Psychotropic Drug Use Among the Elderly: Risk Factors Involved in Long-Term Use

This study explores the environmental, clinical, and personality factors that are associated with increased chronic psychotropic drug consumption in elderly patients. We collected data from 88 elderly individuals living in nursing homes, home-dwellings, and residential homes between December 2003 and June 2004. We assessed each subject's (1) current (previous four weeks) and chronic (>90 days) psychotropic drug consumption, (2) mood and anxiety (GHQ), and (3) personality (Temperament and Character Inventory). We found that 63% of the elderly subjects studied had used psychotropic drugs at least once and that one out of three elderly chronically consumed psychotropic drugs. Personality factors like harm avoidance and low level of persistence seem to be associated with chronic consumption.     

CYP2D6 variation,behaviour and psychopathology: implications for pharmacogenomics-guided clinical trials

Individual and population differences in polymorphic cytochrome P450 enzyme function have been known for decades. The biological significance of these differences has now been deciphered with regard to drug metabolism, action and toxicity as well as disposition of endogenous substrates, including neuroactive compounds. While the cytochrome P450 enzymes occur abundantly in the liver, they are expressed in most tissues of the body, albeit in varying amounts, including the brain. The latter location of cytochrome P450s is highly pertinent for susceptibility to neuropsychiatric diseases, not to mention local drug metabolism at the site of psychotropic drug action in the brain. In the current era of personality medicine with companion theranostics (i.e. the fusion of therapeutics with diagnostics), this article underscores that such versatile biological roles of cytochrome P450s offer multiple points of entry for personalized medicine and rational therapeutics. We focus our discussion on CYP2D6, one of the most intensively researched drug and endogenous compound metabolism pathways, with a view to relevance for, and optimization of, pharmacogenomic-guided clinical trials. Working on the premise that CYP2D6 is related to human behaviour and certain personality traits such as serotonin and dopamine system function, we further suggest that the motivation of healthy volunteers to participate in clinical trials may in part be influenced by an under-or over-representation of certain CYP2D6 metabolic groups.     

上海市高中生性格特点及其与血型的相关性研究

目的揭示上海市高中生的性格特点,并分析其与血型的相关性。方法通过采用国际上广泛使用的五因素性格测试问卷,对1696名上海市高中生进行性格测试并辅以相关的问卷调查,采用SPSS生物统计学分析软件对所得数据进行分析。结果目前上海市高中生性格相对稳定;女生比男生更加外向且宜人性特征更加显著;高一和高二学生相比,高一学生更加宜人和具有责任心;重点高中学生更加情绪稳定,偏离神经质;更倾向外向性、经验的开放性、宜人性和责任心。大五模型性格特征与血型间不存在相关性。结论目前上海市高中生性格相对稳定,并且与血型之间不存在相关性。后天的培养对高中生性格的形成和发展有不可忽视的重要作用,家庭和学校应在教育过程中对学生良好性格的培养给予足够的重视。     

大学生自立人格与焦虑的关系

目的探索大学生的自立人格与焦虑的关系。方法共选取280名大学生为调查对象,用青少年学生自立人格量表和焦虑自评量表对其进行问卷调查。结果人际独立(r=-0.15)、人际责任(r=-0.30)、人际灵活(r=-0.15)、人际开放(r=-0.27)、个人独立(r=-0.23)、个人主动(r=-0.13)、个人责任(r=-0.26)均与焦虑呈负相关(P<0.05或P<0.01)。人际责任、人际开放、个人责任、个人独立4种自立人格特质进入焦虑对自立人格的多元线性回归方程(P<0.05或P<0.01)。结论自立人格对焦虑有预测作用,自立人格是焦虑的保护性人格因素的假设获得了支持。     

军医大学各专业学员的典型人格类型分析

目的：调查军医大学不同专业学员人格类型的异同,寻找各专业的典型人格,为进一步探讨人格类型与专业的匹配情况,开展教育教学工作提供依据。方法：应用迈尔斯类型指标（ MBTI）量表,调查某军医大学所有在校学员的个性类型。结果：①不同专业学员在MBTI每个维度的百分比均有差异（χ2＝24．988,23．653,25．641,24．567;P均＜0．05）;②不同专业学员的16种人格类型比较均有统计学差异（χ2＝5．421,1．289,3．070,2．468,1．526,56．778,1．246,2．371,6．260,1．965,3．529,2．112,3．553,1．784,3．930,4．866;P均＜0．001））。其中ESFJ比例最高的是护理、海医学员（21．30％、19．8％）;ISTJ比例最高的是心理、药学、生物技术学员（23．1％、22．1％、18．2％）;INFP比例最高的是卫管、中医学员（24．2％、17．6％）;③不同专业学员8种偏好的标准化分数比较均有不同（F＝3．002,3．010,2．875,2．070,2．825,2．825,2．162,2．170;P均＜0．05）。结论：军医大学各专业学员大多有典型人格类型,存在一定相似性;要根据军医大学不同专业学员的个性特点进行针对性的教学。     

A prospective study of obsessive‐compulsive and borderline personality traits,race and disordered eating

Most previous investigations of the relationship between personality and disordered eating have been cross‐sectional and have utilised relatively homogeneous samples. The current study sought to prospectively explore two specific putative personality risk factors for disordered eating in an ethnically diverse sample of women (n = 58). During the initial and 2‐year follow‐up assessments, semi‐structured diagnostic interviews were administered. Analyses revealed that borderline personality disorder symptoms, as well as an interaction between obsessive‐compulsive personality disorder symptoms and race, significantly predicted disordered eating over a 2‐year period. Obsessive‐compulsive personality pathology was most strongly predictive of disordered eating for the African American women, specifically. These data supported both borderline and obsessive‐compulsive personality pathology as predictors of the development of eating disorder symptoms among women over a 2‐year period in college. In addition, race may be an important consideration in understanding the role of personality in the aetiology of disordered eating. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association.     

Mental stress and gastric acid secretion

In 14 healthy male volunteers, we studied the influence of acute mental (=psychological) stress induced by performing mental arithmetic and solving anagrams against a financial reward on endogenously stimulated gastric acid output. Personality factors were determined by the Personality Research Form. Acute mental stress significantly (P<0.05) increased systolic blood pressure (+8.9±2.0 mm Hg±sem) and heart rate (+5.3±1.6 beatslmin). The mean gastric acid output during the mental stress period (17.9±2.7 mmol/32 min) did not significantly differ from pre- (16.9±2.3 mmol/32 min) and poststress (18.1±2.2 mmol/32 min) values. However, detailed analysis revealed that mental stress induced contrary changes of gastric acid output in different subjects. About half the individuals reacted with a decrease (up to 60%) and the other half with an increase (up to 60%) in acid output. In some individuals the changes of gastric acid output were very small. By multiple correlations, impulsivity was identified as the personality trait with the highest correlation coefficient (r=0.82) with changes of gastric acid output during the acute mental stress period. During the mental stress period, gastric acid output increased in subjects with high scores on the impulsivity scale, but significantly decreased in those with low scores. We conclude that (1) there is a great individual variability in gastric acid response to acute mental stress, and (2) this variability may be partly attributed to differences in personality traits.     

Attachment and Object Relations in Patients With Narcissistic Personality Disorder: Implications for Therapeutic Process and Outcome

This article presents a therapeutic approach for patients with severe personality disorders, transference‐focused psychotherapy (TFP), a manualized evidence‐based treatment, which integrates contemporary object relations theory with attachment theory and research. Case material is presented from a narcissistic personality disorder (NPD) patient in TFP whose primary presenting problems were in the arena of sexuality and love relations, and whose attachment state of mind showed evidence of oscillation between dismissing and preoccupied mechanisms. Clinical process material is presented to illustrate the tactics and techniques of TFP and how they have been refined for treatment of individuals with NPD. The ways in which conflicts around sexuality and love relations were lived out in the transference is delineated with a focus on the interpretation of devalued and idealized representations of self and others, both of which are key components of the compensatory grandiose self that defensively protects the individual from an underlying sense of vulnerability and imperfection.