Self-mutilation in female remanded prisoners II: A cluster analytic approach towards identification of a behavioural syndrome

Cluster analysis of phenomenological variables and the associated symptom profile of self-mutilation in 74 female prisoners identified a subgroup with a disorder of mood who injured themselves as a symptom-relieving mechanism and received a diagnosis of borderline personality disorder (BPD). Marked differences were found between the women in this cluster in the form of their behaviour and on a range of different variables compared with a second, more heterogeneous, cluster who had injured themselves as a reaction to life-events, psychotic illness, or in a suicide attempt. The relevance of a symptom-relieving mechanism to research into self-mutilation and BPD is discussed. It is proposed that future research should concentrate on the ‘affective instability’ component of BPD and the affective symptoms reported by subjects with this diagnosis prior to impulsive behaviours such as self-mutilation.     

DSM-III diagnosis in criminal psychopaths: a way forward

Research diagnostic instruments were administered to 243 subjects, consisting of three subsamples. These included men detained under the English legal category of psychopathic disorder from one special hospital, female ‘psychopaths’ from three special hospitals, and male prisoners from three special units developed in prisons for the containment and control of highly dangerous and disruptive inmates. Using the DSM-III classification, subjects were found to have multiple Axis-II personality disorder categories and multiple Axis-I clinical syndromes over their lifetime. Borderline and antisocial personality disorder were the most prevalent diagnoses, often in combination. The remaining subjects comprised subgroups with schizoid personality disorder and ‘pseudopsychopaths’, who were later recognised as suffering from slowly developing chronic schizophrenia or organic psychoses. Problems of treatability of these subjects relate to the ‘severity’ of their personality disorder. This in turn is reflected in the multiple Axis-II diagnoses which are required to encompass the sheer range of their psychopathology. Multiple recurring Axis-I conditions, which are amenable to conventional psychiatric treatment, indicate a need for specialist medical services for these patients, irrespective of arguments over the treatability of their Axis-II conditions.     

临床药师基于CYP2D6基因检测指导他莫昔芬个体化用药及其疗效评价

目的：临床药师利用CYP2D6基因检测指导他莫昔芬个体化用药。方法：选取某院2016年3月至2020年7月就诊的168例乳腺癌患者,采用荧光原位杂交技术测定患者的基因型,临床药师根据基因类型为患者制定个体化用药建议。对于正常代谢型患者,建议他莫昔芬20 mg·d^-1;对于中间代谢型患者,建议予他莫昔芬40 mg·d^-1。结果：在168例患者中,基因检测结果显示,正常代谢型患者131例,占77.98%;中间代谢型患者37例,占22.02%。结论：临床药师基于CYP2D6基因检测可以指导他莫昔芬个体化用药。对于中间代谢型患者,乳腺癌复发率高于正常代谢型患者。