Background: Despite an abundance of questionnaire data, the prevalence of clinically significant and medically unexplained pain syndromes in the general population has rarely been examined with a rigid personal-interview methodology. Objective To examine the prevalence of pain syndromes and DSM-IV pain disorder in the general population and the association with other mental disorders, as well as effects on disability and health-care utilization. Methods: Analyses were based on a community sample of 4.181 participants 18–65 years old; diagnostic variables were assessed with a standardized diagnostic interview (M-CIDI). Results: The 12-month prevalence for DSM-IV pain disorder in the general population was 8.1%; more than 53% showed concurrent anxiety and mood disorders. Subjects with pain disorder revealed significantly poorer quality of life, greater disability, and higher health-care utilization rates compared to cases with pain below the diagnostic threshold. The majority had more than one type of pain, with excessive headache being the most frequent type. Conclusions: Even when stringent diagnostic criteria are used, pain disorder ranks among the most prevalent conditions in the community. The joint effects of high prevalence in all age groups, substantial disability, and increased health services utilization result in a substantial total burden, exceeding that of depression and anxiety.

Background Among adolescents and young adults with DSM-IV alcohol use disorders (AUDs), there are inter-individual differences in the speed of transition from initial alcohol use (AU) to AUD. AUDs are highly co-morbid with other mental disorders. The factors associated with rapid transition from first AU to AUD remain unknown and the role of mental disorders in rapid transitions is unclear. Given this background we examined (1) whether prior anxiety, mood, externalizing and non-alcohol substance use disorders are related to the risk and speed of transition from first AU to DSM-IV alcohol abuse (AA) and alcohol dependence (AD) and (2) whether early age of onset of prior mental disorders (PMDs) is a promoter of rapid transition. Method A total of 3021 community subjects (97.7% lifetime AU) aged 14–24 years at baseline were followed up prospectively for up to 10 years. AU and mental disorders were assessed with the DSM-IV/M-CIDI. Results Among subjects with lifetime AU, several PMDs, such as specific phobia, bipolar disorder and nicotine dependence, were associated with an increased risk of AUD independent of externalizing disorders. Associations of PMDs with the speed of transition to AUDs were mostly weak and inconsistent. Only social phobia and externalizing disorders were associated with faster transitions to AD even after adjustment for other PMDs. Earlier age of onset of PMD was not associated with rapid transition. Conclusions Mental disorders are associated with the risk of AUD. With the possible exception of social phobia and externalizing disorders, they do not promote rapid transition, even if they occur particularly early. Future research needs to identify factors relevant to rapid transition to AUD.

La présente étude évalue la compréhension du DSM-IV-MR-J auprès d'adolescents de 12 à 15 ans. Cet instrument sert à l'identification des joueurs pathologiques. Le DSM-IV-MR-J est d'abord administré en classe. Les participants, sélectionnés selon leur score, sont ensuite répartis entre les groupes contrôle et expérimental. Le questionnaire est administré une seconde fois aux participants du groupe contrôle en présence d'un expérimentateur. Les participants du groupe expérimental expliquent quant à eux l'ensemble des questions du DSM-IV-MR-J lors d'une entrevue individuelle. L'expérimentateur rectifie les items incompris et une deuxième administration suit. Les résultats démontrent que pour l'ensemble des participants, 22% des questions s'avèrent incomprises. De plus, des baisses de scores sont observées entre les deux passations et se révèlent plus prononcées pour les participants du groupe contrôle que pour ceux du groupe expérimental. Des changements de catégories diagnostiques apparaissent aussi pour les deux groupes lors de leur seconde administration. Une baisse de 20% du nombre de joueurs à risque/pathologiques est observée dans le groupe expérimental et atteint 29,4% dans le groupe contrôle. L'utilisation du DSM-IV-MR-J comme instrument auto-diagnostique du jeu pathologique est abordée lors de la discussion.

Student Number : 8887128 - PhD thesis - School of Psychology - Faculty of Humanities / There is a manifest similarity between the disorders of deficient attention and borderline psychopathology as they are described in the DSM IV. In my experience, those with borderline psychopathology have a history of problems with attention. This study seeks to explore the experiential link between the two disorders and how deficient attention acts as a precipitant factor in the development of borderline psychopathology. Ten interviews were conducted with adults diagnosed as having borderline personality disorder with a history of deficient attention. The interviews were unstructured, audiotaped and transcribed. The transcriptions were analysed according to the method of thematic content analysis. The transcriptions were also rerepresented in the testimonial form of life history. The data produced seven categories of experience, set in an overall context of trauma. Attention formed only one of these categories. The others were incoherence, incompetence, discord, refraction, dispossession and persecution. The categories, together with existing literature, were linked to form a traumatogenic model of the development of borderline psychopathology. This constitutes an extension of existing literature and is intended to contribute to the prevention and treatment of both disorders.

<p>Denna studie utgår från Judith Butlers genusteori om hur <em>kön görs</em> samt Michel Foucaults teorier om samhällsnormer och makt i förhållande till särskiljandemekanismer och vansinnesdefinitioner. Studien fokuserar på psykiatriska diagnoser ur ett genusperspektiv. Fokus har lagts på diagnoserna Aspergers syndrom och borderline personlighetsstörning då tidigare forskning visat att könsfördelningen inom dessa psykiatriska diagnoser är väldigt ojämn.</p><p> </p><p>Syftet med studien är att undersöka genusstrukturers påverkan på psykiatrisk diagnostisering utifrån DSM-IV. Utifrån syftet har följande frågeställningar utformats: Går det att benämna diagnoskriterier som könsneutrala då diagnostisering i hög grad handlar om andra människors (vars egna erfarenheter och värderingar färgar neutraliteten) bedömningar? Hur kommer det sig att könsfördelningen är så ojämn inom diagnoser som Aspergers syndrom och borderline personlighetsstörning?</p><p> </p><p>En enkätundersökning har utförts bland verksamma psykologer inom Östersunds kommun. Enkäten har utformats från de utvalda diagnosernas kriterier i DSM-IV. För att behandla enkätens svar har dataprogrammet SPSS använts. Undersökningens resultat visar på att det finns frågetecken kring DSM-IV:s könsneutralitet. Resultaten visar dock att det finns en medvetenhet kring den ojämna könsfördelningen inom de utvalda diagnoserna. Studien visar på psykiatriska diagnosers symbios med samhällsstrukturer och normer, däribland genus.</p>

<p>The subjects were 130 male prisoners in Swedish jails were examined by SCID and the diagnoses given in terms of DSM-IV. The most common mental disorder was drug abuse. On Axis II several personality disorders were diagnosed. Personality assessments were made by KSP. High scores were mainly found for e.g. impulsiveness, sensation seeking, aggression and low scores in socialisation.</p><p>MAO assays were performed in 99 male criminal offenders and in 60 non-criminal volunteers. Offenders had lower MAO activity than controls also with the confounding factor smoking under control. It is proposed that platelet MAO is linked to personality traits, which can predispose for criminality. </p><p>For testing the existence of combinations of vulnerability factors, a configuration frequency analysis (CFA) was used. The criteria which formed the basis for the subgrouping were; MAO activity below or above –0.5 SD of the mean (L and H), the presence or absence of an Axis I disorder (= drug abuse) (Y/N), the presence or absence of an Axis II disorder (Y/N), or the presence or absence of an Axis I and II disorder (Y/N). In this way eight subgroups were formed. Two significant "types" were found among the criminals: One was characterised by low platelet MAO activity, Cluster B personality diagnosis as well as Drug Abuse Disorder diagnosis (LYY); and the other by a pattern of normal platelet MAO activity, no Cluster B personality disorder, and no Drug Disorder diagnosis (HNN). Also two "antitypes", occurring less frequent than expected, were identified; LYN and LNY. Thus, the aggregation of certain risk factors in the same individual has been shown to contribute to the development of criminal behaviour.</p><p>The subgroups HNN, LYN, LNY and LYY were then analysed for a variety of criminological factors. There was a difference in mean age between the subgroups, the HNN being lowest. Economical crimes were more common at an early criminal debut and crimes involving violence at an adult debut. The HNN subgroup had a lower number of crimes and times spent in jail than the other subgroups. More than 50% of the clients in all groups had previously been sentenced to Reformatory.</p>

The subjects were 130 male prisoners in Swedish jails were examined by SCID and the diagnoses given in terms of DSM-IV. The most common mental disorder was drug abuse. On Axis II several personality disorders were diagnosed. Personality assessments were made by KSP. High scores were mainly found for e.g. impulsiveness, sensation seeking, aggression and low scores in socialisation. MAO assays were performed in 99 male criminal offenders and in 60 non-criminal volunteers. Offenders had lower MAO activity than controls also with the confounding factor smoking under control. It is proposed that platelet MAO is linked to personality traits, which can predispose for criminality. For testing the existence of combinations of vulnerability factors, a configuration frequency analysis (CFA) was used. The criteria which formed the basis for the subgrouping were; MAO activity below or above –0.5 SD of the mean (L and H), the presence or absence of an Axis I disorder (= drug abuse) (Y/N), the presence or absence of an Axis II disorder (Y/N), or the presence or absence of an Axis I and II disorder (Y/N). In this way eight subgroups were formed. Two significant "types" were found among the criminals: One was characterised by low platelet MAO activity, Cluster B personality diagnosis as well as Drug Abuse Disorder diagnosis (LYY); and the other by a pattern of normal platelet MAO activity, no Cluster B personality disorder, and no Drug Disorder diagnosis (HNN). Also two "antitypes", occurring less frequent than expected, were identified; LYN and LNY. Thus, the aggregation of certain risk factors in the same individual has been shown to contribute to the development of criminal behaviour. The subgroups HNN, LYN, LNY and LYY were then analysed for a variety of criminological factors. There was a difference in mean age between the subgroups, the HNN being lowest. Economical crimes were more common at an early criminal debut and crimes involving violence at an adult debut. The HNN subgroup had a lower number of crimes and times spent in jail than the other subgroups. More than 50% of the clients in all groups had previously been sentenced to Reformatory.

Denna studie utgår från Judith Butlers genusteori om hur kön görs samt Michel Foucaults teorier om samhällsnormer och makt i förhållande till särskiljandemekanismer och vansinnesdefinitioner. Studien fokuserar på psykiatriska diagnoser ur ett genusperspektiv. Fokus har lagts på diagnoserna Aspergers syndrom och borderline personlighetsstörning då tidigare forskning visat att könsfördelningen inom dessa psykiatriska diagnoser är väldigt ojämn.   Syftet med studien är att undersöka genusstrukturers påverkan på psykiatrisk diagnostisering utifrån DSM-IV. Utifrån syftet har följande frågeställningar utformats: Går det att benämna diagnoskriterier som könsneutrala då diagnostisering i hög grad handlar om andra människors (vars egna erfarenheter och värderingar färgar neutraliteten) bedömningar? Hur kommer det sig att könsfördelningen är så ojämn inom diagnoser som Aspergers syndrom och borderline personlighetsstörning?   En enkätundersökning har utförts bland verksamma psykologer inom Östersunds kommun. Enkäten har utformats från de utvalda diagnosernas kriterier i DSM-IV. För att behandla enkätens svar har dataprogrammet SPSS använts. Undersökningens resultat visar på att det finns frågetecken kring DSM-IV:s könsneutralitet. Resultaten visar dock att det finns en medvetenhet kring den ojämna könsfördelningen inom de utvalda diagnoserna. Studien visar på psykiatriska diagnosers symbios med samhällsstrukturer och normer, däribland genus.

Personer som genomgått en traumatisk händelse befinner sig i riskzonen för att utveckla post-traumatic stress disorder (PTSD), som innebär en stor livsbegränsning och ett stort lidande. Dagligen möter hälso- och sjukvårdspersonal personer som ännu ej diagnostiserats och det är därför av vikt att kunna identifiera PTSD-symptom. Syftet med litteraturstudien var att undersöka samband mellan olika trauman och PTSD-symptom enligt diagnostiseringssystemet DSM IV. Studien grundades på en deduktiv ansats och resultatet bestod av 15 vetenskapliga artiklar som granskades. Resultatet behandlade DSM IV:s tre symptomkluster: re-experience/intrusion, avoidance och hyperarousal. Studien fann att det kan föreligga en skillnad mellan olika typer av trauma och vilka PTSD-symptom som var det mest frekvent upplevda. Det framkom också i studien att re-experience/intrusion och avoidance var de kluster som var mest frekventa hos dem som uppvisade PTSD-symptom efter ett trauma. Det finns ett behov av en utökad kvalitativ forskning inom området PTSD-symptom, samtidigt som hälso- och sjukvårdpersonal är i behov av att hålla sig uppdaterade när det kommer till de symptom som är ett resultat av sjukdomen. Det är av vikt att synliggöra PTSD och att låta kunskapen kring psykisk ohälsa få mer utrymme under sjuksköterskeutbildningen. För att tidigare kunna identifiera PTSD krävs en utförligare anamnes, där sjuksköterskan kan synliggöra tidigare upplevda trauman hos personen. Personer som hälso- och sjukvården vet har genomgått ett tidigare trauma kan vara i behov att screenas för PTSD.

Thèse (M.Ps.)--Université Laval, 2003. / Bibliogr.: f. 14-15. Publié aussi en version électronique.