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PubMed1987

[Problem of the classification of borderline states].

On the basis of comprehensive clinical follow-up, neurodynamic and clinico-sociological examination of a large group of patients (n = 4638) the author proposes a clinico-pathogenetic classification of borderline states. Having considered the leading pathogenetic factor, the severity and duration of the ascertained personality pathology, four groups of borderline neuro-psychic disturbances have been identified: neurotic, psychopathic, neurosis-like and psychopathy-like. The main stages of their clinical dynamics with an emphasis on the initial ones have been determined. The author has revealed a close correlation between individual clinical forms, the possibility of transformation and mutual transition. Detailed systematization of each of the identified subgroups of borderline states is presented.

Borderline Personality Disorder↗
PubMedDate not supplied

[New diagnostic and neuroendocrine approaches to the borderline syndrome].

The recent literature reflects a growing interest in Borderline Disorders. This paper summarizes the recent developments on nosological, genetical and biological aspects of the Borderline syndrome. Original neuroendocrine results from our group are presented and discussed. They suggest that an endogenomorphic depressive spectrum may be associated with the Borderline personality disorders.

Adult↗
PubMed1986

Day hospital treatment for borderline adolescents.

Short-term psychiatric hospitalization for acute disturbances in adolescents has little effect on underlying developmental deficits. A day hospital treatment program based on psychoanalytic object relations concepts can provide an alternative to costly long-term inpatient hospital adolescent programs while limiting regressive and destructive behavior. An understanding of the characteristics and dynamics of borderline adolescent patients provided the basis for practical approaches that also were helpful to other patients. A review of the literature on the day treatment of borderline patients precedes a discussion of the diagnosis and dynamics of borderline adolescents. This is followed by a description of the methods utilized in a day hospital program whose goal was to potentiate a successful start of a longer-term psychotherapeutic process that could continue after discharge. Difficulties in prognosis and in designing verifying research are discussed.

Adolescent↗
PubMed1985

Borderline disorders--the validity of the diagnostic concept.

Reliable concepts of borderline disorders are a prerequisite for studies of validity. Gunderson's and DSM-III's definition of Borderline personality disorder (BPD) and DSM-III's definition of Schizotypal personality disorder (SPD) fulfill these demands. The empirical evidence for descriptive, construct and predictive validity of these disorders is presented and discussed. The review concludes that BPD has descriptive validity but lacks the 2 other stronger types of validity. SPD has both descriptive and construct validity but lacks predictive validity. Various strengths and weaknesses of the empirical studies of these borderline concepts are discussed.

Adolescent↗
PubMed1986

The demographic profile of borderline personality disorder.

In a survey of borderline personality disorder, 23 studies that included data on age, sex, or race of the patient samples were identified. Comparison of patients who had borderline personality disorder with control groups in these studies revealed that a significant preponderance of patients with the disorder were young, white, and female. This finding cannot be considered conclusive because data were pooled from studies with questionable sampling techniques. Yet, this demographic profile warrants confirmation because it may imply diagnostic biases or actual differences in the prevalence of borderline personality disorder among various groups.

Adolescent↗
PubMed1985

Borderline: an adjective in search of a noun.

Outpatients diagnosed as borderline (N = 100) were prospectively followed for 6-36 months and examined from phenomenologic developmental, and family history perspectives. At index evaluation, 66 met criteria for recurrent depressive, dysthymic, cyclothymic, or bipolar II disorders, and 16 for those of schizotypal personality. Other subgroups included sociopathic, somatization, panic-agoraphobic, attention deficit, epileptic, and identify disorders. Compared with nonborderline personality controls, borderlines had a significantly elevated risk for major affective but not for schizophrenic breakdowns during follow-up. Prominent substance abuse history, tempestuous biographies, and unstable early home environment were common to all diagnostic subgroups. In family history, borderlines were most like bipolar controls, and differed significantly from schizophrenic, unipolar, and personality controls. It is concluded that, despite considerable overlap with subaffective disorders, the current adjectival use of this rubric does not identify a specific psychopathologic syndrome.

Adolescent↗
PubMed1983

The fairy tale as paradigm of the separation-individuation crisis: implications for treatment of the borderline adolescent.

This chapter is an attempt to offer a model for therapeutic work with borderline patients that is based on the structure and content of the fairy tale. It views the fairy tale as both descriptive in its echoing of developmental struggles of childhood and integrative in providing a model for resolution of these conflicts. Clare's use of the fairy tale offers confirmation of theoretical notions which place the etiology of borderline pathology in early developmental failures and a clue to the therapeutic work with borderline patients. While the childhood route of the fairy tale may no longer be available to most, its subtle mirroring of the separation-individuation crisis and gradual, growthful steps toward integration of both the external and the internal worlds offer an exquisite model for the work of psychotherapy. "Once a king in Narnia , always a king in Narnia . But don't go trying to use the same route twice. . ." (Lewis 1950, p. 186).

Adolescent↗
PubMed1981

[Evolution of borderline states].

This study presents all the anamnestic, clinical and catamnestic data and information regarding 111 patients diagnosed as Borderline in patients. The research confirms the assertion of various authors concerning the existence, in the daily clinical practice, of a Borderline psychopathological group, distinct and autonomous, comprising patients who present psycho-affectives and social specific features and often manifest typical depressed and psychotic syndromes; the statistical survey shows the heuristic interest of the Borderline diagnostic since several social and cultural as personal and familiar psychopathological variable factors appeared to be determinant in what concerns the psycho-social evolution of these patients.

Adult↗
PubMed1980

[Diagnosis of the borderline disorder].

A typical borderline case is presented, "borderline" being conceptualized as a form of personality disorder/psychopathy. The main characteristics have turned out to be 1. diversity and variability of symptoms, 2. affective disturbances and insufficient impulse control, 3. disturbed interpersonal relations, 4. pronounced suffering compelling the patient to seek treatment. The necessity of standardizing conceptions and characteristics of borderline disorders is being stressed and reporting on prototype cases considered an expedient measure to this effect.

Adult↗
PubMed1995

Diagnostic assessment and therapeutic approaches to borderline disorders in adolescents.

Not all young people who present with a borderline syndrome are equally vulnerable. Clinical manifestations appear along a spectrum that varies from an apparently less severely disturbed psychoneurotic to those who appear with almost total ego fragmentation (Giovacchini, 1964). When the syndrome appears as a result of social system trauma in early adolescence, adequate diagnosis and appropriate intervention can make for speedy recovery. A typical scenario is the absence of a peer group that is developmentally needed, along with the family tension and social system turbulence produced by a change of location, school, or cultural environment. When executives move with their families, for example, their adolescent children are likely to react with at least depression, with at worst a borderline syndrome. The therapy of disturbed borderline young people is likely to be successful only in an environment that optimally meets developmental needs with skilled intervention in biological, psychological, and social fields. The latter should include work with the family in which the individual psychopathology of the parents, their marital relationships, and the strengths and weaknesses of the family system are all assessed.

Adolescent↗
PubMed1995

[Possibilities in psychiatric-psychotherapeutic and family practice treatment of borderline patients].

In this article it is shown that, in spite of the diagnostic heterogeneity and in spite of differing concepts for treatment, basic principles for treatment may be assessed that have proven effective in daily therapeutic routine. It is decisive to consider typical difficulties in which therapists of borderline patients may get involved. Treatment is primarily based on psychotherapy. After a short review of different therapeutic concepts for borderline derangements, fundamental psychotherapeutic principles are illustrated. According to target symptoms, psychotropic drugs may be indicated as an adjunct. The use of various drugs is discussed. Ambulatory and clinical options for treatment and their indications are summarized, and treatment of borderline patients by their family doctor is stressed in particular.

Borderline Personality Disorder↗
PubMed1994

Dracula. Disorders of the self and borderline personality organization.

It has been proposed that Bram Stoker's novel Dracula can best be understood as a dramatic, hyperbolic, and fantastic expression of themes consistent with contemporary psychoanalytic conceptions of borderline personality disorder organization. Such an understanding may, in turn, shed further light on the nature of the intrapsychic world and experiences of borderline patients. Excerpts from the novel can be used to support the conceptualization of recent contributions to object relations theory and the understanding of borderline personality organization. It is uncanny how consistent Dracula's characteristics are to the generally seen complaints of patients suffering from this disorder.

Borderline Personality Disorder↗
PubMed1994

Prognostic implications of stable versus transient "borderline features" in bulimic patients.

BACKGROUND: This study examined the association between "borderline features" and treatment response in bulimic patients. METHOD: Treatment response was assessed in 69 bulimic patients over 6 months of treatment (and 1-year response in 44 of the patients). Patients were classified as a function of whether "borderline features" were (1) "stably" present (at pretreatment and after 3 months), (2) "transiently" present (at pretreatment only), or (3) "absent" (at both time points). RESULTS: The stably borderline profile coincided systematically with Axis II comorbidity (not with mood disorders) and was generally predictive of poorer 6- and 12-month response of eating and comorbid symptoms. Hierarchical regressions showed predictive effects to have a partial independence from effects caused by concurrent eating symptoms and depression. CONCLUSION: Results highlight the importance, with respect to prognosis in bulimia nervosa, of establishing the temporal stability of features that imply character disturbance.

Adult↗
PubMed1995

[Borderline disorder and schizophrenia. Still a diagnostic problem].

Two case-reports highlight the problems of co-morbidity of schizophrenia and borderline disorder. On the other hand, borderline disorder in schizophrenia can represent a pre-existent, lasting personality disorder, on the other hand it can be temporary syndrome in the course of illness. The assumption that a borderline syndrome can be a recompensation stage in the course of schizophrenia seems evident by clinical and psychodynamic points of view (concerning a coping strategy). The present categories of DSM III-R and ICD-10, however, do not allow an adequate diagnostic classification of this syndrome.

Adult↗
PubMed1997

Era-related changes in the Japanese cultural and social structure and conformist personality pathology--with a particular emphasis on borderline personality disorder.

We discussed relationship between the change of social structure and the specific conformist personality pathology, that is, Morita shinkeishitsu and borderline personality disorder. Morita shinkeishitsu that has been regarded as a basic pathology of broad range of neurosis is seldom seen in daily practice these days. On the other hand, borderline personality disorder that is a relatively new diagnostic domain is regarded as having a contemporary pathology, for example impulsivity, drug and sex abuse, and fragile interpersonal relationship. We consider that Morita shinkeshitsu corresponds to an industrialized society and that borderline personality disorder corresponds to a post industrialized (information based) society. This assumption should be leaded to the further discussion from a point of view of treatment.

Borderline Personality Disorder↗
PubMed1978

The borderline patient. A comparative analysis of four sets of diagnostic criteria.

In reviewing the evidence for the validity of the diagnosis borderline, four descriptions in the literature seem to offer comprehensive criteria for the diagnosis. When the four are compared, a total of 104 criteria are enumerated encompassing the mental status, history, interpersonal relationships, defense mechansisms, and other judgments of personality functioning of the borderline patient. Half of these criteria are mentioned in only one of the four diagnostic descriptions. This apparent lack of agreement over diagnostic criteria has three possible interpretations: (1) the borderline concept is an illusion; or (2) the concept is adequately defined by those criteria held in common, the others being nonessential; or (3) apart from the concept defined by the common criteria, there are subtypes emphasized by different authors. Although we favor the third interpretation, it is suggested that further speculation await an adequate test of existing diagnostic criteria.

Diagnosis, Differential↗
PubMed1979

Low-dose neuroleptic regimens in the treatment of borderline patients.

The use of pharmacologic agents in treating patients described as borderline generally has been accorded an insignificant, or at best, minor, role. We discuss this observation and review the literature that has dealt with this aspect of treatment. Diagnostic criteria are presented that appear to define a specific population of borderline patients who have been observed to be responsive to low doses of neuroleptic drugs. Five case histories of patients with conditions diagnosed and treated in this manner are presented, followed by a discussion of the implications of this approach in terms of clarifying the nosologic issues that have arisen around the "borderline" concept.

Adult↗
PubMed1980

The families of borderlines. A comparative study.

The families of 12 carefully diagnosed patients with borderline personality disorder are compared with the families of both paranoid schizophrenic patients and patients with neurotic personality disorders. The families of the borderline patients were distinguished by the rigid tightness of the marital bond to the exclusion of the attention, support, or protection of the children. This pattern of neglect conforms to one theme in the clinical literature, and its implications for understanding and treating borderline patients are discussed. Limitations in the research methodology make the conclusions from this study tentative, but the results suggest new areas in need of research attention.

Adolescent↗