This study investigated similarities and differences in the experience of auditory hallucinations, paranoia, and childhood trauma in schizophrenia and borderline personality disorder (BPD). Patients with clinical diagnoses of schizophrenia or BPD were interviewed using the Structured Clinical Interviews for DSM-IV. Axes 1 and 2 and auditory hallucinations, paranoia, and childhood trauma were assessed. A total of 111 patients participated; 59 met criteria for schizophrenia, 33 for BPD, and 19 for both. The groups were similar in their experiences of voices, including the perceived location of them, but they differed in frequency of paranoid delusions. Those with a diagnosis of BPD, including those with schizophrenia comorbidity, reported more childhood trauma, especially emotional abuse. BPD and schizophrenia frequently coexist, and this comorbidity has implications for diagnostic classification and treatment. Levels of reported childhood trauma are especially high in those with a BPD diagnosis, whether they have schizophrenia or not, and this requires assessment and appropriate management.
These results suggest that studies that rely on maternal recall alone are susceptible to bias. The excess of OCs recalled by the mother could be related to abnormal behaviour in their child rather than maternal illness, family history or psychotic symptoms.
Abstract.
Background: Escaping from emotional pain is a recognized driver in suicidal patients' desire to die.
Formal scales of emotional pain are rarely used during routine contact between patients and
their care team. No study has explored facilitators and inhibitors of emotional pain
communication between staff and suicidal patients during regular care. Aims: To identify factors
impeding or facilitating emotional pain communication between patients at risk of suicide and
mental health professionals. Method: Nine patients with a history of a medically serious suicide
attempt and 26 mental health (NHS) staff participated in individualized and focus group
interviews, respectively. Results: A typological model was created, describing how patients
either speak out or inhibit communication, and professionals may hear the communication or fail
to do so. Four permutations are possible: unspoken/unheard, spoken/unheard,
spoken/heard, and unspoken/heard. We found 14 subthemes of impediments and facilitators,
which include misaligned, alienated and, co-bearing. Limitations: No male patients participated.
Conclusion: Numerous factors influence whether emotional pain communication is responded to,
missed, or ignored. Patients may try more than one way to communicate. Some patients fear that
being able to speak out results in their emotional pain being taken less seriously. Knowledge of
this model should improve the care of suicidal patients.
The objective of the study was to contrast patient-reported outcomes of patients treated with venlafaxine and fluoxetine with major depression. The study design was a six-week, double-blind placebo-controlled flexible dose study of venlafaxine (37.5 to 225 mgday) and fluoxetine (20 to 60 mg/day) in 297 intent-totreat adult outpatients with major depression, Venlafaxine was significantly superior to placebo based on the total score of the General Life Functioning scale (GLF) @
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