scholarly journals Exploring schizophrenia spectrum psychopathology in borderline personality disorder

2019 ◽  
Vol 270 (8) ◽  
pp. 969-978
Author(s):  
Maja Zandersen ◽  
Josef Parnas
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Psychiatric Evaluation ◽  
Main Diagnosis ◽  
Schizophrenia Spectrum Disorders ◽  
Diagnostic Systems ◽  
Schizotypal Personality ◽  
Schizophrenia Spectrum ◽  
Icd 10

Abstract We have previously argued that the current borderline personality disorder (BPD) diagnosis is over-inclusive and clinically and conceptually impossible to distinguish from the schizophrenia spectrum disorders. This study involves 30 patients clinically diagnosed with BPD as their main diagnosis by three BPD dedicated outpatient treatment facilities in Denmark. The patients underwent a careful and time-consuming psychiatric evaluation involving several senior level clinical psychiatrists and researchers and a comprehensive battery of psychopathological scales. The study found that the vast majority of patients (67% in DSM-5 and 77% in ICD-10) in fact met the criteria for a schizophrenia spectrum disorder, i.e., schizophrenia (20%) or schizotypal (personality) disorder (SPD). The schizophrenia spectrum group scored significantly higher on the level of disorders of core self as measured by the Examination of Anomalous Self-Experiences Scale (EASE). The BPD criterion of “identity disturbance” was significantly correlated with the mean total score of EASE. These findings are discussed in the light of changes from prototypical to polythetic diagnostic systems. We argue that the original prototypes/gestalts informing the creation of BPD and SPD have gone into oblivion during the evolution of polythetic criteria.

scholarly journals Anxiety symptoms in a major mood and schizophrenia spectrum disorders

2016 ◽  
Vol 37 ◽  
pp. 1-7 ◽  
Author(s):  
B. Karpov ◽  
G. Joffe ◽  
K. Aaltonen ◽  
J. Suvisaari ◽  
I. Baryshnikov ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mood Disorders ◽  
Borderline Personality ◽  
Anxiety Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Comorbid Anxiety ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

AbstractBackgroundComorbid anxiety symptoms and disorders are present in many psychiatric disorders, but methodological variations render comparisons of their frequency and intensity difficult. Furthermore, whether risk factors for comorbid anxiety symptoms are similar in patients with mood disorders and schizophrenia spectrum disorders remains unclear.MethodsThe Overall Anxiety Severity and Impairment Scale (OASIS) was used to measure anxiety symptoms in psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) in the Helsinki University Psychiatric Consortium Study. Bivariate correlations and multivariate linear regression models were used to examine associations of depressive symptoms, neuroticism, early psychological trauma and distress, self-efficacy, symptoms of borderline personality disorder, and attachment style with anxiety symptoms in the three diagnostic groups.ResultsFrequent or constant anxiety was reported by 40.2% of SSA, 51.5% of BD, and 55.6% of DD patients; it was described as severe or extreme by 43.8%, 41.4%, and 41.2% of these patients, respectively. SSA patients were significantly less anxious (P = 0.010) and less often avoided anxiety-provoking situations (P = 0.009) than the other patients. In regression analyses, OASIS was associated with high neuroticism, symptoms of depression and borderline personality disorder and low self-efficacy in all patients, and with early trauma in patients with mood disorders.ConclusionsComorbid anxiety symptoms are ubiquitous among psychiatric patients with mood or schizophrenia spectrum disorders, and in almost half of them, reportedly severe. Anxiety symptoms appear to be strongly related to both concurrent depressive symptoms and personality characteristics, regardless of principal diagnosis.

Performance-Based Assessment of Social Cognition in Borderline Versus Psychotic Psychopathology

2019 ◽  
Vol 40 (2) ◽  
pp. 95-111
Author(s):  
Jeremy M. Ridenour ◽  
Katie C. Lewis ◽  
John M. Poston ◽  
Destiny N. Ciecalone
Keyword(s):  
Social Cognition ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Partial Support ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Performance Based Assessment ◽  
Spectrum Disorders ◽  
Social Causality

Abstract. Individuals diagnosed with borderline personality disorder (BPD) and schizophrenia spectrum disorders (SSD) are known to display deficits in social cognition (SC). Our sample comprised 81 patients enrolled in residential treatment for complex psychopathology. We used performance-based assessments to test the hypothesis that individuals with SSD would display decrements on the cognitive/perceptual facets of SC, whereas individuals with BPD would evidence greater dysfunction on the affective/interpersonal facets of SC, with consideration taken for how gender may interact with diagnosis to influence results. Our findings suggested that women with SSD displayed more impaired understanding of social causality compared with their female BPD counterparts, while female patients with BPD evidenced greater expectation for aggression in their SC compared with women with SSD. These findings provide partial support for our hypotheses while highlighting the importance of accounting for the influence of gender on SC functional disparities between these two groups.

scholarly journals Pharmacotherapy of borderline personality disorder: what has changed over two decades? A retrospective evaluation of clinical practice

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Charles Timäus ◽  
Miriam Meiser ◽  
Borwin Bandelow ◽  
Kirsten R. Engel ◽  
Anne M. Paschke ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychotropic Drug ◽  
Inpatient Treatment ◽  
Medical Center ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Main Diagnosis ◽  
Tetracyclic Antidepressants ◽  
Prescription Rates

Abstract Background The purpose of this study was to assess the pharmacological treatment strategies of inpatients with borderline personality disorder between 2008 and 2012. Additionally, we compared pharmacotherapy during this period to a previous one (1996 to 2004). Methods Charts of 87 patients with the main diagnosis of borderline personality disorder receiving inpatient treatment in the University Medical Center of Goettingen, Germany, between 2008 and 2012 were evaluated retrospectively. For each inpatient treatment, psychotropic drug therapy including admission and discharge medication was documented. We compared the prescription rates of the interval 2008–2012 with the interval 1996–2004. Results 94% of all inpatients of the interval 2008–2012 were treated with at least one psychotropic drug at time of discharge. All classes of psychotropic drugs were applied. We found high prescription rates of naltrexone (35.6%), quetiapine (19.5%), mirtazapine (18.4%), sertraline (12.6%), and escitalopram (11.5%). Compared to 1996–2004, rates of low-potency antipsychotics, tri−/tetracyclic antidepressants and mood stabilizers significantly decreased while usage of naltrexone significantly increased. Conclusions In inpatient settings, pharmacotherapy is still highly prevalent in the management of BPD. Prescription strategies changed between 1996 and 2012. Quetiapine was preferred, older antidepressants and low-potency antipsychotics were avoided. Opioid antagonists are increasingly used and should be considered for further investigation.

All-Cause Mortality of Hospital-Treated Borderline Personality Disorder: A Nationwide Cohort Study

2020 ◽  
Vol 34 (6) ◽  
pp. 723-735 ◽  
Author(s):  
Jesper N⊘rgaard Kjær ◽  
Robert Biskin ◽  
Claus Vestergaard ◽  
Povl Munk-J⊘rgensen
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mortality Rate ◽  
Borderline Personality ◽  
High Rate ◽  
Standardized Mortality Ratio ◽  
Central Research ◽  
Emergency Rooms ◽  
Icd 10 ◽  
Mortality Ratio

Patients with borderline personality disorder (BPD) are known to present frequently in emergency rooms, and they have a high rate of suicide. The mortality rate of patients with BPD is still unclear. The Danish Psychiatric Central Research Register and The Danish Register for Causes of Death were used to identify patients with a first-ever diagnosis of BPD (ICD-10: F60.31) from 1995 through 2011 together with time and cause of death. A total of 10,545 patients with a BPD diagnosis were followed for a mean time of 7.98 years. A total of 547 deaths were registered. The standardized mortality ratio of patients with BPD compared to the general population was 8.3 (95% CI [7.6, 9.1]). More than three inpatient admissions per year or a comorbid diagnosis of substance use disorder correlated with a higher mortality rate. The increased mortality rate in patients with BPD treated in secondary care emphasizes that it is a severe mental disorder.

Personality problems and disorders

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Mental Illness ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Team Work ◽  
Dimensional Approach ◽  
Outreach Workers ◽  
Dsm V ◽  
Icd 10

This chapter deals with the controversial issue of personality disorder, whether these are meaningful diagnoses and, if so, how they affect management. The classification is entirely pragmatic: the definitions and classification in both ICD-10 and DSM-V are outlined along with proposals to abandon categories in favour of a dimensional approach. The issue of treatability is explored, but we conclude that ignoring personality and personality disorders is not a viable alternative for outreach workers. Most of the chapter deals with the management of dissocial personality disorder (usually in men) and borderline personality disorder (usually in women). Specific psychotherapies are not dealt with here; the focus is on how to use team work to manage individuals with severe mental illness and disorders of personality.

Neural Correlates of Schizotypal Personality Disorder: a Systematic Review of Neuroimaging and EEG Studies

2021 ◽  
Vol 17 ◽  
Author(s):  
Luigi Attademo ◽  
Francesco Bernardini ◽  
Norma Verdolini
Keyword(s):  
Systematic Review ◽  
Personality Disorder ◽  
Affect Regulation ◽  
Functional Neuroimaging ◽  
Neural Correlates ◽  
Schizotypal Personality Disorder ◽  
Schizophrenia Spectrum Disorders ◽  
Schizotypal Personality ◽  
Reality Testing ◽  
Schizophrenia Spectrum

Background: : Schizotypal personality disorder (SPD) is a cluster A personality disorder affecting 1.0% of general population, characterised by disturbances in cognition and reality testing dimensions, affect regulation, and interpersonal function. SPD shares similar but attenuated phenomenological, genetic, and neurobiological abnormalities with schizophrenia (SCZ) and is described as part of schizophrenia spectrum disorders. Objective: Aim of this work was to identify the major neural correlates of SPD. Methods: This is a systematic review conducted according to PRISMA statement. The protocol was prospectively registered in PROSPERO - International prospective register of systematic reviews. The review was performed to summarise the most comprehensive and updated evidence on functional neuroimaging and neurophysiology findings obtained through different techniques (DW-MRI, DTI, PET, SPECT, fMRI, MRS, EEG) in individuals with SPD. Results: Of the 52 studies included in this review, 9 were on DW-MRI and DTI, 11 were on PET and SPECT, 11 were on fMRI and MRS, and 21 were on EEG. It was complex to synthesise all the functional abnormalities found into a single, unified, pathogenetic pathway, but a common theme emerged: the dysfunction of brain circuits including striatal, frontal, temporal, limbic regions (and their networks) together with a dysregulation along the dopaminergic pathways. Conclusion: Brain abnormalities in SPD are similar, but less marked, than those found in SCZ. Furthermore, different patterns of functional abnormalities in SPD and SCZ have been found, confirming the previous literature on the ‘presence’ of possible compensatory factors, protecting individuals with SPD from frank psychosis and providing diagnostic specificity.

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