Clinical decision-making style preferences of European psychiatrists: Results from the Ambassadors survey in 38 countries.

Background: While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe.

Methods: We conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style - Staff questionnaire and a set of questions regarding clinicians' expertise, training, and practice.

Self-invalidation in borderline personality disorder: A content analysis of patients' verbalizations.

Objective: The ability to trust one's own perceptions is crucial for psychological well-being and growth. The relevance of its opposite, self-invalidation (SI), to the psychopathology of borderline personality disorder (BPD) is emphasized in many contemporary theories of evidence-based treatments for BPD. Empirical research on this topic remains scarce, however.

"If you don't have a word for something, you may doubt whether it's even real" - how individuals with borderline personality disorder experience change.

This study explored how psychological change was experienced and what treatment-related factors or events were perceived as supporting or hindering their process by individuals with borderline personality disorder. Eight BPD sufferers attended a 40-session psychoeducational group intervention at a community mental health care center. At intervention end, personal experience of meaningful change was explored in an in-depth interview and data were content-analyzed.

Self-reported treatment adherence among psychiatric in- and outpatients.

Background: Poor adherence to psychiatric treatment is a common clinical problem, leading to unfavourable treatment outcome and increased healthcare costs.

Aim: The aim of this study was to investigate the self-reported adherence and attitudes to outpatient visits and pharmacotherapy in specialized care psychiatric patients.

Methods: Within the Helsinki University Psychiatric Consortium (HUPC) pilot study, in- and outpatients with schizophrenia or schizoaffective disorder (SSA, n  =  113), bipolar disorder (BD, n  =  99), or depressive disorder (DD, n  =  188) were surveyed about their adherence and attitudes towards outpatient visits and pharmacotherapy.

Single dose of mirtazapine modulates whole-brain functional connectivity during emotional narrative processing.

The link between neurotransmitter-level effects of antidepressants and their clinical effect remain poorly understood. A single dose of mirtazapine decreases limbic responses to fearful faces in healthy subjects, but it is unknown whether this effect applies to complex emotional situations and dynamic connectivity between brain regions. Thirty healthy volunteers listened to spoken emotional narratives during functional magnetic resonance imaging (fMRI).

Pharmacological and psychosocial treatment of depression in primary care: Low intensity and poor adherence and continuity.

Background: Primary health care bears the main responsibility for treating depression in most countries. However, few studies have comprehensively investigated provision of pharmacological and psychosocial treatments, their continuity, or patient attitudes and adherence to treatment in primary care.

Methods: In the Vantaa Primary Care Depression Study, 1111 consecutive primary care patients in the City of Vantaa, Finland, were screened for depression with Prime-MD, and 137 were diagnosed with DSM-IV depressive disorders via SCID-I/P and SCID-II interviews.

A single dose of mirtazapine attenuates neural responses to self-referential processing.

Increased self-focus is a core factor in the psychopathology of depression. Cortical midline structures (CMS) are implicated in the neurobiology of self, depression and antidepressant treatment response. Mirtazapine, an antidepressant that increases serotonin and norepinephrine release, enhances processing of positive and attenuates processing of negative emotional information in healthy volunteers after a single dose.

The effect of personality on daily life emotional processes.

Personality features are associated with individual differences in daily emotional life, such as negative and positive affectivity, affect variability and affect reactivity. The existing literature is somewhat mixed and inconclusive about the nature of these associations. The aim of this study was to shed light on what personality features represent in daily life by investigating the effect of the Five Factor traits on different daily emotional processes using an ecologically valid method.

[How can a doctor meet an anxious patient?].

A doctor can meet an anxious patient and handle her/his own reactions emerging in the therapeutic relationship. It is especially necessary to focus attention on the phenomena of the therapeutic relationship if the problems are prolonged and the patient and the doctor feel burdened. Mindfulness refers to conscious directing of alertness to the present, and to the approval and permissive perception of both extrinsic and intrinsic events (e.

Depression and smoking: a 5-year prospective study of patients with major depressive disorder.

Background: Major depressive disorder (MDD) and smoking are major public health problems and epidemiologically strongly associated. However, the relationship between smoking and depression and whether this is influenced by common confounding factors remain unclear, in part due to limited longitudinal data on covariation.

Methods: In the Vantaa Depression Study, psychiatric out- and inpatients with DSM-IV MDD and aged 20-59 years at were followed from baseline to 6 months, 18 months, and 5 years.

[Psychiatric evaluation of functional and work capacity--why, when and how?].

Evaluation and support of functional capacity are an essential part of treatment and rehabilitation of mental disorders. The evaluation requires objective observations from the examination situation and functional environment and is best effected multi-professionally and in network collaboration. In addition to functional limitations it is important to elucidate the remaining functional capacity, resources, strengths and coping mechanisms of the examined person and the possibilities of the workplace to support continuation in the work.

Do antidepressants change personality?--a five-year observational study.

Background: Whether antidepressants influence personality is a major clinical and societal issue due to their widespread use. In an observational study, we investigated whether depressive patients' neuroticism and extraversion scores covary with antidepressant pharmacotherapy, and if so, whether this remains significant after accounting for depressive or anxiety symptoms.

Methods: Major depressive disorder patients (N=237) were interviewed at up to four time-points in a five-year prospective longitudinal study.

Neuroticism mediates the effect of P2RX7 on outcomes of mood disorders.

Background: We previously reported an association between P2RX7 variant rs208294, diagnosis, and the longitudinal course of mood disorders. Here, we test whether the personality trait neuroticism mediates the effect of P2RX7 on the course of mood disorders.

Methods: Patients with DSM-IV mood disorder (256 with major depressive disorder and 168 with bipolar disorder [BD]) were diagnosed with semistructured interviews, genotyped, and followed up for a median of 60 (range 6-83) months.

Temperament trait Harm Avoidance associates with μ-opioid receptor availability in frontal cortex: a PET study using [(11)C]carfentanil.

Harm Avoidance is a temperament trait that associates with sensitivity to aversive and non-rewarding stimuli, higher anticipated threat and negative emotions during stress as well as a higher risk for affective disorders. The neurobiological correlates of interindividual differences in Harm Avoidance are largely unknown. We hypothesized that variability in Harm Avoidance trait would be explained by differences in the activity of μ-opioid system as the opioid system is known to regulate affective states and stress sensitivity.

P2RX7 gene is associated consistently with mood disorders and predicts clinical outcome in three clinical cohorts.

We investigated the effect of nine candidate genes on risk for mood disorders, hypothesizing that predisposing gene variants not only elevate the risk for mood disorders but also result in clinically significant differences in the clinical course of mood disorders. We genotyped 178 DSM-IV bipolar I and II and 272 major depressive disorder patients from three independent clinical cohorts carefully diagnosed with semistructured interviews and prospectively followed up with life charts for a median of 60 (range 6-83) months. Healthy control subjects (n = 1322) were obtained from the population-based national Health 2000 Study.

Family history of psychiatric disorders and the outcome of psychiatric patients with DSM-IV major depressive disorder.

Background: Major Depressive Disorder (MDD) is often comorbid with other heritable disorders. The correlates of a family history (FH) of mood disorders but not of comorbid disorders among MDD patients have been investigated. Since bipolar disorder (BD) is highly heritable, latent BD may bias findings.

[A patient with personality disorder on a consultation visit].

Personality disorders are disorders of cerebral function, in which the regulation of emotions or impulse control has become disturbed in a manner that impairs the capacity for reciprocal personal relationships. Persons suffering from unstable personality are exceedingly sensitive in reading emotional states from faces. In a crisis situation it is helpful for the patient, if the physician attempts to catch what is valid in the patient's experience and actively messages such understanding to the patient.