Purpose: Antisocial Personality Disorder (ASPD) and Borderline Personality Disorder (BPD) challenge mental health professionals with similar maladaptive behaviors. However, these two disorders differ regarding available evidence-based treatments. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been criticized as being gender-biased diagnostic construct. The present study aimed to determine the gender bias of ASPD and BPD among Turkish psychiatrists. Methods: Three case vignettes were randomly presented as male or female to the psychiatrists online. The first case was a patient with schizophrenia case to confirm the participant’s ability to diagnose. The second case was a patient with ASPD, and the third one was a patient with BPD. Results: Two hundred fifty participants diagnosed the first case correctly ( n = 250). The results with statistical significance demonstrated that a female case with ASPD was 5.1 times more likely to get misdiagnosed than a male case with ASPD (p˂0.0001). Conclusions: Categorical classification of personality disorders in DSM leads to gender bias in in the diagnosis of ASPD and BPD. The present study shows that female cases with ASPD are misdiagnosed as BPD which may result in treatment attempts without evidence.

Introduction: Although major depression is the disorder most frequently associated with suicidal behavior, it is unclear that major depressive disorder patients may develop suicidal ideation. Basic affective system theory may provide a novel and beneficial viewpoint in this field. The goal of this study was to investigate the basic affective system in relation to suicidal ideation in individuals with depression.Method: The study population comprised 160 participants who had been formally diagnosed with major depressive disorder. Participants were divided into two groups according to whether they had suicide ideation (depression with suicide [DS]) (N = 93) or not (depression with no suicidal ideation [DNS]) (N = 67). The Beck Depression Inventory (BDI), the Suicide Probability Scale (SPS), the Beck Hopelessness Scale (BHS), and the Affective Neuroscience Personality Scale (ANPS) were applied. Statistical Product and Service Solutions (SPSS) 24 and the SPSS macroprocess, which were specifically developed for assessing complex models including serial mediators, were used to analyze the data.Results: The mean age of all participants was 31.1 ± 11 years, and most of them were female (65%). The DS group had a higher family history of psychiatric medication use and suicidal attempts. In addition, BDI, BHS, and SPS total scores were higher, as well as ANGER subscale scores were higher in the DS group. In mediation analysis, the ANGER subscale significantly predicted the presence of suicide ideation. We observed a direct effect of the ANGER subscale score on suicide ideation as well as an indirect effect of the ANGER subscale score on suicidal ideation via depression severity.Conclusion: Higher scores on ANGER are associated with suicidal ideation. Neurobiological correlates, including the ANGER system, may be promising in understanding suicidal behaviors.

Antidepressants are widely prescribed, yet evidence on their short-term effectiveness and tolerability in routine outpatient psychiatric care remains limited. This observational study followed 123 patients newly initiated or switched to an antidepressant in a university hospital outpatient clinic to examine early-term side effects, their associations with treatment discontinuation, and predictors of short-term response in a pragmatic routine-care setting. Depression and anxiety symptoms, sociodemographic variables, and functionality were assessed at baseline; side effects and adherence were evaluated through structured interviews during the first month; and treatment response was determined at follow-up. The remission rate at one month was 72.3%, while 12.3% showed no response. Higher pretreatment anxiety levels predicted greater severity of early side effects, and lower baseline functionality predicted poorer adherence. Patients who achieved response or remission were more likely to report at least one side effect. These findings suggest that many patients struggle to maintain antidepressant treatment during the early phase, and that anxiety and functional impairment influence both tolerability and adherence. Early psychoeducation, close monitoring, and tailored support for patients with elevated anxiety or reduced functionality may improve continuity of treatment and reduce the risk of delayed recovery.

Objective: Personality traits serve as a transdiagnostic tool and may contribute to the clinical diversity of major depressive disorder (MDD) through shared neurobiological mechanisms. In the Pankseppian affective neuroscience perspective, SADNESS, FEAR, and ANGER as affective personality traits have been shown to play a role in the development of MDD. However, the relationship between depressive symptoms and affective personality traits is not well understood. The aim of this study is to investigate the longitudinal relationship between depressive symptoms and affective personality traits. Methods: The study included 60 patients diagnosed with MDD and 53 healthy controls (HCs). The Structured Interview Guide for the Hamilton Depression Rating Scale Seasonal Affective Disorder version (SIGH-SAD), the Hamilton Anxiety Rating Scale (HAM-A), as well as the Affective Neuroscience Personality Scales (ANPS) and the Rumination Response Scale (RRS) were administered to all participants at baseline and follow-up, with an interval of 4–8 weeks. Group-time interactions for clinical variables and affective system scores were evaluated using linear mixed-effects analysis (LME). Following the findings obtained from the LME analyses, the mediating effects of brooding and psychic anxiety were examined in the relationship between changes in SADNESS and atypical symptoms and melancholic features. Statistical analyses were conducted using the R 4.1.1. Results: Patients had higher negative affective system scores with medium to large effect sizes at baseline. In addition, while the PLAY score was higher in HC, there was no significant difference between the groups in terms of SEEKING and CARE scores. The relationships between affective systems and symptoms exhibited partially overlapping but different patterns in patients and HCs. During follow-up, SADNESS, FEAR, and ANGER scores decreased, while the PLAY score increased in patients; however, there were no changes in the affective system scores of the HCs. Change in SADNESS was positively correlated with changes in the HDRS-17 total score, melancholic features, atypical symptoms, the psychic anxiety subscale of the HAM-A, and brooding-type rumination. A significant relationship was also observed between FEAR and atypical symptoms. However, no significant associations were found between ANGER and any clinical variables. In addition, changes in the PLAY score were negatively correlated with both the somatic anxiety subscale and the total scores of the HAM-A. Mediation analyses revealed that changes in SADNESS had a positive direct effect on brooding and psychic anxiety. Additionally, psychic anxiety fully mediated the effect of SADNESS on melancholic features and atypical symptoms. Conclusion: These findings suggest that affective personality traits, particularly SADNESS, play a dynamic role in the clinical presentation and progression of MDD. The identified mediating roles of brooding and psychic anxiety highlight potential transdiagnostic mechanisms linking primary affective systems to specific symptom profiles. Understanding these pathways may contribute to more individualized and biologically informed approaches to the assessment and treatment of depression. The findings of our study may be instructive for future neuroimaging studies.