Personality psychopathology in temporal lobe epilepsy: An Arabian study.
Previous research has linked epilepsy of the temporal lobe (TLE) with comorbidities of psychiatric nature, yet few studies have investigated personality psychopathology in patients with TLE. This is the first study on the topic in the Arab world and the first study using the Personality Inventory for DSM-5-Brief From (PID-5-BF). Thus, this study, which is cross-sectional by nature, aims to explore the potential relationship between TLE and personality psychopathology.
Utilizing the validated Arabic version of the Personality Inventory for DSM-5 - Brief Form (PID-5-BF), this study compared average total scores and domain scores among 24 TLE patients and 48 controls from the general population, using the Independent Samples t-test. Binary logistic regression used to assess the impact of gender and age on personality psychopathology in both the TLE and control group.
Following adjustment for age and gender, notable disparities emerged in average total scores (p < 0.001), as well as negative affect (p < 0.0001), disinhibition (p < 0.04), and psychoticism scores (p < 0.01), with TLE patients exhibiting higher scores across these domains with a score of 1.28, 2.00, 1.08 and 1.25 respectively compared to controls with a score of 0.85, 1.08, 0.69 and 0.69 respectively. Nevertheless, analyses investigating age and gender as predictors for personality psychopathology yielded non-significant results in both groups.
The study hints at a possible positive link between TLE and personality psychopathology, possibly attributable to limbic system involvement. This is the first study of its kind in the Arab world, highlighting a neglected topic in the region. While these results hold clinical implications, further research is warranted to validate these relationships.
Joy Khachan M
，Khachan J
，Tannous N
，El Ahdab J
，Raad G
，Kallab K
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Mentalization based treatment for a broad range of personality disorders: a naturalistic study.
Several studies have observed that mentalization-based treatment (MBT) is an effective treatment for borderline personality disorder (BPD), but its effectiveness for other personality disorders (PDs) has hardly been examined. Additionally, the evidence supporting the claim that MBT improves mentalizing capacity is scarce. The present study examined whether (i) patients with a broad range of PDs enrolled in an MBT program would improve on several outcome measures (ii) mentalizing capacity would improve over time; (iii) patients with BPD would improve more than those with non-borderline PDs.
Personality disorders, psychiatric symptoms, social functioning, maladaptive personality functioning and mentalizing capacity were measured in a group of individuals with various PDs (n = 46) that received MBT. Assessments were made at baseline and after 6, 12, and 18 months of treatment. The severity of psychiatric symptoms, measured using the Outcome Questionnaire 45, was the primary outcome variable.
Overall, enrollment in the MBT program was associated with a decrease in psychiatric symptoms and an improvement of personality functioning, social functioning for a mixed group of PDs (all p's ≤ .01). Bigger effect sizes were observed for BPD patients (n = 25) than for patients with non-BPD (n = 21), but the difference failed to reach statistical significance (p = 0.06). A primary analysis showed that the decrease in psychiatric symptoms was significant in BPD patients (p = 0.01), not in non-BPD (p = 0.19) patients. However, a sufficiently powered secondary analysis with imputed data showed that non-BPD patients reported a significant decrease in psychiatric symptoms too (p = 0.01). Mentalizing capacity of the whole group improved over time (d = .68 on the Toronto Alexithymia Scale and 1.46 on the Social Cognition and Object Relations System).
These results suggest that MBT coincides with symptomatic and functional improvement across a broad range of PDs and shows that MBT is associated with improvements in mentalizing capacity. As the study is not experimental in design, we cannot make causal claims.
Mentalization-based treatment may be an effective treatment for patients with a broad range of PDs.
The study design was approved by the Leiden University Ethical Committee.
Rizzi E
，Weijers JG
，Kate CT
，Selten JP
... -
《BMC Psychiatry》
Clinical heterogeneity of feeding and eating disorders: using personality psychopathology to differentiate "simplex" and "complex" phenotypes.
To investigate Feeding and Eating Disorders (FED) heterogeneity based on the co-occurrence of FED symptoms and personality psychopathology, on the hypothesis that empirical profiles would not confirm current FED categories but identify unique phenotypes carrying different levels of clinical complexity.
Latent Profile Analysis profiled FED patients based on the assessment of both FED symptoms, through the Eating Disorders Inventory, third version (EDI-3), and personality characteristics, through the Minnesota Multiphasic Personality Inventory-2. Then, profiles were compared across socio-demographic and clinical characteristics.
Among 109 eligible patients, three FED profiles were identified: (i) FED simplex (low eating symptoms, absence of dysfunctional personality); (ii) FED simplex-severe (high eating symptoms only); and (iii) FED complex-severe (high eating symptoms and dysfunctional personality). Despite an uneven distribution (χ2(6) = 15.20, adjusted-p = 0.029), FED profiles did not unequivocally confirm clinical diagnoses (e.g., Anorexia Nervosa). A difference in Body Mass Index (BMI) was observed (K(2) = 15.06, adjusted-p = 0.001), but lower BMI did not identify the most severe group. Profiles differed in EDI-3 overall scores (e.g., Eating Disorder Risk Composite: K(2) = 43.08, adjusted-p < 0.001), Body Uneasiness Test Global Severity Index (GSI: K(2) = 29.33, adjusted-p < 0.001), Binge Eating Scale severity (K(2) = 25.49, adjusted-p < 0.001), number of psychiatric (K(2) = 8.79, adjusted-p = 0.021) and personality diagnoses (K(2) = 11.86, adjusted-p = 0.005), and Symptom Checklist-90-Revised GSI (F(2,103) = 37.68, adjusted-p < 0.001), with FED complex-severe patients being generally the most severely impaired in terms of FED symptoms, body concerns, depersonalization, and psychiatric comorbidities.
Findings support the hypothesis of distinguishing FED simplex and complex phenotypes, based on the co-occurrence of dysfunctional personality, with implications for FED severity and clinical practice.
Colizzi M
，Comacchio C
，Garzitto M
，Bucciarelli L
，Candolo A
，Cesco M
，Croccia V
，Ferreghini A
，Martinelli R
，Nicotra A
，Sebastianutto G
，Balestrieri M
... -
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