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At least 37 records · Page 2Linked to original sources
PubMed2003

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours.

OBJECTIVES: To review our experience with the laparoscopic restaging procedure of presumed early stage borderline ovarian tumours. DESIGN: Retrospective study. SETTING: Cancer centre. POPULATION: Thirty patients with presumed stage I borderline ovarian tumours after limited initial surgery. METHODS: From April 1991 to May 2001, the patients were laparoscopically reassessed. The procedure involved peritoneal cytology, exploration of the peritoneal cavity, infracolic omentectomy, directed or random peritoneal biopsies, and when appropriate, contralateral oophorectomy and hysterectomy and appendectomy. Medical records were reviewed for patients' age, interval time between procedures, tumour stage, histological type, operative time, hospital stay, peri-operative complications and follow up. MAIN OUTCOME MEASURES: Seroperative and postoperative data, pathology and clinical follow up. RESULTS: Laparoscopic restaging was completed in all 30 (100%) identified patients. The mean age was 34.8 (10.5) years; the delay between initial operation and restaging laparoscopy averaged 9.8 (6.6) weeks. The mean operative time was 165.4 (53.8) minutes, and the mean hospital stay was 2.7 (1.3) days. There were two (7.0%) major complications related directly to the procedure. Eight (26.6%) patients were upstaged. Mean follow up was 29.1 (6.6) months, all patients are alive and one (3.2%) recurrence was observed. CONCLUSIONS: Laparoscopic approach of restaging for borderline ovarian tumours is an accurate safe procedure. It is associated with an acceptable rate of minor complications, it has similar morbidity associated with laparotomy and it minimises the incidence of infertility in the young patients. Whenever staging of borderline ovarian tumours is to be considered in an individual patient, laparoscopy provides a suitable alternative approach.

Adolescent↗
PubMed1983

Discriminating borderline disorder from other personality disorders. Cluster analysis of the diagnostic interview for borderlines.

The statistical technique of cluster analysis was applied to 252 hospitalized patients' scores on the 29 statements of the Diagnostic Interview for Borderlines. We found that this statistical treatment could reliably differentiate borderline disorder from other personality disorders. Two subtypes similar to Spitzer's schizotypal and unstable subtypes emerged.

Borderline Personality Disorder↗
PubMedDate not supplied

Borderline or bipolar? Distinguishing borderline personality disorder from bipolar spectrum disorders.

This article addresses the question whether borderline personality disorder (BPD) can be understood as a variant of bipolar disorder. In the past, borderline pathology has been seen as a variant of psychosis, depression, or posttraumatic stress disorder, but there are important differences between all of these conditions and BPD. The proposal that BPD falls within the bipolar spectrum depends on the assumption that affective instability develops through the same mechanism in both diagnostic categories. There are major differences in phenomenology, family history, longitudinal course, and treatment response between BPD and bipolar disorder, and the findings of comorbidity studies are equivocal. Thus, existing evidence is insufficient to support the concept that BPD falls in the bipolar spectrum.

Bipolar Disorder↗
PubMed1981

Borderline personality disorder: interrater reliability of the diagnostic interview for borderlines.

Three interviewers, working in pairs and using the Diagnostic Interview for Borderlines (DIB), interviewed three samples of 10 adult psychiatric inpatients. The two members of each interviewer pair alternated in the role of interviewer. Each member of the interviewer pairs completed the interview schedule and scored the protocol according to the instructions provided by the authors of the DIB. Interrater reliability was determined for each interviewer pair using the Kappa statistic. Reliability values were at about the level reported recently by Spitzer, Forman, and Nee (1979) for DSM-III axis I diagnoses in general. Additional statistical analyses were performed to determine whether there were patient sex differences on DIB scores, whether the two male interviewers differed from the female interviewer in their ratings of male or female patients, and whether experience differences among the three interviewers were reflected in their rating of patients. Among the latter analyses, the only significant finding was that in the interviewer pair consisting of a very experienced male psychiatrist and a male first year psychology graduate student, the former rated male patients as less borderline than did the latter. No other difference was found among raters, or between sex of patient and interviewer sex or amount of clinical experience. It was concluded that the DIB is sufficiently reliable for use in clinical research.

Adolescent↗
PubMed1985

Borderline diagnosis from hospital records. Reliability and validity of Gunderson's Diagnostic Interview for Borderlines (DIB).

Two trained and experienced clinical psychologists and two nontrained students rated the sections in Gunderson's Diagnostic Interview for Borderlines (DIB) on the basis of hospital records for 16 patients (DIB-R). The results showed that both reliability and validity, i.e., correlations with an actual interview, were unexpectedly high, around .80 for the trained judges and around .55 for the nontrained judges. The conclusion is that the DIB may be used for retrospective diagnosis of borderline patients from hospital records.

Adult↗
PubMed1988

Borderline symptom inventory: assessing inpatient and outpatient borderline personality disorders.

The Borderline Symptom Inventory (BSI), a 52-item self-report inventory, was administered to cohorts of patients diagnosed with borderline personality disorder (BPD), affective disorder and a normal control sample. The study failed to demonstrate that the inventory could effectively discriminate either ambulatory or hospitalized BPD patients from those with affective disorders, but that the inventory could correctly specify a control group without a psychiatric disorder. The results suggest that it is premature to utilize the BSI as a reliable screen to detect BPD.

Adult↗
PubMed2003

Borderline patients at the border of treatability: at the intersection of borderline, narcissistic, and antisocial personalities.

The author discusses the difficulties involved in treating patients with borderline personality disorder and concomitant Cluster B-narcissistic, histrionic, and/or antisocial-personality traits or disorders. He presents eight vignettes of patients with borderline personality disorder combined with various types of Cluster B personality traits or disorders and describes the course of their treatment. The author posits that such patients fall on a continuum ranging from difficult to treat but still treatable, to those with strong narcissistic or even psychopathic traits whose illness fails to improve no matter what treatment methods are applied (i.e., they have "untreatable" illness).

Journal Article↗
PubMed1991

[Ultrasonography of the borderline between normal and pathological state of the hip in newborn infants (borderline hip)].

Infant hips are classified, according to Graf, in 4 US types on the basis of the morphologic changes in both the cartilaginous and the bony roofs (type I, II, III, IV). Out of 6,000 examined hips, 170 (2.8%) were considered, which could be classified neither as type I (mature) nor as type II (delayed/immature ossification). These hips were called borderline hips. They exhibited some characteristic US features: good bone modeling, rounded cotyle, and alpha angle 60 degrees +/- 2. They were always observed during the first month of the patients' life. Anamnestic data were not specific (27.5% breech delivery, and 13% oligohydramnios); clinics sometimes overestimated the actual anatomic development (64/170 cases with positivity of Ortolani's sign and/or restricted abduction; 25% of patients presented with no suspicious signs). Dynamic hip examination showed only physiological cranial deflection of the cartilaginous roof. Finally, borderline hips developed into type I hips in 99% of cases, within the third month of the patients' life.

Follow-Up Studies↗
PubMed1990

[Selected problems of diagnosis, natural course and prognostic significance of borderline arterial hypertension. I. Long-term observations of borderline arterial hypertension in the population of working men].

Of 1236 men, aged 40-59 years, working in the same industrial plant borderline arterial hypertension (BH) was found in 253 (20.5%) subjects. The hypertensives and matched control normotensives (n = 237) were followed up for many years. At 13 years 343 subjects i.e. 70% of the original population were reevaluated. Arterial hypertension developed in 79.1% of the subjects with initial BH, most frequently with systolic++-diastolic, less frequently with systolic and diastolic BH. In normotensives hypertension was diagnosed in 30% of the subjects (p less than 0.001). A negative correlation between blood pressure rise and its initial value was found in all subjects. Out of various risk factors such as overweight, family hypertension, smoking and tachycardia possibly contributing to the development of established hypertension genetic factors and overweight were shown to be predisposing. The results of the studies indicate the need of preventive measures in all men with borderline hypertension and normotensives with family hypertension and overweight.

Adult↗
PubMed1994

The borderline family in the borderline child--understanding and managing the noise.

This paper demonstrates the particular functions of noise communication in a borderline child and family. Analysis shows noise to have a primary role for the individuals and the family in protecting self, promoting attachment, defending against the experience of emptiness and depletion and communicating lack of attunement. Treatment objectives were to foster the development of a more differentiated and cohesive self for the individuals and the family.

Adolescent↗
PubMed1999

Childhood antisocial behaviors as predictors of psychotic symptoms and DSM-III-R borderline criteria among inpatients with borderline personality disorder.

Structured clinical interviews of 107 female inpatients diagnosed with borderline personality disorder (BPD) were used to determine whether antisocial personality disorder (APD) diagnostic criteria evident prior to age 15 could be used to predict current Axis I and Axis II psychopathology. Diagnostic information was gathered using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and the Structured Clinical Interview for DSM-III-R-Patient Version (SCID-P). Childhood APD criteria were subjected to principal-components analysis, and three factors--rule-breaking, assault, and sadism--emerged. The severity of the childhood APD criteria was related to psychotic symptoms, as well as to the unstable relationships and labile affect BPD criteria and the current overall severity of BPD criteria. Sadism predicted psychotic symptoms and BPD severity, while rule-breaking predicted unstable relationships and BPD severity. Childhood APD severity also had a larger effect on BPD severity than on psychotic symptoms. Possible explanations for these findings are explored and discussed.

Adult↗
PubMed2006

The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial.

The outcome of a randomized controlled trial of cognitive behavior therapy in addition to treatment as usual (CBT plus TAU) compared with TAU alone (TAU) in one hundred and six participants meeting diagnostic criteria for borderline personality disorder is described. We anticipated that CBT plus TAU would decrease the number of participants with in-patient psychiatric hospitalizations or accident and emergency room contact or suicidal acts over twelve months treatment and twelve months follow-up, compared with TAU. We also anticipated that CBT plus TAU would lead to improvement in a range of secondary outcomes of mental health and social functioning compared to TAU. Of the 106 participants randomized, follow-up data on 102 (96%) was obtained at two years. Those randomized to CBT were offered an average of 27 sessions over 12 months and attended on average 16 (range 0 to 35). We found that the global odds ratio of a participant in the CBT plus TAU group compared with the TAU alone group having any of the outcomes of a suicidal act, in-patient hospitalization, or accident and emergency contact in the 24 months following randomization was 0.86 (95% confidence interval [CI] 0.45 to 1.66, p = 0.66). The corresponding global odds ratio, excluding accident and emergency room contact, was 0.75 (95% CI 0.37 to 1.54, p = 0.44). In terms of the number of suicidal acts, there was a significant reduction over the two years in favor of CBT plus TAU over TAU, with a mean difference of -0.91 (95% CI -1.67 to -0.15, p = 0.020). Across both treatment arms there was gradual and sustained improvement in both primary and secondary outcomes, with evidence of benefit for the addition of CBT on the positive symptom distress index at one year, and on state anxiety, dysfunctional beliefs and the quantity of suicidal acts at two year follow-up. CBT can deliver clinically important changes in relatively few clinical sessions in real clinical settings.

Adult↗
PubMed1990

[Selected problems of diagnosis, natural course and prognostic significance of borderline arterial hypertension. II. Sequelae of borderline arterial hypertension].

In 490 working men, aged 40-59 years the sequelae of borderline arterial hypertension (BH) were evaluated. The patients with BH (n = 253) were matched with normal controls (n = 237). At 13 years the cardiovascular state, ability to work and mortality were assessed. A significantly more frequent incidence of left ventricular hypertrophy and overload was found when hypertension developed. In the group of initial BH less men continued work (36%) than in the control group (48.1%, p less than 0.01), despite the same age. A relation between the ability to work and blood pressure becomes more prominent while taking into account final diagnosis; i.e. 65.7% of actual normotensives, 56.4% of the patients with BH and 47.5% with hypertension continue their work. The mortality rate was higher (15.4%) in the group with BH than in the controls (8.4%, p less than 0.01). The highest death rate was found when BH was combined with other coronary risk factors. The results confirm the presence of both indirect (through the development of arterial hypertension) and harmful effects of BH. They also show the need of devoting special attention to patients with BH and concommitant coronary risk factors.

Adult↗
PubMed1990

[Selected problems of diagnosis, natural course and prognostic significance of borderline arterial hypertension. III. Long-term studies of borderline hypertension in children and adolescents].

Cardiological reevaluation was carried out in a group of subjects aged 19-28 years in whom elevated (n = 80) or normal blood pressure (n = 69) had been found 10 years earlier. Control physical examination was extend to 24 hour ambulatory blood pressure monitoring. In both groups differences in systolic and diastolic blood pressure levels after 10 years are characterized by significant (p less than 0.001) negative correlation with its initial values. Elevated blood pressure (greater than 140/90 mmHg) was found in 21 patients of the studied group (23.3%) and in 4 controls (5.8%, p less than 0.001). The results of blood pressure monitoring are in accordance with traditional measurements and confirm equalization of mean blood pressure values, maintenance of group differences in diastolic pressure and correctness of diagnosis (at 10 years) of borderline or mild arterial hypertension. Complaints reported by the patients as well as ECG studies do not suffice for verification of young persons with elevated blood pressure and risk of hypertension. In this respect it is more useful to repeat measurements by using continuous automatic recording devices although considerable variations in blood pressure levels in longterm observations in young subjects indicate the need of careful prognosis concerning evolution of the disease.

Adolescent↗