Cognitive impairment in patients with bipolar disorder alone versus those with bipolar disorder comorbid with borderline personality disorder

BACKGROUND Bipolar disorder(BD)is a severe mental illness.BD often coexists with borderline personality disorders,making the condition more complex.AIM To explore the differences in cognitive impairment between patients with BD and those with BD comorbid with borderline personality disorder.METHODS Eighty patients with BD and comorbid borderline personality disorder and 80 patients with BD alone were included in groups A and B,respectively,and 80 healthy volunteers were included as controls.Cognitive function in each group was evaluated using the Chinese version of the repeatable battery for the assess-ment of neuropsychological status(RBANS),the Stroop color-word test,and the Wechsler intelligence scale-revised(WAIS-RC).RESULTS The indices of the RBANS,Stroop color-word test,and WAIS-RC in groups A and B were significantly lower than those of the control group(P<0.05).Group A had significantly longer Stroop color-word test times for single-character,single-color,double-character,and double-color,lower scores of immediate memory,visual breadth,verbal function dimensions and total score of the RBANS,as well as lower scores of verbal IQ,performance IQ,and overall IQ of the WAIS-RC compared with group B(P<0.05).Compared to group B,group A exhibited significantly longer single-character time,single-color time,double-character time,and double-color time in the Stroop color-word test(P<0.05).CONCLUSION The cognitive function of patients with BD complicated with borderline personality disorder is lower than that of patients with BD.

The Relationship between Mental Disorders and Personality of Outpatients in a Psychiatric Clinic in Nanjing, China

Psychosis has increasingly become a social problem,emphasizing the need to understand the relationship between mental disorders and personality.This study aimed to investigate the relationship between mental disorders and personality among psychiatric outpatients based on real-world data.Symptom Checklist 90(SCL-90)and Eysenck Personality Questionnaire(EPQ)were used to evaluate the personality and psychopathological symptoms of patients(n=8409)in the Psychiatric Outpatient Department at Nanjing Drum Tower Hospital.t-test was used to compare scores between patients and national norms.Pearson’s correlation coefficient and path analysis were used to explore the relationship between mental health status and personality.The correlation coefficient between the neuroticism(N)score and each factor score of the SCL-90 test,as well as the correlation between psychoticism(P)and hostility and paranoia,exceeded 0.4.Path analysis revealed that the standardized path coefficients of N score and SCL-90 were all higher than 0.4.In addition,the standardized path coefficient of hostility and paranoia on P score were 0.313 and 0.280,respectively.Interpersonal sensitivity,depression and obsessive-compulsive symptoms were affected by extraversion(E)score,with standardized path coefficients of-0.149,-0.138,and-0.105,respectively.The path analysis also showed the direct and indirect effects of age,gender,education,and marital status on SCL-90.Patients characterized as melancholic had higher scores in all factors of SCL-90.In conclusion,mental health was related to personality traits of neuroticism,psychoticism and introversion.

The Narcissistic Dilemma: Exploring NPD Traits in Hamlet from a Beauvoirian Perspective

This research paper explores the intersection of existential philosophy and psychological disorders in William Shakespeare’s Hamlet,with a focus on Narcissistic Personality Disorder(NPD)as viewed through the existentialist lens of Simone de Beauvoir.Drawing upon Beauvoir’s existentialist framework,the study delves into the complexities of identity,agency,and societal expectations as portrayed in the characters of Gertrude and Ophelia.Through an interdisciplinary approach,the paper examines how existential crises intertwine with narcissistic behaviors,shedding light on the psychological intricacies of Shakespeare’s iconic figures.By synthesizing literary analysis with psychological insights,the study offers valuable contributions to our understanding of human psychology,societal dynamics,and the timeless themes of existential authenticity portrayed in literature.

Better understanding of c-reactive protein and leukocytes in psychiatric inpatients with affective disorders:A biopsychosocial approach

BACKGROUND Affective disorders(AD)have been linked to inflammatory processes,although the underlying mechanisms of this relationship are still not fully elucidated.It is hypothesized that demographic,somatic,lifestyle,and personality variables predict inflammatory parameters in AD.AIM To identify biopsychosocial factors contributing to inflammation in AD measured with two parameters,C-reactive protein(CRP)and leukocytes.METHODS This observational study investigated 186 hospital inpatients diagnosed with AD using demographic parameters,serum inflammatory markers,somatic variables,psychological questionnaires,and lifestyle parameters.Hierarchical regression analyses were used to predict inflammatory markers from demographic,somatic,lifestyle,and personality variables.RESULTS Analyses showed that 33.8%of the variance of CRP was explained by body mass index and other somatic medication(e.g.anti-diabetics),age and education,and age of affective disorder diagnosis.For leukocytes,20.1%of the variance was explained by smoking,diet,metabolic syndrome(MetS),and anti-inflammatory medication(e.g.non-steroidal anti-inflammatory drugs).Other psychiatric or behavioural variables did not reach significance.CONCLUSION Metabolic components seem important,with mounting evidence for a metabolic affective disorder subtype.Lifestyle modifications and psychoeducation should be employed to prevent or treat MetS in AD.

Personalized medicine and opioid use disorder

Opioid use disorder(OUD)is a major public health problem affecting millions of people worldwide.Although OUD is a chronic and relapsing disorder,a variety of pharmacological and non-pharmacological interventions are available.Medication-assisted treatment of OUD generally relies on competition for opioid receptors against the addictive substance.The mechanisms of this competition are to block or inactivate the opioid receptor or activate the receptor with a substance that is intermittent or long acting.Methadone and buprenorphine are two United States Food and Drug Administration-approved medications that have long-term positive effects on the health of opioid-dependent individuals.Although clinical studies of drugs generally demonstrate efficacy in thousands of people and toxicity is excluded,it cannot be predicted whether the given drug will cause side effects in one of the patients at the treatment dose.Individual differences can be explained by many biological and environmental factors.Variations in genes encoding drug metabolism or cellular drug targets significantly explain the variability in drug response between individuals.Therefore,for the effects of candidate genes to be accepted and included in individual treatment protocols,it is important to repeat studies on individuals of different ethnic backgrounds and prove a similar effect.

Understanding Relational Dysfunction in Borderline, Narcissistic, and Antisocial Personality Disorders: Clinical Considerations, Presentation of Three Case Studies, and Implications for Therapeutic Intervention

Personality disorders are a class of mental disorders involving enduring maladaptive patterns of behaving,thinking,and feeling which profoundly affect functioning,inner experience,and relationships.This work focuses on three Cluster B personality disorders(PDs)(Borderline,Narcissistic,and Antisocial PDs),specifically illustrating how relational dysfunction manifests in each condition.People with Borderline Personality Disorder(BPD)experience pervasive instability in mood,behavior,self-image,and interpersonal patterns.In relationships,they tend to alternate between extremes of over-idealization and devaluation.Intense fear of abandonment,fluctuating affect,inappropriate anger,and black/white thinking deeply influence how they navigate personal relationships,which are often unstable,chaotic,dramatic,and ultimately destructive.They have a fundamental incapacity to self-soothe the explosive emotional states they experience as they oscillate between fears of engulfment and abandonment.This leads to unpredictable,harmful,impulsive behavior and chronic feelings of insecurity,worthlessness,shame,and emptiness.Their relationships are explosive,marked by hostility/contempt for self and partner alternating with bottomless neediness.Manipulation,lying,blaming,raging,and“push-pull”patterns are common features.Individuals with Narcissistic Personality Disorder(NPD)exhibit a long-standing pattern of grandiosity and lack of empathy.They have an exaggerated sense of self-importance,are self-absorbed,feel entitled,and tend to seek attention.Scarcely concerned with others’feelings,they can be both charming and exploitative.Oversensitive to criticism,they are prone to overt or covert rage,gaslighting and self-referential thinking.Antisocial Personality Disorder(APD)is marked by impulsive,callous,and irresponsible behavior with no regard to be manipulative,parasitic,aggressive,cold,cruel,and self-serving.In addition to analyzing relational dysfunction in each disorder,this paper presents three relational case studies(BPD-couple,NPD-parent/child,APD-various relations)and discusses treatment implications.

White matter abnormalities in young males with antisocial personality disorder Evidence from voxel-based morphometry-diffeomorphic anatomical registration using exponentiated lie algebra analysis

Voxel-based morphometry-diffeomorphic anatomical registration using exponentiated lie algebra analysis was used to investigate the structural characteristics of white matter in young males with antisocial personality disorder （APD） and healthy controls without APD. The results revealed that APD subjects, relative to healthy subjects, exhibited increased white matter volume in the bilateral prefrontal lobe, right insula, precentral gyrus, bilateral superior temporal gyrus, right postcentral gyrus, right inferior parietal Iobule, right precuneus, right middle occipital lobe, right parahippocampal gyrus and bilateral cingulate, and decreased volume in the middle temporal cortex and right cerebellum. The white matter volume in the medial frontal gyrus was significantly correlated with antisocial type scores on the Personality Diagnostic Questionnaire in APD subjects. These experimental findings indicate that white matter abnormalities in several brain areas may contribute to antisocial behaviors in APD subjects.

Psychic euosmia and obsessive compulsive personality disorder

Patients with obsessive compulsive personality disorder(OCPD) often refer to a prompt mood improvement upon encountering good scents in general, or fresh laundry borax on their clothes, pillows or home settings. The Authors propose the new term psychic euosmia in the mean of an overstated psychological predisposition for a real pleasant smell that elicits an immediate sense of pleasure, order and calm. The prompt reactions to a pleasant odor might be explained by the involvement of rhinencephalon and its proximity to mood-related limbic circuits, which bypass the cognitive awareness. Cleanliness may not preclude a subject to enjoy a good smell, even if we are representing smells that resemble freshness, in other words order. A potentially even more important argument is given by the continuum of personality disorders and their variability. Not all personality characteristics led to disturbed behaviors. In evolutionary perspectives having the ability to differentiate between unpleasant and pleasant odors should have made the difference in surviving. On the other hand, psychic euosmia could be considered a normal reaction, but in our clinical experience it is over-represented among OCPD subjects with marked orderliness and disgust. Therefore, detecting psychic euosmia might vicariously confirm the relevance of disgust as a cognitive driver of OCPD. Hereby we support research to characterize psychic euosmia as a feature of orderliness and cleanliness for OCPD.

Autism spectrum disorder and personality disorders: Comorbidity and differential diagnosis

BACKGROUND Differential diagnosis,comorbidities and overlaps with other psychiatric disorders are common among adults with autism spectrum disorder(ASD),but clinical assessments often omit screening for personality disorders(PD),which are especially common in individuals with high-functioning ASD where there is less need for support.AIM To summarize the research findings on PD in adults with ASD and without intellectual disability,focusing on comorbidity and differential diagnosis.METHODS PubMed searches were performed using the key words“Asperger’s Syndrome”,“Autism”,“Personality”,“Personality disorder”and“comorbidity”in order to identify relevant articles published in English.Grey literature was identified through searching Google Scholar.The literature reviews and reference sections of selected papers were also examined for additional potential studies.The search was restricted to studies published up to April 2020.This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method.RESULTS The search found 22 studies carried out on ASD adults without intellectual disability that met the inclusion criteria:16 evaluated personality profiles or PD in ASD(comorbidity),five compared ASD and PD(differential diagnosis)and one performed both tasks.There were significant differences in the methodological Cluster A and cluster C PD are the most frequent co-occurring PD,but overlapping features should be considered.Data on differential diagnosis were only found with cluster A and cluster B PD.CONCLUSION ASD in high-functioning adults is associated with a distinct personality profile even if variability exists.Further studies are needed to explore the complex relationship between ASD and PD.

Neuronal degeneration in the hippocampus and dorsolateral prefrontal cortex in depressive disorder Correlation between ~1H-MRS and Minnesota Multiphasic Personality Inventory

Previous studies using magnetic resonance imaging（MRI）and functional MRI to study depression have primarily focused on proton magnetic resonance spectroscopy（1H-MRS）appearance in various areas of the brain and volume measurements in the limbic system.However,results have not been consistent.To the best of our knowledge,very little is known about the relationship between 1H-MRS appearance and depression inventory.In the present study,the relationship between 1H-MRS appearance in depressive patients and Minnesota Multiphasic Personality Inventory-2 scale was analyzed.MRI and 1H-MRS exhibited widened sulci and cisterns,as well as an absence of abnormal signals in depressive patients.In addition,N-acetyl aspartate/total creatine ratios in bilateral hippocampi and dorsolateral prefrontal cortex were significantly less in depressive patients than in control subjects（P 〈 0.01）.In contrast,choline-containing compounds/total creatine ratios in the dorsolateral prefrontal cortex were significantly greater in depressive patients than in control subjects（P 〈 0.01）.These ratios significantly and positively correlated with patient total depression scores as assessed using the Minnesota Multiphasic Personality Inventory-2 scale（r=0.934 7,0.878 7,P 〈 0.01）.These results suggested that 1H-MRS could be used to reveal a reduced number of neurons in the hippocampus and dorsolateral prefrontal cortex,as well as altered membrane phospholipid metabolism in the dorsolateral prefrontal cortex,in patients with depressive disorder.Abnormal mechanisms partially reflected severity of depressive disorder.

Integrative therapy for personality disorders: Experiences in developing integrative approaches for treatment-refractory personality-disordered clients

Personality Disordered (herein referred to as PD) clients are challenging to statutory mental healthcare programmes. They can be difficult to diagnose: their disorders can be obscured by second-order problems such as anxiety and depression, caused by PD cognitive processes. Treatment-as-usual (the predominant model of psychiatric intervention) for PD clients in crisis tends to focus on these second-order presentations, but provide no means of identifying underlying PD. The purpose of this paper is to describe how heuristic methods of diagnosis can be used to reframe the client’s distress in the context of personality disorders (according to DSM-IV criteria), and how subsequent application of integrative therapies can break their cycle of recidivism. Method: Two case studies of treatment-refractory individuals with cyclical patterns of crisis-point service engagement for self-harm or psychotic depression where heuristic/ integrative therapies were used. Results: The use of integrative therapies in the case studies presented resulted in a marked change in recidivism and quality of life for each client, as measured by a significant reduction in presentation of symptoms and hypervigilance. Discussion: By understanding the maladaptive cognitive-behavioural processes of PD clients, they can be modified to reduce the client’s self-defeating behavioural patterns, breaking the cycle of recidivism. However, a new diagnostic strategy must first be formulated that looks at the clients past use of mental health services to detect underlying PD.

Modern Health Worries and the Personality Disorders: Two Studies Using Different Measures

This paper reports on two studies using different measures of both Modern Health Worries (MHW) and the Personality Disorders (PDs) to establish the relationship between the two concepts. Study 1 used the PID-5 which is a measure of maladaptive personality traits and the extended 40 item MHW scale. Study 2 used the original 28 item measure of MHW and PDs as measured by the Coolidge Axis-II Inventory—Short Form: SCATI. In study 1 a regression on the total MHW scale accounted for 14% of the variance: those who scored higher on Antagonism and Negative Affect had higher MHW scores. In the study 2 regressions showed four variables consistently related to MHW: sex (females with higher scores), optimism, political beliefs (left wing liberals with higher scores) and those with Cluster B personality disorders (dramatic, overly emotional, erratic). There was enough overlap in the two studies to conclude that various PDs mainly from Cluster B (Moving Against others) were modestly related to MHW as predicted. Limitations and implications are considered.

Management of a Cluster of Foreign Body Ingestion Incidents in Patients with Borderline Personality Disorder

Objective: Deliberate foreign body ingestion (DFBI) has been reported in patients with personality disorders as part of a spectrum of self-harming behaviours, however the published literature is small (15 case reports). Method: This was a retrospective audit of medical and psychological management of a cluster of 12 DFBI incidents over 9 months in 4 young female patients with Borderline Personality Disorder (BPD). Results: All four patients knew one another from outpatient psychotherapy programmes. DFBI was associated with substance use in 5/12 incidents, and with precipitants (experiencing strong emotions, witnessing self-harm) in 4/12 incidents. Most DFBI involved sharp objects (razor blades, glass, safety pins). Medical intervention was initially active (endoscopy/surgery) but progressed to a more conservative, observational approach. Psychological management was initially restrictive, but also changed over time to focus on identifying distress, enhancing coping mechanisms and patient responsibility. Co-ordination of patient care management involvedintensive liaison (provision of interdisciplinary support and education) between medical, surgical and psychiatric teams. Conclusion: Management of DFBI in patients with BPD requires high levels of interdisciplinary collaboration. In this cluster of DFBI incidents, effective management was achieved with conservative medical/surgical methods (observation) and non-restrictive psychological approaches that enhanced patient self-efficacy.

Psychic euosmia among obsessive-compulsive personality disorder patients:A case control study

BACKGROUND Psychic euosmia(PE)has been described as a supposed psychological predisposition for which pleasant smells elicit an immediate sense of pleasure,order and calmness in obsessive-compulsive personality disorder(OCPD).In this study we tried to verify the interpretation that PE is the counterpart of disgust that has been associated to contamination and moral purity.Disgust and morality are significantly associated in people with obsessive-compulsive personality traits.We expected that OCPD patients would experience higher levels of PE.AIM To investigate the PE frequency in OCPD patients and healthy controls(HC)and to evaluate the relationship between PE and disgust.METHODS A single-center,case-control study was conducted in an outpatient service for obsessive-compulsive and related disorders.The sample consisted of 129 subjects:45 OCPD patients and 84 HC.In both groups we submitted the Disgust Scale Revised(DS-R)and the self-report Structured Clinical Interview for DSM-5 Screening Personality Questionnaire to which we added an additional yes or no question to investigate the presence of PE.In order to verify differences between groups,t-test was employed for continuous variables and 2 test for categorical variable;odds ratio was employed to analyze group differences in the PE survey.Correlation was explored with Pearson r correlations.RESULTS No differences were observed between groups in gender composition or education.A slight significant difference was found in mean age(t=1.988;P=0.049).The present study revealed significantly higher proportions of PE among OCPD patients when compared to HC(OR:5.3,2.28-12.46).Patients with OCPD were more likely to report PE(n=36;80%)whereas a much lower proportion endorsed PE in the HC group(n=36;42.9%).Interestingly,no differences were observed between groups in mean score for the Disgust Scale.There was also no difference between the two groups in any of the Disgust Scale Revised subscales.Moreover,no significant correlations were observed in the OCPD group between PE and Disgust Scale Revised subscales.CONCLUSION Results suggested that PE might be part of the clinical spectrum of OCPD,and it does not reflect the counterpart of disgust.This could also indicate that this phenomenon is a manifestation of orderliness or incompleteness.Further studies will need to be undertaken to better understand PE and its significance in OCPD.

Borderline Personality Disorders by Dialectical Therapy

This study aimed to discover the possibility of reducing the symptoms of borderline personality disorders (BPD) through the dialectical treatment of a sample group of individuals with BPD in Kuwait. To achieve this objective, a quasi-experimental approach was applied by dividing the study sample into two groups;the control group consisted of 75 individuals and the experimental group consisted of 75 individuals. In addition, a borderline personality disorder scale and program were developed based on American psychologist Marsha Linehan’s rules of dialectical behavioral therapy (DBT). Among the results, the study found statistically significant differences between members of the two groups due to the use of the counseling program based on dialectical treatment. This indicates a positive effect of using the counseling program to reduce the level of BPD among the members of the study sample, in favor of the experimental group.

A Review of Stressors as Inducer for Personality Disorders and Anxiety Disorders

Personality Disorders(PDs)and Anxiety Disorders(ADs)are common mental disorders.PDs are often more or less related to anxiety and ADs are affected by Personality Functioning(PF).To clarify the pathology of both ADs and PDs,along with their similarities and differences,the literature review by paired keywords search on NCBI PubMed and subsequent analysis are used.The findings support that abnormal stressors can damage the Hypothalamus-Pituitary-Adrenal(HPA)axis time by time throughout life through the epigenetic pathway,lowering down the ability of the stress system to deal with stressors.Biological basis,like the genetic issue,for PDs,is important but after-born experience also matters a lot.Adjoint stressful long-term memory may largely affect normal personality formation,contributing to some kinds of PDs.It seems that early exposure to these stressors influences PDs more,compared to ADs.More researches are needed to explore the effect on ADs from later life stress.This study partially explained the process of ADs and PDs,linked them by abnormal stressors,and emphasized the importance of focusing on the effect of stressful long-term memory formation,which is psychological,and the HPA axis disability,which is biological,on patients having these diseases,reminds psychiatrist to treat disease at the source,to lower down the potential risk of getting PDs in patients who are diagnosed with ADs,to prevent arouse of ADs in patients who are diagnosed with PDs and to combine biological treatment with psychological therapies.

Affect regulation in psychoanalytic treatments of patients with a borderline personality disorder–psychoanalysis and psychodynamic psychotherapy–a comparison

BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different types of therapies has been questioned.AIM To study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic therapy.METHODS Psychoanalysis(PSA)or psychodynamic psychotherapy(PDT)was administered to 10 patients each,the two groups were matched.Therapy regimens were applied according to care as usual/manualized including quality control and supervision as usual.Randomization to one of the groups was done after baseline assessment.During classical PSA(n=10)and PDT(n=10),semiannually,recordings(audio or video)of five consecutive therapy sessions were taken over three years for an ex-post analysis.The patients'characteristics,such as affect parameters[Affect regulation and experience Q-sort(AREQ)],quality of object relations(quality of object relations scale)and personality traits[Shedler-Westen Assessment Procedure(SWAP-200)]were analyzed retrospectively by independent raters.Therapeutic action(psychotherapy process Q-sort)and affective(re)actions of the patients(AREQ)were then analyzed in relation to changes found in the patients'characteristics.RESULTS During the first year of therapy(PSA:n=10;PDT:n=9),the therapeutic method PSA was associated with significant improvements in the variable"SWAP Borderline",while in PDT change was not significantly different to baseline(PSA:P=0.04;PDT:P=0.33).Long-term results and follow up was available for seven participants in PSA and for five in PDT after three years;change in SWAP borderline for the whole sample was not significant at this time point when confronting to baseline(P=0.545).However,differences between PSA and PDT were significant when analyzing the“mean change”in the SWAP Borderline variable after one year of therapy(P=0.024):PSA led to slightly increased BPD symptoms,while PDT to a decrease;for the long run,variance of observed change was higher in PSA than in PDT(SDPSA±9.29 vs SDPDT±7.94).Our assumption that transference interpretations,closely followed by affective changes in the patient,could be useful modes of interaction was reproducible in our findings,especially when looking at the descriptive findings in the long-term data.The analysis of repetitive interaction structures demonstrated a very specific"time-lag"between therapeutic intervention and a corresponding increase in positive affect in successful therapy cases.CONCLUSION Exploring the change processes in the patients'characteristics and linking these changes to specific treatment strategies is of clinical importance when starting treatment and for its long-term progress.

Borderline Personality Disorder: A General Overview

Borderline Personality Disorder(BPD)is a personality disorder marked by unpredictable behaviors,emotional instability,and self-injurious conduct,which typically begins in adolescence.BPD patients are difficult to treat.The majority have had child sexual abuse,and roughly a quarter have experienced sexual abuse by a caregiver.The study is an overview of Borderline Personality Disorder,including current and past understanding of its main features,etiology,impact,treatment,and future directions since the public’s recognition of BPD is only at a beginning stage.The passage would be mainly focused on the part of the discussion,where I would illustrate the possible factors that lead to the development of Borderline Personality Disorder from both biological and social perspectives,its impact on individual’s behavior and social functioning,and the current ways of treatments.The discipline has changed dramatically over the last two decades,with a growing number of specialized psychotherapies and drugs being explored.Since BPD patients are especially hard to treat,an evaluation of multiple therapies should be necessary.Limitations and future directions would be discussed in the conclusion.Overall,the paper is aimed to provide a comprehensive summary for the general public.

The Process of Support by Nursing Professionals for Families Having a Member with Borderline Personality Disorder

The purpose of this study was to explore the process of family support provided by nurses to families with a borderline personality disorder (BPD) patient. Semi-structured interviews were conducted with 16 nurses who had provided care to BPD patients. Data obtained from the interviews were qualitatively analyzed using a modified grounded theory approach. As an overall core category of family support processes practiced by nurses for families with BPD patients, family support practiced without awareness that the nurses were supporting families was extracted. Through this process, nurses held perceptions that were premises for family support, which were formed through their individual nursing experiences and perspectives. Nurses also had diverse perceptions concerning the image of families. Through the integration of perceptions that were premises for family support and perceptions of an image of the family, nurses underwent a process of “determination and ambivalence about the need for family support.” Then, nurses provided “family support practice” when they acknowledged the need for family support. During the “family support practice,” nurses had difficulties in providing family support. When family support was not successfully provided, nurses provided “family support practice with seeking more effective ways through trial and error.” For cases in which nurses did not acknowledge the need for intervention, they intentionally chose “not to provide family support.” Furthermore, during the “family support practice,” nurses had contradictory perspectives of family support. Such family support processes ultimately led to an awareness of the same family support required for the future. Family support was provided with “family support practice” and “family support practice with seeking more effective ways through trial and error.” In some cases, however, the process ended in “not to provide family support intentionally.” Experiences and perspectives in providing family support are important factors in carrying out future family support. Developing the positive implications of these factors and reducing psychological strain on nurses may ensure smooth implementation of family support. Thus, nurses need to recognize that they are supporting the family, which is identified as a core category.

医疗美容门诊咨询者的焦虑症状和人格障碍

目的:描述医疗美容门诊咨询者焦虑症状和人格障碍阳性率,探讨医疗美容咨询者焦虑症状的相关因素。方法:选取2021年11月-2023年7月期间在北京某三甲医院成形外科针对各部位进行医疗美容手术咨询的788名来访者,采用人格诊断问卷第4版(PDQ-4)和焦虑自评量表(SAS)作为调查工具,分别以42分和50分为阳性界值筛查其是否存在人格障碍和焦虑症状。采用方差分析、χ^(2)检验、多重线性回归和logistic回归的方法进行统计分析。结果:本研究中医疗美容门诊咨询者焦虑症状阳性率为15.23%(120/788),人格障碍阳性率为3.50%(28/788)。年龄与SAS量表得分负关联(β=-0.82,P=0.009),PDQ-4量表得分与SAS量表得分正关联(β=0.15,P<0.001),眼整形、面部轮廓整形、微创整形与SAS量表得分正关联(β=2.00~3.64,P<0.05)。结论:医疗美容门诊咨询者年龄越小和人格偏离越突出,焦虑症状越严重。眼整形、面部轮廓整形、微创整形的咨询者焦虑症状更严重。