The Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5) and International Classification of Diseases – 11th Revision (ICD-11) employ different post-traumatic stress disorder (PTSD) criteria, necessitating updated prevalence estimates. Most of the existing evidence is still based on ICD-Tenth Revision and DSM-Fourth Edition criteria, leading to varied estimates across populations. This study provides current PTSD prevalence rates in the German general population, comparing DSM-5 and ICD-11 criteria and examines variations by age and gender.

In a 2016 cross-sectional survey of 2404 adults (18–94 years) representative of the German general population, participants completed the Life-Events-Checklist for DSM-5 (LEC-5) for trauma exposure and the PTSD Checklist for DSM-5 (PCL-5) for PTSD symptoms. Probable PTSD diagnoses were based on DSM-5-, ICD-11-algorithms and suggested cut-off scores. Chi-square and McNemar’s tests were used to test differences in prevalence rates by diagnostic framework, age and gender.

Of the total sample, 47.2% (n = 1135) reported experiencing at least one lifetime traumatic event (TE), with transportation accidents (7.3%) and life-threatening injuries (4.9%) being most common. Probable PTSD prevalence was 4.7% under both DSM-5 and ICD-11 criteria, and 2.6% based on a conservative cut-off normed for prevalence estimation. Gender and age were not significantly associated with TE exposure or PTSD prevalence, though trauma types varied: female participants more often reported sexual violence and severe suffering, while more male participants reported physical assaults and various types of accidents. DSM-5 and ICD-11 diagnostic algorithms had substantial yet not perfect agreement (κ = 0.62). Particularly within the re-experiencing symptoms, cluster agreement was only moderate (κ = 0.57). The cut-off method aligned more closely with DSM-5 (κ = 0.60) than ICD-11 algorithm (κ = 0.42).

This study provides updated PTSD prevalence estimates for the German general population and underscores differences between DSM-5 and ICD-11 in identifying cases, particularly with respect to re-experiencing symptoms. These findings emphasize that while overall PTSD prevalence rates under DSM-5 and ICD-11 criteria are similar, the diagnostic frameworks identify partially distinct cases, reflecting differences in symptom definitions. This highlights the need to carefully consider the impact of evolving diagnostic criteria when interpreting prevalence estimates and comparing results across studies.

Genetic and environmental factors, including adverse childhood experiences (ACEs), contribute to substance use disorders (SUDs). However, the interactions between these factors are poorly understood.

We examined associations between SUD polygenic scores (PGSs), ACEs, and the initiation of use and severity of alcohol (AUD), opioid use disorder (OUD), and cannabis use disorder (CanUD) in 10,275 individuals (43.5% female, 47.2% African-like ancestry [AFR], and 52.8% European-like ancestry [EUR]). ACEs and SUD severity were modeled as latent factors. We conducted logistic and linear regressions within ancestry groups to examine the associations of ACEs, PGS, and their interaction with substance use initiation and SUD severity.

All three SUD PGS were associated with ACEs in EUR individuals, indicating a gene–environment correlation. Among EUR individuals, only the CanUD PGS was associated with initiating use, whereas ACEs were associated with initiating use of all three substances in both ancestry groups. Additionally, a negative gene-by-environment interaction was identified for opioid initiation in EUR individuals. ACEs were associated with all three SUD severity latent factors in EUR individuals and with AUD and CanUD severity in AFR individuals. PGS were associated with AUD severity in both ancestry groups and with CanUD severity in AFR individuals. Gene-by-environment interactions were identified for AUD and CanUD severity among EUR individuals.

Findings highlight the roles of ACEs and polygenic risk in substance use initiation and SUD severity. Gene-by-environment interactions implicate ACEs as moderators of genetic susceptibility, reinforcing the importance of considering both genetic and environmental influences on SUD risk.

The diagnosis of ADHD in adults is on the rise. Applying the ADHD diagnosis, which originally was described in children, to adults has involved a “subjectivization” of some of the diagnostic criteria, i.e., some behavioral features (signs) in children have become experiences (symptoms) in adults. These issues raise the question of how ADHD is best diagnosed in adults? Thus, we examined how ADHD is diagnosed in adults in research.

A review of how ADHD is diagnosed in adults in randomized controlled studies (RCTs).

We include 292 RCTs. We found substantial variation and no consensus about the diagnostic method. More than half of the studies did not seem to include an assessment of general psychopathology, and only in 35% of studies was the ADHD diagnosis allocated by psychiatrists or psychologist. More than half of the studies included patients with psychiatric comorbidity.

These findings raise concerns about the validity of the ADHD diagnosis in many of the included RCTs. It is worrying that securing a reasonably accurate diagnosis is not prioritized in more than half of the studies. If neither clinicians nor researchers can rely on the basic fact the patients in scientific studies diagnostically resemble the patients they are facing, scientific studies risk losing their clinical relevance. Since RCTs can lead to changes in clinical practice, they must be conducted carefully. To advance research on adult ADHD, the quality of the diagnostic assessment must be prioritized, requiring comprehensive differential diagnosis by a skilled psychiatrist or psychologist.

Paranoid ideas occur very often in humans (prevalence of 0.2%). According to several studies, the origin could be found in a genetic predisposition to a selective hyperdopaminergia related to the D2 receptor and dopamine neurotransmitter dysfunction.

To delve into this pathology, including origin and development, epidemiology, diagnostic criteria, clinical aspects, differential diagnosis, treatment, evolution and prognosis.

We conducted a literature review of delusional disorder.

The disease appears in middle age, between ages 35 and 55, being slightly more frequent in women. It seems to affect more economically and educationally disadvantaged social strata, and it is more frequent in immigrants. The onset is usually progressive and insidious. Correct perception but delusional interpretation: the objectivity of what is perceived is disturbed by the subjectivity of what is registered. The delirium is usually logical, contagious, and frequently credible. Patients retain their lucidity. It is very important to make a correct differential diagnosis with schizophrenia. With regard to treatment, the therapeutic relationship with the patient will be basic. If possible, psychotherapy should be combined with pharmacological treatment (second generation antipsychotics being the treatment of choice). In general, their evolution is compatible with out-of-hospital life, being considered “odd guys”.

The risk of suffering from Delusional Disorder during the lifetime is between 0.05 and 0.1%. This pathology constitutes 1-4% of all psychiatric admissions. Therefore, it is essential to know it in depth in order to be able to manage it properly.

No significant relationships.

Cognitive deficits are common, clinically relevant and closely linked to poor functional outcomes in everyday functioning in patients with schizophrenia and other psychoses.

To ascertain to which extent a polydiagnostic assessment of schizophrenia is associated with clinically-derived criteria of cognitive impairment and gold-standard neuropsychological assessment.

We assessed 98 patients with a psychotic disorder. We tested if patients met criteria for schizophrenia according to five diagnostic classifications: Krapelin, Bleuler, Schneider, ICD-10 and DSM-IV. Also, we applied a set of clinically-derived criteria to assess cognitive impairment associated with psychosis (CIAPs). Gold-standard neuropsychological assessment was administered, covering the cognitive domains included in the MATRICS Cognitive Battery: attention, processing speed, verbal memory, visual memory, working memory, executive function and social cognition. MANOVAs were performed to test the association between polydiagnostic and clinically-derived criteria and neuropsychological assessment.

MANOVA profile analyses revealed that patients who met CIAPs criteria showed cognitive impairment in all the cognitive domains except for social cognition. Patients diagnosed with Kraepelin’s criteria showed significant differences in processing speed, visual memory, working memory and GCI. Patients fulfilling Bleuler and DSM-IV criteria showed significant deficits in processing speed and verbal memory, respectively. Schneider and ICD-10 diagnostic criteria did not reveal differences in cognition between patients who fulfilled these criteria.

CIAPs criteria were the most accurate classifying patients with cognitive impairment, followed by Kraepelin’s criteria, which were the ones among diagnostic criteria which better differentiated patients regarding cognitive impairment. These criteria take into consideration the outcome in addition to symptoms.

This work was supported by the Government of Navarra (grants 17/31, 18/41, 87/2014) and the Carlos III Health Institute (FEDER Funds) from the Spanish Ministry of Economy and Competitivity (14/01621 and 16/02148). Both had no further role in the study des

Even though cognitive impairment is considered a hallmark of schizophrenia, it has not been included as a criterion into major diagnostic systems.

To test whether a set of clinical-defined cognitive impairment criteria can have utility in the assessment of psychosis patients in clinical practice.

We assessed 98 patients with a psychotic disorder, diagnosed using DSM 5 criteria. We developed a set of cognitive impairment associated with psychosis (CIAPs) criteria following the format of current DSM criteria and based on previous literature. The CIAPs criteria include: A) criterion for evidence of cognitive impairment after the beginning of illness; B) cognitive impairment clinically evidenced, affecting functioning in everyday activities in at least two out of six cognitive domains; C) and D) exclusion criterion for either delirium or other neurocognitive disorders, respectively, as causal agents of the cognitive impairment. The psychosis patients dichotomized by the CIAPs criteria were tested regarding the neuropsychological performance in attention, speed of processing, verbal memory, visual memory, working memory, executive function and social cognition tasks. Also a Global Cognitive Index was calculated.

Forty-three patients with psychosis fulfilled the CIAPs criteria (43.9%). MANOVA profile analyses revealed a pattern of statistically significant deficits in all the cognitive dimensions except for social cognition in CIAPs+ patients regarding CIAPS-, with prominent deficits in processing speed and memory functions.

The CIAPs criteria could be an auxiliary method for clinicians to assess cognitive impairment. It may also permit clinical estimation of the influence of cognitive deficits on the ecological functioning of patients.

This work was supported by the Government of Navarra (grants 17/31, 18/41, 87/2014) and the Carlos III Health Institute (FEDER Funds) from the Spanish Ministry of Economy and Competitivity (14/01621 and 16/02148). Both had no further role in the study des

For decades confirmatory factor analysis (CFA) has been the preeminent method to study the underlying structure of posttraumatic stress disorder (PTSD); however, methodological limitations of CFA have led to the emergence of other analytic approaches. In particular, network analysis has become a gold standard to investigate the structure and relationships between PTSD symptoms. A key methodological limitation, however, which has significant clinical implications, is the lack of data on the potential impact of item order effects on the conclusions reached through network analyses.

The current study, involving a large sample (N = 5055) of active duty army soldiers following deployment to Iraq, assessed the vulnerability of network analyses and prevalence rate to item order effects. This was done by comparing symptom networks of the DSM-IV PTSD checklist items to these same items distributed in random order. Half of the participants rated their symptoms on traditionally ordered items and half the participants rated the same items, but in random order and interspersed between items from other validated scales. Differences in prevalence rate and network composition were examined.

The prevalence rate differed between the ordered and random item samples. Network analyses using the ordered survey closely replicated the conclusions reached in the existing network analyses literature. However, in the random item survey, network composition differed considerably.

Order effects appear to have a significant impact on conclusions reached from PTSD network analysis. Prevalence rates were also impacted by order effects. These findings have important diagnostic and clinical treatment implications.

DSM-IV definition of hypomania of bipolar-II disorder (BP-II), which includes elevated/irritable mood change as core feature (i.e., it must always be present), is not based on sound evidence.

Following classic descriptions of hypomania, was to test if hypomania could be diagnosed on the basis of its number (9) of DSM-IV symptoms, setting no-priority symptom.

Consecutive 422 depression-remitted outpatients were re-interviewed by a mood specialist psychiatrist using the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version [a semi-structured interview modified by Benazzi and Akiskal (J Affect Disord, 2003; J Clin Psychiatry, 2005) to improve the probing for BP-II] in a private practice. History of episodes of subthreshold (i.e., 2 or more symptoms) and threshold (i.e., meeting DSM-IV criteria of elevated mood plus at least 3 symptoms, or irritable mood plus at least 4) hypomania, lasting at least 2 days, and which were the most common symptoms during the episodes, were systematically assessed.

Bipolar-II disorder (BP-II) patients (according to DSM-IV criteria, apart from hypomania duration) were 260, and major depressive disorder (MDD) patients were 162. Mood change was present in all BP-II by definition. The most common symptoms were overactivity, which was present in almost all BP-II, followed by elevated mood and racing thoughts. ROC analysis of the number of hypomanic symptoms predicting BP-II found that a cut point of 5 or more symptoms over 9 had the best combination of sensitivity (90%) and specificity (84%), and the highest figure of correctly classified (87%) BP-II. History of episodes of 5 or more hypomanic symptoms was met by almost all BP-II.

Single interviewer.

Following classic descriptions of hypomania, not setting any priority among the three basic domains of hypomania (mood, thinking, behavior), results suggest that a cutoff number of 5 symptoms over 9 (of those listed by DSM-IV) could be used to diagnose hypomania of BP-II. Diagnosing hypomania by counting a checklist of symptoms should make it easier to diagnose BP-II, and should reduce the current high misdiagnosis of BP-II as MDD, significantly impacting the treatment of depression.