In the last few decades, there has been a growing interest in anxiety disorders (AnxD) in the perinatal period. Although AnxD are diagnosed in 4-39% of pregnant women and in up to 16% of women after delivery, evidence on their clinical management is limited. A systematic review was conducted on pharmacological and non-pharmacological treatment of AnxD in the perinatal period. Relevant papers published from January 1st 2015 were identified searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library. 18 articles met inclusion criteria. Selected studies supported the use of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD), panic disorder (PD) and specific phobia both in pregnancy and postpartum. Selective serotonin reuptake inhibitors (SSRIs) led to significant OCD and PD improvement both in pregnancy and postpartum with no side effects for the babies. In the largest clinical sample to date, 65% of postpartum patients who entered the open-label trial of fluvoxamine (up to 300mg/day) experienced a 30% or greater decrease in the total score of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). During pregnancy, SSRIs and tricyclic antidepressants (TCAs) led to remission of panic symptoms and healthy outcomes for the babies. Study design, mostly case reports, and enrolment of subjects mainly from outpatient specialty units might have limited community-wide generalisability. Keeping in mind the scantiness and heterogeneity of the available literature, the best interpretation of the available evidence appears to be that CBT should be the first treatment offered to pregnant and breastfeeding women with AnxD. However SSRIs can represent a first line treatment strategy, and not exclusively in cases where AnxD is refractory to CBT.

The study aims to explore the personality patterns of a group of transgender individuals who accessed an Italian gender clinic to undergo gender affirming treatments, by evaluating both dimensional personality domains proposed by the Alternative Model of Personality Disorders and categorical DSM-IV personality disorder (PD) diagnoses. Eighty-seven participants (40 transgender women and 47 transgender men) completed the Personality Inventory for DSM-5 and the Structured Clinical Interview for DSM-IV Axis II personality disorders. Scores obtained were compared to those of the normative samples of cisgender women and men. Results indicated that transgender women scored lower than cisgender women on two main domains (Negative Affectivity and Psychoticism) and on seven facets. As for transgender men, lower scores than cisgender men were found on Antagonism and on five facets. Transgender men scored higher than cisgender men on Depressivity. Nearly 50% of participants showed at least one PD diagnosis, with no gender differences in prevalence. Borderline PD was the most frequent diagnosis in the overall sample. Self-report measures provide a less maladaptive profile of personality functioning than the clinician-based categorical assessment. Results are interpreted in the light of the Minority Stress Model and support the need for a multi-method assessment of personality in medicalized transgender people.

This study evaluated whether the impairment in cooperation that characterizes individuals with borderline personality disorder (BPD) can be explained by the difficulty to use emotion regulation strategies and to accurately perceive the fairness of others' behavior. Forty-one patients with BPD and 41 sex and age matched healthy controls (HC) played the responder's role in a Modified Ultimatum Game during which they were asked to apply 3 different emotion regulation strategies: look, distancing, and reappraisal. Offer rejection rates were used as an index of punishment behavior. After the experiment, participants also rated the degree of perceived equity of the offers after receiving fair and unfair offers. Reappraisal was effective in decreasing punishment behaviors for unfair offers in both the BPD and HC groups. By contrast, BPD patients displayed a different behavior than HC when making decisions upon fair offers, independently from the regulation strategies adopted. In fact, they rejected higher rates of fair offers than HC. Further, BPD patients judged fair offers as less fair than HC. This indicates an altered judgment and decision making on fair interpersonal exchanges. In conclusion, BPD patients exhibit increased punishment behavior during fair, "favorable" social exchanges, which they tend to perceive as less fair than controls. Thus, BPD patients may be biased toward underestimating positive feedback from others. (PsycINFO Database Record (c) 2019 APA, all rights reserved).