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O'Higgins M, Benito A, Real-López M, Gil-Miravet I, Ochoa E, Haro G. Relationship of DRD5 and MAO-B VNTR polymorphisms with paranoid and antisocial personality disorders in polydrug users. Personal Ment Health 2023; 17:77-86. [PMID: 35961947 DOI: 10.1002/pmh.1563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/09/2022]
Abstract
Although multiple studies have shown the role genetics plays in personality disorders and in addictions, few have studied the genetic aspects of their comorbidity. Here, we carried out a cross-sectional study in a sample comprising 303 Caucasian polydrug-consuming patients. The presence of personality disorders was evaluated using the International Personality Disorder Examination, and genes related to dopamine, serotonin and monoamine oxidase (MAO) were genotyped. A significant relationship was observed between the bp 279 DRD5 variable number of tandem repeat (VNTR) polymorphism and paranoid personality disorder OR 95 % CI = 2.186 1.074 ; 4.449 ; p = 0.006 . The bp 182 OR 95 % CI = 0.407 0.178 ; 0.931 ; p = 0.033 and bp 184 OR 95 % CI = 0.391 0.188 ; 0.813 ; p = 0.012 alleles of the MAOB VNTR were also associated with antisocial personality disorder. Among patients with addictions, paranoid personality disorder should also be considered in addition to the importance of antisocial and borderline personality disorders. The higher frequency of the bp 279 DRD5 VNTR allele found in patients with paranoid personality disorder, as well as the associations between alleles of the MAOB VNTR and antisocial personality disorder, support the monoaminergic bases of these personality disorders, especially when dealing with patients with addictions.
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Affiliation(s)
- Marcelo O'Higgins
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Ana Benito
- TXP Research Group, Medicine and Surgery Department, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló, Spain.,Mental Health Unit of Torrent, Hospital General Universitario de Valencia, Valencia, Spain
| | - Matías Real-López
- Pre-department Medicine Unit, Universitat Jaume I, Castelló, Spain.,Severe Mental Disorder in Childhood and Adolescence Program, Mental Health Department, Consorcio Hospitalario Provincial de Castelló, Castelló, Spain
| | - Isis Gil-Miravet
- TXP Research Group, Medicine and Surgery Department, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló, Spain.,Pre-department Medicine Unit, Universitat Jaume I, Castelló, Spain
| | - Enrique Ochoa
- Molecular Biopathology Department, Consorcio Hospitalario Provincial de Castelló, Castelló, Spain
| | - Gonzalo Haro
- TXP Research Group, Medicine and Surgery Department, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló, Spain.,Severe Dual Pathology Program, Mental Health Department, Consorcio Hospitalario Provincial de Castelló, Castelló, Spain
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Riddle M, Meeks T, Alvarez C, Dubovsky A. When personality is the problem: Managing patients with difficult personalities on the acute care unit. J Hosp Med 2016; 11:873-878. [PMID: 27610608 DOI: 10.1002/jhm.2643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 07/07/2016] [Accepted: 07/18/2016] [Indexed: 11/06/2022]
Abstract
Personality disorders are pervasive patterns of maladaptive behaviors, thoughts, and emotions that often go unrecognized and can wreak havoc in the patient's interpersonal life. These inflexible patterns of managing the world can be disruptive when an individual is admitted to the hospital, causing distress for both the patient who lacks the skills to deal with the expectations of the hospital environment and the treatment team who can feel ill equipped to manage such behavior. Having a personality disorder has implications for an individual's healthcare outcomes; those with a personality disorder have a life expectancy nearly 2 decades shorter than the general population for a multitude of reasons, among them trouble interacting with the healthcare system. Although a diagnosis of a specific personality disorder may be difficult to make on an acute care unit, identification of dysfunctional personality structures can provide opportunity for better management of an individual patient's medical and psychological needs. This review focuses on the identification of these individuals in the acute care setting and provides an overview of evidence-based behavioral and pharmacological interventions. Journal of Hospital Medicine 2015;11:873-878. © 2015 Society of Hospital Medicine.
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Affiliation(s)
- Megan Riddle
- Psychiatry Residency Program, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Timothy Meeks
- Department of Clinical Education, Harborview Medical Center, Seattle, Washington
| | - Carrol Alvarez
- Department of Clinical Education, Harborview Medical Center, Seattle, Washington
| | - Amelia Dubovsky
- Psychiatry Residency Program, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
- Department of Clinical Education, Harborview Medical Center, Seattle, Washington
- Department of Psychiatry and Behavioral Sciences, University of Washington and Harborview Medical Center, Seattle, Washington
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