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Personality disorder (PD) is particularly common in adolescents, which underscores the significance of early screening, diagnosis, and intervention. To date, the definition of PD in the new ICD-11 has not yet been investigated in adolescents. This study therefore aimed to investigate the unidimensionality and criterion validity of self-reported ICD-11 PD features in Peruvian adolescents using the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale. A total of 1,073 students (63% female; age range 12-16 years) were administered the PDS-ICD-11 scale along with criterion measures of personality pathology and symptom distress. The PDS-ICD-11 score showed adequate unidimensionality and conceptually meaningful associations with external criterion variables. The findings indicate that ICD-11 PD features, as measured with the PDS-ICD-11 scale, are structurally and conceptually sound when employed with adolescents. Norm-based cutoffs derived from the present study may be used for clinical interpretation. The PDS-ICD-11 may be employed as an efficient screening tool for personality dysfunction in adolescents.

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Psychosis can be considered a dimension that in its most severe extreme can be expressed with alterations in sensory perception, mainly hallucinations. Their presence is a fact that is frequently observed in severe psychiatric pathologies such as schizophrenia (EZQ) and bipolar disorder (BD) where they can be markers of severity. However, sensory-perceptual disturbances are not pathognomonic of these disorders, nor do they signal any of these illnesses as an isolated event. Such symptomatology can be described in a variety of situations both within and outside psychopathology. In this sense, proposing a direct line between hallucinations and diseases such as CZS or TB disregards their occurrence in other pathologies, as is the case of Borderline Personality Disorder (BPD). It is feasible that we may find the expression of pseudo hallucinations or hallucinations in patients with this disorder and their presence may have etiological, clinical and therapeutic connotations that should be reviewed and taken into account in our clinical practice.

La psicosis puede ser considerada una dimensión que en su extremo de mayor gravedad puede expresarse con alteraciones en la sensopercepción, principalmente alucinaciones. Su presencia es un hecho que se constata con frecuencia en patologías psiquiátricas severas como la esquizofrenia (EZQ) y el trastorno bipolar (TB) donde pueden ser marcadores de gravedad. No obstante, las alteraciones sensoperceptivas no son patognomónicas de estos trastornos ni señalan ninguna de estas enfermedades como un hecho aislado. Dicha sintomatología puede ser descripta en diversas situaciones dentro y fuera de la psicopatología. En este sentido, proponer una línea directa entre las alucinaciones con enfermedades tales como la EZQ o el TB desestima su ocurrencia en otras patologías, como es el caso del Trastorno límite de la personalidad (TLP). Es factible que constatemos la expresión de alucinaciones en pacientes con este trastorno y su presencia puede tener connotaciones etiológicas, clínicas y terapéuticas que deben ser revisadas para tener en cuenta en nuestra práctica clínica.

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Borderline Personality Disorder (BPD) symptoms include inappropriate control of anger and severe emotional dysregulation after rejection in daily life. Nevertheless, when using the Cyberball paradigm, a tossing game to simulate social exclusion, the seven basic emotions (happiness, sadness, anger, surprise, fear, disgust, and contempt) have not been exhaustively tracked out. It was hypothesized that these patients would show anger, contempt, and disgust during the condition of exclusion versus the condition of inclusion. When facial emotions are automatically detected by Artificial Intelligence, "blending", -or a mixture of at least two emotions- and "masking", -or showing happiness while expressing negative emotions- may be most easily traced expecting higher percentages during exclusion rather than inclusion. Therefore, face videos of fourteen patients diagnosed with BPD (26 ± 6 years old), recorded while playing the tossing game, were analyzed by the FaceReader software. The comparison of conditions highlighted an interaction for anger: it increased during inclusion and decreased during exclusion. During exclusion, the masking of surprise; i.e., displaying happiness while feeling surprised, was significantly more expressed. Furthermore, disgust and contempt were inversely correlated with greater difficulties in emotion regulation and symptomatology, respectively. Therefore, the automatic detection of emotional expressions during both conditions could be useful in rendering diagnostic guidelines in clinical scenarios.

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Resumen Los Trastornos del Espectro Autista (TEA) y los Tras tornos por Déficit de Atención Hiperactividad (TDAH) son Trastornos del Neurodesarrollo (TN) que coexisten frecuentemente y que tienen factores etiológicos, bio lógicos, clínicos en común. La comorbilidad de ambos TN se asocia a un retraso en el diagnóstico del TEA o un diagnóstico que nunca llegan a recibir y es frecuente el desarrollo de alteraciones perceptivas, emocionales, cognitivas y conductuales relacionadas con la Desregu lación Emocional (DE). Cuando ambos TN no son diag nosticados en infancia, frecuentemente reciben diag nósticos equivocados en edades más tardías, siendo el más frecuente el Trastorno Límite de Personalidad (TLP). Se analiza la presentación clínica de la asociación del TEA y el TDAH, la asociación con DE, diferenciación del TLP y evaluación e intervención. La comorbilidad TEA, TDAH, DE, es un trastorno más severo, asociado a poli farmacología y a ingresos hospi talarios.

Abstract Autism Spectrum Disorders (ASD) and Attention Defi cit Hyperactivity Disorders (ADHD) are Neurodevelop mental Disorders (ND) that frequently coexist together and have etiological, biological, and clinical factors in common. The comorbidity of both neurodevelopmental disorders is associated with a delay or lack of ASD di agnosis and the development of perceptual, emotional, cognitive and behavioral alterations related to Emotional Dysregulation (ED) is common. When both TN are not diagnosed in childhood, they frequently receive wrong diagnoses at later ages, the most frequent being Border line Personality Disorder (BPD). The clinical presentation of the association of ASD and ADHD, the association with ED, differentiation of BPD, and evaluation and intervention are here analyzed. The comorbidity ASD, ADHD, ED is a more severe disorder associated to polypharmacology and hospital admissions.

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Background: Discovering biological markers is essential for understanding and treating mental disorders. Despite the limitations of current non-invasive methods, neural progenitor cells from the olfactory epithelium (hNPCs-OE) have been emphasized as potential biomarker sources. This study measured soluble factors in these cells in Major Depressive Disorder (MDD), Borderline Personality Disorder (BPD), and healthy controls (HC). Methods: We assessed thirty-five participants divided into MDD (n=14), BPD (n=14), and HC (n=7). MDD was assessed using the Hamilton Depression Rating Scale. BPD was evaluated using the DSM-5 criteria and the Structured Clinical Interview for Personality Disorders. We isolated hNPCs-OE, collected intracellular proteins and conditioned medium, and quantified markers and soluble factors, including Interleukin-6, interleukin-8, and others. Analysis was conducted using one-way ANOVA or Kruskal-Wallis test and linear regression. Results: We found that hNPCs-OE of MDD and BPD decreased Sox2 and laminin receptor-67 kDa levels. MASH-1 decreased in BPD, while tubulin beta-III decreased in MDD compared to controls and BPD. Also, we found significant differences in IL-6, IL-8, MCP-1, and thrombospondin-1 levels between controls and MDD, or BPD, but not between MDD and BPD. Conclusions: Altered protein markers are evident in the nhNPCs-OE in MDD and BPD patients. These cells also secrete higher concentrations of inflammatory cytokines than HC cells. The results suggest the potential utility of hNPCs-OE as an in vitro model for researching biological protein markers in psychiatric disorders. However, more extensive validation studies are needed to confirm their effectiveness and specificity in neuropsychiatric disorders.

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[This corrects the article DOI: 10.3389/fpsyt.2023.1325583.].

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Objective: Borderline personality disorder (BPD) is a serious public health problem. Dialectical Behavior Therapy (DBT) is a program that has provided encouraging results for its treatment. However, scientific evidence about its efficacy is scarce. Therefore, we aimed to describe the scientific production on the components of the DBT program and its therapeutic efficacy in the treatment of people with BPD. Method : A systematic review with relevant keywords was conducted based on studies available in Scopus, Web of Science, and PubMed until June 2023, including studies in English, research on therapeutic intervention, studies with a randomized controlled trial (RCT) design that included people with the diagnosis of BPD. Results: We found 18 RCTs, most of which supported the effectiveness of DBT for BPD. There were a total of 1,755 participants in these studies, most of whom were women. These studies looked for treating self-injurious behaviors, suicidal thoughts or ideations, number of visits to emergency services, and frequency of hospital admissions. Most studies revealed that both short-term DBT and standard DBT improved suicidality in BPD patients with small or moderate effect sizes, lasting up to 24 months after the treatment period. Furthermore, these studies showed that DBT can significantly improve general psychopathology and depressive symptoms in patients with BPD. Improvement of compliance, impulsivity, mood instability, as well as reduction in hospitalization rate are other findings observed in the trials following DBT. Conclusion: Although DBT shows efficacy in the treatment of BPD, heterogeneity in the methodologies employed is highlighted. Therefore, it is necessary to design studies from a homogeneous theoretical and methodological framework.

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Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorders (ADHD) are Neurodevelopmental Disorders (ND) that frequently coexist together and have etiological, biological, and clinical factors in common. The comorbidity of both neurodevelopmental disorders is associated with a delay or lack of ASD diagnosis and the development of perceptual, emotional, cognitive and behavioral alterations related to Emotional Dysregulation (ED) is common. When both TN are not diagnosed in childhood, they frequently receive wrong diagnoses at later ages, the most frequent being Borderline Personality Disorder (BPD). The clinical presentation of the association of ASD and ADHD, the association with ED, differentiation of BPD, and evaluation and intervention are here analyzed. The comorbidity ASD, ADHD, ED is a more severe disorder associated to polypharmacology and hospital admissions.

Los Trastornos del Espectro Autista (TEA) y los Trastornos por Déficit de Atención Hiperactividad (TDAH) son Trastornos del Neurodesarrollo (TN) que coexisten frecuentemente y que tienen factores etiológicos, biológicos, clínicos en común. La comorbilidad de ambos TN se asocia a un retraso en el diagnóstico del TEA o un diagnóstico que nunca llegan a recibir y es frecuente el desarrollo de alteraciones perceptivas, emocionales, cognitivas y conductuales relacionadas con la Desregulación Emocional (DE). Cuando ambos TN no son diagnosticados en infancia, frecuentemente reciben diagnósticos equivocados en edades más tardías, siendo el más frecuente el Trastorno Límite de Personalidad (TLP). Se analiza la presentación clínica de la asociación del TEA y el TDAH, la asociación con DE, diferenciación del TLP y evaluación e intervención. La comorbilidad TEA, TDAH, DE, es un trastorno más severo, asociado a poli farmacología y a ingresos hospitalarios.

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Introducción. El trastorno somatomorfo se caracteriza por la presentación de múltiples síntomas físicos que no pueden ser atribuidos a otra enfermedad física, mental o al uso de sustancias, teniendo como comorbilidad más prevalente a los trastornos de personalidad. Objetivo. Determinar la frecuencia de trastorno somatomorfo, sus características principales y diferentes rasgos de personalidad entre pacientes con lumbalgia crónica. Metodología. Estudio descriptivo transversal realizado con pacientes ingresados en el servicio de neurocirugía del Hospital General del Instituto Salvadoreño del Seguro Social. La recolección de datos se realizó a través de la escala Screening for Somatoform Symptoms 2 y la escala InternationalPersonality Disorder Examination. Las variables cualitativas fueron analizadas a través de frecuencias absolutas. Las variables cuantitativas fueron analizadas a través de medidas de tendencia central y de dispersión. Los análisis estadísticos fueron realizados en el programa Statistical Package for the Social Sicience, versión 26. Resultados. Se incluyeron 60 pacientes, 40 de ellos mujeres, 31 entre los 41 y 60 años. Veintiocho pacientes presentaron ocho o más síntomas, excluyéndose dolor lumbar. Cuarenta y cinco pacientes reportaron sintomatología por más de un año. Cincuenta y tres pacientes presentaron trastorno somatomorfo. Los trastornos de personalidad más frecuentes fueron obsesivo-compulsivos (31), límites (21) y paranoides (21). Conclusión. Los pacientes con dolor lumbar crónico que requieren ingreso hospitalario presentan una alta frecuencia de trastornos somatomorfos, con dolor en piernas o brazos como síntoma principal; además, estos pacientes se caracterizan por presentar en su mayoría rasgos de personalidad obsesivo-compulsivos.

Introduction. The somatoform symptoms disorder is characterized by multiple psychical symptoms that can't be attributed to another physical or mental health diagnosis or drug abuse, having personality disorders as the most common comorbidity. Objective. To determine the frequency of somatoform disorders, it's most important characteristics and different personality traits among patients with chronic back pain. Methodology. Cross-sectional descriptive study carried out with patients admitted to the neurosurgery department of the General Hospital of the Salvadoran Social Security Institute. Data collection was carried out using the Screening for Somatoform Symptoms 2 scale and the International Personality Disorder Examination scale. The qualitative variables were analyzed through absolute frequencies. The quantitative variables were analyzed through measures of central tendency and dispersion. The statistical analyzes were carried out using the Statistical Package for the Social Sciences version 26. Results. The study included 60 patients, 40 of them women, 31 between 41 and 60 years old. Twenty-eight patients presented eight or more symptoms, excluding low back pain. Forty-five patients reported symptoms for more than one year. Fifty-three patients presented somatoform disorder. The most frequent personality disorders were obsessive-compulsive (31), borderline (21) and paranoid (21). Conclusion. Patients with chronic lower back pain who require hospital admission have a high frequency of somatoform disorders, with the main symptom being pain in the legs or arms; furthermore, these patients are characterized by mostly presenting obsessive-compulsive personality traits

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RESUMO Objetivo Analisar o conteúdo da produção de literatura no que diz respeito a relação entre trauma infantil e o diagnóstico de TPB na vida adulta, a fim de compreender as especificidades das bases etiológicas do TPB. Material e Métodos Trata-se de uma revisão integrativa onde realizou-se uma busca nas bases de dados PubMed, SciELO e Lilacs, utilizando os descritores "TRAUMA INFANTIL E TRANSTORNO DA PERSONALIDADE BORDERLINE" e "CHILDHOOD TRAUMA AND BORDERLINE PERSONALITY DISORDER". Foram incluídos os artigos completos publicados de 2011 a 2021 em jornais científicos, em língua portuguesa, espanhola e inglesa que retratavam a relação entre trauma infantil e o diagnóstico do TPB. Foram excluídos os artigos sem descrição metodológica explícita de definição da amostra TPB através de escalas validadas e/ou a partir dos critérios do DSM e os estudos de revisão. Resultados Foram identificados 423 artigos, e, após uma triagem, restaram 23 artigos elegíveis. 65,2% das obras incluídas foram estudos transversais e 34,8% estudos caso-controle. Todos os trabalhos abordaram abuso sexual, e, a maioria deles também abordou abuso físico (95,6%), abuso emocional (86,9%), negligência emocional (82,6%) e negligência física (78,2%). Todas as obras evidenciaram associação entre vivências traumáticas na infância e o diagnóstico de TPB. Conclusões O trauma infantil pode ser encarado como fator de risco para o diagnóstico de TPB, assim como associa-se com maior gravidade dos sintomas e pior prognóstico.

ABSTRACT Objective To analyze the content of the literature regarding the relationship between childhood trauma and the diagnosis of BPD in adulthood, in order to understand the specificities of the etiological bases of BPD. Material and Methods This is an integrative review where a search was carried out in PubMed, SciELO and Lilacs databases, using the descriptors "TRAUMA INFANTIL E TRANSTORNO DA PERSONALIDADE BORDERLINE" and "CHILDHOOD TRAUMA AND BORDERLINE PERSONALITY DISORDER". Full articles published from 2011 to 2021 in scientific journals in Portuguese, Spanish and English that portrayed the relationship between childhood trauma and the diagnosis of BPD were included. Articles without an explicit methodological description of the BPD sample definition through validated scales and/or based on the DSM criteria and review studies were excluded. Results 423 articles were identified, and, after screening, 23 eligible articles remained. 65.2% of the works included were cross-sectional studies and 34.8% were case-control studies. All studies addressed sexual abuse, and most of them also addressed physical abuse (95.6%), emotional abuse (86.9%), emotional neglect (82.6%) and physical neglect (78.2%). All the works showed an association between traumatic experiences in childhood and the diagnosis of BPD. Conclusions Childhood trauma can be seen as a risk factor for the diagnosis of BPD, as well as being associated with greater severity of symptoms and worse prognosis.

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1). La vida de Ludwig van Beethoven experimentó un cambio existencial al morir su hermano y dejar a su hijo Karl en tutoría compartida con su madre Johanna. 2). Casi sin haber tenido relación con su sobrino, se desencadena una necesidad emocional intensa e inesperada de convertirse en su único tutor, objetivo que consigue derrotando legalmente a su madre. 3). La relación Beethoven-Karl se desarrolla plagada de disputas, vigilancia, exigencias, control, como si el compositor viviera por vez primera lo que siempre se había negado, llegar a ser padre. 4). El intento de suicidio del sobrino le señala a Beethoven que convertirse en padre significa permitir que el hijo llegue a ser diferente a las arrogantes y desmesuradas ambiciones y expectativas personales, pero esta señal extrema fue insuficiente para hacerle entender que el otro siempre es un peligro porque muestra una verdad oculta intolerable y dolorosa del propio sí-mismo.

Ludwig van Beethoven's life underwent an existential change when his brother died and left his son Karl in shared tutorship with his mother Johanna. 2. Almost without having had any relationship with his nephew, an intense and unexpected emotional need to become his sole guardian is triggered, an objective that he achieves by legally defeating his mother. 3. The Beethoven-Karl relationship develops plagued by disputes, surveillance, demands, control, as if the composer were experiencing for the first time what he had always denied himself, becoming a father.4. The nephew's suicide attempt points out to Beethoven that becoming a father means allowing the son to become different from the arrogant and inordinate personal ambitions and expectations, but this extreme signal was insufficient to make him understand that the other is always a danger because it shows a hidden and painful truth of one´s own self.

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La violencia contra los niños es una preocupación muy importante en el sistema de salud pública. El filicidio es un acto deliberado de una madre o un padre que mata a su propio hijo. El objetivo de este estudio es describir un caso de filicidio asociado a la presencia del Trastorno Límite de la Personalidad (TLP), analizando la evaluación de la imputabilidad criminal relacionada con este caso, utilizando el criterio biopsicológico. Medidas de protección a los niños deben ser ofrecidas de forma activa cuando los padres tienen estrés y falta de equilibrio emocional, y al mismo tiempo deben cuidar a los niños.

Violence against children is a very important concern in the public health system. Filicide is a deliberate act of a mother or father killing his own child. The aim of this study is to describe a case of filicide associated with the presence of borderline personality disorder, discussing the evaluation of criminal imputability related to this case, using the biopsychological criterion. Child protection measures should be actively offered when parents have stress and lack of emotional balance while needing to care for children.

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Abstract Objective Borderline personality disorder (BPD) is a serious and extremely prevalent mental disorder. Early diagnosis is vital for treatment. However, there are no specific screening instruments validated for Brazilian Portuguese. This study aimed to adapt the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) to the Brazilian context. The MSI-BPD is a self-report instrument based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), that enables fast and reliable assessment of BPD, with measures of sensitivity (SN) and specificity (SP) similar to the diagnostic interview for the DSM-5 (Structured Clinical Interview for DSM-V Axis II Disorders [SCID-II]), taken as the gold standard. Methods Two independent translations, a synthesis version, back-translation, and analysis by experts were employed to create the final version of the instrument in Brazilian Portuguese. The translated instrument was administered to 1,702 adults aged 18-59 years to verify evidence of validity relating to content, internal structure, relationship with other variables, and reliability. Results The exploratory and confirmatory factor analyses show that the one-factor structure is adequate. The scale showed satisfactory internal consistency (Kuder-Richardson coefficient [KR-20] of Cronbach's alpha = 0.691) and good test-retest reliability (intraclass correlation coefficient [ICC] = 0.802). Logistic regression analysis using the Personality Inventory for the DSM-5-Brief Form (PID-5-BF) (DSM-5) as reference established an ideal cut-off point of eight symptoms, with adequate SN (0.79) and SP (0.75), similar to the original instrument. The area under the curve (AUC) was 0.830 (95% confidence interval: 0.802-0.858), with a positive predictive value of 89.2%. Conclusion The Brazilian version of the MSI-BPD has adequate psychometric properties for use as a BPD screening tool by clinicians.

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The present case report describes a 19-year-old male patient whose main symptoms were emotional coldness, absence of close relationships, difficulty experiencing pleasure with other people, and lack of motivation to work or to continue his studies. A schizoid personality disorder was diagnosed as a product of early maladaptive patterns such as inhibition, emotional deprivation, social isolation, and inadequacy. Likewise, a rigid and fragmented family context was evidenced, with an affective absence of parents and a focus on strict behavioral rules. The study aimed to intervene, from a cognitive clinical approach, the early maladaptive patterns and symptoms that maintained the features of schizoid personality disorder in the patient. For this purpose, cognitive behavioral therapy was carried out, with techniques such as debates, images to reparentalize, assignment of tasks, use of humor, and social skills training, among others. In conclusion, it can be stated that the early maladaptive patterns maintained the schizoid personality symptomatology. Finally, it was demonstrated through clinical and psychometric criteria that cognitive behavioral therapy decreased schizoid personality behaviors in the patient.

El presente reporte de caso describe a un paciente varón de 19 años, que presentaba como principales síntomas frialdad emocional, ausencia de relaciones cercanas, problemas para experimentar placer con otras personas y carencia de motivación para trabajar o retomar sus estudios. Se diagnosticó un trastorno de personalidad esquizoide, producto de esquemas maladaptativos tempranos como inhibición, privación emocional, aislamiento social e inadecuación. Asimismo, se evidenció un contexto familiar rígido y fragmentado, con ausencia afectiva de padres y direccionado hacia normas estrictas en la conducta. El objetivo del estudio fue intervenir desde un enfoque clínico cognitivo los esquemas maladaptativos tempranos y síntomas que mantenían los rasgos de trastorno esquizoide de la personalidad en el paciente. Para esto se realizó una terapia cognitiva conductual, con técnicas como debates, imágenes para reparentalizar, asignación de tareas, uso del humor, entrenamiento de habilidades sociales, entre otros. Como conclusión se puede manifestar que los esquemas maladaptativos tempranos mantenían la sintomatología de personalidad esquizoide. Por último, se demostró a través de un criterio clínico y psicométrico que la terapia cognitiva conductual disminuyo las conductas de personalidad esquizoide en el paciente.

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El presente reporte de caso describe a un paciente varón de 19 años, que presentaba como principales síntomas frialdad emocional, ausencia de relaciones cercanas, problemas para experimentar placer con otras personas y carencia de motivación para trabajar o retomar sus estudios. Se diagnosticó un trastorno de personalidad esquizoide, producto de esquemas maladaptativos tempranos como inhibición, privación emocional, aislamiento social e inadecuación. Asimismo, se evidenció un contexto familiar rígido y fragmentado, con ausencia afectiva de padres y direccionado hacia normas estrictas en la conducta. El objetivo del estudio fue intervenir desde un enfoque clínico cognitivo los esquemas maladaptativos tempranos y síntomas que mantenían los rasgos de trastorno esquizoide de la personalidad en el paciente. Para esto se realizó una terapia cognitiva conductual, con técnicas como debates, imágenes para reparentalizar, asignación de tareas, uso del humor, entrenamiento de habilidades sociales, entre otros. Como conclusión se puede manifestar que los esquemas maladaptativos tempranos mantenían la sintomatología de personalidad esquizoide. Por último, se demostró a través de un criterio clínico y psicométrico que la terapia cognitiva conductual disminuyo las conductas de personalidad esquizoide en el paciente.

The present case report describes a 19-year-old male patient whose main symptoms were emotional coldness, absence of close relationships, difficulty experiencing pleasure with other people, and lack of motivation to work or to continue his studies. A schizoid personality disorder was diagnosed as a product of early maladaptive patterns such as inhibition, emotional deprivation, social isolation, and inadequacy. Likewise, a rigid and fragmented family context was evidenced, with an affective absence of parents and a focus on strict behavioral rules. The study aimed to intervene, from a cognitive clinical approach, the early maladaptive patterns and symptoms that maintained the features of schizoid personality disorder in the patient. For this purpose, cognitive behavioral therapy was carried out, with techniques such as debates, images to reparentalize, assignment of tasks, use of humor, and social skills training, among others. In conclusion, it can be stated that the early maladaptive patterns maintained the schizoid personality symptomatology. Finally, it was demonstrated through clinical and psychometric criteria that cognitive behavioral therapy decreased schizoid personality behaviors in the patient.

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In the current diagnostic systems, the International Classification of Diseases-11th rev. (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders-5th ed. (DSM-5), the evaluation and diagnosis of personality disorder (PD) aim at dimensional examination of the severity of its dysfunction and the stylistic features that accompany it. Since their implementation, or even before, several measures have been developed to assess PD severity and traits in both models. Thus, convergent validity metrics have been reported with various PD measures; however, the convergence of the same constructs included in the measures of these two models remains undefined. The objective of the present review was to examine whether there is a sufficient relationship between PD measures of the ICD-11 and DSM-5 AMPD in the general population. For this meta-analytic review, systematic searches were conducted in Web of Science, PubMed, Scopus, and Google Scholar. We included studies that reported Pearson's r correlations without restrictions on language, age, sex, setting, type of sample, or informant of the measures. We excluded associations with anankastia, psychoticism or the borderline pattern because they were not comparable between one dimensional model and the other. We examined the quality of the evidence with the JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies, and performed the random effects meta-analysis with the 'meta' package of the RStudio software. Of the 5,629 results returned by the search, 16 studies were eligible; and showed moderate quality. The risk of bias was manifested by not specifying the details of the sample, the recruitment environment, and the identification and control of confounding factors. Thirteen studies provided two or more correlations resulting in a total of 54 studies for meta-analysis. The overall effect size estimate (correlation) was moderate for the overall model (r = 0.62, 95% CI [0.57, 0.67], p < 0.0001, I2 = 97.6%). For the subgroup of associations, ICD-11 severity model and DSM-5 AMPD severity model, the correlation was also moderate (k = 10, r = 0.57, 95% CI [0.48; 0.66]; I2 = 92.9%); as for the subgroup of associations, ICD-11 traits model and DSM-5 AMPD traits model (k = 44, r = 0.63, 95% CI [0.57; 0.69], I2 = 97.9%). The convergent validity between measures of PD severity and traits between one diagnostic system and another has been demonstrated in this review and they can probably be used interchangeably because they also measure the same constructs. Future research can address the limitations of this study and review the evidence for the discriminant validity of these measures.

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With the implementation of new dimensional models of personality disorder (PD) in the DSM-5 and ICD-11, several investigators have developed and evaluated the psychometric properties of measures of severity. The diagnostic accuracy of these measures, an important cross-cultural metric that falls between validity and clinical utility, remains unclear. This study aimed to analyze and synthesize the diagnostic performance of the measures designed for both models. For this purpose, searches were carried out using three databases: Scopus, PubMed, and Web of Science. Studies that presented sensitivity and specificity parameters for cut-off points were selected. There were no restrictions on the age and gender of the participants nor on the reference standard used or the settings. Study quality and synthesis were assessed using QUADAS-2 and MetaDTA software, respectively. Twelve studies were eligible covering self-reported and clinician-rated measures based on the ICD-11 and DSM-5 PD severity models. A total of 66.7% of the studies showed a risk of bias in more than 2 domains. The 10th and 12th studies provided additional metrics, resulting in a total of 21 studies for evidence synthesis. Adequate overall sensitivity and specificity (Se = 0.84, Sp = 0.69) of these measures were obtained; however, the cross-cultural performance of specific cut-off points could not be assessed due to the paucity of studies on the same measure. Evidence suggests that patient selection processes should mainly be improved (avoid case-control design), use adequate reference standards, and avoid only reporting metrics for the optimal cut-off point.

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BACKGROUND: Borderline personality disorder (BPD) is characterized by frequent and intense moment-to-moment changes in affect, behavior, identity, and interpersonal relationships, which typically result in significant and negative deterioration of the person's overall functioning and well-being. Measuring and characterizing the rapidly changing patterns of instability in BPD dysfunction as they occur in a person's daily life can be challenging. Ecological momentary assessment (EMA) is a method that can capture highly dynamic processes in psychopathology research and, thus, is well suited to study intense variability patterns across areas of dysfunction in BPD. EMA studies are characterized by frequent repeated assessments that are delivered to participants in real-life, real-time settings using handheld devices capable of registering responses to short self-report questions in daily life. Compliance in EMA research is defined as the proportion of prompts answered by the participant, considering all planned prompts sent. Low compliance with prompt schedules can compromise the relative advantages of using this method. Despite the growing EMA literature on BPD in recent years, findings regarding study design features that affect compliance with EMA protocols have not been compiled, aggregated, and estimated. OBJECTIVE: This systematic meta-analytic review aimed to investigate the relationship between study design features and participant compliance in EMA research of BPD. METHODS: A systematic review was conducted on November 12, 2021, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analyses of Observational Studies in Epidemiology) guidelines to search for articles featuring EMA studies of BPD that reported compliance rates and included sufficient data to extract relevant design features. For studies with complete data, random-effect models were used to estimate the overall compliance rate and explore its association with design features. RESULTS: In total, 28 peer-reviewed EMA studies comprising 2052 participants were included in the study. Design features (sampling strategy, average prompting frequency, number of items, response window, sampling device, financial incentive, and dropout rate) showed a large variability across studies, and many studies did not report design features. The meta-analytic synthesis was restricted to 64% (18/28) of articles and revealed a pooled compliance rate of 79% across studies. We did not find any significant relationship between design features and compliance rates. CONCLUSIONS: Our results show wide variability in the design and reporting of EMA studies assessing BPD. Compliance rates appear to be stable across varying setups, and it is likely that standard design features are not directly responsible for improving or diminishing compliance. We discuss possible nonspecific factors of study design that may have an impact on compliance. Given the promise of EMA research in BPD, we also discuss the importance of unifying standards for EMA reporting so that data stemming from this rich literature can be aggregated and interpreted jointly.

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Introducción: El espectro de la conducta suicida (CS) es nuclear en la clínica y el tratamiento del trastorno límite de personalidad (TLP). Los rasgos patológicos del TLP intervienen como factores de riesgo de CS en confluencia con otras variables clínicas y sociodemográficas asociadas con el TLP. El objetivo del presente trabajo consiste en evaluar los rasgos de personalidad específicos del TLP que se relacionan con la CS. Métodos: Se realiza un estudio transversal, observacional y retrospectivo, de una muestra de 134 pacientes con diagnóstico de TLP según los criterios del DSM-5. Se utilizan los cuestionarios de Millon-II, Zuckerman-Kuhlman y Barrat para valorar distintos parámetros de la personalidad. Se realizan comparaciones por variables mediante las pruebas de la x2 y de la t de Student. La asociación entre variables se analiza mediante regresión logística multivariada. Resultados: Se objetivan diferencias estadísticamente significativas entre la CS y relacionadas y la dimensión neuroticismo-ansiedad en el test de Zuckerman-Kuhlman. Asimismo se relaciona de manera significativa con la subescala fóbica y antisocial del Millon-II. La impulsividad medida con las pruebas de Zuckerman-Kuhlman y Barrat no aparece relacionada con la CS. Conclusiones: Los resultados presentados plantean el papel de los rasgos fóbicos, antisociales y del neuroticismo como posibles rasgos de personalidad del TLP relacionados con la CS. Incluso se propone una importancia mayor que el de la impulsividad dentro de la relación del TLP con la CS. De cara al futuro, estudios longitudinales permitirían aumentar la evidencia científica de los hallazgos presentados. © 2021 Asociación Colombiana de Psiquiatría. Publicado por Elsevier Espafña, S.L.U. Todos los derechos reservados.

Introduction: The spectrum of suicidal behaviour (SB) is nuclear in the clinic andmanagement of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. Methods: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. Results: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. Conclusions: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings. © 2021 Asociacio´n Colombiana de Psiquiatria. Published by Elsevier España, S.L.U. All rights reserved.

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The aim was to assess the lifetime prevalence of psychiatric comorbidity (PC) in Brazilian euthymic individuals with bipolar disorder type I, and investigate its effects on clinical outcomes and functioning. A group of 179 outpatients with BD-I in the recuperation phase were assessed, of whom 75 (41.9%) had PC and 104 (58.1%) had not. Both groups were compared using sociodemographic/clinical questionnaire, Structured Clinical Interview for DSM-IV axis I and II, Sheehan Disability and Barratt Impulsiveness Scales. Patients with PC presented less religious affiliation, more history of lifetime psychotic symptoms, rapid cycling, suicide attempts, worse scores of functioning, and higher prevalence of personality disorders. Ordinal logistic regression indicated that PC was associated with increased odds of worse levels of disability. Therefore, it could be observed that patients with BD evaluated only in euthymia presented a high mental disorders comorbidity. Considering their burdensome impact, appropriate management is a challenging reality and a crucial factor in reducing morbidity and mortality associated with BD. Further longitudinal studies on their relationship may broaden interventions to reduce patient's suffering.

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