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At least 217 records · Page 12Linked to original sources
PubMed1994

The relationship of platelet 5-HT2 receptor indices to major depressive disorder, personality traits, and suicidal behavior.

Previous research has suggested that major depression and suicidal behavior may be associated with altered serotonin receptor function. In this study, platelet serotonin2 (5-HT2) receptor binding indices were measured in conjunction with serotonin-amplified platelet aggregation, a response mediated by the platelet 5-HT2 receptor complex, in depressed patients and normal controls. The magnitude of serotonin-amplified platelet aggregation was positively correlated with the number of platelet 5-HT2 receptor sites in both groups. Mean values for the receptor binding indices and the receptor-mediated response did not differ significantly between patients and controls, although patients exhibited a wider range of values for each parameter compared with controls. Exploratory analyses were undertaken to determine clinical variables that might contribute to the increased variance in depressed individuals. These analyses failed to reveal a statistically significant relationship between any of the platelet 5-HT2 receptor measures and the subtype or severity of depressive illness, or the presence of comorbid borderline personality disorder. Although the mean number of receptor sites did not differ between patients who had recently attempted suicide and those who had never attempted suicide, a strong positive correlation (p = 0.002) was found between receptor number and the degree of medical damage resulting from the suicidal act. Furthermore, the ratio of the serotonin-amplified platelet aggregation response to platelet 5-HT2 receptor number, an index of the mean responsivity of an individual receptor complex, was lower in suicide attempters versus nonattempters (p = 0.06) and normal controls (p = 0.01). Exploratory analyses also suggested that recent exposure to psychotropic medication may result in a significant increase in platelet 5-HT2 receptor number (p = 0.03). Thus, although the study did not show a consistent alteration in platelet 5-HT2 receptor indices in major depression, the data suggest that specific factors such as suicidality and drug exposure may explain some of the variance in depressed patients.

Adolescent↗
PubMed1988

Psychosurgery and personality disorders.

Defining personality and its pathological variants is a hazardous enterprise. The personality concept refers to the global coherence of functioning of a person as a whole and can be divided into two components, temperament and character. Personality disorders will be discussed according to the DSM III-R (1987) (The Diagnostic and Statistical Manual of Mental Disorders) the most recent psychiatric taxonomy of the American Psychiatric Association. The interaction between psychosurgery and personality is multiple. It will be stated that the mere presence of a personality disorder in a patient should never be an indication for psychosurgery. It may sometimes even act as a contraindication. Psychosurgery can produce changes in some basic psychic dysfunctions and although there is no universally accepted understanding of how it works, some hypothetical neurobiological foundations will be discussed.

Humans↗
PubMedDate not supplied

[Psychiatric disorders, personality and traumatic experiences in conversive non-epileptic seizures patients].

AIM: To study the clinical characteristics in patients with conversion non-epileptic seizures, and the influence that traumatic childhood experiences could have in their psychopathologic status and personality. METHODS: Seventeen patients with non-epileptic seizures confirmed through video-EEG were included. A structured clinical interview (SCID-DSM-III-R), a measure of personality variables (MMPI), and an interview designed for collecting data on personal history of childhood traumas were administered. Descriptive and comparative statistical methods were used. RESULTS: More than 70% of the sample fulfilled the criteria for two or more simultaneous diagnoses in Axis I, and for at least one personality disorder. The subgroup experiencing childhood traumatic experiences showed more clinically significant MMPI scales, a younger age at correct diagnosis, and higher scores on the MMPI psychastenia and psychopathic deviation scales than the non experiencing childhood traumatics events. CONCLUSIONS: Our sample of patients with conversion non-epileptic seizures shows a significant level of psychopathology, and the absence of a unique character substrate. Under the generic term of pseudoseizures, a number of subgroups according to childhood traumatic experiences, with different levels of severity and different clinical and personality properties, may be defined.

Adult↗
PubMed2005

Borderline personality disorder.

Borderline personality disorder is a chronic psychiatric disorder characterized by marked impulsivity, instability of mood and interpersonal relationships, and suicidal behaviour that can complicate medical care. Identifying this diagnosis is important for treatment planning. Although the cause of borderline personality disorder is uncertain, most patients improve with time. There is an evidence base for treatment using both psychotherapy and psychopharmacology. The clinical challenge centres on managing chronic suicidality.

Adult↗
PubMed2006

Interpersonal precipitants and suicide attempts in borderline personality disorder.

Borderline personality disorder (BPD) is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression. The relationships among life events, impulsiveness, and type of suicidal behavior has hardly been studied in BPD and mood disorders. This study compared depressed attempters with and without BPD to identify specific suicide precipitants and risk factors in BPD and their relationship to severity of suicidal behavior. Attempters with comorbid BPD and major depressive disorder (MDD) had a higher number of lifetime suicide attempts; made their first attempt at a younger age; reported more interpersonal triggers; and had higher levels of lifetime aggression, hostility, and impulsivity, compared with attempters with major depression only. Environmental triggers of attempts in BPD are more likely to be interpersonal stressors. Lethality of attempts in BPD plus MDD is equal to that in MDD only, indicating that the seriousness of precipitants is unrelated to the lethality of the suicidal behavior. The differences between groups suggest that risk assessment and treatment should target both depression and personality disorder in those with combined illness.

Adult↗
PubMed2006

Association between serotonin transporter gene and borderline personality disorder.

Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability in regulation of emotion, interpersonal relationships, self-image, and impulse control beginning in early adulthood. BPD affects about 1-2% of the general population and has a high mortality rate as a result of suicide and impulsive behaviour. The serotonin transporter gene (5-HTT) is considered as a candidate gene for BPD as multiple lines of evidence have suggested that it plays an important role in suicide, impulsive behaviour, and emotional liability. To test for an association between 5-HTT and BPD, we genotyped three common polymorphisms: the serotonin transporter linked promoter region (5-HTTLPR); a variable number of tandem repeat (VNTR) in intron 2, and a single nucleotide variant (A/G) within the LPR region. Eighty-nine Caucasian patients with BPD and 269 Caucasian healthy controls were analyzed. The program UNPHASED was used to compare allele and haplotype frequencies between cases and controls. Significant differences in allele frequencies of the VNTR marker (p=0.012) and haplotype frequencies (p=0.002) between patients and controls were found. Compared with healthy controls, patients with BPD showed higher frequencies of the 10 repeat of the VNTR marker and the S-10 haplotype, and lower 12 repeat and L(A)-12 haplotype. Our results suggest that the serotonin transporter gene may play a role in the aetiology of borderline personality disorder.

Adult↗
PubMed2001

[Symptom-focussed drug therapy in borderline personality disorder].

Borderline Personality Disorder (BPD) is a common and serious psychiatric illness. Psychopathological symptoms often are heterogenous and difficult to influence. Psychotherapy stands in the core of treatment efforts. However, during the treatment of these patients often situations occur that make the use of drug treatment necessary. Symptoms such as depression, impulsivity, or dissociation can be difficult to deal with in this population. There appears to be no treatment of choice for the disorder as a whole. Reviews so far have organized the literature by groups of pharmacological agents. In this review we give an overview over psychopathological symptoms in BPD, i.e. depression, affective dysregulation, aggression, impulsivity, dissociation, self-injuries, suicidality, psychotic symptoms, anxiety, obsessions and compulsions, and sleep disturbance. Effectivity of different drugs in influencing these symptoms is presented and significances of findings are used to assess the relevance of these findings. We conclude that certain symptoms such as depression or impulsivity can be successfully treated. Serotonin reuptake inhibitors play a decisive role in pharmacological treatment of Borderline Personality Disorder. Finally, recommendations for effective drug treatment of BPD symptoms are presented. Comorbid depression should be treated with Selective Serotonin Reuptake Inhibitors. These substances could also be shown to be effective in the treatment of impulsive and aggressive behavior. Intermittent psychotic symptoms are a target for atypical neuroleptics. Benzodiazepines are no longer viewed to be useful in the treatment of BPD.

Borderline Personality Disorder↗
PubMedDate not supplied

History of childhood attention deficit/hyperactivity disorder symptoms and borderline personality disorder: a controlled study.

To evaluate the association between history of childhood attention deficit/hyperactivity disorder (ADHD) symptoms and the diagnosis of borderline personality disorder (BPD) in adulthood, the Wender Utah Rating Scale (WURS) was administered to 42 consecutively admitted BPD subjects, 94 consecutively admitted controls with any cluster B personality disorder (PD) diagnosis other than BPD, 38 consecutively admitted controls with any cluster A or cluster C PD diagnosis but no cluster B PD diagnosis, and 69 consecutively admitted controls with no PD diagnosis. A fourth control group was composed by 201 nonclinical volunteers. According to Dunn-Bonferroni contrasts, BPD subjects showed a significantly higher mean WURS total score compared to all control groups (minimum t = 7.93, maximum t = 11.63, all Ps <.001). These contrasts remained significant even controlling for potential confounders such as antisocial personality disorder (ASPD) diagnosis, gender, inpatient status, and axis I diagnoses. The results of this study seem to support the hypothesis of an association between history of childhood ADHD symptoms and adult BPD diagnosis.

Adult↗
PubMed1990

Increased morbid risk for schizophrenia-related disorders in relatives of schizotypal personality disordered patients.

To evaluate whether probands from a clinical sample diagnosed as having DSM-III schizotypal and/or paranoid personality disorder have a familial relationship to the schizophrenia-related disorders, the morbid risk for schizophrenia-related disorders and other psychiatric disorders were evaluated in the first-degree relatives of patients with schizotypal and/or paranoid personality disorder and compared with the corresponding risk for these disorders in the first-degree relatives of patients with other non-schizophrenia-related personality disorders. The morbid risk for all schizophrenia-related disorders, and specifically for schizophrenia-related personality disorders, was significantly greater among the relatives of the probands with schizotypal and/or paranoid personality disorder than among the relatives of probands with other personality disorder. The morbid risk for other psychiatric disorders did not differ significantly between the first-degree relatives of the schizotypal/paranoid personality disorder and the other personality disorder control proband samples. These results suggest a specific familial association between schizophrenia-related disorders, particularly schizophrenia-related personality disorders, and clinically diagnosed schizotypal patients.

Adolescent↗
PubMed2004

Suicidality in DSM IV cluster B personality disorders. An overview.

Personality disorders are a considerable risk factor for suicidal behavior. In psychological autopsy studies, individuals with personality disorders are frequently found among suicide victims. Suicidal attempts (which are a major risk factor for completed suicide) are also an important issue among affected patients. We performed careful MedLine, Excerpta Medica, PsycLit and PsycINFO searches from 1980 to 2004. Search terms were "suicide", "personality disorders", "mortality", "follow-up". We identified studies dealing with suicide and the following areas of interest: borderline personality disorder, narcissistic personality disorder, antisocial personality disorder, comorbidity (especially with affective disorder and substance abuse disorder) and risk factors for suicide in personality disorders. Despite the fact that comorbidity with DSM-IV Axis I disorders often impairs a correct judgment of suicidality in personality disorders, this overview showed that some personality disorders have a stronger link to suicide and that identifiable risk factors may be used for the development of preventive measures. Given the fact that personality disorders have high prevalence in the general population, prediction and prevention of suicide among these individuals is a problem of public health.

Diagnostic and Statistical Manual of Mental Disord↗
PubMed1996

Obsessive-compulsive disorder comorbid with borderline personality disorder: a long-term case study.

Three case reports of patients with borderline personality disorder (BPD) and obsessive-compulsive disorder (OCD) for more than 10 years are used to illustrate the relationship between OCD and borderline pathology. The recognizable features of the obsessive-compulsive symptoms in these reports are: (i) pervasiveness, the symptomatic overlap of obsessive-compulsive symptoms; (ii) poor insight and resistance; and (iii) obsessive control evident in personal relationships. These features are manifestations of OCD psychopathology as well as of a personality disorder. The symptoms with these features are located hypothetically towards the severe end of the symptomatic spectrum of OCD. The comorbidity is not a simple relationship, and the symptomatology of the comorbid patient is derived from OCD pathology linked with the personality disorder rather than from independent BPD pathology.

Adolescent↗
PubMed1997

Invited essay: the challenge of differentiating normal and disordered personality.

By separating personality disorders from other psychiatric conditions and requiring mental health professionals to assess the personalities of all their patients, DSM-III Axis II created an explosion of ideas and research on the nature and structure of personality. Since 1980, theorists and researchers from previously segregated camps have come together to address a number of important taxonomic issues, including the relationship between normal and disordered character. In this article, we place the challenge of differentiating normal and abnormal personality in historical perspective, and outline major theories, models, and methods that inform personologists in their quest. The complexity of personality, and the differences in the way people view the subject matter, ensure that there will be several research lines in the next generation. Progress in the field can be quickened by refinements in theory, the development of more assessment instruments that tap both normal and abnormal traits, and empirical studies that follow well-match groups of normals and patients over significant time periods.

Comorbidity↗
PubMedDate not supplied

Patterns of anxiety and personality disorder comorbidity.

The purpose of this study was to examine patterns of comorbidity of DSM-III-R anxiety disorders and personality disorders (PD). Two-hundred subjects were independently interviewed with the Structured Clinical Interview for DSM-III-R (SCID) and the Personality Disorder Examination (PDE) face-to-face by two experienced clinicians. One-hundred and forty-six also completed the Personality Diagnositc Questionnaire-Revised (PDQ-R). Rates of personality disorder among patients with and without anxiety disorders were determined by each of the three instruments. Comorbidity between panic disorder social phobia, obsessive-compulsive disorder and simple phobia and a conservative estimate of individual Axis II disorders was examined. Results indicate that panic disorder, either current or lifetime, is associated with borderline, avoidant, and dependent personality disorders: social phobia is associated with avoidant personality disorder, and obsessive-compulsive disorder is associated with obsessive-compulsive and avoidant personality disorders. Anxiety disorders with personality disorders are characterized by chronicity and lower levels of functioning compared with anxiety disorders without personality disorders.

Adolescent↗
PubMed1998

Personality dimensions associated with depressive personality disorder.

Depressive personality disorder (DPD) is a historically important construct that requires empirical attention. This study compares 26 subjects with this disorder to 20 non-DPD subjects who have similar histories of longstanding early-onset depression on three personality measures, the Tridimensional Personality Questionnaire (TPQ), NEO-Five Factor Inventory, and Defense Style Questionnaire (DSQ). The samples were demographically similar and had similar rates of comorbid depression and dysthymia. They differed in that DPD subjects scored significantly higher on Harm Avoidance and Neuroticism, and significantly lower on Novelty Seeking, Extroversion, and Adaptive defense mechanisms. Implications for clinical care and nosology are discussed.

Adaptation, Psychological↗
PubMed1988

Cognitive analysis of multiple personality disorder.

Multiple personality disorder is not rare, and it can be treated using the principles of cognitive therapy. Noncognitive techniques are also required. The purpose of this paper is to define the basic cognitive map of multiple personality disorder, one which recurs in the majority of cases. Multiple personality patients commonly make the classical cognitive errors such as selective abstraction and dichotomization, but they also have a set of schemata and cognitions derived from their abusive childhoods that are specific for the disorder.

Adaptation, Psychological↗
PubMedDate not supplied

[Sleep disorders in patients with personality disorders].

63 patients with personality disorders have been hospitalized in a Sleep Disorder Clinic. Sleep disorders usually started during childhood, disappeared ant the reappeared around the age of 25. The polysomnographic data do not show a specific profile. Most of the patients were of the schizotypal or the borderline type. Therapeutic guidelines are presented.

Adult↗