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Personality disorders and cause-specific mortality: a nationwide study of 2 million adolescents
- Shmuel Tiosano, Lucian Laur, Amir Tirosh, Ariel Furer, Arnon Afek, Noam Fink, Estela Derazne, Dorit Tzur, Eyal Fruchter, Ariel Ben-Yehuda, Tarif Bader, Howard Amital, Moyses Szklo, Mark Weiser, Gilad Twig
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- Journal:
- Psychological Medicine / Volume 52 / Issue 9 / July 2022
- Published online by Cambridge University Press:
- 14 October 2020, pp. 1746-1754
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Background
Personality disorders are prevalent in 6–10% of the population, but their risk for cause-specific mortality is unclear. The aim of the study was to assess the association between personality disorders diagnosed in late adolescence and all-cause as well as cause-specific (cardiovascular-related, external-related) mortality.
MethodsWe performed a longitudinal study on a historical prospective cohort based on nationwide screening prior to recruitment to the Israeli army. The study participants were 16–19-year-old persons who attended the army screening (medical and cognitive, including screening for psychiatric disorders) between 1967 and 2006. Participants were followed from 1967 till 2011.
ResultsThe study included 2 051 606 subjects, of whom 1 229 252 (59.9%) were men and 822 354 (40.1%) were women, mean age 17.36 years. There were 55 508 (4.5%) men and 8237 (1.0%) women diagnosed with personality disorders. The adjusted hazard ratio (HRs) for coronary, stroke, cardiovascular, external-related causes and all-cause mortality among men with personality disorders were 1.34 (1.03–1.74), 1.82 (1.20–2.76), 1.45 (1.23–1.71), 1.41 (1.30–1.53) and 1.44 (1.36–1.51), respectively. The absolute rate difference for all-cause mortality was 56.07 and 13.19 per 105 person-years among men and women, respectively. Among women with personality disorders, the adjusted HRs for external-related causes and all-cause mortality were 2.74 (1.87–4.00) and 2.01 (1.56–2.58). Associations were already evident within 10 years of follow-up.
ConclusionsPersonality disorder in late adolescence is associated with increased risk of cardiovascular, external- and all-cause mortality. Increased cardiovascular mortality is evident before the age of 40 years and may point to the importance of lifestyle education already in youth.
Contributors
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- By Lenard A. Adler, Pinky Agarwal, Rehan Ahmed, Jagga Rao Alluri, Fawaz Al-Mufti, Samuel Alperin, Michael Amoashiy, Michael Andary, David J. Anschel, Padmaja Aradhya, Vandana Aspen, Esther Baldinger, Jee Bang, George D. Baquis, John J. Barry, Jason J. S. Barton, Julius Bazan, Amanda R. Bedford, Marlene Behrmann, Lourdes Bello-Espinosa, Ajay Berdia, Alan R. Berger, Mark Beyer, Don C. Bienfang, Kevin M. Biglan, Thomas M. Boes, Paul W. Brazis, Jonathan L. Brisman, Jeffrey A. Brown, Scott E. Brown, Ryan R. Byrne, Rina Caprarella, Casey A. Chamberlain, Wan-Tsu W. Chang, Grace M. Charles, Jasvinder Chawla, David Clark, Todd J. Cohen, Joe Colombo, Howard Crystal, Vladimir Dadashev, Sarita B. Dave, Jean Robert Desrouleaux, Richard L. Doty, Robert Duarte, Jeffrey S. Durmer, Christyn M. Edmundson, Eric R. Eggenberger, Steven Ender, Noam Epstein, Alberto J. Espay, Alan B. Ettinger, Niloofar (Nelly) Faghani, Amtul Farheen, Edward Firouztale, Rod Foroozan, Anne L. Foundas, David Elliot Friedman, Deborah I. Friedman, Steven J. Frucht, Oded Gerber, Tal Gilboa, Martin Gizzi, Teneille G. Gofton, Louis J. Goodrich, Malcolm H. Gottesman, Varda Gross-Tsur, Deepak Grover, David A. Gudis, John J. Halperin, Maxim D. Hammer, Andrew R. Harrison, L. Anne Hayman, Galen V. Henderson, Steven Herskovitz, Caitlin Hoffman, Laryssa A. Huryn, Andres M. Kanner, Gary P. Kaplan, Bashar Katirji, Kenneth R. Kaufman, Annie Killoran, Nina Kirz, Gad E. Klein, Danielle G. Koby, Christopher P. Kogut, W. Curt LaFrance, Patrick J.M. Lavin, Susan W. Law, James L. Levenson, Richard B. Lipton, Glenn Lopate, Daniel J. Luciano, Reema Maindiratta, Robert M. Mallery, Georgios Manousakis, Alan Mazurek, Luis J. Mejico, Dragana Micic, Ali Mokhtarzadeh, Walter J. Molofsky, Heather E. Moss, Mark L. Moster, Manpreet Multani, Siddhartha Nadkarni, George C. Newman, Rolla Nuoman, Paul A. Nyquist, Gaia Donata Oggioni, Odi Oguh, Denis Ostrovskiy, Kristina Y. Pao, Juwen Park, Anastas F. Pass, Victoria S. Pelak, Jeffrey Peterson, John Pile-Spellman, Misha L. Pless, Gregory M. Pontone, Aparna M. Prabhu, Michael T. Pulley, Philip Ragone, Prajwal Rajappa, Venkat Ramani, Sindhu Ramchandren, Ritesh A. Ramdhani, Ramses Ribot, Heidi D. Riney, Diana Rojas-Soto, Michael Ronthal, Daniel M. Rosenbaum, David B. Rosenfield, Durga Roy, Michael J. Ruckenstein, Max C. Rudansky, Eva Sahay, Friedhelm Sandbrink, Jade S. Schiffman, Angela Scicutella, Maroun T. Semaan, Robert C. Sergott, Aashit K. Shah, David M. Shaw, Amit M. Shelat, Claire A. Sheldon, Anant M. Shenoy, Yelizaveta Sher, Jessica A. Shields, Tanya Simuni, Rajpaul Singh, Eric E. Smouha, David Solomon, Mehri Songhorian, Steven A. Sparr, Egilius L. H. Spierings, Eve G. Spratt, Beth Stein, S.H. Subramony, Rosa Ana Tang, Cara Tannenbaum, Hakan Tekeli, Amanda J. Thompson, Michael J. Thorpy, Matthew J. Thurtell, Pedro J. Torrico, Ira M. Turner, Scott Uretsky, Ruth H. Walker, Deborah M. Weisbrot, Michael A. Williams, Jacques Winter, Randall J. Wright, Jay Elliot Yasen, Shicong Ye, G. Bryan Young, Huiying Yu, Ryan J. Zehnder
- Edited by Alan B. Ettinger, Albert Einstein College of Medicine, New York, Deborah M. Weisbrot, State University of New York, Stony Brook
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- Book:
- Neurologic Differential Diagnosis
- Published online:
- 05 June 2014
- Print publication:
- 17 April 2014, pp xi-xx
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- By Douglas L. Arnold, Laura J. Balcer, Amit Bar-Or, Sergio E. Baranzini, Frederik Barkhof, Robert A. Bermel, Francois A. Bethoux, Dennis N. Bourdette, Richard K. Burt, Peter A. Calabresi, Zografos Caramanos, Tanuja Chitnis, Stacey S. Cofield, Jeffrey A. Cohen, Nadine Cohen, Alasdair J. Coles, Devon Conway, Stuart D. Cook, Gary R. Cutter, Peter J. Darlington, Ann Dodds-Frerichs, Ranjan Dutta, Gilles Edan, Michelle Fabian, Franz Fazekas, Massimo Filippi, Elizabeth Fisher, Paulo Fontoura, Corey C. Ford, Robert J. Fox, Natasha Frost, Alex Z. Fu, Siegrid Fuchs, Kazuo Fujihara, Kristin M. Galetta, Jeroen J.G. Geurts, Gavin Giovannoni, Nada Gligorov, Ralf Gold, Andrew D. Goodman, Myla D. Goldman, Jenny Guerre, Stephen L. Hauser, Peter B. Imrey, Douglas R. Jeffery, Stephen E. Jones, Adam I. Kaplin, Michael W. Kattan, B. Mark Keegan, Kyle C. Kern, Zhaleh Khaleeli, Samia J. Khoury, Joep Killestein, Soo Hyun Kim, R. Philip Kinkel, Stephen C. Krieger, Lauren B. Krupp, Emmanuelle Le Page, David Leppert, Scott Litwiller, Fred D. Lublin, Henry F. McFarland, Joseph C. McGowan, Don Mahad, Jahangir Maleki, Ruth Ann Marrie, Paul M. Matthews, Francesca Milanetti, Aaron E. Miller, Deborah M. Miller, Xavier Montalban, Charity J. Morgan, Ichiro Nakashima, Sridar Narayanan, Avindra Nath, Paul W. O’Connor, Jorge R. Oksenberg, A. John Petkau, Michael D. Phillips, J. Theodore Phillips, Tammy Phinney, Sean J. Pittock, Sarah M. Planchon, Chris H. Polman, Alexander Rae-Grant, Stephen M. Rao, Stephen C. Reingold, Maria A. Rocca, Richard A. Rudick, Amber R. Salter, Paula Sandler, Jaume Sastre-Garriga, John R. Scagnelli, Dana J. Serafin, Lynne Shinto, Nancy L. Sicotte, Jack H. Simon, Per Soelberg Sørensen, Ryan E. Stagg, James M. Stankiewicz, Lael A. Stone, Amy Sullivan, Matthew Sutliff, Jessica Szpak, Alan J. Thompson, Bruce D. Trapp, Helen Tremlett, Maria Trojano, Orla Tuohy, Rhonda R. Voskuhl, Marc K. Walton, Mike P. Wattjes, Emmanuelle Waubant, Martin S. Weber, Howard L Weiner, Brian G. Weinshenker, Bianca Weinstock-Guttman, Jeffrey L. Winters, Jerry S. Wolinsky, Vijayshree Yadav, E. Ann Yeh, Scott S. Zamvil
- Edited by Jeffrey A. Cohen, Richard A. Rudick
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- Book:
- Multiple Sclerosis Therapeutics
- Published online:
- 05 December 2011
- Print publication:
- 20 October 2011, pp viii-xii
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- By Antony R. Absalom, Lorenz Breuer, Christoph S. Burkhart, Rowan M. Burnstein, Ian Calder, Jonathan P. Coles, Amanda Cox, Marek Czosnyka, Armagan Dagal, Judith Dinsmore, Derek Duane, Kristin Engelhard, Ari Ercole, Rik Fox, Sabrina G. Galloway, Arnab Ghosh, Arun K. Gupta, Nicholas Hirsch, Robin Howard, Peter Hutchinson, Nicole C. Keong, Martin Köhrmann, Arthur M. Lam, Andrea Lavinio, Brian P. Lemkuil, Luca Longhi, Craig D. McClain, Robert Macfarlane, Basil F. Matta, Stephan A. Mayer, David K. Menon, Andrew W. Michell, Dick Moberg, Paul G. Murphy, Clara Poon, Amit Prakash, Frank Rasulo, Fred Rincon, Stefan Schwab, Martin Smith, Sulpicio G. Soriano, Luzius A. Steiner, Nino Stocchetti, Stephan P. Strebel, Jane Sturgess, Magnus Teig, Tonny Veenith, Christian Werner, Christian Zweifel
- Edited by Basil F. Matta, David K. Menon, Martin Smith
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- Book:
- Core Topics in Neuroanaesthesia and Neurointensive Care
- Published online:
- 05 December 2011
- Print publication:
- 13 October 2011, pp vii-x
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Israeli Defense Forces Medical Corps Humanitarian Mission for Kosovo's Refugees
- Howard Amital, Michael L Alkan, Jakov Adler, Iyzhak Kriess, Yehezkel Levi
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- Journal:
- Prehospital and Disaster Medicine / Volume 18 / Issue 4 / December 2003
- Published online by Cambridge University Press:
- 28 June 2012, pp. 301-305
- Print publication:
- December 2003
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In April 1999, during the crisis in Kosovo, the Israeli government launched a medical, field hospital in order to provide humanitarian aid to the Albanian refugees that fled from their homes in Kosovo. This facility was set up by the Medical Corps of the Israeli Defense Forces, in a refugee camp located in Northern Macedonia. During the 16 days during which the hospital functioned, the medical staff treated 1,560 patients and hospitalized >100. The field hospital served as a referral center for all of the other primary clinics that were hastily erected in the camp and its surroundings. This communication elaborates on the various aspects of the humanitarian medical aid that were provided by this medical facility and the conclusions that learned from such a mission.
Development of Porous Polymer-Ceramic Composites as Bone Grafts
- Samar Kalita, John Finley, Susmita Bose, Howard Hosick, Amit Bandyopadhyay
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- Journal:
- MRS Online Proceedings Library Archive / Volume 726 / 2002
- Published online by Cambridge University Press:
- 01 February 2011, Q5.8
- Print publication:
- 2002
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Biomaterials have made significant contributions to the advancement of modern health care and drug delivery industries. The present research is based on development of porous polymerceramic composite scaffolds using polypropylene (PP) polymer and tricalcium phosphate (TCP) ceramic for bone-graft applications. Three dimensionally interconnected controlled porosity scaffolds were fabricated using a fused deposition modeling (FDM) system. First, ceramic and polymeric materials were compounded under high shear using a torque rheometer. Compounded materials were then extruded to a 1.78mm diameter continuous filament using a single screw extruder. These filaments were used as a feedstock material for an FDM 1650 machine for direct fabrication of controlled porosity parts. Hg-porosimetry was done to determine pore size and their distribution in these structures. Tensile properties of neat composites and as received polymer were measured and compared using standard dog bone samples. Uniaxial compression tests were performed on cylindrical porous samples having average pore size of 160 μm and 36 vol% porosity. These samples showed an average ultimate compressive strength of 12.7 MPa. Average compressive modulus was calculated as 263 MPa. Cytotoxicity and cell proliferation studies were conducted with OPC1 modified human osteoblast cell-line. It was found that composite matrices were non-toxic and they showed excellent cell growth with OPC1 cells.
Calcium Carbonate Reinforced Natural Polymer Composite For Bone Grafts
- Samar J. Kalita, Susmita Bose, Howard L. Hosick, Steve A. Martinez, Amit Bandyopadhyay
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- Journal:
- MRS Online Proceedings Library Archive / Volume 724 / 2002
- Published online by Cambridge University Press:
- 01 February 2011, N8.18
- Print publication:
- 2002
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Challenges in tissue engineering have always-motivated scientists and engineers to develop new biomaterials that can restore the structural features and physiological functions of natural tissues. A novel ceramic-polymer composite was processed with bio-active ceramics dispersed in a natural bio-active polymer for bone graft applications. A commercially available caster bean extract polymer (CBP) was used. It is a natural polymer extracted from the oily caster beans of the dicotyledonous class. During processing of these composites, in situ random interconnected porosity was generated similar to natural bone. Hg-porosimetry results of these composites show that most of the pores are between 50 to 150 microns. Compression tests were performed on cylindrical samples to determine the mechanical properties. Average compression modulus was calculated as 173 MPa, while the average failure strength was 6.7 MPa. Cytotoxicity and cell proliferation studies were conducted with modified human osteoblast cell-line (OPC-1) to show that these composites are biocompatible. Composites showed good cell attachment with a continuous increase in cell growth for at least up to two weeks.