Abstract Autism Spectrum Disorders (ASD) and Attention Defi cit Hyperactivity Disorders (ADHD) are Neurodevelop mental Disorders (ND) that frequently coexist together and have etiological, biological, and clinical factors in common. The comorbidity of both neurodevelopmental disorders is associated with a delay or lack of ASD di agnosis and the development of perceptual, emotional, cognitive and behavioral alterations related to Emotional Dysregulation (ED) is common. When both TN are not diagnosed in childhood, they frequently receive wrong diagnoses at later ages, the most frequent being Border line Personality Disorder (BPD). The clinical presentation of the association of ASD and ADHD, the association with ED, differentiation of BPD, and evaluation and intervention are here analyzed. The comorbidity ASD, ADHD, ED is a more severe disorder associated to polypharmacology and hospital admissions.

Resumen Los Trastornos del Espectro Autista (TEA) y los Tras tornos por Déficit de Atención Hiperactividad (TDAH) son Trastornos del Neurodesarrollo (TN) que coexisten frecuentemente y que tienen factores etiológicos, bio lógicos, clínicos en común. La comorbilidad de ambos TN se asocia a un retraso en el diagnóstico del TEA o un diagnóstico que nunca llegan a recibir y es frecuente el desarrollo de alteraciones perceptivas, emocionales, cognitivas y conductuales relacionadas con la Desregu lación Emocional (DE). Cuando ambos TN no son diag nosticados en infancia, frecuentemente reciben diag nósticos equivocados en edades más tardías, siendo el más frecuente el Trastorno Límite de Personalidad (TLP). Se analiza la presentación clínica de la asociación del TEA y el TDAH, la asociación con DE, diferenciación del TLP y evaluación e intervención. La comorbilidad TEA, TDAH, DE, es un trastorno más severo, asociado a poli farmacología y a ingresos hospi talarios.

Abstract Objective Borderline personality disorder (BPD) is a serious and extremely prevalent mental disorder. Early diagnosis is vital for treatment. However, there are no specific screening instruments validated for Brazilian Portuguese. This study aimed to adapt the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) to the Brazilian context. The MSI-BPD is a self-report instrument based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), that enables fast and reliable assessment of BPD, with measures of sensitivity (SN) and specificity (SP) similar to the diagnostic interview for the DSM-5 (Structured Clinical Interview for DSM-V Axis II Disorders [SCID-II]), taken as the gold standard. Methods Two independent translations, a synthesis version, back-translation, and analysis by experts were employed to create the final version of the instrument in Brazilian Portuguese. The translated instrument was administered to 1,702 adults aged 18-59 years to verify evidence of validity relating to content, internal structure, relationship with other variables, and reliability. Results The exploratory and confirmatory factor analyses show that the one-factor structure is adequate. The scale showed satisfactory internal consistency (Kuder-Richardson coefficient [KR-20] of Cronbach’s alpha = 0.691) and good test-retest reliability (intraclass correlation coefficient [ICC] = 0.802). Logistic regression analysis using the Personality Inventory for the DSM-5-Brief Form (PID-5-BF) (DSM-5) as reference established an ideal cut-off point of eight symptoms, with adequate SN (0.79) and SP (0.75), similar to the original instrument. The area under the curve (AUC) was 0.830 (95% confidence interval: 0.802-0.858), with a positive predictive value of 89.2%. Conclusion The Brazilian version of the MSI-BPD has adequate psychometric properties for use as a BPD screening tool by clinicians. (BPD treatment However Portuguese MSIBPD MSI (MSI-BPD context selfreport self report th DSM5, DSM5 DSM 5 , (SN (SP DSM- Structured DSMV V SCIDII, SCIDII SCID [SCID-II]) standard translations backtranslation, backtranslation back translation, translation back-translation 1702 1 702 1,70 1859 18 59 18-5 content variables onefactor one KuderRichardson Kuder Richardson KR20 KR 20 [KR-20 Cronbachs Cronbach s 0.691 0691 0 691 testretest test retest intraclass ICC [ICC 0.802. 0802 0.802 . 802 0.802) DSM5Brief DSMBrief Brief PID5BF PIDBF PID BF (PID-5-BF (DSM-5 cutoff cut off symptoms 0.79 079 79 (0.79 0.75, 075 0.75 75 (0.75) AUC (AUC 0830 830 0.83 95% 95 (95 interval 0.8020.858, 08020858 0.858 858 0.802-0.858) 892 89 2 89.2% clinicians [SCID-II] 170 70 1,7 185 18- KR2 [KR-2 0.69 069 69 080 0.80 80 (DSM- 0.7 07 7 (0.7 (0.75 083 83 0.8 9 (9 8020 0.8020.858 0802085 0858 0.85 85 0.802-0.858 8 89.2 [SCID-II 17 1, [KR- 0.6 06 6 08 (DSM 0. (0. ( 0.8020.85 080208 085 0.802-0.85 89. [KR (0 0.8020.8 08020 0.802-0.8 0.8020. 0.802-0. 0.8020 0.802-0 0.802-

RESUMEN El tema de la salud mental en niños y adolescentes requiere mayor atención. Por lo tanto, este estudio tuvo como objetivo determinar las características de los pacientes de consulta externa de un centro especializado de un hospital universitario paraguayo. Este estudio empleó una serie retrospectiva, no probabilística, de casos consecutivos. Se examinaron las historias clínicas de pacientes de ambos sexos, de entre 2 y 17 años de edad, que solicitaron consulta en el Departamento de Psiquiatría del Niño y del Adolescente del Hospital de Clínicas entre julio de 2021 y julio de 2023, y que fueron diagnosticados con un trastorno mental según la CIE-10. Se recogieron datos demográficos y clínicos de 447 pacientes, representando 1278 consultas. La mayoría de los pacientes eran mujeres (57,7%), con una edad media de 13 ± 3 años. La mayoría de los pacientes (57,3%) procedían del Departamento Central, el 61,5% eran de zonas rurales y el 72% no tenían seguro médico. Los diagnósticos más frecuentes fueron episodios depresivos (F32), otros trastornos de ansiedad (F41), trastornos de conducta (F91) y trastornos específicos de la personalidad (F60). Los resultados de este estudio proporcionan información crucial sobre la salud mental de niños y adolescentes, que es esencial para informar las políticas de salud mental, asignar recursos y formar a los profesionales sanitarios encargados de atender a este grupo de pacientes.

ABSTRACT The topic of mental health in children and adolescents requires increased attention. Therefore, this study aimed to determine the characteristics of outpatient clinic patients at a specialized center within a Paraguayan University Hospital. This study employed a retrospective, non-probabilistic series of consecutive cases. The medical records of patients of both sexes, aged between 2 and 17 years, who sought consultation at the Department of Child and Adolescent Psychiatry of the Hospital de Clínicas between July 2021 and July 2023, and were diagnosed with a mental disorder according to the ICD-10, were examined. Demographic and clinical data were collected from 447 patients, representing 1278 consultations. The majority of the patients were female (57.7%), with a mean age of 13 ± 3 years. Most patients (57.3%) were from the Central Department, 61.5% were from rural areas, and 72% did not have medical insurance. The most frequent diagnoses were depressive episodes (F32), other anxiety disorders (F41), conduct disorders (F91), and specific personality disorders (F60). The findings of this study provide crucial information on child and adolescent mental health, which is essential for informing mental health policies, allocating resources, and training healthcare professionals tasked with caring for this patient group.

ABSTRACT The instinctive tendency to manipulate the skin and its small imperfections is a normal part of body-focused repetitive behaviors. When this behavior increases without control and causes somatic and psychic damage to the individual, we are dealing with a case of Excoriative Disorder (ET), a pathology that has been included in the International Classification of Diseases (ICD-11), and that, in the Classification American Mental Disorders, is part of the disorders related to the obsessive-compulsive disorder. In adults, the lifetime prevalence of ET ranges between 3 and 5% and presents high comorbidities with affective problems, substance use and morbid personality traits. Although it is not apparently a severe pathology, it causes significant disability and requires systematic screening due to its frequent avoidance by both the affected patient and health professionals.

RESUMEN La tendencia instintiva a manipular la piel y sus pequeñas imperfecciones forma parte normal de las conductas repetitivas centradas en el cuerpo. Cuando esta conducta se incrementa sin control y causa daños somáticos y psíquicos al individuo, estamos ante un caso de Trastorno Excoriativo (TE), patología que ha sido incluida en la Clasificación Internacional de Enfermedades (CIE-11), y que, en la Clasificación Norteamericana de Trastornos Mentales, forma parte de los trastornos relacionados con el trastorno obsesivo compulsivo. La prevalencia de vida del TE en adultos oscila entre 3 y 5% y presenta elevadas comorbilidades con problemas afectivos, de consumo de sustancias y rasgos mórbidos de personalidad. Aunque no es aparentemente una patología severa, acarrea importante discapacidad y requiere ser tamizada sistemáticamente por su frecuente soslayamiento, tanto por el paciente afectado como por los profesionales de salud.

ABSTRACT Introduction: The main cause of degenerative dementia is Alzheimer's disease. In the Cuban population, one in four people aged 65 and over dies from this disease or another form of dementia. Objective: To identify the risk factors associated with the clinical worsening of patients admitted with Alzheimer's disease at the Rene Vallejo Ortiz University Psychiatric Hospital. Methods: An observational, descriptive and cross-sectional study was carried out. The universe was made up of all patients admitted to the aforementioned healthcare and teaching institution. The non-probabilistic sample and at the discretion of the authors was made up of 77 adult patients with the diagnosis of the disease in the indicated study period between January 2013 and December 2022. Medical records were the secondary source of information. Descriptive and inferential statistics were used. The information was summarized in tables and graphics. Results: 90.6% were over 60 years old and more than half were male (54.5%). Most patients presented various associated symptoms. Personality and orientation disorders were found in 75.3%, while memory disorders were found in 72.7%. Conclusions: The clinical worsening after hospital admission was accentuated in those patients without schooling, single, unemployed, with cerebrovascular diseases and presence of dysfunctional families. Anemic patients or patients with signs of focal cortical irritation in the frontoparietal region with secondary generalization mostly presented clinical worsening.

RESUMEN Introducción: La principal causa de demencia degenerativa es la enfermedad de Alzhéimer. En la población cubana, una de cada cuatro personas de 65 años y más fallece por esta enfermedad u otra forma de demencia. Objetivo : Identificar los factores de riesgo asociados al agravamiento clínico de los pacientes ingresados con enfermedad de Alzhéimer en el Hospital Psiquiátrico Universitario Rene Vallejo Ortiz entre enero de 2013 y diciembre de 2022. Métodos: Se realizó un estudio observacional, descriptivo y transversal. El universo estuvo integrado por todos los pacientes ingresados en la mencionada institución asistencial y docente. La muestra no probabilística y a criterio de los autores la integraron 77 pacientes adultos con el diagnóstico de la enfermedad en el periodo de estudio señalado. Las historias clínicas fueron la fuente secundaria de información. Se utilizó estadística descriptiva e inferencial. La información se resumió en tablas y gráficos. Resultados: El 90,6 % presentaban más de 60 años y más de la mitad eran del sexo masculino (54,5 %). La mayoría de los pacientes presentaron diversos síntomas asociados. Lo trastornos de personalidad y orientación se constataron en el 75,3 % mientras que los de memoria en el 72,7 %. Conclusiones: El agravamiento clínico luego del ingreso hospitalario se acentuó en aquellos pacientes sin escolaridad, solteros, desocupados, con enfermedades cerebro vasculares y presencia de familias disfuncionales presentaron. Los pacientes anémicos o con signos de irritación cortical focal en región frontoparietal con generalización secundaria presentaron mayoritariamente un empeoramiento clínico.

BACKGROUND: Childhood adversities and adult trauma are common among female inmates. Associations have been documented with childhood adversities and mental illness, personality disorders, human immunodeficiency virus (HIV) and violent offending. However, no such study had been conducted in South Africa (SA), despite the high prevalence of HIV and trauma in SA. AIM: To measure the prevalence of childhood adversities and adult trauma; and to determine if there is a relationship between childhood adversities, mental illness, personality disorders, HIV and violent offending among female inmates. SETTING: The study was conducted at the largest correctional centre in Durban, KwaZulu-Natal, South Africa. METHODS: This cross-sectional, descriptive study randomly recruited 126 female inmates. The World Health Organization's Adverse Childhood Experiences- International Questionnaire (WHO ACE-IQ) was used to measure childhood adversities; the Structured Clinical Interview for the Diagnostics and Statistical Manual-5 Research Version (SCID 5-RV) was used to diagnose mental illness; and a structured questionnaire was used to measure adult trauma. Human immunodeficiency virus data was confirmed from prison medical records RESULTS: Elevated rates of individual childhood adversities and adult trauma were found. Associations were found between cumulative childhood adversities and post-traumatic stress disorder (PTSD), alcohol use disorder, substance use disorder, borderline personality disorder, and HIV. CONCLUSION: Female inmates are a highly traumatised population. Prison mental health services should provide trauma-informed and trauma-focussed care to improve inmates' mental health outcomes and decrease recidivism. CONTRIBUTION: This study contributes to the emerging literature on adverse childhood experiences (ACEs) and their associations among incarcerated female populations, in a low- and middle-income, South African setting.

Resumo: O Child Problematic Traits Inventory (CPTI) é um instrumento de avaliação de traços psicopáticos em crianças dos 3 aos 6 anos, reportado pelo professor (M=4.78, DP=.60). Este é o primeiro estudo a testar a fiabilidade e validade deste instrumento numa amostra portuguesa de 264 crianças com idades compreendidas entre os 3 e os 6 anos (43,2% do sexo feminino). Foram observados valores de alfa de Cronbach superiores a .80 para todas as pontuações da escala CPTI. Relativamente à validade de critério, o CPTI total e as suas três dimensões mostraram-se correlacionados significativamente com uma medida alternativa de impulsividade. Os itens do CPTI saturaram de forma diferente nos três fatores propostos teoricamente: (1) Interpessoal/Grandioso-Dissimulado, (2) Afetivo/Frieza-Insensibilidade Emocional, e (3) Comportamental/Impulsivo-Necessidade de Estimulação. O CPTI Total e as três dimensões do CPTI foram significativamente correlacionados com a medida alternativa de Impulsividade - subescala de Impulsividade do CBQ (r=.37Total; .29Interpessoal; .26Afetivo; .45Comportamental). Os resultados sugerem que o CPTI é uma medida psicometricamente sólida para avaliar traços psicopáticos em amostras comunitárias de crianças portuguesas.

Abstract: The Child Problematic Traits Inventory (CPTI) is a teacher-reported instrument to assess psychopathic personality traits in 3 to 6-year-old children (M=4.78, SD=.60). This is the first study to test the reliability and validity of this instrument within a Portuguese sample of 264 children aged between 3 to 6 years (43.2% female). Cronbach alpha values greater than .80 were observed for all CPTI scale scores. Regarding the criterion validity, CPTI total and its three dimensions were significantly correlated with an alternative measure of impulsiveness. The CPTI items loaded differently on the three theoretically proposed factors: (1) Interpersonal/Grandiose-Deceitful, (2) Affective/Callous-Unemotional, and (3) Behavioral/Impulsive-Need for Stimulation. The Total CPTI and the three dimensions of CPTI were significantly correlated with the alternative measure of Impulsiveness - CBQ Impulsivity subscale (r=.37Total; .29Interpersonal; .26Affective; .45Behavioral). In conclusion, our findings suggest that the CPTI is a psychometrically sound measure to assess psychopathic personality traits in a sample of community-residing Portuguese children.

ABSTRACT Introduction: Biological medical factors underlying certain psychiatric illnesses and personality disorders contribute to the increased risk of certain types of violent behavior and affect the intensity of their expression and recurrence. The presence of brain dysfunction in violent offenders has been frequently examined from neuro-psycho-biological perspectives, the main goals of the present study were to identify alterations in brain function and anatomy in violent prisoners, especially those diagnosed with Antisocial Personality Disorder and Psychopathy. Methods: The study evaluated the quantitative EEG, current density source and synchronization likelihood analysis during the rest condition and structural MRI images to compare volumetric and cortical thickness, in inmates recruited from two prisons located in Havana City. The Psychopathy Checklist (PCL-R) was used as a quantitative measure of psychopathy. Results: This study showed most beta energy and less alpha activity in male psychopath offenders. LORETA signified an increase of beta activity in psychopath offender groups within paralimbic regions. There were no significant differences in brain volumes when comparing male inmates with and without psychopathy. Cortical thickness in the left dorsal anterior cingulate cortex and the temporal pole was negatively associated with PCL-R total score. Conclusions: Our findings support the hypothesis that paralimbic areas play an important role in genesis of violent behavior.

RESUMEN Introducción: Los factores médicos biológicos que subyacen determinadas enfermedades psiquiátricas y trastornos de la personalidad contribuyen al incremento del riesgo de determinados tipos de conducta violenta y afectan la intensidad de la expresión y recurrencia de estas. La presencia de disfunción cerebral en delincuentes violentos ha sido examinada desde perspectivas neuropsicobiológicas, el principal objetivo del presente estudio fue identificar alteraciones en la función cerebral y anatomía en reos violentos, especialmente aquellos diagnosticados con trastorno de la personalidad antisocial y psicopatía. Métodos: El estudio evaluó el electroencefalograma cuantitativo, la fuente de densidad de corriente y el análisis de sincronización del electro encefalograma (EEG) en estado de reposo y las imágenes estructurales de resonancia magnética para comparar el grosor y volumen cerebrales en reos procedentes de 2 cárceles ubicadas en La Habana. Se utilizó la escala de psicopatía (PCL-R) como medida cuantitativa de la psicopatía. Resultados: Este estudio mostró mayor energía beta y menos actividad alfa en el EEG de delincuentes psicópatas masculinos. LORETA significó un aumento de la actividad beta en los grupos de delincuentes psicópatas dentro de las regiones paralímbicas. No hubo diferencias significativas en los volúmenes cerebrales al comparar reos masculinos con y sin psicopatía. El grosor cortical en la corteza cingulada anterior dorsal izquierda y el polo temporal se asoció negativamente con la puntuación total de PCL-R. Conclusiones, nuestros hallazgos apoyan la hipótesis de que las áreas paralímbicas desempeñan un rol significativo en la génesis del comportamiento violento.

Abstract: The aim of the study was to evaluate depression in Paraguayan health care workers who are in contact with COVID-19 patients, as well as symptoms associated with it. A cross-sectional descriptive study was conducted. A total of 130 Paraguayan health professionals participated by means of purposive sampling. The HPQ-9 scale (Patient Health Questionnaire) was used. It is an instrument composed of 9 items related to depressive symptomatology. The mean score obtained by the healthcare workers in the PHQ-9 test was 6.56, which is interpreted as “mild or moderate depression”. In the somatic variables, there was a feeling of tiredness (83.1%), especially in the nurses (p=,016). Eating disorders were reported by 58.5% and sleep difficulties by 56.2%. In relation to personality disorders, 47.7% showed depressive symptoms in the last few days, especially among women. 37.7% felt that they had failed in the last few days. 37.7% felt they were failures, 11.5% at some time had suicidal thoughts, 58.4% had difficulties in concentrating on activities and 41.6% were affected in their social relationships. The binary logistic regression analysis showed that 27.6% of the medical professionals and 26.3% of the nursing professionals had thought about leaving the profession. Further study of this type is required to design effective interventions for protection and support.

Resumen: La pandemia COVID-19 ha supuesto un gran desafío para los sistemas de salud y su personal en todo el mundo. El objetivo del estudio fue evaluar la depresión en sanitarios paraguayos que están en contacto con pacientes COVID-19, así como síntomas asociados a la misma. Se realizó un estudio descriptivo transversal. Participaron 130 profesionales paraguayos en el área de la salud mediante muestreo intencional. Se empleó la escala HPQ-9 (Patient Health Questionnaire). Se trata de un instrumento compuesto por 9 ítems relacionados con sintomatología depresiva. La puntuación media obtenida por los sanitarios, en la prueba PHQ-9, fue de 6,56, lo que se interpreta como “depresión leve o moderada”. En las variables de tipo somático, se presentó sensación de cansancio (83,1%), especialmente, en los enfermeros/as (p= ,016). El 58,5% manifestó alteraciones en la alimentación y el 56,2% dificultades en el sueño. En relación con trastornos de personalidad, el 47,7% evidenció síntomas depresivos en los últimos días, en especial las mujeres. El 37,7% se sintió fracasado, el 11,5% en algún momento tuvo ideas suicidas, el 58,4% dificultades en la concentración para actividades y el 41,6% vio afectadas sus relacione sociales. El análisis de regresión logística binaria percibió que el 27,6% de los profesionales en medicina y el 26,3% de enfermería había pensado en abandonar la profesión. Se requiere profundizar en este tipo de estudio para diseñar intervenciones eficaces de protección y ayuda.

ABSTRACT Objective To investigate the prevalence of internet gaming disorder (IGD) symptoms in a sample of Brazilian adults, and its association with personality, psychiatric symptoms and psychosocial measures. Methods We evaluated 219 adults online recruited using questionnaires and psychometric scales. We evaluated the behavior and pattern of internet games using the Game Addiction Scale (GAS). We tested the association of the previous measures with the GAS scores by spearman correlations and multiple regression analysis. Results Of our sample, 74% played games online. We found correlations between IGD symptoms and most symptoms of mental disorders, with small or moderate effect sizes, as well as correlations with the personality traits of agreeableness (r = -0.272; p < 0.001), conscientiousness (r = - 0.314; p < 0.001), and neuroticism (r = 0.299; p < 0.001). Additionally, we found a negative association with psychosocial outcomes such as quality of life (r = -0.339; p < 0.001) and life satisfaction (r = - 0.202; p < 0.003). The multivariate model included the personality traits of conscientiousness and agreeableness and symptoms of dissociation and somatization as predictors. The prevalence of IGD was 9% in those who played online games. Conclusion IGD is correlated with different areas of the individual’s life, such as personality, quality of life, and several common symptoms of mental disorders. The prevalence can be considered high among players (9%). Conscientiousness, agreeability, somatic symptoms, and dissociative symptoms were associated with the symptoms of IGD. (IGD 21 scales GAS. . (GAS) analysis 74 disorders sizes r 0.272 0272 0 272 -0.272 0.001, 0001 0.001 , 001 0.314 0314 314 0.299 0299 299 0.001. Additionally 0.339 0339 339 -0.339 0.202 0202 202 0.003. 0003 0.003 003 0.003) predictors 9 individuals individual s 9%. (9%) Conscientiousness agreeability 2 (GAS 7 0.27 027 27 -0.27 000 0.00 00 0.31 031 31 0.29 029 29 0.33 033 33 -0.33 0.20 020 20 (9% 0.2 02 -0.2 0.0 0.3 03 3 -0.3 (9 0. -0. ( -0

RESUMO Objetivo Investigar a prevalência de sintomas do transtorno do jogo pela internet (TJI) em uma amostra de adultos brasileiros e sua associação com personalidade, sintomas psiquiátricos e medidas psicossociais. Métodos Avaliamos 219 adultos recrutados on-line por meio de questionários e escalas psicométricas. Avaliamos o comportamento e o padrão dos jogos na internet usando a Game Addiction Scale (GAS). Testamos a associação das medidas anteriores com as pontuações na GAS por meio de correlações de Spearman e análise de regressão múltipla. Resultados De nossa amostra, 74% jogavam jogos on-line. Encontramos correlações entre sintomas do TJI e a maioria dos sintomas de transtornos mentais, com tamanhos de efeito pequenos ou moderados, bem como correlações com os traços de personalidade de amabilidade (r = -0,272; p < 0,001), conscienciosidade (r = - 0,314; p < 0,001) e neuroticismo (r = 0,299; p < 0,001). Além disso, encontramos uma associação negativa com resultados psicossociais, como qualidade de vida (r = -0,339; p < 0,001) e satisfação com a vida (r = - 0,202; p < 0,003). O modelo multivariado incluiu os traços de personalidade de conscienciosidade e amabilidade e sintomas de dissociação e somatização como preditores. A prevalência de TJI foi de 9% entre os que jogavam jogos on-line. Conclusão O TJI está correlacionado com diferentes áreas da vida do indivíduo, como personalidade, qualidade de vida e vários sintomas comuns de transtornos mentais. A prevalência pode ser considerada alta entre os jogadores (9%). Conscienciosidade, amabilidade, sintomas somáticos e sintomas dissociativos estavam associados aos sintomas do TJI. (TJI psicossociais 21 online on line psicométricas GAS. . (GAS) múltipla 74 online. line. mentais moderados r 0,272 0272 0 272 -0,272 0,001, 0001 0,001 , 001 0,314 0314 314 0,299 0299 299 0,001. disso 0,339 0339 339 -0,339 0,202 0202 202 0,003. 0003 0,003 003 0,003) preditores 9 indivíduo 9%. (9%) Conscienciosidade 2 (GAS 7 0,27 027 27 -0,27 000 0,00 00 0,31 031 31 0,29 029 29 0,33 033 33 -0,33 0,20 020 20 (9% 0,2 02 -0,2 0,0 0,3 03 3 -0,3 (9 0, -0, ( -0

Abstract: Institutions dedicated to the care of serious mental illness (SMI) have admission criteria that determine the users who are admitted. A thorough analysis of the patients may reveal the existence of different clinical profiles with diverse therapeutic needs. In order to determine the existence of different clinical profiles in the UCPP of the Centro San Juan de Dios de Ciempozuelos (CSJD), a cross-sectional descriptive study was carried out, finding five clinical typologies by applying a two-stage cluster analysis. 413 people with SMI, admitted in different devices of the Prolonged Psychiatric Care Unit (according to their autonomy and needs), with a mean age of 53.78 years (95.4% males and 4.4% females) and high levels of institutionalization (mean 13.06 years), took part in the study. The main diagnosis found was residual schizophrenia (38.3%; n= 158), followed by paranoid schizophrenia (26.6%; n= 110). There was also a significant number of personality disorders (35 cases). The five typologies of users were named according to their most salient characteristics: Rehab (R), Rehab Behav (RB), Young Care (YC), Old Care (OC) and Young Behav (YB). A discussion on the implications of the determination of these profiles for a better use of existing resources is held. In addition, different alternatives for particularly difficult cases of SMI, such as borderline personality disorder, are proposed.

Resumen: El acceso de los usuarios con trastorno mental grave (TMG) a los dispositivos sociosanitarios viene determinado por unos criterios preestablecidos que pueden estar opacando la existencia de perfiles clínicos con diferentes necesidades terapéuticas. En esta línea, desde el Centro San Juan de Dios de Ciempozuelos (CSJD), se ha realizado un estudio descriptivo de tipo transversal en el que se han encontrado cinco tipologías clínicas mediante la aplicación de un análisis de conglomerados en dos fases. En el estudio participaron 413 personas con TMG ingresadas en diferentes dispositivos de la Unidad de Cuidados Psiquiátricos Prolongados -UCPP- del CSJD (en función de su autonomía y necesidades) y que presentaban una media de edad de 53.78 años (95.4% varones y 4.4% mujeres) y altos niveles de institucionalización (media de 13.06 años). El diagnóstico principal encontrado fue el de esquizofrenia residual (38.3%; n= 158), seguido de esquizofrenia paranoide (26.6%; n= 110). También había un número significativo de trastornos de la personalidad (35 casos). Las cinco tipologías de usuarios se denominaron en función de sus características más destacadas: Rehab (R), Rehab Behav (RB), Young Care (YC), Old Care (OC) y Young Behav (YB). En función de estos resultados se debate la idoneidad de los recursos existentes a la par que se proponen alternativas que maximicen la efectividad de los mismos en relación a casos de TMG complejos, como los de trastorno límite de la personalidad.

Abstract: Since the publication of DSM-5, it has become more important to carry out a differential diagnosis to distinguish people with autism spectrum disorder (ASD) from cluster C personality disorders. The aim of the present research study was to identify a personality profile of adults with ASD using the Minnesota Multiphasic Personality Inventory (MMPI) in order to carry out this differential diagnosis. The study sample consisted of a total of 178 subjects divided into four groups for comparison purposes. The ASD group obtained a MMPI personality profile with a characteristic 2-0 code that was specific to this sample of people with mild ASD, and higher scores in scales 6, 7 and 8 relative to the other scale scores. A specific MMPI personality profile was identified for ASD subjects, which differentiated this group from the other groups studied.

Resumen: Desde la publicación de DSM-5, se ha vuelto más importante llevar a cabo un diagnóstico diferencial para distinguir a las personas con TEA de los trastornos de personalidad del grupo C. El objetivo de la presente investigación fue identificar un perfil de personalidad de sujetos con trastorno del espectro autista (TEA) utilizando el Inventario de Personalidad Multifásico de Minnesota (MMPI) para llevar a cabo dicho diagnóstico diferencial. La muestra del estudio consistió en un total de 178 sujetos divididos en cuatro grupos de comparación. El grupo TEA obtuvo un perfil de personalidad MMPI con un código característico 2-0 que era específico para esta muestra de personas con TEA leve, y puntuaciones más altas en las escalas 6, 7 y 8 en relación con las otras puntuaciones de la escala. Se identificó un perfil de personalidad MMPI específico para los sujetos con TEA que diferenció a este grupo de los otros grupos estudiados.

Abstract Objectives: To compare the factors and facets of psychopathy based on criminal characteristics in a sample of women in prison. Material and method: Descriptive, comparative, cross-sectional study composed of a sample of 41 women incarcerated in the Ambato prison in Ecuador. In an individual session, the Hare Psychopathy Scale Revised was applied. Results: Recidivist women, with a juvenile criminal history and who are admitted to the maximum-security ward, have a higher score in the affective facet of the PCL-R. In addition, those women who are in the maximum-security pavilion have scored high in factor 2 (social deviance), mainly in the antisocial aspect. Discussion: This subgroup of women in prison is characterized by lack of remorse, emotional insensitivity, manipulation, inability to accept responsibility for their own actions, and superficial affection. Further expansion of the study of psychopathy in women is required.

Resumen Objetivos: Comparar los factores y facetas de la psicopatía en función de las características delictivas en una muestra de mujeres en prisión. Material y método: Estudio descriptivo, comparativo, de corte transversal, compuesto por una muestra de 41 mujeres en- carceladas en el centro penitenciario de Ambato en Ecuador. En una sesión individual, se aplicó la escala de evaluación de la psicopatía de Hare revisada (PCL-R). Resultados: Las mujeres reincidentes, con historial delictivo juvenil y que se encuentran ingresadas en el pabellón de seguridad máxima, presentan mayor puntuación en la faceta afectiva de la PCL-R. Además, aquellas mujeres que se encuentran en el pabe- llón de máxima seguridad han puntuado alto en el factor 2 (desviación social), principalmente en la faceta antisocial. Discusión: Este subgrupo de mujeres en prisión se caracteriza por presentar ausencia de remordimiento, insensibilidad afectiva, manipulación, incapacidad de aceptar la responsabilidad de las propias acciones y afecto superficial. Se requiere ampliar más el estudio de la psicopatía en mujeres.

Resumen El modelo dimensional alternativo para los trastornos de personalidad incluye 25 facetas (rasgos patológicos) organizadas en cinco dominios de orden superior (Desapego, Afectividad Negativa, Psicoticismo, Antagonismo y Desinhibición). Para evaluar este modelo, se desarrolló el Personality Inventory for DSM-5 (PID-5), que posee dos versiones: una extensa (220 ítems) que evalúa dominios y facetas, y una breve (25 ítems) que evalúa solo los dominios. En un trabajo anterior, se brindó evidencia favorable para una versión breve (31 ítems) adaptada para ser utilizada en población argentina. En el presente trabajo se estudian las propiedades psicométricas de una versión reducida y modificada del PID-5 que permite evaluar ambos componentes por medio de una cantidad de ítems (108). La validez convergente se evaluó a través de la relación con una medida de rasgos de personalidad normal del Modelo de los Cinco Grandes Factores. Se trabajó con una muestra de tipo no probabilística de n = 525 sujetos de población general, que respondieron la versión adaptada del PID-5 y el Listado de Adjetivos para Evaluar la Personalidad. Los resultados brindaron evidencia de validez y confiabilidad para el instrumento. El Análisis Factorial Exploratorio y Confirmatorio sugirió un buen ajuste de la estructura pentafactorial. La consistencia interna resultó adecuada y los ítems presentaron buenos índices de discriminación. Se observaron diferencias de género y edad, y correlaciones con los factores correspondientes de los cinco grandes. Esta versión puede ser utilizada para evaluar el modelo, con fines tanto clínicos como de investigación, y con ventajas respecto al tiempo de administración respecto a la versión extensa original.

Abstract The official classification of personality disorders in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) remains categorical. However, a dimensional alternative for personality disorders is presented as an emerging model. The model is organized in five higher order domains (Negative Affectivity, Detachment, Antagonism, Disinhibition and Psychoticism), with relationships with the Big Five Model of Personality, strongly established within the Personality Psychology. The proposal also includes 25 facets or second-order traits, included within the main domains. Domains and facets represent psychopathological traits with clinical relevance. To assess this model, the Personality Inventory for DSM-5 (PID-5) was developed. PID-5 has two forms: extensive (220 items) that assesses domains and facets, and brief (25 items) that assesses only the domains. In a previous study, evidence for a short version (31 items) adapted to the Argentine population was provided, that overcomes some of the limitations of the original one. In this work, the psychometric properties of a reduced and modified version of the PID-5 are studied, which allows evaluating five domains and 25 facets, through a reduced number of items (108). We worked with a non-probabilistic sample of n = 525 subjects from the general population, who answered the adapted version of the PID-5 and the Adjectives Checklist to Assess the Big Five Personality Factors (AEP), a Big Five Model measure. The following data analyses were performed: (1) Exploratory and Confirmatory Factor Analysis to evaluate the internal structure of PID-5; (2) reliability analysis to assess the internal consistency of the PID-5 scales; (3) item analysis to assess discriminating power; (4) multivariate analysis of variance (MANOVA) to examine significant differences due to gender and age; and (5) bivariate correlation analysis to analyze PID-5 convergent validity. The results provided evidence of validity and reliability. Exploratory and Confirmatory Factor Analysis suggested a five-factor structure. The facets presented factor loadings in the domain theoretically expected, with some exceptions: Suspiciousness (loaded in Psychoticism), Hostility (loaded in Disinhibition), Depressivity (loaded in Detachment) and Insensitivity (loaded in Detachment). CFA also suggested a good model fit (CFI = .98; RMSEA = .04; SRMR = 0.083). Psychoticism, Detachment, and Disinhibition facets had their higher factor loadings in the expected domain. Negative affectivity showed higher correlations with the rest of the scales. Internal consistency was satisfactory, especially at the domain level, and the items had good discrimination indices. Correlations with the corresponding of the Big Five factors were observed, similar to previous studies. The five PID-5 domains were also found positively correlated. Additionally, gender and age differences were found. In line with previous literature, results suggest that some facets scales are “pure” markers of these domains (e. g., Psychoticism and Antagonism facets), whereas others (e. g., Negative Affectivity facets such as Depressiveness, Suspicion, Hostility), are located “in between” domains since they share features of more than one domain. Psychoticism facets presented higher loadings in their domains and lower in the rest. This is not surprising; although most of psychopathology cannot be understood as categories, schizophyte and Schizotypal Personality Disorder are exceptions, and Psychoticism would be the representation of these categories in the APA model. Findings also provide evidence of convergent validity for the instrument, as well as theorical evidence regarding the relationship between normal and pathological personality traits. This version can be used to evaluate the model, both in research and clinical practice. It has advantages over the original longer version, in terms of administration time and participants' fatigue, while maintaining its psychometric properties. The results are also expected to contribute to the recent literature on the dimensional approach to personality psychopathology. However, complementary studies, particularly with a clinical population, are needed.

Abstract Objectives: To compare the factors and facets of psychopathy based on criminal characteristics in a sample of women in prison. Material and method: Descriptive, comparative, cross-sectional study composed of a sample of 41 women incarcerated in the Ambato prison in Ecuador. In an individual session, the Hare Psychopathy Scale Revised was applied. Results: Recidivist women, with a juvenile criminal history and who are admitted to the maximum-security ward, have a higher score in the affective facet of the PCL-R. In addition, those women who are in the maximum-security pavilion have scored high in factor 2 (social deviance), mainly in the antisocial aspect. Discussion: This subgroup of women in prison is characterized by lack of remorse, emotional insensitivity, manipulation, inability to accept responsibility for their own actions, and superficial affection. Further expansion of the study of psychopathy in women is required.

Resumen Objetivos: Comparar los factores y facetas de la psicopatía en función de las características delictivas en una muestra de mujeres en prisión. Material y método: Estudio descriptivo, comparativo, de corte transversal, compuesto por una muestra de 41 mujeres en- carceladas en el centro penitenciario de Ambato en Ecuador. En una sesión individual, se aplicó la escala de evaluación de la psicopatía de Hare revisada (PCL-R). Resultados: Las mujeres reincidentes, con historial delictivo juvenil y que se encuentran ingresadas en el pabellón de seguridad máxima, presentan mayor puntuación en la faceta afectiva de la PCL-R. Además, aquellas mujeres que se encuentran en el pabe- llón de máxima seguridad han puntuado alto en el factor 2 (desviación social), principalmente en la faceta antisocial. Discusión: Este subgrupo de mujeres en prisión se caracteriza por presentar ausencia de remordimiento, insensibilidad afectiva, manipulación, incapacidad de aceptar la responsabilidad de las propias acciones y afecto superficial. Se requiere ampliar más el estudio de la psicopatía en mujeres.