had been interviewed regarding Axis I disorders twice while in adolescence (first when 14 through 18 years of age) were carefully assessed regarding Axis I and II psychopathology at age 24. RESULTS: The prevalence of PD diagnoses was relatively low (3.8% in participants with a history of Axis I versus 1.7% in participants with no Axis I history). The occurrence of all four Axis I diagnostic categories (major depression, anxiety disorders, disruptive behavior disorders, substance use disorders) in childhood and adolescence was associated with elevated PD dimensional scores. The likelihood of elevated PD dimensional scores increased as a function of the number of Axis I disorders. Elevated PD scores were significantly associated with a negative course of major depression. CONCLUSIONS: Although the rates of PDs were low, the findings suggest a substantial degree of association between early-onset Axis I disorders and Axis II psychopathology in young adulthood. More research is needed to develop assessment and treatment recommendations addressing the early manifestations of PDs.     

Predictors of relationship functioning for patients with bipolar disorder and their partners.

Previous investigations have examined family functioning, including marital functioning, as an important predictor of the course of bipolar disorder, but limited research exists identifying the factors that influence relationship functioning in patients with bipolar disorder. In the current study, 56 patients with bipolar disorder and their partners were assessed for Axis II pathology, general family functioning, and relationship distress. Patient mood symptoms and Axis II pathology variables were examined as predictors of general relationship functioning (Family Assessment Device, McMaster Clinical Rating Scale, and Dyadic Adjustment Scale) in regression models. Analyses indicated that patients' depressive symptomatology was associated with patient ratings of general family functioning and couple functioning, while patients' manic symptoms were associated with partners' ratings of the romantic relationship. Partners' total Axis II pathology, but not patients' Axis II pathology, was associated with patient and partner perception of the couple's relationship. These findings highlight the importance of mood and personality pathology to relationship functioning, and represent one of the first investigations to verify the impact of personality pathology on patients' and partners' perceptions of relationship functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Morbidity of DSM-IV Axis I disorders in patients with noncardiac chest pain: Psychiatric morbidity linked with increased pain and health care utilization.

The present study examined current and lifetime psychiatric morbidity, chest pain, and health care utilization in 229 patients with noncardiac chest pain (NCCP), angina-like pain in the absence of cardiac etiology. Diagnostic interview findings based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) revealed a psychiatrically heterogeneous sample of whom 44% had a current Axis I psychiatric disorder. A total of 41% were diagnosed with a current anxiety disorder, and 13% were diagnosed with a mood disorder. Overall, 75% of patients had an Axis I clinical or subclinical disorder. Lifetime diagnoses of anxiety (55%) and mood disorders (44%) were also prevalent, including major depressive disorder (41%), social phobia (25%), and panic disorder (22%). Patients with an Axis I disorder reported more frequent and more painful chest pain compared with those without an Axis I disorder. Presence of an Axis I disorder was associated with increased life interference and health care utilization. Findings reveal that varied DSM-IV Axis I psychiatric disorders are prevalent among patients with NCCP, and this psychiatric morbidity is associated with a less favorable NCCP presentation. Implications for early identification of psychiatric disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Axis I and II comorbidity in adults with ADHD.

Ongoing debate over the validity of the attention-deficit/hyperactivity disorder (ADHD) construct in adulthood is fueled in part by uncertainty regarding implications of potentially extensive yet incompletely described comorbid Axis I and II psychopathology. Three hundred sixty-three adults ages 18 to 37 completed semistructured clinical interviews; informants were also interviewed, and best estimate diagnoses were obtained. Results were as follows: First, ADHD combined type (ADHD-C) had an excess of externalizing and internalizing Axis I disorders, suggesting a gradient-of-severity relationship between it and ADHD inattentive type (ADHD-I). Second, ADHD-C and ADHD-I did not differ in frequency of Axis II disorders. Third, however, ADHD overall was associated with increased rates of Axis II disorders, compared with rates in non-ADHD control participants, including both Cluster B (primarily borderline personality disorder) and Cluster C disorders. Fourth, ADHD incrementally accounted for clinician-rated global assessment of functioning scores above and beyond comorbid conditions or symptoms on either Axis I or Axis II. Results further inform nosology of ADHD in adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Associations in the Course of Personality Disorders and Axis I Disorders Over Time.

In this study, the authors examined time-varying associations between schizotypal (STPD), borderline (BPD), avoidant (AVPD), or obsessive-compulsive (OCPD) personality disorders and co-occurring Axis I disorders in 544 adult participants from the Collaborative Longitudinal Personality Disorders Study. The authors tested predictions of specific longitudinal associations derived from a model of crosscutting psychobiological dimensions (L. J. Siever & K. L. Davis, 1991) with participants with the relevant Axis I disorders. The authors assessed participants at baseline and at 6-, 12-, and 24-month follow-up evaluations. BPD showed significant longitudinal associations with major depressive disorder and posttraumatic stress disorder. AVPD was significantly associated with anxiety disorders (specifically social phobia and obsessive-compulsive disorder). Two of the four personality disorders under examination (STPD and OCPD) showed little or no association with Axis I disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive personality characteristics: State dependent concomitants of depressive disorder and traits independent of current depression.

Depressive personality disorder (DPD) characteristics may reflect both state dependent concomitants and traits independent of current depression. In all, 30 clinically, 30 formerly, and 30 never depressed participants were given the Diagnostic Interview for Depressive Personality (J. G. Gunderson, K. A. Phillips, J. Triebwasser, & R. M. A. Hirschfeld, 1994). Negative reactivity, remorsefulness, a limited capacity for fun, gloominess, pessimism, difficulty being critical or angry, unassertiveness, self-denial, and seriousness differentiated depressed and nondepressed participants, indicating that they are primarily concomitants of depression. Self-criticalness differentiated formerly from never depressed participants after subclinical symptoms were controlled, suggesting that it is a trait independent of current depression. Low self-esteem, feeling burdened, and counterdependency manifested both state and trait components. If DPD is placed on Axis II, it should be defined by traits at least partly independent of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The comorbidity of alcoholism and personality disorders in a clinical population: Prevalence and relation to alcohol typology variables.

This study assessed prevalence rates and overlap among Diagnostic and Statistical Manual of Mental Disorders ( 3rd ed., revised; DSM-III—R; American Psychiatric Association, 1987) personality disorders in a multisite sample of 366 substance abusers in treatment. In addition, the relation of antisocial personality disorder (APD), borderline personality disorder (BPD), and paranoid personality disorder (PPD) to alcohol typology variables was examined. Structured diagnostic interviews and other measures were administered to participants at least 14 days after entry into treatment. Results indicated high prevalence rates for APD and non-APD disorders. There was extensive overlap between Axis I disorders and personality disorders, and among personality disorders themselves. APD, BPD, and PPD were linked to more severe symptomatology of alcoholism and other clinical problems. However, only APD and BPD satisfied subtyping criteria, after controlling for other comorbidity. Implications for classifying alcoholics by comorbid disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality disorders among alcoholics and alcohol-comorbid subtypes with a Vietnam-era military sample.

Promotes the enhancement of the alcohol and psychiatric comorbidity typology by including the full range of Axis II personality disorders in addition to Axis I disorders. Data from 3,210 male Vietnam-era veterans were used to document the prevalence of personality disorders in male alcoholic Ss with and without other psychiatric comorbidity. Ss were classified into 1 of 6 groups. The results of the personality disorder scales of the MMPI demonstrate increased Axis II comorbidity in alcoholic Ss across a wide range of personality disorders compared with no-diagnosis control Ss and across alcoholic subtypes based on psychiatric comorbidity. In addition, a relationship was found between personality dysfunction and multiple comorbidity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of free radical production and scavengers on occlusion-reperfusion induced arrhythmias

The DSM-IV section of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences between the samples with regard to patterns of personality pathology in relation to concurrent Axis I disorders and sociodemographic variables were analysed. The prevalence of personality disorders according to DIP-Q was 14% among the healthy volunteers, compared to 59% in the general psychiatric sample, 68% in the forensic psychiatric sample and up to 90% among psychotherapy candidates. Moreover, from a dimensional perspective (i.e. the number of fulfilled Axis II criteria), all clinical groups differed significantly from the control group in all specified personality dimensions and clusters. Dimensional DIP-Q cluster scores also discriminated significantly between the three clinical samples. Unexpectedly, the odds ratio for an Axis II disorder was nearly five times higher among psychotherapy applicants than among general psychiatric patients, independent of concomitant Axis I disorders, gender or age. The strongest association between DIP-Q score and Axis I disorders was found for depressive disorders, which more than doubled the odds ratio for a personality disorder diagnosis. This association could result from high true comorbidity, but could also be due to the fact that a concomitant depressive state can increase self-reported personality difficulties. The high prevalence among psychotherapy candidates may to some extent reflect help-seeking exaggeration of problems. These are aspects to consider when using the DIP-Q, which overall appears to discriminate well between different samples.     

Comorbid psychopathology in binge eating disorder: Relation to eating disorder severity at baseline and following treatment.

Individuals with binge eating disorder (BED) have high rates of comorbid psychopathology, yet little is known about the relation of comorbidity to eating disorder features or response to treatment. These issues were examined among 162 BED patients participating in a psychotherapy trial. Axis I psychopathology was not significantly related to baseline eating disorder severity, as measured by the Structured Clinical Interview for DSM-III-R (SCID-I and SCID-II) and the Eating Disorder Examination. However, presence of Axis II psychopathology was significantly related to more severe binge eating and eating disorder psychopathology at baseline. Although overall presence of Axis II psychopathology did not predict treatment outcome, presence of Cluster B personality disorders predicted significantly higher levels of binge eating at 1 year following treatment. Results suggest the need to consider Cluster B disorders when designing treatments for BED. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric comorbidity in women with binge eating disorder: Prevalence rates from a non-treatment-seeking sample.

This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates for major depression. any Axis I disorder, and any Axis II disorder relative to controls. BED women also evidenced greater eating and psychiatric symptomatology than did controls. Results suggest that the prevalence of comorbid psychiatric disorders in BED may be lower than previously indicated by clinical studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Axis I and Axis II disorders as predictors of prospective suicide attempts: Findings from the Collaborative Longitudinal Personality Disorders Study": Correction to Yen et al (2003).

Reports an error in "Axis I and Axis II disorders as predictors of prospective suicide attempts: Findings from the Collaborative Longitudinal Personality Disorders Study" by Shirley Yen, Tracie Shea, Maria Pagano, Charles A. Sanislow, Carlos M. Grilo, Thomas H. McGlashan, Andrew E. Skodol, Donna S. Bender, Mary C. Zanarini, John G. Gunderson and Leslie C. Morey (Journal of Abnormal Psychology, 2003[Aug], Vol 112[3], 375-381). On p. 378, the values in the "95% CI" column of Table 1 are incorrect. The correct values are given in the far right column of the table provided in the erratum. (The following abstract of the original article appeared in record 2003-05990-006.) This study examined diagnostic predictors of prospectively observed suicide attempts in a personality disorder (PD) sample. During 2 years of follow-up, 58 participants (9%) reported at least 1 definitive suicide attempt. Predictors that were examined include 4 PD diagnoses and selected Axis I diagnoses (baseline and course). Multivariate logistic regression analyses indicated that baseline borderline personality disorder (BPD) and drug use disorders significantly predicted prospective suicide attempts. Controlling for baseline BPD diagnosis, proportional hazards analyses showed that worsening in the course of major depressive disorder (MDD) and of substance use disorders in the month preceding the attempt were also significant predictors. Therefore, among individuals diagnosed with PDs, exacerbation of Axis I conditions, particularly MDD and substance use, heightens risk for a suicide attempt. (PsycINFO Database Record (c) 2010 APA, all rights reserved)