ObjectiveThe objective of this study was to test if the Personality Inventory for DSM‐5 (PID‐5) is an adequate instrument to evaluate psychiatric inpatients' pathological personality traits.MethodsInpatients (n = 130; mean age: 38.5 years; 62.3% female; 63.9% single) answered the PID‐5 after clinical improvement of their psychiatric symptoms. The mean scores of the DSM‐5 personality domains, facets and profiles, and ICD‐11 domain traits were compared with the mean scores of a Brazilian normative sample (n = 656). We investigated the diagnostic performance of the scales to identify individuals with and without psychopathology.ResultsThe final sample included mainly diagnoses of mood disorders. Except for Antagonism and Disinhibition, all DSM‐5 personality domains and most facets as well as almost all DSM‐5 personality disorder profiles (except Narcissist) and ICD‐11 trait domains (except Detachment and Dissociality) of the inpatients presented high differences compared with the normative sample. In general, the PID‐5 scales presented a high negative predictive value and a low positive predictive value to identify individuals with severe psychopathology.DiscussionThis study found high scores of pathological personality traits in a sample of Brazilian psychiatric inpatients. The PID‐5 may be a promising instrument to measure pathological personality traits among psychiatric inpatients. Methodological and sample size limitations may have influenced the results. © 2018 John Wiley & Sons, Ltd.

Background Anxiety, obsessive-compulsive, and stress-related disorders frequently co-occur, and patients often present symptoms of several domains. Treatment involves the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), but data on comparative efficacy and acceptability are lacking. We aimed to compare the efficacy of SSRIs, SNRIs, and placebo in multiple symptom domains in patients with these diagnoses over the lifespan through a 3-level network meta-analysis. Methods and findings We searched for published and unpublished randomized controlled trials that aimed to assess the efficacy of SSRIs or SNRIs in participants (adults and children) with diagnosis of any anxiety, obsessive-compulsive, or stress-related disorder in MEDLINE, PsycINFO, Embase, and Cochrane Library from inception to 23 April 2015, with an update on 11 November 2020. We supplemented electronic database searches with manual searches for published and unpublished randomized controlled trials registered in publicly accessible clinical trial registries and pharmaceutical companies’ databases. No restriction was made regarding comorbidities with any other mental disorder, participants’ age and sex, blinding of participants and researchers, date of publication, or study language. The primary outcome was the aggregate measure of internalizing symptoms of these disorders. Secondary outcomes included specific symptom domains and treatment discontinuation rate. We estimated standardized mean differences (SMDs) with 3-level network meta-analysis with random slopes by study for medication and assessment instrument. Risk of bias appraisal was performed using the Cochrane Collaboration’s risk of bias tool. This study was registered in PROSPERO (CRD42017069090). We analyzed 469 outcome measures from 135 studies (n = 30,245). Medication (SSRI or SNRI) was more effective than placebo for the aggregate measure of internalizing symptoms (SMD −0.56, 95% CI −0.62 to −0.51, p < 0.001), for all symptom domains, and in patients from all diagnostic categories. We also found significant results when restricting to the most used assessment instrument for each diagnosis; nevertheless, this restriction led to exclusion of 72.71% of outcome measures. Pairwise comparisons revealed only small differences between medications in efficacy and acceptability. Limitations include the moderate heterogeneity found in most outcomes and the moderate risk of bias identified in most of the trials. Conclusions In this study, we observed that SSRIs and SNRIs were effective for multiple symptom domains, and in patients from all included diagnostic categories. We found minimal differences between medications concerning efficacy and acceptability. This 3-level network meta-analysis contributes robust evidence to the ongoing discussion about the true benefit of antidepressants, with a significantly larger quantity of data and higher statistical power than previous studies. The 3-level approach allowed us to properly assess the efficacy of these medications on internalizing psychopathology, avoiding potential biases related to the exclusion of information due to distinct assessment instruments, and to explore the multilevel structure of transdiagnostic efficacy.