Precision psychiatry promises a more objective and effective approach to psychiatric care, yet its implementation raises growing ethical challenges as technology advances. This narrative review offers a qualitative synthesis of the ethical issues reported in 62 studies, with emphasis on the practical tensions that arise when core principles conflict. Rather than organising concerns around traditional ethical principles, the review maps them across the main modalities of precision psychiatry, namely genomics, neuroimaging, digital phenotyping, and AI-driven interventions. Four explicit positions are advanced. First, equity must be engineered from the outset rather than assumed. Second, interpretability should outweigh marginal gains in accuracy in a field built on subjective report. Third, stigma is bidirectional and contingent on framing and the availability of meaningful intervention. Fourth, individualised care must demonstrate clinical and economic superiority over standardised approaches. Precision psychiatry is likely to reshape psychiatric practice and the therapeutic relationship itself. Interdisciplinary collaboration, clear guidelines, and continuous ethical vigilance will be essential for responsible adoption and sustained public trust.

Background: The Testamentary Capacity Assessment Tool (ΤCAT) is a brief instrument with good psychometric properties, specifically designed for the assessment of testamentary capacity (TC) in individuals with dementia. It assesses memory, perception of financial matters, and judgment, as well as cognitive functions, such as theory of mind, not measured by other traditional tools. Additionally, it does not require collateral sources of financial information. The aim of the present study was to provide an updated report on the use of the TCAT in research and systematic review studies. Methods: This narrative review includes studies that have used the TCAT for clinical use, validation in different cultures, and comparison with the two other specialized TC assessment tools. The PubMed database was searched using the keyword “Testamentary Capacity Assessment Tool”. Results: The TCAT has been validated in a healthy Italian population and was found to be a useful adjunct instrument for TC assessments in older adults. Another study demonstrated its clinical utility in patients with acute ischemic stroke. A systematic review compared the TCAT to the other two existing specialized TC assessment tools, namely the Testamentary Capacity Instrument (TCI) and the Testamentary Definition Scale (TDS), highlighting the superiority of the TCAT in clinical practice. Conclusions: The TCAT is a useful, specialized screening tool that is easily applicable in clinical practice by both experts and non-experts. Further studies are recommended across different cultures, in both healthy and cognitively impaired adults, to support its standardized use in forensic and clinical settings.

This retrospective study examines emergency involuntary psychiatric admission procedures for minors in Athens (2018–2022), using case records accessed through collaboration between the ‘postgraduate Master’s programme at the Medical School of Athens and the Public Prosecutor’s Office for Minors Athens. Findings indicate a 37.9

Background: The TCAT (Testamentary Capacity Assessment Tool) is a short instrument with good psychometric properties, specialized for the assessment of testamentary capacity (TC) in dementia. It assesses memory, perception of financial parameters and judgment. It evaluates cognitive functions, such as social cognition, not measured by other traditional tools, while collateral sources of information regarding financial parameters are not needed. The present study is a review including all the relevant studies both for TCAT’s use in clinical settings and its validation in different cultures. Methods: Pubmed database has been used. Results: At the present, there are no other specialized screening TC assessment instruments with measured psychometric properties in the scientific literature. The TCAT has been validated in healthy Italian population and is highlighted that it is useful as an adjuvant instrument for TC assessment in the elderly. It is clinically useful in acute ischemic stroke, while its strengths are emphasized in a systematic review of the existing TC assessment instruments. Conclusions: TCAT is a useful screening specialized tool, easily applicable in clinical practice both from experts and non-experts. More studies are recommended to be held in different cultures, both in healthy and cognitively impaired adults, for its standardized use in forensic and clinical settings.

Background: Optimal coping with chronic pain (CP) has a positive impact on minimizing the barriers to patients' quality of life. Mindfulness-based approaches have been shown to improve emotional regulation and coping strategies in CP management, promoting a greater acceptance of pain and reducing psychological distress. Given that personality traits may influence the adjustment to chronic pain, this study aimed to investigate whether specific personality dimensions, based on Cloninger's model of temperament-character dimensions, affect the enrolment and the response to pain treatment in an innovative hybrid arts-based CBT-CP group intervention for patients with non-malignant CP. Methods: A pre-and-post assessment design was implemented in a non-randomized control trial. A total number of 100 outpatients at a University Pain Management Unit were allocated through self-selection in either an arts-based CBT-CP group intervention (N = 50) or a treatment-as-usual (TAU) control group (N = 50). All participants completed the Brief Pain Inventory (BPI), the Orbach and Mikulincer Mental Pain Scale (OMMP), the Tolerance for Mental Pain Scale (TMPS), and the Temperament and Character Inventory (TCI-140). The assessment took place at baseline and at the end of the intervention, after a 10-week period. The statistical analyses included a t-test for independent samples, Chi-square, and linear regression analyses. Results: At baseline, the arts-based CBT-CP intervention group had a higher score in the novelty seeking character dimension (M = 64.04; SD = 9.56), whereas the TAU group was found to have higher scores in self-directedness (M = 74.34; SD = 11.22) and self-transcendence (M = 51.42; SD = 6.61). The arts-based CBT-CP group reported a lower loss of control (M = 22.94; SD = 6.70) and higher belief in the ability to cope with pain (M = 21.10; SD = 3.76) after the intervention, compared to the control group. Self-transcendence was found to be a significant predictor of average pain as well as of patients' belief in their ability to cope with pain. Conclusions: The current study provides practice-based evidence suggesting that an arts-based CBT-CP group intervention is a promising treatment for non-malignant CP. Personality dimensions affect patients' enrolment and response to pain treatment. Furthermore, integrating mindfulness-based strategies within such interventions may further enhance treatment outcomes by fostering acceptance, improving coping mechanisms, and reducing the emotional burden associated with chronic pain.

Background/Objectives: The COVID-19 pandemic has profoundly disrupted mental health globally, affecting individuals across all age groups. Understanding its long-term impact is crucial for identifying age-specific vulnerabilities and informing targeted mental health interventions. This longitudinal study aimed to investigate the within-person changes in mental health across different age groups in Greece from the first to the third pandemic wave of coronavirus disease 2019 (COVID-19) (i.e., one year later) during nationwide lockdowns. It further compared the mental health outcomes of three distinct age groups, stratified based on their vulnerability to COVID-19—younger adults (18–29 years), adults (30–59 years), and older adults (60–84 years)—and examined correlates of depression and anxiety during the third pandemic wave. Methods: A total of 720 participants—92 younger adults, 543 adults, and 85 older adults—completed the same set of questionnaires during the first (April–May 2020) and third (March–May 2021) pandemic-related lockdowns. At both time points, participants provided data on the Generalized Anxiety Disorder-2, Patient Health Questionnaire-2, Systemic Clinical Outcome and Routine Evaluation-15, Connor–Davidson Resilience Scale-2, and demographic information. Results: Results indicated a within-individual increase in depression and a decrease in resilience for all participants, irrespective of age. Anxiety increased only among younger adults and adults, whereas family functioning remained stable across all age groups one year post-pandemic onset. Furthermore, younger adults reported higher levels of depression and anxiety, lower resilience, and more impaired family functioning compared to the older age groups in both lockdowns. Among the different age groups, factors independently associated with depression and anxiety were identified through stepwise regression analyses. Conclusions: The present study provides evidence for mental health deterioration during the pandemic across all age groups, with younger adults exhibiting heightened vulnerability.

INTRODUCTION:The risk for general or criminal recidivism in forensic psychiatric patients has not been extensively investigated in the literature. The aim of this review is to evaluate criminal recidivism among forensic patients with mental disorders undergoing some type of outpatient treatment. METHODS:In this review, we utilized PubMed, Embase, Scopus, and the Cochrane Library to search for studies published from January 1990 up to July 2024. Eligible studies should i) evaluate forensic patients with mental health conditions, ii) evaluate patients undergoing outpatient treatment, and iii) evaluate criminal recidivism (general, sexual, or violent) as a primary outcome. Recidivism was also compared between groups when reported. RESULTS:Overall, 12 clinical studies including 3271 patients were evaluated. Of these, 3048 patients undergoing outpatient treatment were analyzed. The mean age of all patients was 23.4 years (SD = 6.3), and 79.7 %. were male. The mean follow-up was 33.82 months. Overall, the pooled proportion for general recidivism was 39.1 % (95 % CI: 25 %-54.3 %), and for violent recidivism was 21.7 % (95 % CI: 2.6 %-52.3 %; data from four studies). In group comparisons (data from five studies), there was no difference between patients under treatment and the control groups as far as general recidivism (OR = 0.489; 95 % CI [0.202-1.183]; P = 0.112), and violent recidivism (OR = 0.283; 95 % CI [0.056-1.416]; P = 0.124) were concerned. CONCLUSION:The general and violent recidivism rates are high among forensic patients undergoing outpatient treatment for mental health disorders. There was no difference between outpatient treatment and control groups regarding their effect on recidivism. However, most of the studies reviewed did not provide information about drug treatment; more comparative studies focusing on pharmacotherapy are needed to verify any benefits of outpatient treatment.

Background: Prisoners are often associated with mental health and substance use disorders. Coercive measures are widely used in prison settings. The objective of this study was to compare inmates’ perceptions and satisfaction with telepsychiatry versus face-to-face consultation and the effects of telepsychiatry on the use of coercive measures. The sample consisted of 100 male inmates from various backgrounds who had experienced both approaches of services (face to face and telepsychiatry). Method: The data were obtained through an interview where the individuals completed a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and a Participant Satisfaction Questionnaire to assess their satisfaction with services offered via telepsychiatry. Additionally, calculations of time spent waiting for a face-to-face psychiatric evaluation and time spent in handcuffs and in confined spaces were made before and after the introduction of telepsychiatry. Results: Statistically significant improvements (all p-values < 0.001) were noted in waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behavior of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry led to the elimination of time spent in handcuffs and in confined spaces (transport vehicles). Conclusion: According to the results of this study, telepsychiatry is an acceptable method of service delivery in correctional facilities and was associated with a reduction of coercive practices.

Telepsychiatry is an effective tool to support and provide mental health services to prison inmates. In Greece, telepsychiatry was formally applied in two correctional facilities in 2018. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation. The sample consisted of 100 male inmates with a multicultural background and prior experience with both methods of services provision. The data were obtained through a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and another Participant Satisfaction Questionnaire to assess satisfaction with telepsychiatric services. The results have shown a higher level of satisfaction with telepsychiatry compared to face-to-face care. Statistically significant improvements (all p-values <0.001) were noted in: waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behaviour of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry has proved to be an acceptable way of approaching and supporting inmates in Greece, with most of the participants expressing high acceptance, satisfaction, and preference rates. Implications for additional research and further development of telepsychiatry are discussed.

BackgroundThis study investigated patient- and caregiver-related predictors of expressed emotion (EE) toward individuals with schizophrenia in families and halfway houses and yet understudied differential effects across settings.MethodsWe included 40 individuals with schizophrenia living with their families (“outpatients”) and 40 “inpatients” in halfway houses and recorded the EE of 56 parents or 22 psychiatric nurses, respectively, through Five Minutes Speech Sample. Each outpatient was rated by one to two parents; each inpatient was rated by two to five nurses. As EE ratings had a multilevel structure, EE predictors were investigated in backward stepwise generalized linear mixed models using the “buildmer” R package. We first fitted models including either caregiver- or patient-related predictors in each setting and finally included both types of predictors. Setting-specific patient-related effects were investigated in interaction analyses. Adjustment for multiple tests identified the most robust associations.ResultsIn multivariate models including either caregiver- or patient-related predictors, nurses’ higher age, shorter work experience and lower inpatients’ negative symptoms robustly predicted higher emotional overinvolvement (EOI). In the final models including both types of predictors, nurses robustly displayed lower EOI (i.e., reduced concern and disengagement) toward inpatients with higher negative symptoms. Several other features were nominally associated with criticism and EOI in each setting. However, no feature robustly predicted criticism in inpatients and criticism/EOI in outpatients after adjustment for multiple tests. In interaction analyses, higher negative symptoms differentially predicted lower EOI in nurses only.ConclusionOur findings suggest setting-specific pathogenetic pathways of EOI and might help customize psychoeducational interventions to staff in halfway houses.

A paucity of cognitive and affective features of empathy can be correlated with violent behavior. We aimed to identify differences in empathy among four groups in a sample of 100 male participants: (1) 27 violent offenders with schizophrenia, (2) 23 nonviolent patients with schizophrenia, (3) 25 patients with antisocial personality disorder, and (4) 25 subjects from the general population, who formed the control group. Schizophrenia symptoms were quantified with the Positive and Negative Syndrome Scale. Empathy was measured with the empathy quotient. Theory of mind was evaluated using (a) the first-order false-belief task, (b) the hinting task, (c) the faux pas recognition test and (d) the “reading the mind in the eyes” test (revised). Differences noted among the groups were age (controls were younger) and educational status (antisocials were less educated). The empathy quotient scoring (p < 0.001) and theory-of-mind tests (p < 0.001) were distinct between the control group and the three other groups of participants, but not among the three patient groups. Patients with antisocial personality disorder, violent psychotic offenders and psychotic nonviolent patients show no remarkable differences in affective or cognitive empathy tests, but they all present deficits in empathy and theory of mind when compared to controls.

Purpose This study systematically searched for differential correlates of criticism vs. emotional overinvolvement (EOI) towards patients with schizophrenia in families and halfway houses, which have only incidentally been reported in previous research. Identified patterns were compared across settings. Methods We included 40 inpatients with schizophrenia living in halfway houses and 40 outpatients living with their families and recorded the expressed emotion (EE) of 22 psychiatric nurses or 56 parents, respectively, through Five Minutes Speech Samples. Each nurse rated 1–12 inpatients and each inpatient was rated by 2–5 nurses. Each outpatient was rated by one or both parents. As EE ratings had a multilevel structure, weighted Spearman correlations of criticism and EOI with various patient- and caregiver-related characteristics were calculated and compared with Meng’s z-test. Results Criticism was weakly negatively correlated with EOI in nurses but negligibly in parents. Distinct patterns of significant differential correlates arose across settings. Outpatients’ aggressive behavior and parents’ related burden were mainly associated with higher criticism. Inpatients’ symptoms (agitation/aggression, negative and other psychotic symptoms) and nurses’ burnout (Depersonalization) were mainly associated with lower EOI. Inpatients’ perceived criticism and outpatients’ previous suicide attempts were equally associated with higher criticism and lower EOI (mirror correlations). Finally, various inpatient attributes (older age, chronicity, unemployment and smoking) triggered higher EOI only. Inpatients’ age, psychopathology (esp. agitation/aggression and negative symptoms) and perceived criticism survived adjustment for multiple comparisons. Conclusion Our findings suggest setting-specific pathogenetic pathways of criticism and EOI and might help customize psychoeducational interventions to staff and families.

Expressed emotion (EE) toward patients with schizophrenia is typically reported to be lower in psychiatric halfway houses than in families. This is the first study directly comparing EE between these settings and investigating the pathways mediating EE differences. We included 40 inpatients in halfway houses and 40 outpatients living with their families and recorded 22 psychiatric nurses' and 56 parents' EE, respectively, through Five Minutes Speech Samples. Each inpatient was rated by 2-5 nurses and each outpatient by 1-2 parents. As EE ratings had a multilevel structure, generalized linear mixed models were fitted, adjusting for patient-related confounders and caregiver demographics. Mediatory effects were investigated in multilevel structural equation models. Outpatients were younger, less chronic, and better educated, with higher negative symptoms and perceived criticism than inpatients. Nurses were younger and better educated than parents. Before adjustment, EE rates were equally high across settings. After adjusting for patient-related confounders, emotional overinvolvement was significantly higher in parents. However, after also adjusting for caregiver demographics, only criticism was significantly higher in nurses. Patients' age, negative symptoms, and perceived criticism and caregivers' age and sex significantly mediated EE group differences. Our findings highlight pathways underlying EE differences between halfway houses and families and underscore the importance of staff and family psychoeducation.

Temporal trends in epidemiological parameters of domestic homicide and femicide in Greece over the last decade have not yet been studied. We conducted this study to fulfill this purpose. Specifically, we conducted a retrospective epidemiological study using 11-year data from the official nationwide Hellenic Police Archives and statistically analyzed data regarding domestic homicide and femicide. Overall, 1370 records of homicides among which 236 domestic homicides were identified. The pattern emerging from the statistical results of the present study highlighted the phenomenon of femicide as the gravest current issue to be interpreted and addressed. Nationally, the average number of homicides was 114.2/year, among which 19.7 domestic homicides. However, in 2021, while a decrease was recorded in homicides in general to 89 incidents per year, domestic homicides skyrocketed to 34 cases, reaching the highest annual number ever nationally recorded. On average, domestic homicides account for 18.2% of all homicides in Greece. In 2021, however, this percentage rose to 38.2%. The number of male victims of domestic homicide has declined over the years, with a further decline in 2021, in stark contrast to the number of women escalating over time and even more sharply in 2021. The proportion of female victims of domestic homicides in Greece was fourfold higher on average. The fact that cases of domestic homicide and femicide have received a lot of media attention, the recent Greek financial crisis, as well as increased alcohol and drug consumption due to the COVID-19 pandemic constitute possible aggravating factors.

Few studies in the literature have examined the effect of meteorological factors, especially temperature, on psychiatric hospitalization and even less on their association with involuntary admission. This study aimed to investigate the potential association of meteorological factors with the involuntary psychiatric hospitalization in the region of Attica, Greece. The research was conducted at the Psychiatric Hospital of Attica "Dafni". This was a retrospective time series study of 8 consecutive years of data (2010 to 2017) and included 6887 involuntarily hospitalized patients. Data on daily meteorological parameters were provided from the National Observatory of Athens. Statistical analysis was based on Poisson or negative binomial regression models with adjusted standard errors. Analyses were initially based on univariable models for each meteorological factor separately. All meteorological factors were taken into account through factor analysis and then, through cluster analysis, an objective grouping of days with similar weather type was performed. The resulting types of days were examined for their effect on the daily number of involuntary hospitalizations. Increases in maximum temperature, in average wind speed and in minimum atmospheric pressure values were associated with an increase in the average number of involuntary hospitalizations per day. Increase of the maximum temperature above 23 °C at lag 6 days before admission did not affect significantly the frequency of involuntary hospitalizations. Low temperature and average relative humidity above 60% levels had a protective effect. The predominant day type at lag 1 to 5 days before admission showed the strongest correlation with the daily number of involuntary hospitalizations. The cold season day type, with lower temperatures and a small diurnal temperature range, northerly winds of moderate speed, high atmospheric pressure and almost no precipitation, was associated with the lowest frequency of involuntary hospitalizations, whereas the warm season day type, with low daily temperature and small daily temperature range during the warm season, high values of relative humidity and daily precipitation, moderate wind speed/gust and atmospheric pressure, was associated with the highest. As climate change increases the frequency of extreme weather events, it is necessary to develop a different organizational and administrative culture of mental health services.

Introduction:Implementation models, frameworks and theories (hereafter tools) provide researchers and clinicians with an approach to understand the processes and mechanisms for the successful implementation of healthcare innovations. Previous research in mental health settings has revealed, that the implementation of coercion reduction programs presents a number of challenges. However, there is a lack of systematized knowledge of whether the advantages of implementation science have been utilized in this field of research. This systematic review aims to gain a better understanding of which tools have been used by studies when implementing programs aiming to reduce formal coercion in mental health settings, and what implementation outcomes they have reported.Methods:A systematic search was conducted using PubMed, CINAHL, PsycINFO, Cochrane, Scopus, and Web of Science. A manual search was used to supplement database searches. Quality appraisal of included studies was undertaken using MMAT-Mixed Methods Appraisal Tool. A descriptive and narrative synthesis was formed based on extracted data. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed in this review.Results:We identified 5,295 references after duplicates were removed. Four additional references were found with a manual search. In total eight studies reported in nine papers were included in the review. Coercion reduction programs that were implemented included those that were holistic, and/or used professional judgement, staff training and sensory modulation interventions. Eight different implementation tools were identified from the included studies. None of them reported all eight implementation outcomes sought from the papers. The most frequently reported outcomes were acceptability (4/8 studies) and adaptation (3/8). With regards to implementation costs, no data were provided by any of the studies. The quality of the studies was assessed to be overall quite low.Discussion:Systematic implementation tools are seldom used when efforts are being made to embed interventions to reduce coercive measures in routine mental health care. More high-quality studies are needed in the research area that also involves perspectives of service users and carers. In addition, based on our review, it is unclear what the costs and resources are needed to implement complex interventions with the guidance of an implementation tool.Systematic review registration:[Prospero], identifier [CRD42021284959].

Mental health disorders are more prevalent among incarcerated people than in the general population, while the difficulties experienced by inmates in gaining access to mental health services often make their care and treatment inadequate. To systematically review the use of video-teleconferencing (VTC) and telepsychiatry in forensic settings and its application within the criminal justice system. The electronic bibliographic databases MEDLINE, Scopus, PsychINFO and Google Scholar were searched using a systematic approach from January 1998 until September 2021 to identify papers on the use of VTC and telepsychiatry in forensic settings and within the criminal justice system. A total of 1303 articles were identified, after screening 27 publications fulfilled the inclusion criteria. Studies identified strengths and weaknesses of the use of telepsychiatry in forensic settings and criminal justice system. Telepsychiatry in forensic settings and the criminal justice system is associated with more benefits than limitations. Strengths identified include access to specialized services, flexibility in rescheduling meetings, security and safety among all parties involved, acceptance and user satisfaction, as well as efficiency and effectiveness of services provided, cost and time savings, and the absence of risks for infection spread in correctional settings. Weaknesses identified include the reluctance of professionals to provide remote consultations, the quality of the therapeutic relationship established, restrictions on its use by special patient groups, as well as issues underlying its implementation such as the legal framework, ethical issues and the civil or criminal responsibility of health attitudes. Overall, there is evidence to support its use and acceptance within forensic settings and the criminal justice system and our review highlights its benefits and limitations.

Introduction Violent behavior has been linked to deficits in social cognition, namely cognitive and affective aspects of empathy. Schizophrenia and antisocial personality disorder have been associated with violence and empathy deficits. Objectives Our main objective is to search for differences in empathy between patients with schizophrenia who have committed a violent offence, patients with schizophrenia with no history of violent offence and patients with antisocial personality disorder. Methods A total sample of Ν=100 participants was divided into four groups: 1) 27 patients with schizophrenia and history of committing a violent offence, 2) 23 patients with schizophrenia with no history of committing a violent offence, 3) 25 participants with antisocial personality disorder and 4) 25 general population participants comprising the control group. Symptoms of schizophrenia were rated using the Positive(P), Negative(N) and General Psychopathology (G) subscales of the Positive and Negative Syndrome Scale (PANSS). Empathy was evaluated using a) The Empathy Quotient (EQ). Theory Of Mind was evaluated using a) The First Order False Belief task, b) The Hinting task, c) The Faux pas Recognition Test and d) The Reading the Mind in the Eyes Test (Revised). Results The four groups differed in PANSS scoring (p<0.001), EQ scoring (p<0.001) and Theory of Mind tests (p<0.001), but this difference was only significant between the controls and the three groups of patients. The three groups of patients did not differ to each other in any of the Theory of Mind tests. No difference was also found between the two groups of psychotic patients. Conclusions Patients with antisocial personality disorder, schizophrenia and schizophrenia with a history of violent offence do not seem to perform differently in affective and cognitive empathy tests. Disclosure of Interest None Declared

Abstract. The 5th version of DSM ( American Psychiatric Association, 2013 ) employed a dimensional approach to describe and assess personality disorders, namely, the alternative model of personality disorders (AMPD). So far, AMPD has been translated and validated in many countries. Herein, the results of a series of studies conducted to develop and validate the Greek Personality Psychopathology Inventory (GPPI-5) following the AMPD are reported. Data from more than 1,200 adults were analyzed to examine factor structure. The ESEM approach was applied (1) to examine the proposed personality model, (2) to confirm previous validity studies on AMPD, and (3) to examine the invariance of GPPI-5 across gender. Results successfully replicated the AMPD at both the domain and facet levels. Measurement invariance across gender supported the GPPI-5 structure. Reliability and validity studies were conducted, providing evidence that GPPI-5 is a valid and psychometrically sound measure for assessing personality disorders in clinical and research settings.