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PubMed1989

An open, noncomparative study of amoxapine in borderline disorders.

Five patients with borderline personality disorder (BPD) and 5 patients with schizotypal personality disorder (SPD) completed at least 3 weeks of treatment with amoxapine. The patients fulfilled DSM-III criteria for borderline disorders and scored 7 points or more in Gunderson's Diagnostic Interview for Borderlines (DIB). The final median medication in patients with BPD was 200 mg amoxapine/day and 42 mg oxazepam/day. Duration of treatment averaged 28 days. In patients with SPD the corresponding figures were 250 mg amoxapine/day, 36 mg oxazepam/day and 39 days. The study suggests that amoxapine improves schizophrenic-like and depressive symptoms in patients with schizotypal personality disorders (SPD). No effect could be shown in patients with borderline personality disorders (BPD).

Adult↗
PubMed1994

The borderline syndromes of depression, mania and schizophrenia: the coaxial or temperamental approach.

When analyzing the diagnostic position of "neurosis", Akiskal found it clinically meaningless because it lacks sufficient phenomenological characterization. In contrast, Tyrer found it meaningful because it explains the heterogeneity of neurotic symptoms. The diagnostic position of "borderline" has been treated analogically by Akiskal and Tyrer. Thus, Tyrer uses the term borderline in a very broad and general sense, while Akiskal again has found it without sufficient phenomenological characterization. Hence, the DSM-III concept of borderline personality disorder includes the temperament borders of affective disorders (melancholic, choleric and sanguine). A closer look at the Tyrer concept of neurosis places it within the melancholic temperament. The choleric temperament covers cyclothymia and the sanguine temperament the subclinical manifestations of mania. The term borderline personality disorders should, then, be restricted to cover the phlegmatic temperament or mild degrees of the schizophrenic spectrum disorders, which is in accordance with ICD-10.

Bipolar Disorder↗
PubMed1989

The relationship between borderline personality disorder and anxiety disorders.

Eleven "pure" borderlines, ten borderlines with depression, 16 "pure" depressives, and 31 normal subjects were compared on a number of standardized inventories of anxiety. While patient groups experienced more anxiety of all types than did normals, borderlines did not emerge as more anxious than other patient groups. Qualitative differences in the anxiety experienced by borderlines and nonborderlines are discussed.

Adult↗
PubMedDate not supplied

Dysphoria and aloneness in borderline personality disorder.

A close examination of dysphoria, anger and aloneness (three main characteristics of the borderline syndrome) provides a theoretical model of reference for the therapist. Dysphoria results from the cyclical emotional oscillation between hope for stability and disappointment in its inattainability; a dependent-anaclitic depression arises from the mixture of anger, aloneness and inner emptiness which is so characteristic of the borderline syndrome. The tendency to be immersed in the here-and-now, an intra-festum mentality, exacerbates the sense of isolation, causing more irritation, mute frustration and, consequently, anger. The effects and ramifications of anger, and the resultant precarious cohesion of the self, are explored in the borderline syndrome; they are especially illuminated by the application of Kernberg's pain-anger-hate-vengefulness cycle concept. Meanings of solitude, in its forms of aloneness and loneliness, are explored in their pertinence. Aloneness - the constant needy search for, but condemnation to never finding, objects to fill an inner sense of emptiness - is especially germane. Suggestions for assisting subjects with borderline personality disorder to overcome aloneness and the lack of historical progression are made.

Anger↗
PubMed1985

Diagnosis of the borderline disorders.

Only a few of the borderline concepts introduced in clinical psychiatry have adequate diagnostic reliability. They are the borderline personality disorder of Gunderson and of DSM-III and the schizotypal personality disorder of DSM-III. Diagnostic interviews for these disorders have been developed, and their features are discussed. The diagnosis of borderline disorder can also be made with self-report instruments which are presented. Basic prevalence and demographic data for these disorders are given. The delimitation of the borderline disorders from other personality disorders is a major diagnostic problem still unresolved. The method of differentiated weight for symptoms is discussed as a probable solution for this problem.

Adolescent↗
PubMed1985

Demography of psychiatric patients with borderline personality traits.

This study was designed to identify the intensity of borderline personality traits in a large sample of psychiatric inpatients (n = 4,800) and to determine the relationship between the borderline traits and a variety of demographic variables. Results indicated the intensity of borderline pathology increased in (1) students or the unemployed, (2) married and separated patients, (3) patients with a criminal record, (4) atheists, and (5) patients from a broken home. It lessened with increasing age of the patient. There was no relation between race or level of education and intensity of borderline traits. Findings are discussed in terms of previous empirical studies and the existent theoretical literature.

Adult↗
PubMed1989

Characteristics of psychosis in borderline personality disorder.

Comparing a sample of 88 inpatients with borderline personality disorder (BPD) to inpatients with borderline traits, this paper addresses four hypotheses regarding the association between BPD and psychotic symptoms: (1) narrowly defined psychotic symptoms are rare in BPD; (2) broadly defined psychotic symptoms are often reported in BPD; (3) narrowly defined psychotic symptoms are due to concomitant disorders, and (4) psychotic symptoms may be factitious. Consecutive admissions to acute inpatient services were screened for borderline features and patients were examined using the Diagnostic Interview for Borderlines and the Schedule for Affective Disorders and Schizophrenia. The results generally supported the proposed explanations for the association between BPD and psychotic symptoms. Factitious psychotic symptoms were found in only 13% of the BPD sample.

Adolescent↗
PubMed1991

Primary process thinking, primitive defensive operations and object relationships in borderline and neurotic patients.

In the present paper Kernberg's hypothesis concerning the connection between primary process thinking on the one hand and primitive defense mechanisms and modes of object relationships on the other hand were tested empirically in a sample of 30 hospitalized borderline and 30 hospitalized neurotic patients. The diagnoses of the patients were given according to the 'Diagnostic Interview for Borderlines' of Gunderson and Kolb, the functions mentioned above were assessed on the basis of the Holtzman Inkblot Technique applying scoring systems of Lerner and coworkers for primitive defense mechanisms and of Urist for the scoring of object relationships to the Holtzman Inkblot Technique. According to the results the hypothesis derived from assumptions of Kernberg could be corroborated. Primary process thinking in borderline patients seems to be closely connected with high levels of anxiety and hostility, projective identification/projection, primitive denial and sadomasochistic relationships. A model for the coming about of primary process thinking in borderline patients is proposed.

Borderline Personality Disorder↗
PubMed1982

Identifying the depressive border of the borderline personality disorder.

The relationship between depression and borderline disorder is unclear. Using standardized observer- and subject-rated scales for depression, the authors compared patients satisfying DSM-III criteria for borderline personality disorder and dysthymic disorder. The two groups did not differ on depression as defined by the scales; however, there was a substantial intergroup difference on certain characteristics of the depression spectrum thought empirically to be associated more often with the borderline patient. The depth and quality of the depression of the borderline patient may largely overlap with that of the dysthymic patient, but it also possesses features that make it qualitatively distinct.

Adolescent↗
PubMed1984

EEG sleep evaluation of depression in borderline patients.

In this study the sleep of borderline patients and patients with primary nondelusional depression showed sleep continuity disturbance and greater REM activity and density (particularly during the first REM period) than that of normal control subjects. First-night REM latencies were more variable in the borderline than in the depressed group, but by the second night both groups showed shorter REM latencies than the controls. The similarities in EEG sleep suggest a relationship between borderline disorder and the affective spectrum and cast doubt on the definition of the borderline disorder as a pure character type.

Adolescent↗
PubMed1985

Depression in borderline personality disorder: lifetime prevalence at interview and longitudinal course of symptoms.

The author compared a group of patients with borderline personality disorder with groups of subjects with antisocial personality and bipolar II illness. The lifetime prevalence at interview of DSM-III major depression was high in all groups. Chronic depression demonstrated a specific relationship to borderline psychopathology. Prospectively, borderline psychopathology predicted high levels of depressive and anxiety symptoms. This relationship was reversed for depressive symptoms in patients with antisocial personality disorder, suggesting that when borderline and antisocial personality disorders occur together, some features may arise that differentiate patients with both disorders from those with either disorder alone.

Adolescent↗
PubMed1985

An empirical study of psychosis in borderline personality disorder.

To assess the nature and prevalence of psychotic symptoms in borderline personality disorder, the authors reviewed the cases of 33 patients meeting DSM-III criteria for borderline personality disorder, using both "narrow" and "broad" definitions of psychosis. Only eight patients displayed psychotic symptoms meeting the "narrow" DSM-III definition; in all of these cases, the symptoms appeared to be attributable to either severe drug abuse or major affective disorder, present simultaneously with borderline personality disorder. The remaining patients displayed only "broadly defined" psychotic symptoms or symptoms that appeared to be under voluntary control. These findings weigh against the assumption that borderline personality disorder lies "on the border" of classical psychotic disorders.

Adolescent↗
PubMed1985

The interface between borderline personality disorder and affective disorder.

The authors review the available literature on the interface between borderline personality disorder and affective disorder. Three competing hypotheses have been offered to explain the substantial overlap between these diagnostic categories; they postulate that borderline disorder arises from affective disorder, that affective disorder arises from borderline disorder, or that the two are independent and overlap coincidentally. None of these hypotheses satisfactorily explains the existing data. The authors propose a fourth hypothesis focusing on the multiple etiologies of the signs and symptoms used to diagnose both affective and borderline disorders and suggesting that some patients in the resulting heterogeneous population have symptom clusters that fit both syndromes.

Antidepressive Agents↗
PubMed1986

Transitional object use and borderline psychopathology.

The authors examined whether transitional object use distinguishes borderline patients from patients with other personality disorders or schizophrenia and from normal subjects. One hundred five subjects were given a structured interview to assess present and past transitional object use. The borderline group had the highest scores on the interview, and the group with nonborderline axis II diagnoses the lowest. Although transitional object use was not specific to the borderline diagnosis, it did emerge as a potentially useful developmental and psychodynamic marker for borderline persons.

Adolescent↗
PubMed1986

Schizotypal symptoms in patients with borderline personality disorders.

The authors assessed the frequency of schizotypal symptoms in 48 criteria-defined borderline patients. In the total sample schizotypal symptoms were surprisingly common; the average patient had more than seven symptoms and every patient at least one. Even in the "pure" DSM-III borderline subgroup, 67% of the patients had perceptual symptoms, 92% had cognitive symptoms, and 87% reported other "affective" symptoms. Visual phenomena were more prevalent than auditory ones, suggesting a possible contributing role for organic factors in borderline disorders. The results also indicate a close link between borderline and schizotypal personality disorders.

Adult↗
PubMed1986

An examination of the borderline diagnosis in children.

A retrospective study of 86 children aged 6-12 years who had been hospitalized for psychiatric reasons revealed that adult criteria for borderline personality disorder could identify a group of children with many of the features attributed in the literature to the borderline child. The relative paucity of significant differences between the children identified as borderline and those identified as nonborderline raises questions about the validity and utility of the term. Further work is necessary to clarify the meaning of a vulnerability to psychotic regression in the disturbed child and the relation of such a vulnerability to the adult borderline personality disorder.

Adult↗
PubMed1987

Sexual practices among patients with borderline personality disorder.

The authors found that 12 (57%) of 21 consecutive male patients with borderline personality disorder who presented for psychiatric treatment at two distant geographic sites were homosexual. They then obtained the sexual histories of 80 patients who met standardized criteria for borderline disorder and found that 17 (21%) of these patients were homosexual, four (5%) were bisexual, and nine (11%) had diagnoses of paraphilias. Ten (53%) of the 19 men with borderline disorder were homosexual, compared with seven (11%) of the 61 women. Homosexuality was 10 times more common among the men and six times more common among the women with borderline personality disorder than in the general population or in a depressed control group.

Adult↗
PubMed1988

The amphetamine challenge test in patients with borderline disorder.

The authors used amphetamine as a psychopharmacological probe to investigate the hypothesis that patients with borderline personality disorder are prone to psychosis following ingestion of a dopamine agonist. Sixteen patients with borderline personality disorder participated in the study. Significant increases in the mean total Brief Psychiatric Rating Scale scores and in activation and thought disturbance factors after amphetamine administration were noted in the sample. Patients with diagnoses of both schizotypal and borderline personality disorders worsened transiently with amphetamine administration, but patients with only the borderline diagnosis improved. These results indicate the usefulness of pharmacological probes to further understand DSM-III axis II disorders.

Acute Disease↗