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Preliminary findings on diagnostic validity of the ICD-11 personality disorder scales among Croatian psychiatric patients
- N. Jaksic, I. Simunovic Filipcic, M. Sagud, B. Vuksan Cusa, M. Skocic Hanzek, Z. Madzarac, V. Bilic, J. Grubisin, I. Filipcic, M. Copo, Z. Vuksan Cusa, E. Podolski, D. Marcinko
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S364
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Introduction
Official classification of personality disorders (PDs) has witnessed a significant shift from traditional categorical to more dimensional diagnostic perspective in the recently published International Classification of Diseases - 11th Revision (ICD-11).
ObjectivesThe goal of this preliminary study was to explore the clinical use (i.e., diagnostic validity) of the newly constructed, as well as recently adapted to Croatian language, self-report measures of the ICD-11 PD severity and personality trait domains.
MethodsThis study was carried out in a sample of 363 psychiatric patients (54% female, mean age 46 years) who were being treated at Department of Psychiatry and Psychological Medicine of the University Hospital Center Zagreb and the University Psychiatric Clinic Sveti Ivan, Zagreb, Croatia. Patients were divided into two groups: 98 patients with the diagnosis of PD (‘’PD group”) based on the ICD-10 criteria and 265 patients with other psychiatric disorders (‘’non-PD group”) (43% anxiety disorders, 31% affective disorders, 16% psychotic disorders, and 10% substance use disorders). They filled out the following scales that were developed according to the ICD-11 PD guidelines: the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale and the Personality Assessment Questionnaire for ICD-11 (PAQ-11).
ResultsStatistical comparison of the two clinical groups revealed that the ‘’PD group” was significantly younger, had relatively more female patients and showed a trend towards higher number of psychiatric hospitalizations, whereas there were no group difference in terms of education level, relationship status and treatment length. More importantly, the ‘’PD group” exhibited a significantly higher total score (mean 16.30 vs. 12.39) on the PDS-ICD-11, indicating greater global personality dysfunction (i.e., more severe PD). Also, of the five PD trait domains measured by the PAQ-11, the ‘’PD group” had significantly more pronounced Negative Affectivity, Dissociality, Disinhibition and Detachment, whereas Anankastia was similar across the two groups.
ConclusionsGiven the radical changes in ICD-11 related to PD diagnosis, there is an urgent need to culturally adapt and evaluate psychometric properties of the scales developed to measure PD severity and personality trait domains. Our preliminary findings support diagnostic validity of two such instruments among Croatian psychiatric patients: the PDS-ICD-11 and PAQ-11.
Disclosure of InterestNone Declared
Substance use among people with severe mental illness during the COVID-19 pandemic and earthquakes: the role of community-based treatment
- S. Levaj, S. Medved, J. Gerlach, L. Shields-Zeeman, F. Bolinski, Z. Bradaš, Z. Madžarac, I. Rojnić Palavra, M. Rojnić Kuzman
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S598
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Introduction
The COVID-19 pandemic has disrupted mental healthcare delivery in many countries. The restricted access to psychiatric services and double disasters (pandemic and earthquakes) coincided in Croatia, potentially placing people with severe mental illness (SMI) in a very vulnerable position.
ObjectivesThe aim of this study was to examine the changes in substance use in people with SMI in the first and the second COVID-19 wave and co-occurring earthquakes. The secondary aim was to explore whether the type of treatment (community mental health teams (CMHT) vs. treatment as usual) influenced those changes.
MethodsThis study was nested within the RECOVER-E project (LaRge-scalE implementation of COmmunity based mental health care for people with seVere and Enduring mental ill health in EuRopE, Horizon 2020 research and innovation programme, grant agreement No 779362). The study involved 90 participants with SMI assessed at two time points: in May/June 2020 (during the first COVID-19 wave and after Zagreb earthquake) and in December 2020/January 2021 (during the second COVID-19 wave and after Petrinja earthquake). The changes in the use of psychoactive substances (alcohol, cannabis, other drugs, sedatives) were assessed using self-reported survey.
ResultsThe increase in tobacco smoking behavior and the use of sedatives was observed in both COVID-19 waves in people with SMI. No increase was reported in cannabis and other drugs use, while less than 5% of participants reported increase in alcohol consumption. Not receiving CMHT service predicted the increase in sedative use.
ConclusionsEnsuring accessible mental health care provided by CMHT is recommended for counteracting the negative effect of external stressors (such as pandemic and co-occurring earthquakes) on the increased substance use among people with SMI.
Disclosure of InterestS. Levaj Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., S. Medved Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., J. Gerlach: None Declared, L. Shields-Zeeman Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., F. Bolinski Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., Z. Bradaš Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., Z. Madžarac Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., I. Rojnić Palavra: None Declared, M. Rojnić Kuzman Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362.