Genetic, Developmental and Personality Correlates of Self-Mutilation in Depressed Patients

2006 ◽  
Vol 40 (3) ◽  
pp. 225-229 ◽  
Author(s):  
Peter R. Joyce ◽  
Janice M. McKenzie ◽  
Roger T. Mulder ◽  
Suzanne E. Luty ◽  
Patrick F. Sullivan ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Abuse ◽  
Term Treatment ◽  
Borderline Personality ◽  
Depressed Patients ◽  
Self Mutilation ◽  
Long Term Treatment ◽  
History Of

Objective: To examine whether the T allele of G protein β3 (GNβ3) is associated with self-mutilation in depressed patients. Method: A history of self-mutilation was systematically inquired about when recruiting depressed patients for a long-term treatment trial. Risk factors such as borderline personality disorder and childhood abuse experiences were systematically assessed, and patients were genotyped for polymorphisms of GNβ 3. Results: The T allele of GNβ 3, borderline personality disorder and childhood sexual abuse were all significantly associated with self-mutilation in depressed patients. These associations were significant in both univariate andmultivariate analyses, and as predicted were stronger in young depressed patients than in depressed patients of all ages. Conclusions: If the association between the T allele of GNβ 3and self-mutilation can be replicated, this may provide clues to understanding the neurobiology of self-mutilation.

Borderline Personality Disorder

2018 ◽  
pp. 245-270
Author(s):  
Carol S. North ◽  
Sean H. Yutzy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Borderline Personality ◽  
Historical Background ◽  
Self Mutilation ◽  
History Of ◽  
The Common ◽  
Cognitive Problems

Borderline personality disorder is a fairly recent label of a variously conceptualized phenomenon which has been characterized by affective instability and emotional crises, cognitive problems, impulsivity, and intense and unstable personal relationships. This chapter reviews the historical background, epidemiology, and clinical picture (including comorbidity) of borderline personality disorder. Although progress toward validation of this diagnosis has been made, the current definition does not appear to meet the accepted gold standard criteria for a syndrome that is currently considered valid (and reliable). The natural history of what is known is reviewed, as well as the common complications, including self-mutilation and suicide attempts. Treatment remains challenging at best, with few interventions meeting rigorous randomized controlled trial standards.

scholarly journals Audit of pharmacological management of borderline personality disorder as per NICE clinical guidelines CG78

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S319-S319
Author(s):  
Bethany Dudley ◽  
Shakina Bellam ◽  
Andrew Lawrie
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Current Practice ◽  
Term Treatment ◽  
Borderline Personality ◽  
Duration Of Treatment ◽  
Pharmacological Management ◽  
Single Drug ◽  
Written Information

AimsTo audit the current practice of pharmacological management of Borderline Personality Disorder with NICE Clinical guideline [CG78]: Borderline personality disorder:Objectives:23 patient records were analysed in the last 18months with a diagnosis of EUPD to compare current practice against NICE clinical guidance. (2009)Standards:When prescribing 1)Use a single drug.2)Use the minimum effective dose.3)Agree with the person the target symptoms, monitoring arrangements and anticipated duration of treatment. Antipsychotic drugs should not be used for medium, long term treatment.Indication:4)Drug treatment should not be used specifically for borderline personality disorder or for the individual symptoms or behaviour associated. (Repeated self-harm, marked emotional instability, risk taking behaviour and transient psychotic symptoms).5)Short-term use of sedative medication may be considered cautiously as part of the overall treatment plan in a crisis. The duration of treatment should be no longer than 1 week.6)When considering drug treatment, provide the person with written material about the drug. This should include evidence for the drug's effectiveness in the treatment of borderline personality disorder and for any comorbid condition, and potential harm.Review:7)Review the effectiveness and tolerability of previous and current treatments.8)Discontinue ineffective treatments.BackgroundBorderline Personality Disorder is common in psychiatric settings with a reported prevalence of 20%.As per NICE Guidance (CG 78), no medications have been found effective for the longer term treatment of personality difficulties.This audit was carried out to review if patients were offered psychiatric reviews to discuss the medications they are using, the effectiveness of these, and any potential side effects.ResultGood practice compliance of 90-100% was noted where >90% compliance was seen in areas where the effectiveness and tolerability of current and previous medication was reviewed by the clinicians under Structured Clinical Management. Also was noted that antipsychotics were not used for medium to long term in patients with Borderline Personality Disorder in the cohort.The following areas were non-compliant with the NICE recommendations where a compliance <79% has been achieved.When prescribing, use a single drug (avoid polypharmacy), agree target symptoms, monitoring and duration, provide written information, discuss evidence for effectiveness in treatment of borderline personality disorder.Partial compliance was achieved (80-89%) with use of sedatives for less than 1 week and discontinuation of ineffective treatment.ConclusionDistribute key cards to clinicians.Provide written information to patients.Re-audit in 6 months.

The Long-Term Course of the Symptoms of Borderline Personality Disorder

2018 ◽  
pp. 67-80
Author(s):  
Mary C. Zanarini
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Clinical Implications ◽  
Prevalence Rates ◽  
Symptom Trajectories ◽  
Self Mutilation ◽  
Over Time

This chapter reports on the prevalence rates of the 24 symptoms of BPD assessed in this study; prevalence rates that are declining over time. It also reports on rates of remission of each of these symptoms and rates of recurrence following periods of remission. The 24 symptoms are divided into 12 acute symptoms (e.g., self-mutilation, suicide efforts) and 12 temperamental symptoms (e.g., chronic feelings of anger, intolerance of aloneness). It was found that acute symptoms remit more rapidly and are less likely to recur. The clinical implications of these different symptom trajectories are discussed in detail.

Cognitive memory control in borderline personality disorder patients

2008 ◽  
Vol 39 (5) ◽  
pp. 845-853 ◽  
Author(s):  
M. Sala ◽  
E. Caverzasi ◽  
E. Marraffini ◽  
G. De Vidovich ◽  
M. Lazzaretti ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Abuse ◽  
Borderline Personality ◽  
Expected Improvement ◽  
Traumatic Experiences ◽  
Probe Test ◽  
History Of ◽  
Memory Control ◽  
Cognitive Memory

BackgroundIt has been demonstrated that the mechanism of cognitive memory control in humans is sustained by the hippocampus and prefrontal cortices, which have been found to be structurally and functionally abnormal in borderline personality disorder (BPD). We investigated whether the memory control mechanism is affected in BPD.MethodNineteen Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV BPD patients and 19 matched healthy controls (HC) performed a specific think/no-think paradigm exploring the capacity of remembering and suppressing pair of words previously learned. After the think–no think phase, the second member of each word pair has to be remembered either when subjects are presented with the cue word showed at the beginning of the test (Same Probe Test; SPT) or when they are presented with an extra-list categorical word (Independent Probe Test; IPT). We evaluated the effect of suppression and of retrieval activity on later retention of words.ResultsBoth on the SPT and on the IPT, HC showed the expected improvement of memory retrieval on to-be-remembered words, unlike BPD patients. On the SPT, HC, but not BPD patients, correctly recalled significantly more words among remembered words (RW) than among suppressed words (SW). Similarly to HC, subjects with BPD without a history of childhood abuse showed a significantly higher percentage of correctly recalled words among RW than among SW.ConclusionsThe mechanism of active retrieval of memories and of improvement through repetition is impaired in BPD, particularly in those who experienced traumatic experiences. This impairment might play an important role, possibly resulting in the emergence of unwanted memories and dissociative symptoms.

scholarly journals Borderline Personality Disorder: What Predicts Acute Psychiatric Readmissions?

2019 ◽  
pp. 1-13 ◽  
Author(s):  
Desiré Furnes ◽  
Rolf Gjestad ◽  
Lars Mehlum ◽  
Joanne Hodgekins ◽  
Rune A. Kroken ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Treatment Strategies ◽  
Term Treatment ◽  
Borderline Personality ◽  
Index Admission ◽  
Psychiatric Admission ◽  
Psychiatric Admissions ◽  
Long Term Treatment ◽  
Suicidal Thoughts And Behaviors

Individuals diagnosed with borderline personality disorder (BPD) often struggle with chronic suicidal thoughts and behaviors and have frequent acute psychiatric admissions. Prevention of serial admissions and disruptions in long-term treatment strategies is needed. This study explored predictors of how frequently and how quickly patients diagnosed with BPD are readmitted after an index psychiatric admission. The authors identified self-harming behavior as a predictor of readmission frequency, whereas depression and hallucinations and delusions predicted time elapsed between the index admission and the first readmission. The authors recommend that predictors of readmissions should be carefully monitored and treated following index admission.

scholarly journals A dopamine transporter polymorphism is a risk factor for borderline personality disorder in depressed patients

2006 ◽  
Vol 36 (6) ◽  
pp. 807-813 ◽  
Author(s):  
PETER R. JOYCE ◽  
PATRICK C. McHUGH ◽  
JANICE M. McKENZIE ◽  
PATRICK F. SULLIVAN ◽  
ROGER T. MULDER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Dopamine Transporter ◽  
Childhood Abuse ◽  
Borderline Personality ◽  
Developmental Risk ◽  
Repeat Allele ◽  
Depressed Patients ◽  
Developmental Risk Factors

Background. Borderline personality disorder (BPD) is often co-morbid with major depression and may complicate its treatment. We were interested in differences in genetic and developmental risk factors between depressed patients with or without a co-morbid BPD.Method. Out-patients with major depressive disorder were recruited for two treatment trials. Assessment of depressed patients included the assessment of personality disorders, developmental risk factors and DNA samples for genetic analyses.Results. In each study there was a significant association between the 9-repeat allele of the dopamine transporter (DAT1) and BPD, with odds ratios (OR) >3 and p[les ]0·02. This association remained significant when developmental risk factors for BPD (childhood abuse and neglect and borderline temperament) were also included in the analyses. The OR was even larger in the depressed patients aged [ges ]35 years (OR 9·31, p=0·005).Conclusion. This replicated association in depressed patients between the 9-repeat allele of DAT1 and BPD may provide clues to understanding the neurobiology of BPD. The finding that the association is larger in the older depressed patients, suggests that the 9-repeat allele may be associated with a poorer prognosis BPD, rather than a young adult limited variant of BPD.

Factors associated with borderline personality disorder in major depressive patients and their relationship to bipolarity

2013 ◽  
Vol 28 (8) ◽  
pp. 463-468 ◽  
Author(s):  
J.M. Azorin ◽  
A. Kaladjian ◽  
M. Adida ◽  
E. Fakra ◽  
R. Belzeaux ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Age At Onset ◽  
Borderline Personality ◽  
First Episode ◽  
Contributory Factor ◽  
Structured Interviews ◽  
Major Depressive ◽  
History Of ◽  
Depressive Patients

AbstractObjectiveTo analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.MethodsAs part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).ResultsCompared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.ConclusionsThe hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.

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