Multimodal imaging features of dome-shaped macula with subretinal fluid in adolescents with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the multimodal image features of dome-shaped macula(DSM)with subretinal fluid(SRF)in adolescents with high myopia, and investigate its typical features and identification methods.METHODS: This is a retrospective study. A total of 21 adolescent patients(39 eyes)who were diagnosed as DSM in high myopic eyes with SRF in the macula area in our hospital from January 2021 to May 2022 were selected. All patients underwent color fundus photography(CFP), fundus autofluorescence(FAF), spectral-domain optical coherence tomography(SD-OCT), optical coherence tomography angiography(OCTA)and electro oculography(EOG). Among them, 18 patients(36 eyes)underwent fundus fluorescein angiography(FFA), and they were followed-up for 12mo to record the change of the central macular thickness(CMT).RESULTS: Fundus examination showed tessellated retina in affected eyes, and the deposition of granular material could be seen in the fovea of the macular area. SD-OCT showed a dome-like bulge of the whole layer in the macular area, localized detachment of the subfoveal nerve epithelial layer, the medium and high reflection attachment on the inner surface of the outer membrane, and the heterogeneous reflection of the retinal pigment epithelium(RPE)layer. FAF showed a mild “bull's eye sign” change in the macular area. FFA showed granular transmitted fluorescence around the foveal avascular zone. En face of OCTA could see a clear boundary of the neuroepithelial detachment zone. When the tangential line corresponds to the ellipsoid zone-RPE layer, the granular high reflection in different sizes scattered in the neuroepithelial detachment zone could be seen, and no obvious choroidal neovascularization(CNV)was formed. During the follow-up of OCTA, SRF in the macular area can be spontaneously increased or absorbed irregularly. EOG indicates that the ratio of light peak to dark trough(LP/DT, i.e. Arden ratio)was normal, with an Arden ratio>1.55. CMT at 1, 3, 6, 12mo(247.10±13.03, 246.62±12.23, 248.05±14.00, 247.92±11.66 μm)during follow-up period were compared with baseline(246.95±11.46 μm), and the difference was not statistically significant(F=0.144, P=0.965).CONCLUSION: Multimodal imaging is helpful in the clinical diagnosis of DSM with SRF in the macula area in high myopic eyes of adolescents, and plays an important role in the differential diagnosis of the early stage of typical Best disease.

Using transporter to enhance the acid tolerance of Bacillus coagulans DSM1 / 生物工程学报

As the precursor of polylactic acid (PLA), optically pure l-lactic acid production is attracting increasing attention. The accumulation of lactic acid during fermentation inhibits strain growth. Therefore, it is necessary to improve the acid tolerance of lactic acid producers. In this study, comparative transcriptomic analysis was performed to investigate the effects of transporters on lactic acid tolerance of Bacillus coagulans DSM1, which is an l-lactic acid producer. The genes with more than two-fold up-regulation in transcriptional profile were further verified using real-time PCR. The transcriptional levels of RS06895, RS10595, RS10595, RS00500, RS00500, RS10635 and RS10635 were enhanced during lactic acid fermentation. Strain overexpressing RS10595 exhibited a retarded cell growth and low lactic acid production at pH 6.0, but an improved lactic acid production at pH 4.6. This study may facilitate the investigation of the acid tolerance mechanism in B. coagulans DSM1, as well as the construction of efficient lactic acid producers.

A agressividade infantil no DSM: os diagnósticos e os seus efeitos subjetivos / Child aggressiveness in the DSM: the diagnoses and their subjective effect / L'agressivité infantile dans le DSM: les diagnostics et leurs effets subjectifs / Agresividad infantil en el DSM: diagnósticos y sus efectos subjetivos

Neste artigo analisamos a forma pela qual a "agressividade infantil" foi incluída nos sistemas de classificação do DSM ao longo de suas sucessivas edições. Primeiramente, identificamos as transformações significativas no uso desse signo clínico. Em seguida discutimos as consequências clínicas e políticas dessas transformações, tanto na formulação de uma psicopatologia própria à infância quanto na definição social dos quadros de normalidade e de desvio em relação à conduta. Observamos, por fim, que a pretensa regulação da infância pela produção de discursos normativos a respeito da agressividade foi acompanhada pelo incremento das vias agressivas como forma privilegiada de expressão do mal-estar e de subjetivação do sofrimento. Nossa hipótese é que tal produção é reforçada pelas exigências neoliberais de performance, ignorando assim as demandas sociais e subjetivas de reconhecimento.

In this article, we analyze how "child aggressiveness" was included in the classification systems of the DSM throughout its successive editions. First, we identified the significant transformations in the use of this clinical sign. Then, we discuss the clinical and political consequences of its transformations, both in the formulation of a psychopathology specific to childhood and regarding the social definition of normality and conduct deviations. Finally, we observed that the alleged regulation of childhood by the production of normative discourses about aggressiveness was followed by the increase of aggressive expressions of discontent and subjectivation of suffering. Our hypothesis is that such production is reinforced by neoliberal demands of performance, thus ignoring social and subjective demands for recognition.

Dans cet article, nous analysons la manière dont "l'agressivité infantile" a été intégrée dans les systèmes de classification du DSM tout au long de ses éditions successives. Tout d'abord, les transformations significatives dans l'usage de ce signe clinique. Ensuite, nous discutons les conséquences cliniques et politiques de ces transformations, à la fois dans la formulation d'une psychopathologie propre à l'enfance et dans la définition sociale des cadres de normalité et déviation de la conduite. Nous observons enfin que la prétendue régulation de l'enfance par la production de discours normatifs sur l'agressivité s'est accompagnée de l'accroissement des voies d'agressivité comme formes d'expression du malaise et de subjectivation de la souffrance. Notre hypothèse est qu'une telle production est renforcée par des exigences de performance néolibérales, ignorant ainsi les exigences sociales et subjectives de reconnaissance.

En este artículo analizamos la forma en que la "agresividad infantil" fue incluida en los sistemas de clasificación del DSM a lo largo de sus sucesivas ediciones. Primeramente, identificamos los cambios significativos en el uso de ese signo clínico. Luego discutimos las consecuencias clínicas y políticas de estos cambios, tanto en la formulación de una psicopatología propia a la infancia como en la definición social de los cuadros de normalidad y de desviación de la conducta. Observamos, por fin, que la pretendida regulación de la infancia por la producción de discursos normativos respecto a la agresividad estuvo acompañada del aumento de formas agresivas como forma privilegiada de expresión del malestar y de subjetivación del sufrimiento. Nuestra hipótesis es que dicha producción se ve reforzada por las demandas neoliberales de performance, ignoran así las demandas sociales y subjetivas de reconocimiento.

O poder (neuro)psiquiátrico: a psicopatologização do cotidiano na era do cérebro / El poder (neuro)psiquiátrico: la psicopatologización de la vida cotidiana en la era del cerebro / (neuro)psychiatric power: the psychopathologization of everyday life in the brain era

Resumo Esta pesquisa pretende demonstrar como, em decorrência das alianças entre a psiquiatria e neurociências, emerge uma realidade social em que o diagnóstico psiquiátrico é extremamente disseminado, abarcando um número cada vez maior de pessoas e de situações. Logo, questiona-se como a reformulação do poder psiquiátrico, embasada na explicação cerebralista dos transtornos mentais, auxilia a expansão dos processos de psicopatologização do cotidiano. A hipótese é que o próprio saber-poder médico-psiquiátrico vem contribuindo para sua amplificação, confirmando-se como umas das práticas mais sensíveis em termos biopolíticos na atualidade. Nesse sentido, aplicando-se a técnica de pesquisa da documentação indireta e o método dedutivo, foi realizada uma revisão bibliográfica de cunho crítico e interdisciplinar. Testada a hipótese principal, concluiu-se, ao final, que a patologização generalista do sofrimento psíquico corresponde a um novo reducionismo biológico, o qual cria um novo modelo de controle social, embasado, agora, na chamada neuropsiquiatria.

Resumen Esta investigación pretende demostrar cómo de las alianzas entre la psiquiatría y las neurociencias emerge una realidad social en la que el diagnóstico psiquiátrico está extremadamente difundido, abarcando un número creciente de personas y situaciones. Por tanto, cuestiona cómo la reformulación del poder psiquiátrico, a partir de la explicación cerebralista de los trastornos mentales, ayuda a la ampliación de los procesos cotidianos de psicopatologización. La hipótesis es que el propio saber-poder médico-psiquiátrico viene contribuyendo a su amplificación, confirmándose como una de las prácticas más sensibles hoy en día en términos biopolíticos. En este sentido, aplicando la técnica de investigación de la documentación indirecta y el método deductivo, se realizó una revisión bibliográfica crítica e interdisciplinaria. Una vez contrastada la hipótesis principal, concluye, finalmente, que la patologización generalista del sufrimiento psíquico corresponde a un nuevo reduccionismo biológico, que crea un nuevo modelo de control social, ahora basado en la denominada neuropsiquiatría.

Abstract This research aims to demonstrate how a social reality emerges from the alliances between psychiatry and neurosciences in which psychiatric diagnosis is extremely disseminated, encompassing an ever-increasing number of people and situations. Therefore, it questions how the reformulation of psychiatric power, based on the cerebralist explanation of mental disorders, helps the expansion of everyday psychopathologization processes. The hypothesis is that medical-psychiatric knowledge-power itself has been contributing to its amplification, confirming itself as one of the most sensitive practices today in biopolitical terms. In this sense, applying the research technique of indirect documentation and the deductive method, a critical and interdisciplinary bibliographical review was carried out. Having tested the main hypothesis, it concludes, in the end, that the generalist pathologization of psychic suffering corresponds to a new biological reductionism, which creates a new model of social control, now based on the so-called neuropsychiatry.

Toward Developing Clinical cut-off for the Grandiosity Scale of the Dimensional Clinical Personality Inventory 2 / Hacia el Desarrollo del Punto de Corte Clínico Para la Escala de Grandiosidad del Inventario Clínico Dimensional de Personalidad 2

ABSTRACT Objective: The present study aims to establish a clinical cut-off for the Grandiosity dimension, using item-level evaluation procedures. Methods: Participants were 5,387 adults, including outpatients diagnosed with narcissistic personality disorder (NPD), outpatients diagnosed with other personality disorders, and adults from the community. We administered the self-reported Grandiosity scale from the Dimensional Clinical Personality Inventory 2 (IDCP-2). The equating procedure was applied to generate theta scores for participants who did not answer all items. Results: The Wright map revealed that outpatients scored high on the latent continuum of the Grandiosity scale. Group comparison showed large effect sizes for the mean difference between patients and non-patients. The ROC curve supports a cut off at a -0.45 score in theta standardisation, which yields a high sensitivity (91%) and moderate specificity (58%). Moreover, the PPP (71%) and NPP (79%) values suggest that the scale is able to identify NPD patients in 71% of cases, and people without NPD in 79% of cases. Conclusions: The findings suggest the IDCP-2 Grandiosity scale is useful as an NPD screening tool. Possible clinical applications for the scale are described and the limitations of the study are discussed.

RESUMEN Objetivo: El presente estudio tiene como objetivo establecer un corte clínico para la dimensión Grandiosidad, utilizando procedimientos de evaluación a nivel de ítem. Métodos: Los participantes fueron 5.387 adultos, entre pacientes ambulatorios diagnosticados con trastorno de personalidad narcisista (NPD), pacientes ambulatorios diagnosticados con otros trastornos de la personalidad, y adultos de la comunidad. Se administró la escala de Grandiosidad autoinformada del Inventario Dimensional Clínico de Personalidad 2 (IDCP-2). El procedimiento de ecualización se aplicó para generar puntuaciones theta para los participantes que no respondieron a todos los ítems. Resultados: El mapa de Wright reveló que los pacientes ambulatorios estaban ubicados en los niveles altos en el continuo latente de la escala de Grandiosidad. La comparación grupal mostró tamaños de efecto grandes para la diferencia de medias entre pacientes y no pacientes. La curva ROC confirma un corte en -.45 puntos en la estandarización theta que produce una alta sensibilidad (91%) y una especificidad moderada (58%). Además, los valores de PPP (71%) y NPP (79%) indican que la escala puede identificar a los pacientes con NPD en el 71% de los casos y las personas sin NPD en el 79% de los casos. Conclusiones: Los resultados indican que la escala de Grandiosidad del IDCP-2 es útil como instrumento de evaluación para NPD. Se describen posibles aplicaciones clínicas para la escala y se discuten las limitaciones del estudio.

A (dis)função do diagnóstico: uma leitura psicanalítica sobre o DSM / The (dys)function of diagnosis: a psychoanalytic reading about the DSM / La (dis)función del diagnóstico: una lectura psicoanalítica sobre el DSM

INTRODUÇÃO: Partindo da interrogação sobre a função do diagnóstico, reconstrói-se um panorama histórico sobre o diagnóstico para a psiquiatria e os (des)enlaces com a psicanálise. OBJETIVO: Examinar os compromissos e as diferenças do diagnóstico para os diferentes campos. METODOLOGIA: O presente artigo teve como orientação de pesquisa o que Canguilhem (1975) define como trabalho de conceito. A partir de uma epistemologia específica, essa posição baseia-se no princípio de que é preciso partir de uma articulação conceitual para se falar de um fenômeno. Assim, foi realizado um percurso exploratório sobre o diagnóstico para o campo da psiquiatria e da psicanálise. RESULTADOS: A eliminação do aspecto subjetivo como critério elementar para realizar a avaliação diagnóstica a partir da terceira versão do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM) demarca uma ruptura irreparável com a psicanálise, uma vez que nega aquilo que lhe é mais caro. Se o objeto da psiquiatria é o fenômeno observável, a psicanálise se volta para a escuta das ranhuras, ponto opaco em que a nomeação generalista não dá conta de apaziguar a angústia. Isso não requer a negação dos sintomas observáveis, tendo em vista que é possível se servir deles sem, no entanto, reduzir a escuta clínica à mera classificação fenomenológica. CONCLUSÃO: A aposta na singularidade da construção sintomática é o que permite a emergência da subjetividade, negligenciada na universalização diagnóstica contemporânea.

INTRODUCTION: Starting from the question about the function of the diagnosis, a historical panorama about the diagnosis for psychiatry and the (dis)links with psychoanalysis is reconstructed. OBJECTIVE: Examine the commitments and the differences for the different fields. METHODS: This article had as research orientation what Canguilhem (1975) defines as concept work. Based on a specific epistemology, this position is based on the principle that it is necessary from a conceptual articulation to talk about a phenomenon. Thus, an exploratory path on the diagnosis for the field of psychiatry and psychoanalysis was carried out. RESULTS: The elimination of the subjective aspect as an elementary criterion to carry out the diagnostic evaluation from the third version of the Diagnostic and Statistical of Mental Disorders Manual (DSM) marks an irreparable break with psychoanalysis since it denies what is most dear to it. If the object of psychiatry is the observable phenomenon, psychoanalysis turns to listen to the grooves, an opaque point in which the generalist appointment does not manage to alleviate the anguish. This does not require the denial of the observable symptoms, considering that it is possible to use them without, however, reducing clinical listening to a mere phenomenological classification. CONCLUSION: The bet on the singularity of the symptomatic construction is what allows the emergence of the subjectivity, neglected in the contemporary diagnostic universalization.

INTRODUCCIÓN: Partiendo del interrogatorio sobre la función del diagnóstico, el artículo reconstruye un panorama histórico sobre el diagnóstico para la psiquiatría, así como las vinculaciones y desvinculaciones con el psicoanálisis. OBJETIVO: Examinar los compromisos y diferencias para los diferentes campos. METODOLOGÍA: Este artículo tuvo como orientación de investigación lo que Canguilhem (1975) define como trabajo conceptual. A partir de una epistemología específica, esta posición se fundamenta en el principio de que es necesario partir de una articulación conceptual para hablar de un fenómeno. Así, se realizó un recorrido exploratorio sobre el diagnóstico para el campo de la psiquiatría y el psicoanálisis. RESULTADOS: La eliminación del aspecto subjetivo como criterio elemental para realizar la evaluación diagnóstica de la tercera versión del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM) marca una ruptura irreparable con el psicoanálisis, ya que niega lo más importante para él. Si el objeto de la psiquiatría es el fenómeno observable, el psicoanálisis vuelve a escuchar los surcos, el punto opaco en el que la nominación generalista no consigue aliviar la angustia. Esto no requiere la negación de los síntomas observables, considerando que es posible utilizarlos sin, sin embargo, reducir la escucha clínica a una mera clasificación fenomenológica. CONCLUSÃO: La apuesta por la singularidad de la construcción sintomática es lo que permite la emergencia de la subjetividad, desatendida en la universalización diagnóstica contemporánea.

Similarities and differences in the diagnostic criteria of ICD-11 and DSM-5 for sexual dysfunction / 四川精神卫生

The purpose of this paper is to compare the similarities and differences between the diagnostic criteria of sexual dysfunction in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and the International Classification of Diseases， eleventh edition （ICD-11）. Sexual dysfunction is the inability of adults to experience various forms of satisfactory sexual performance. In this paper， the main diagnostic points of sexual dysfunction in both manuals are summarized and compared with a view to assisting psychiatric and psychological workers to acquire a better understanding of the corresponding sections.

Os árbitros do desejo e os enteados da natureza: controvérsias e ontologias sobre a categoria pedofilia em torno do DSM - 5 / The arbiters of desire and the stepchildren of nature: controversies and ontologies on the category pedophilia around the DSM - 5

Pedofilia é categoria originada na psiquiatria do final do século XIX para descrever uma espécie das denominadas perversões ou desvios sexuais, hoje parafilias, que conceitua a atração sexual de adultos por crianças pré-púberes. Tornou-se objeto de proibição e punição legal, ligada à categoria "abuso sexual infantil", e de repúdio social extremo, que configurou um dos pânicos morais/sexuais a partir das últimas décadas do século XX, no Brasil a partir do início dos anos 2000. No entanto, é notável constatar que a categoria, suas definições e características e as práticas científicas e políticas decorrentes (de pesquisa, terapêuticas, jurídicas) são objeto de uma ampla literatura e intensas controvérsias acadêmicas, clínicas e forenses em muitos países centrais da Europa e América do Norte. A tese visa delinear controvérsias recentes sobre o diagnóstico psiquiátrico "pedofilia" em torno da revisão do Diagnostic and Statistic Manual of Mental Disorders ­ DSM (Manual Diagnóstico e Estatístico de Transtornos Mentais) ­, da American Psychiatric Association, para a formulação do DSM-5, publicado em 2013, através de uma amostra de artigos de autores presentes nas propostas de revisão do diagnóstico, que expressam epistemologias, ontologias e deontologias diversas e em confronto. Os temas das controvérsias analisadas são a mudança do diagnóstico para "pedohebefilia", a permanência ou remoção das parafilias e da pedofilia do Manual e sua natureza enquanto "orientação", "interesse" ou "preferência" sexual. As vozes presentes nas controvérsias incluem psiquiatras, sexólogos, psicólogos, historiadores e uma organização de "pessoas atraídas por menores" (MAPs), nova designação utilizada por uma vertente do ativismo pedófilo. O delineamento das controvérsias é feito a partir de seus enquadramentos institucionais, políticos, morais, éticos e clínicos, configurando disputas significativas nestas posições e um consenso em torno do "combate" e prevenção ao abuso sexual infantil, categoria forte na quase totalidade das formulações. Apesar disso, há um dissenso ideológico e político sobre se a psiquiatria deve ser um enquadramento deste crime, se este não é, de fato, problema jurídico e penal e não médico, numa crítica à extensão das entidades diagnósticas para fins morais e políticos de contemplar a opinião pública e o aparato judicial. A psiquiatria forense é campo prevalente e determinante, embora não único, da permanência da categoria enquanto diagnóstico médico. Por outro lado, são abordadas as lutas, presentes nas controvérsias e no ativismo, pela desestigmatização desta condição da sexualidade, sua distinção da violência sexual e pelo estabelecimento de cidadania plena para os MAPs, que inclui o respeito de seus direitos no atendimento em serviços de saúde mental.

Pedophilia is a category originated in psychiatry in the late 19th century to describe a species of the so-called sexual perversions or deviations, nowdays paraphilias, which conceptualizes the sexual attraction by adults of pre-pubertal children. It turned the object of legal prohibition and punition, linked to the category of "child sexual abuse", and of extreme social rejection, that shaped one of the moral/sexual panics since the last decades of the 20th century, in Brasil since the early 2000 years. Nevertheless, it's noticeable to verify that the category, its definitions and features, and the scientific and political ensuing practices (of research, therapeutic, legal) are the object of a large literature and intense academic, clinical and forensic controversies in many central countries of Europe and North America. The thesis intends to outline recent controversies on the psychiatric diagnosis "pedophilia" around the revision of the Diagnostic and Statistic Manual of Mental Disorders ­ DSM - of the American Psychiatric Association and the elaboration of the DSM-5, published in 2013, through a sample of papers of acting authors in the proposals of the revision of the diagnosis, which express various epistemologies, ontologies and deontologies in dispute. The themes of the controversies under analysis are the change of the diagnosis to "pedohebephilia", the tenure or removal of paraphilias and pedophilia from the Manual and its nature as a sexual "orientation", "interest" or "preference". The figuring voices in the controversies include psychiatrists, sexologists, psychologists, historians and an organization of "minor-attracted people" (MAPs), new designation used by a branch of the pedophile activism. The delineation of the controversies is made through their institutional, political, moral, ethical and clinical frames, outlining noteworthy disputes in these positions and a consensus around the "combat" and prevention of child sexual abuse, strong category in almost the whole of the formulations. In spite of this, there is an ideological and political dissent on if psychiatry should be a frame to handle a crime, if this one is a juridical and penal problem and not a medical one, in a criticism of the extension of diagnostic entities for moral and political ends to comply with public opinion and the apparatus of Justice. Forensic psychiatry is a prevailing and decisive field, though not the only one, in the maintenance of the category as a medical diagnosis. On the other hand, the struggles, active in the controversies and activism, over the de-stigmatization of this condition of sexuality, its distinction from sexual violence and for the establishment of a full citinzenship for MAPs, including the respect of their rights of assistance in mental health services, are addressed.

Desafíos bioéticos del DSM-5: ¿ruptura, recalibración o más de lo mismo? / Bioethical challenges of the DSM-5: rupture, recalibration, or more of the same? / Desafios bioéticos do DSM-5: ruptura, recalibração ou mais do mesmo?

Resumen: 11. 1] El DSM-5 representa la incorporación de la psiquiatría a la medicina basada en la evidencia. 2] La psiquiatría, propia de la intención, se transformó en la fundamentada en la validación empírica. 3] El DSM-5 es expresión de la ciencia moderna que da prioridad al saber calculador, objetivador, clasificador y operacional. 4] A la ética de la beneficencia, propia de la intención, se superpuso una ética de la autonomía y de la equidad, características de la validación. 5] El DSM-5 no puede determinar si los trastornos psiquiátricos son entidades naturales, tipos prácticos hechos por los investigadores, entes construidos socialmente, rótulos que se agrupan formando un sistema.

Abstract: 15. 1] The DSM-5 represents the incorporation of psychiatry into evidence-based medicine. 2] The psychiatry proper to the intention was transformed into that based on empirical validation. 3] The DSM-5 is an expression of modern science that gives priority to calculating, objectifying, classifying, operational knowledge. 4] An ethic of autonomy and fairness characteristic of verification was superimposed on the ethics of beneficence proper to the intention. 5] DSM-5 cannot determine whether psychiatric disorders are natural entities, practical types made by researchers, socially constructed entities, labels that are grouped into a system.

Resumo: 19. 1] O DSM-5 representa a incorporação da psiquiatria à medicina baseada em evidencia. 2] A psiquiatria, própria da intenção, se transformou na fundamentada em validação empírica. 3] O DSM-5 é expressão da ciência moderna que dá prioridade ao saber calculador, objetivador, classificador e operacional. 4] À ética da beneficência, própria da intenção, se superpôs uma ética da autonomia e da equidade, características da validação. 5] O DSM-5 não pode determinar se os transtornos psiquiátricos são entidades naturais, tipos práticos criados pelos investigadores, entes construídos socialmente, rótulos que se agrupam formando um sistema.

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for somatic symptoms and related disorders / 四川精神卫生

The purpose of this paper is to compare the similarities and differences between the diagnostic criteria for somatic symptoms and related disorders in the International Classification of Diseases， eleventh edition （ICD-11） and the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. The clinical features of somatic symptoms and related disorders are prominent somatic symptoms that cause significant functional impairment and suffering. This paper discusses the similarities and differences between the two diagnostic systems in order to facilitate mastery of the corresponding content.

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for feeding and eating disorders / 四川精神卫生

The purpose of this paper is to discuss the similarities and differences between the diagnostic criteria of feeding and eating disorders in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and International Classification of Diseases， eleventh edition （ICD-11）. Feeding and eating disorders are clinically characterized by persistent disturbances in feeding or food-related behaviors that result in altered food consumption or absorption and significant impairment in physical health or social function. This paper discusses the similarities and differences of feeding and eating disorders in the two diagnostic manuals， in order to improve psychiatric and psychological workers’ understanding of the corresponding sections.

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for elimination disorders / 四川精神卫生

The purpose of this paper is to discuss the similarities and differences between the diagnostic criteria of elimination disorders in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and International Classification of Diseases， eleventh edition （ICD-11）. Elimination disorders are clinically characterized by inappropriate urination or defecation， resulting in pain or functional impairment. This paper discussed the main points of elimination disorders in the two diagnostic manuals， in order to improve psychiatric and psychological workers’ understanding of the corresponding sections.

Mixed features in DSM-5： problems and solutions / 四川精神卫生

This study contests the mixed states in diagnostic criteria for bipolar disorder and major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， and attempts to propose possible solutions. At present， the DSM-5 defined “mixed feature specifier” in bipolar disorder faces a number of problems in clinical use， particularly with regard to the classification of incidental features， which poses some clinical difficulties. DSM-5 abandons the previous standard setting which conform to the strict diagnostic thinking that both depression and mania exist together， and primarily captures three or more non-overlapping symptoms of the opposite pole in clinical diagnosis， but the difficulty in diagnosing the states or features resulting from the coexistence of two diametrically opposed symptoms or symptom clusters has still not been effectively addressed. In practice， clinical features of depressive episodes across participants with maniac disorder and manic episodes in depressive disorder within bipolar disorder pedigrees become atypical. Therefore， this paper focuses on the psychopathological features of the mixed profile and conducts analysis in the context of clinical practice and selected research perspectives， so as to propose some potentially constructive ideas to inform the solution of the clinical problems of the mixed states.

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for sleep-wake disorders / 四川精神卫生

This paper aims to discuss the similarities and differences between the diagnostic criteria for sleep-wake disorders in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and International Classification of Diseases， eleventh edition （ICD-11）. Sleep-wake disorders are characterized by the unsatisfactory quality， quantity and circadian rhythm of sleep， leading to daytime distress and impaired social functioning. Therefore， the main diagnostic points of sleep-wake disorders in both manuals are summarized and compared in this study， in order to assist psychiatric and psychological workers to acquire a better understanding of the corresponding sections.

The Patient with Depression: Assessment and Management

@#Depression in adults is a condition that is treatable by family physicians. The current Clinical Practice Guidelines from the Ministry of Health recommends a selective serotonin reuptake inhibitor (SSRI) as the first-line of pharmacotherapy. Care should be taken to assess the patient’s psychological and social factors contributing to the illness. These factors should be managed by referring the patient to an appropriate allied health professional, such as a psychologist or community based social worker. Specialist referral should be made under certain circumstances (such as treatment-resistance), or if issues pertaining to risk arise. This review aims to give an update on the recently published DSM-5 criteria for diagnosis, and the treatment of the adult patient with depression.

Construct Validity Of Indonesian Language Version Of Childhood Autism Rating Scale™ Second Edition

@#Combination of The Childhood Autism Rating Scale™ Second Edition - Standard Clinical Tool (CARS2-ST) with criteria for autism spectrum disorder (ASD) based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) is thought to improve diagnostic process. To meet diagnostic needs, localized, Indonesian-translated version of CARS2-ST is developed. Therefore, assessment of construct validity of the Indonesian-language translated CARS2-ST must be performed. A cross-sectional study was conducted in Child Development Center in Surabaya, Indonesia from August to December 2019. Diagnosis of ASD then performed by using CARS2-ST and DSM-5 criteria. To assess construct validity, principal components analysis and Kaiser-varimax rotation was performed for CARS2-ST in order to determine factors. DSM-5 criteria for ASD was used to compare scale.There were 201 children aged 2 - 6 years old with reported speech and behavior problems. Sixty-six children were diagnosed for ASD. Factor analysis using Kaiser-varimax rotation indicates a significant two factors: social communication and interaction factor and restrictive stereotyped behaviors and sensory factor sensitivites. The factors satisfyingly reflects the criteria for ASD in DSM-5.Construct validity of Indonesian-translated version of CARS2-ST is confirmed, as shown by its correspondence with DSM-5 criteria for diagnosing . This study supports the continued relevance of the Indonesian CARS2-ST in ASD assessment.

Mental symptoms and its influencing factors of patients with malignant tumor undergoing chemotherapy in general hospital / 中华行为医学与脑科学杂志

Objective:To estimate the mental symptoms in malignant tumor patients undergoing chemotherapy using DSM-5 cross cutting symptom measure.Methods:A total of 314 patients who undergoing chemotherapy in oncology department of Zhongshan Hospital, Fudan University who met all standards were chosen. The DSM-5 cross cutting symptom measure Level 1 Scale was used to assess the mental symptoms of the patients. SPSS 25.0 software was used for χ 2 test, Pearson correlation analysis and multiple regression analysis. Results:The most common symptoms in the patients were depressive symptoms(85/314, 27.1%), somatic symptoms (79/314, 25.2%), manic symptoms (78/314, 24.5% ) and anxiety symptoms (76/314, 24.3%). The proportion of anxiety symptoms in malignant tumor patients who were taken care of by other personnel(26/64, 40.6%) was significantly higher than that in patients who were taken care of by immediate relatives(50/250, 20.0%)(χ 2=12.23, P<0.05). Patients with unstable working conditions were more likely to have depressive symptoms (χ 2=7.64, P<0.05). There was a significant negative correlation between the patients' understanding of the disease and their scores of depressive symptoms, somatic symptoms, manic symptoms, anxiety symptoms and the total score of mental symptoms( r= -0.26, -0.15, -0.12, -0.25, -0.22, all P<0.05). In addition, the total score of mental symptoms of malignant tumor patients was significantly positively correlated with family burden and family status( r=0.11, 0.11, both P<0.05), and negatively correlated with patients' education ( r=-0.13, P<0.05). Multiple regression analysis showed that the degree of understanding of the disease( β=-0.203) and family status( β=0.197) were the influencing factors of mental symptoms of inpatients malignant tumors undergoing chemotherapy in general hospital ( F=13.653, P<0.001). Conclusion:Malignant tumor patients undergoing chemotherapy may have a variety of mental symptoms. The high incidence mainly includes depressive symptoms, somatic symptoms, manic symptoms and anxiety symptoms. The understanding of the patients to the disease and family situation are the main influencing factors.

Factors Correlated With Internet Gaming Disorder Among Malaysian University Students

@#Introduction: Internet gaming disorder (IGD) has recently been incorporated into the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) as a disorder for future research. The primary objectives of the present study are to describe the level of IGD and to examine its correlations with sociodemographic factors and psychological comorbidities among undergraduate students in a Malaysian university. Methods: A total of 411 undergraduate students completed an online questionnaire. They were selected from a random sample of participating university faculties. The online questionnaire contained the Internet Gaming Disorder Scale-Short-Form and the Depression, Anxiety, Stress Scale. Results: The presents study reported that 52.8% of the participants had high IGH. Using hierarchical multiple regression, age (β = -0.09, p < 0.05), gender (β = -0.40, p < 0.001) and stress (β = 0.23, p < 0.05) were statistically significant predictors of IGD. Academic performance, depression and anxiety did not emerge as significant predictors. Conclusion: These findings highlight the risk factors (in particular, stress) of IGD. Further studies on interventions, particular that of preventative strategies, will be needed to combat this emerging public health problem.

Classificação psiquiátrica: tensionamento atual entre realismo e nominalismo / Management of diabetes by professionals and users of Primary Health Care

Resumo Apresenta-se o "nominalismo dinâmico" de Hacking, aplicado à classificação psiquiátrica, como exemplo ilustrativo de síntese entre realismo e nominalismo. Expõem-se as perspectivas realistas inscritas tanto moderadamente na proposta híbrida do Diagnostic and Statistical Manual of Mental Disorders (DSM-5), quanto fortemente na proposta naturalista de seus concorrentes: Research Domain Criteria (RDoC) e Hierarchical Taxonomy of Psychopathology (HiTOP). Aponta-se o principal efeito do naturalismo aplicado à classificação psiquiátrica, que consiste no abandono do hibridismo entre realismo e nominalismo, em prol de uma cartografia do mental que, com recurso à matemática, reivindica-se estritamente realista, respondendo a demanda por maior precisão da bipsiquiatria.

Abstract Diabetes is a disease that cannot be cured, but managed, and its management is seen as a strategy to overcome its unpleasant consequences in various life situations. This study aims to understand how the diabetes mellitus 2 management process occurs by professionals and users affected by this condition. This is a qualitative research, with observational and explanatory design, which included the participation of health professionals and users they care for, all from primary health care. Information was collected through semi-structured interviews and interpreted using Discourse Analysis. For informants, food aspects are the most difficult to deal with. The professionals' discourse points to flexible eating practices, but users understand the guidelines as prohibitions. Feeding represents a great challenge for both professionals and users, as both need to consider management practices as part of care.

Metabolic syndrome among patients taking second generation antipsychotics: does obstructive sleep apnoea and sleep quality play any role?

Background: Metabolic syndrome (MetS) is common among patients who have been exposed to second generation antipsychotics (SGA). Obstructive sleep apnoea (OSA) and sleep quality may also contribute to MetS. Aims: To study the contribution of sleep quality and OSA on the development of MetS in patients taking SGA. Methods: Total 60 patients taking SGA for more than three months were taken for the study. It was an observational, cross-sectional study. The diagnosis of OSA was done using Hindi translation of Berlin questionnaire. Hindi version of the Pittsburg Sleep Quality Index was used to assess the sleep quality. MetS was diagnosed using Adult Treatment Panel III criteria. Results: Forty two subjects did not have MetS, out of which 35 had low risk of OSA and seven had high risk of OSA, while 18 subjects had MetS of which nine each had high and low risk of OSA. The results were highly significant with a p-value of 0.007 (p?0.05). Subjects without MetS (n=42) comprised four good sleepers and 38 poor sleepers. Subjects with MetS (n=18) comprised of one good sleeper and 17 poor sleepers. The results were non-significant with a p-value of 0.525 (p?0.05). The high risk of OSA had around seven times higher likelihood of contribution to MetS. Conclusions: Sleep quality did not play a significant role in increasing the likelihood of MetS and OSA increased the likelihood of MetS in subjects exposed to SGA by seven times.