It is known for a fact that a number of psychological factors may affect heart pain perception in patients with coronary artery disease (CAD). However, psychosemantics of pain in CAD patients was hardly ever explored.

To study the features of pain psychosemantics in CAD patients.

There were applied McGill Pain Questionnaire (Melzack, 1975); the psychosemantic technique “Classification of sensations” (Tkhostov, Efremova, 1989); the 20-item Toronto Alexithymia Scale (Bagby, Taylor, Parker, 1994); and State-Trait Anxiety Inventory (Spielberger et al., 1983). Fifty-four CAD patients took part in the study, the mean age was 55.9 ± 7.6 years. CAD duration was 5.8 ± 2.6 years.

CAD patients with the high level of trait anxiety (28%) choose greater variety of descriptors for pain definition, revealing an impaired ability to differentiate between emotional states and physical sensations. They show higher scale values for McGill Pain Questionnaire. Patients with high indices of alexithymia (31%) require significantly fewer words for description of painful and dangerous perceptions within the “Classification of sensations”. This may testify to a certain bafflement in verbal description of the pain. With that, intensity of alexithymia does not correlate significantly with the high level of state and trait anxiety (P > 0.05). The method of “Classification of sensations” revealed that patients with trait anxiety, as well as those with alexithymia, define the pain with significantly more numerous metaphorical and affective descriptors (Pervichko, Zinchenko, 2013).

Received results prove an important role of psychological factors in etiology of chest pain in CAD patients with the high level of trait anxiety and alexithymia, which supports the urgency of psychotherapy for them.

References not available.

The authors have not supplied their declaration of competing interest.

Magnesium is an endogenous voltage-dependent NMDA receptor channel blocker and ketamine is a non-competitive NMDA receptor antagonist. Magnesium may potentiate the effect of ketamine in analgesia and anaesthesia, but may also interact in an opposing manner. This study aimed at evaluating type of the interaction between magnesium sulphate and ketamine administered systemically in rats with an acute nociceptive pain (tail-immersion test).

Analgesic activity was assessed by tail-immersion test in male Wistar rats (200-250 g). The distal 5 cm of the tail was immersed in a warm water bath (55 ± 0.5 °C) and the time for tail-withdrawal was measured as response latency.

Magnesium sulphate (2.5–30 mg/kg, s.c.) and ketamine (2.5-30 mg/kg, i.p.) administered alone did not produce any effect. However, significant antinociception (synergistic interaction) was revealed at the following doses of ketamine: magnesium sulphate of 5:5 mg/kg, 2.5:5 mg/kg and 10:5 mg/kg. The effect was not dose-dependent, and a greater response was obtained when ketamine was administered before magnesium sulphate.

This study revealed that (1) magnesium sulphate and ketamine given alone were not effective against acute nociceptive pain in rats, but (2) a combination of both drugs resulted in synergistically inhibited nociception, (3) which occurred only at selected low doses and proportions of the medications in a combination and (4) suggested the importance of the order of drug administration.

The authors have not supplied their declaration of competing interest.

To assess effect of pelvic tilt by birth ball, sacrum-perinea heat therapy and combination use of them on active phase of physiologic labor.

In this randomized control trial, 120 primiparous volunteer with age 18-35 years, gestational age of 38–40 weeks, in one of hospitals of Iran university of medical sciences were randomly selected and divided in four groups: Pelvic tilt by using birth ball, sacrum perinea heat therapy, combined use of two mentioned methods and control group. Tools had 3 main parts of personal characteristic, client examination form and pain visual analogue scale (VAS). All ethical points were considered.

Equality of four groups had been checked before intervention. Lowest pain score first belong to pelvic tilt by birth ball then combined group and finally in heat therapy, which all were significantly less than control group. Significant decrease of pain had been seen in birth ball group and combined group during after 30 minutes intervention, but in the heat therapy group, it was seen after 60 minutes intervention (P-value < 0.05).

All three interventions of this study had significant effect and decreased labor pain during active phase, but highest decrease was in pelvic tilt by birth ball group and its effect started after 30 minutes intervention. It is suggested that that Obstetrics and Midwives consider these safe methods for labor pain management.

The authors have not supplied their declaration of competing interest.

Hofstede's model of cultural dimensions has become the most widely accepted and most frequently cited model for cross-cultural research. His cultural dimensions included power distance index (PDI), individualism vs. collectivism (IDV), masculinity vs. femininity (MAS), uncertainty avoidance index (UAI), and long-term vs. short-term orientation (LTO).

The objective of this study is to explore gender related differences in the Hofstede's five dimensions of national culture for work-related values among a sample from Kuwait.

The participants were 540 first year secondary school Kuwaiti teachers (270 males: mean age = 28.95 ± 2.47; 270 females: mean age = 28.20 ± 2.04). The Arabic version of the Values Survey Module, VSM 08 was administered to participants. Data analysis include independent sample t-test was used to examine gender differences in Hofstede's five dimensions of national culture.

Internal consistency was satisfactory for the Power Distance, Individualism vs. Collectivism, Masculinity vs. Femininity, Uncertainty Avoidance, and Long-term vs. Short-term Orientation subscales respectively (Cronbach's alpha = 0.82, 0.84, 0.90, 0.74, 0.87) for males and (Cronbach's alpha = 0.77, 0.90, 0.83, 0.80, 0.88) for females. The results revealed significant gender differences where the males obtained a higher score than females on individualism (t = 2.95, P < 0.002), and masculinity (t = 2.77, P < 0.005), while females obtained a higher score than males on power distance (t = 4.48, P < 0.000), and long-term orientation (t = 4.13, P < 0.000).

These findings suggest that the gender differences exist for cultural dimensions, and provide insight on leadership characteristics.

The authors have not supplied their declaration of competing interest.

Recent studies suggest that Borderline Personality Disorder (BPD) could be regarded as an affective disorder within the Bipolar Affective Disorder (BP) spectrum. This is supported by evidence suggesting a clinical/neurobiological overlap between these two disorders. The Temperament and Character Inventory Revised (TCI-R) may help differentiate between the two disorders and orientate the clinical approach, considering the evidence of the medium-term temporal stability of TCI-R in a clinical population.

We present a clinical case diagnosed with BD which underwent testing using TCI-R. TCI-R orientated towards a secondary diagnosis of BPD and the case further received a course of Dialectical Behavior Therapy (DBT) which led to clinical improvement. We therefore study the usefulness of TCI-R in this clinical setting.

To study whether TCI-R may help differentiate between BD and BPD in mood stabilized patients.

Our patient is a 52-year-old married male diagnosed with BD. Considering his clinical features of impulsivity/instability of behaviors and pathological interpersonal relationships, patient was started on individual DBT (fortnightly, 4 months). Psychotropic treatment (paroxetine 30 mg/day, lithium 1000 mg/day, aripiprazole 15 mg/day) was not modified.

TCI-R scores: harm avoidance (100%), novelty seeking (53%), reward dependence (20%), persistence (18%), self-directedness (1%), cooperativeness (2%) and self-transcendence (48%). After 4 months of therapy, the patient improved in distress tolerance, acceptance, behavioral activation and assertiveness.

TCI-R is an inventory for personality traits in which character scores differ markedly between PD and non-PD patients. It is a useful tool in BPD patients orientating the clinician in the differential diagnosis and the treatment approach.

The authors have not supplied their declaration of competing interest.

According to Millon, personality is a “complex pattern of psychological factors, which are mostly unconscious and express themselves automatically in almost every functional dimension of the subject”. It has been described how personality traits can modify the expression of other mental diseases, leading to confusion in diagnosis and treatment of the patient.

Systematic review of the literature in English (PubMed) and clinical history of the patient. Keywords: “recurrent depression disorder”; “schizoid personality”.

To highlight the importance of making an accurate and detailed diagnostic formulation, in patients with both mental and personality disorders.

Sixty-seven-year-old woman, with many psychiatric hospitalizations, secondary to a recurrent depression disorder with psychotic symptoms and schizoid personality disorder. Both psychiatric monitoring and pharmacological treatment have been erratic. Initially, depressive episodes were considered as symptoms of her personality disorder. However, over the years, it was possible to make a more accurate diagnosis and a better treatment adjustment. In this case, lack of adherence is probably due to multiple factors, but no awareness of illness and personality disorder itself are the most important ones. This fact makes the patient less concerned about her personal care, leading to irregular treatment.

People with schizoid, schizotypal or paranoid personality traits usually have a worse outcome, and they interfere with the functionality of the patient. This explains the importance of making an accurate and detailed diagnostic formulation, in order to benefit the course of the underlying mental disorders.

The authors have not supplied their declaration of competing interest.

There is growing evidence of the importance of nutrition in mental disorders. Gut microbiota, influenced by environmental factors such as diet and stress, has been proposed as one of the players on a dynamic called gut-brain axis, which is thought to have an influence on behaviour and mental health.

To summarize recent evidence on the topic, and its potential role in psychiatric interventions.

The authors review updated literature collected from online scientific databases.

The development of the brain itself has been shown to be influenced by the gut microbiome. Research demonstrates that the composition of the microbiota has influence on behaviour through neuroendocrine and other neuroactive messengers production by the bacteria within the gut lumen. Studies in germ-free animals, animals exposed to bacterial infections, probiotic suplements or antibiotic drugs suggest a role for the gut microbiota in the regulation of anxiety, mood, cognition and pain. The gut microbiome has been implicated in brain disorders including anxiety and depression, multiple sclerosis, Alzheimer's disease, Parkinson's disease, and autism.

The treatment of mental disorders is usually based on pharmacological and psychotherapeutic interventions, and little attention is given to dietary interventions. The emerging field of research focused on the human microbiome suggests an important role for the gut microbiota in influencing brain development, behaviour and mood in humans, and points new strategies for developing novel therapeutics for mental disorders.

The authors have not supplied their declaration of competing interest.

Borderline Personality Disorder (BPD) is a severe psychiatric health problem with a reputation of being difficult to deal with and to treat. Significant Others (SOs) of patients with BPD show higher levels of psychological distress compared with the general population. Strengthening the coping strategies of SOs has been shown to play an important role in the recovery of the person with psychiatric health problems. Research around SOs of persons with BPD is, to our knowledge, scarce, especially qualitative research exploring their experiences.

We believe that if the personnel working in health care and psychiatric care are able to better understand SOs experiences and life situation, it could be an important step toward improved care.

The aim of this study was to describe SOs experiences of living close to a person with BPD and their experience of encounter with psychiatric care.

Data were collected by free-text questionnaires and group interviews and were analyzed by qualitative content analysis.

The results revealed four categories: a life tiptoeing; powerlessness, guilt, and lifelong grief; feeling left out and abandoned; and lost trust. The first two categories describe the experience of living close to a person with BPD, and the last two categories describe encounter with psychiatric care.

The authors have not supplied their declaration of competing interest.

Borderline personality disorder begins in adolescence, however, its diagnosis is subject to some controversy and tends to be underdiagnosed. Stigma associated with its diagnosis, comorbidity with other axis I disorders or the changeable sense of identity during adolescence are some of the elements that obscure the diagnosis. Increasingly, recent studies have shown the utility of prevention programs as well as instituting early intervention in adolescents, with very hopeful outcomes.

The aim of this study is to review the benefits derived from early prevention and intervention programs in adolescents with borderline symptoms from a cognitive analytic approach.

A systematic review for scientific articles extracted from research databases including Dialnet, EBSCO, Pubmed, Unika and Scholar Google was conducted. Other high-impact studies in the field were also included.

Evidence reported by reviewed articles supports Cognitive analytical therapy as one of the most successful approaches, the same as Mentalization based therapy, in the treatment of Borderline personality disorder. From this approach, prevention and early intervention have shown their effectiveness in reducing borderline symptoms and risk factors besides they contribute to interpersonal functioning improvement.

Prevention and early intervention constitute the main pillars to prevent the potential development of Borderline personality disorder or its evolution in more complex and irreversible forms. But this intervention must be carried not only in young already diagnosed, but also in those who are on the diagnostic threshold, presenting risk factors for further development.

The authors have not supplied their declaration of competing interest.

Personality disorders are chronic affectation of mood, impulsivity, aggression and anxiety. It is thought to have biological factors related to the development of personality disorders.

To evaluate and compare the efficacy of injectable paliperidone in actual clinical practice of patients diagnosed with Personality Disorder, compared to other treatments.

We conducted a descriptive, restrospective and observational study from January 2012 to June 2015 including all the patients who are treated with paliperidone palmitate extended-release injectable suspension with a diagnosis of Personality Disorder according to DSM 5. We included patients with at least 12 months of treatment and the results were compared with respect to the 12 months prior to taking said drug. Variables studied: medical diagnosis, hospital admissions, average length of stay, total number of emergency visits or other devices, maintenance doses.

We recruited 14 patients (7 women and 7 men) with a mean age of 36.2. 64.29% of patients had borderline personality disorder; 21.43% unspecified personality disorder. The mean dose of maintenance treatment is 105.357. Before the treatment, the quantity of total number of hospital admission are 1.14 versus 0.429 after treatment. The number of stay is also decreased from 13.7 to 3.5; like emergency room visits or to other devices. 78.57% of patients continue to psychopharmacological treatment. Fifty percent of patients undergoing treatment with another antipsychotic (P < 0.05).

The present results show that paliperidone palmitate can be an effective way to control the most characteristic symptoms of Personality Disorders, and reducing emergency visits, hospitalisations and other devices.

The authors have not supplied their declaration of competing interest.

The personality disorders are defined according to the DSM-5 like “an enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's cultures. These patterns develop in adolescence and the beginning of adulthood, and are associated with significant distress or disability”. The personality disorders can be a risk factor for different processes of the psychiatric pathology like suicide. The personality disorders are classified in 3 groups according to the DSM-5:

– cluster A (strange subjects): paranoid, schizoid and schizotypal;

– cluster B (immature subjects): antisocial, bordeline, histrionic and narcissistic;

– cluster C (frightened subjects): avoidant, dependent and obsessive-compulsive.

To describe the influence of personality disorders in suicide attempts.

Exhibition of clinical cases.

In this case report, we exhibit three clinical cases of suicide attempts which correspond to a type of personality disorder belonging to each of the three big groups of the DSM-5 classification, specifically the paranoid disorder of the cluster A, the disorder borderline of cluster B and the obsessive compulsive of cluster C.

The personality disorders have a clear relation with the suicide attempts, increasing this influence in some of them, especially the borderline personality disorder.

The authors have not supplied their declaration of competing interest.

Mental illness develops and is inseparable from the sociocultural context. The Disturbances may exhibit different symptoms in different cultures. In personality disorders, there is a pathological expansion of normal traits that often demonstrate a sociocultural change. The quality of life of these patients can improve with certain treatments, which appears to be relevant to be achieved.

Search on Pubmed and Medline for original research or review articles published in English or Portuguese in the last 10 years. It used a combination of terms: “personality”, “treatment”, “personality disorder”, “borderline”, “antissocial”, “pharmacotherapy”, and other named personality disorders.

Search the evidence base and the new perspectives for the effective treatment of personality disorders.

The same personality traits may be adaptive or non-adaptive in different contexts. So, without changing these characteristics, patients can learn to use them more effectively. In other words, although the therapy did not change the personality traits, it can be modified in the way they affect the behavioral expression.

Psychological or psychosocial intervention is recommended as the primary treatment for borderline personality disorder and pharmacotherapy is only advised as an adjunctive treatment. The amount of research about the underlying, abnormal, psychological or biological processes leading to the manifestation of a disordered personality is increasing, which could lead to more effective interventions.

The authors have not supplied their declaration of competing interest.

Histrionic Personality Disorder is one of the most common personality disorders diagnosed in Psychiatry. This disorder has been known to be present in more than 40% of patients. There is also a high tendency for those diagnosed with this disorder to be female.

The case is to show all the difficulties caused by this pathology, differencial diagnosis with other personality disorders, groups of characteristics from different clusters and also, complications produced in daily routine.

The purpose is to study a clinical case of a 27-year-old woman, with a degree in journalism, who began with a depressive episode after a failed relationship. After being diagnosed of infertility, she debuted with dissociative episodes and somatization symptoms. After that, she suffered several depressive episodes. At the moment, all the clinical symptoms support the diagnosis of histrionic personality disorder.

Histrionic Personality Disorder can be found in the cluster B group of personality disorders. They often present in an overly dramatic, erratic or emotional manner. They may fulfil their need for attention through speech and behaviour that draws one's focus of attention toward themselves, and also demanding and manipulative in interpersonal relationships. There are high comorbidity rates in those who suffer from HPD with other diagnoses.

Histrionic Personality Disorder appears to be one of the least threatening diagnosis among personality disorders as those affected are high functioning and do not seek relief for the disorder itself. There is also very little research on HPD which makes treatment options limitless.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

To review the current knowledge about Diogenes symptoms and organic personality disorder through systematic review of the literature and the analysis of a case.

Case report. Review. Literature sources were obtained through electronic search in PubMed.gov database of 10 last years.

Background: Diogenes syndrome is a behavioral disorder characterized by severe self-neglect, hoarding, domestic dirt, and lack of shame regarding one's living state. Patients may present due to a range of reasons, few studies has been described hoarding symptoms secondary to brain injury. Early management could reduce their high-mortality condition.

We present a case of a 67-year-old Caucasian female known with a organic personality disorder secondary to a head trauma with obsessive hoarding symptoms. After being hospitalizated, we were authorized to explore her personal items trough photographs. Her handbag and her house were filled with rubbish and rotting food. Our patient had no insight into any self-hygiene or public health problems.

Information of the characteristics of Diogenes syndrome can help in earlier recognition of such persons, in order to decrease their morbidity and mortality.

The authors have not supplied their declaration of competing interest.

As it has been for the last 30 years, male borderline personality are still misdiagnosed and herded into substance treatment, anger management and prison. Gender matters from the failure of clinicians to identify it in men to the failure of researchers to study how it affects men differently and the treatment implications of those dissimilarities.

The authors propose a retrospective study investigating all patients hospitalized with Borderline Personality Disorder diagnosis from 2000 to 2015 in Baixo Vouga Hospitalar Center.

From an average of 500 patients admitted per year, in the considered period, the number of men with this psychiatric diagnosis was irrelevant.

Taking into account the results, it is important recognise some gender differences in borderline personality disorder with respect to specific types of self-harm behavior, such as self-cutting or levels of psychological distress at clinical presentation in order to prevent clinical disgnosis failure.

The authors have not supplied their declaration of competing interest.

According to time perspective (TP), theory behaviour is influenced by the individual's perception of his/her past, present and future. Boyd and Zimbardo postulate that a healthy balance between orientation to the past, present and future exists.

Investigation of TP in the context of psychopathology.

To investigate and compare TP in Obsessive Compulsive (OCD) and Borderline Personality Disorder (BPD).

Twenty-eight OCD and 28 BPD patients (36% of men), matched for age and education, completed the Greek version of the Zimbardo Time Perspective Inventory (ZTPI); a 56-item self-administered questionnaire measuring individuals’ orientations to the past, present, and future. ZTPI consists of five factors: Past Negative (PN), Past Positive (PP), Present Hedonistic (PH), Present Fatalistic (PF) and Future (F).

BPD patients scored significantly higher in PH and PF and significantly lower in PP factors than OCD patients. No significant gender differences emerged for either group. In the BPD group, age correlated significantly negatively with PH, while education correlated positively with F.

The study's findings suggest that BPD patients have a hedonistic orientation towards time and life and a helpless/hopeless attitude towards the future to a significantly greater degree than OCD patients, whereas OCD patients seem to have a more positive and nostalgic attitude towards the past than BPD patients. Further research would provide additional information concerning the role of TP in OCD and BPD patients.

The authors have not supplied their declaration of competing interest.

Personality disorders designate a series of personality traits involving a behavioural pattern characterized by the recurrent violation of social norms, the importance of medico-legal implications associated to personality disorders being incontestable.

This study aims to obtain a clear image regarding the particularities of violent behaviour, and also the mechanisms of anger in personality disorders, in relation with the legal implications of those reactions.

The present study is a synthesis of recent literature (2012-2014) regarding the role of anger in violent behaviour with legal implications, in personality disorders. The research was made on PubMed, by the following keywords: personality disorder; violence in personality disorders; anger.

The core element that determines violent behaviour is anger. The physical effects of anger include increased heart rate and blood pressure, as well as an increase in the level of epinephrine and norepinephrine. Therefore, anger can be considered an integrant part of the response to a potential aggression or a potentially dangerous environment. Several general circumstances can activate anger. A strong example in supporting this theory is the bidirectional relation between anger within personality disorders and the use of alcohol and psychoactive substances. The individual gets extra stimulation, including through their psychopharmacological properties, thus exacerbating anger.

In conclusion, it is necessary to conduct future studies focusing on the underlying causes of violence in personality disorders, as well as on the warning signs of potential violent acts, considering that personality disorders alone often cannot explain criminality.

The authors have not supplied their declaration of competing interest.

According to previous researches, the risk of addictions and self-harm or suicidal behaviours seems to be higher in patients with personality disorders (PD) than in general population.

To prove that patients with the diagnosis of PD are in the group of risk of addictions, self-harm behaviours and suicidal attempts.

Analysis the occurrence of addictions, autoagressive behaviours and suicidal attempts in patients with PD.

Retrospective analysis of 123 patients diagnosed with PD and hospitalized over the years 2012-2015 in the Department of psychiatry and psychotherapy, medical university of Silesia, Katowice. Statistic analysis of variables and comparing with previous studies.

Three quaters of hospitalized patients were females.

Average age in analysed population was about 48.5 years old.

The frequency of suicidal attempts history was 38% among these patients.

Most popular method of suicidal attempts was drugs overuse.

Nineteen percent of PD patients has revealed self-harm behaviours history.

PD's population have 46% risk of addictions.

Hospitalized patients with personality disorders are in the group of risk of addictions, self-harming behaviours and suicidal attempts.

Care should be taken with patients revealing any risk of autoregressive behaviours and they should be advised accordingly. Preventive actions should be taken with these patients when any life-threatening behaviours suspecting.

The authors have not supplied their declaration of competing interest.

Personality disorders (PD) are weight group of conditions. As possible causes of PD, literatures indicates being victim/witness of domestic violent. There is valid suspicion that PDs may have influence on marital status, education level and professional activity.

Studying the PD influence on patients quality of life concerning both personal and professional areas of life.

Analysis of the exposition to the violence in relation to PD diagnosis. Evaluation of the education level and professional activity in studied group, furthermore marital status.

Retrospective analysis of 123 patients diagnosed with PD hospitalized over the years 2012-2015 in the Department of psychiatry and psychotherapy, medical university of Silesia hospital. Statistic analysis of variables and comparing with previous researches.

Three quarters of hospitalized patients were females.

Average age was about 50 years old.

Proximal martial status: 40% single, 60% formalized relationship (about 20% were divorced).

Among participants, 50% were employed, and 80% have completed at least 12 years of education.

About 40% had been victim/witness of domestic violence.

The patients with PD had often experienced the domestic violence in childhood. Higher risk of impaired personality development with patients, who had been violence victim or witness is possible and they need to be advised accordingly. Research did not reveal PDs’ influence on the education level. To define correlation between employment or marital status and PD further researches are needed.

The authors have not supplied their declaration of competing interest.