scholarly journals Bipolar vs. borderline - diagnosis is prognosis once again

2016 ◽  
Vol 133 (3) ◽  
pp. 171-173 ◽  
Author(s):  
S. N. Ghaemi
Keyword(s):  
2009 ◽  
pp. 43-59
Author(s):  
Paolo Migone

- After an introduction on the dimensional approach in personality diagnosis and on its use as an attempt at solving some of the problems of categorical diagnoses (such as those of DSM-III and DSM-IV), the main dimensional models of personality are presented, namely: 16 PF Questionnaire by Cattell, Eysenck Personality Inventory (EPI), Five-Factor Model (FFM) by Costa & McCrae (Big Five), Temperament and Character Inventory (TCI) by Cloninger, Schedule for Nondaptive and Adaptive Personality (SNAP) by Clark, Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ) by Livesley, Structural Analysis of Social Behavior (SASB) by Benjamin, the "fundamental polarity (anaclitic and introjective) of personality" by Blatt, Shedler-Westen Assessment Procedure (SWAP). Finally, advantages and disadvantages of dimensional models are discussed, with particular emphasis on borderline disorder.key words: personality, dimensional models, categorical model, borderline, diagnosis


1982 ◽  
Vol 27 (7) ◽  
pp. 585-592 ◽  
Author(s):  
Paul S. Links

The author discusses the validity of the borderline concept in terms of the recent empirical research. Five phases of exploration are reviewed; namely, clinical descriptions, laboratory studies, delineation from other disorders, follow-up studies, and family studies. These data are related to the current status of the diagnosis for clinical practice and to areas warranting further research. The conclusions reached show initial support for the validity of the borderline diagnosis. Descriptively, the literature tends to characterize these patients as having impulsivity, heightened affect, mild psychotic reactions and disturbed close relationships. Speculation about possible etiologies is felt to be premature and the identification of meaningful subgroups of patients within this syndrome is not yet possible. Further research using the objective scales in well-defined samples is felt to be required, as are family and prospective follow-up studies.


Author(s):  
Mary Zanarini

Borderline personality disorder (BPD) is still seen in many settings as a chronic disorder. This book details the ways that it is symptomatically a “good prognosis” diagnosis. This is particularly seen in the high rate of remissions of BPD and its constituent symptoms. The rate of suicide is also good news, as it is half the expected rate from four follow-back studies conducted in the 1980s. Areas with a more guarded prognosis, particularly for those who have not recovered, are poor physical health and poor vocational adjustment. In addition, rates of other deaths are increasing and have surpassed the rate of deaths by suicide. This book covers the following topics: History of the borderline diagnosis, models of the core features of BPD, earlier studies of the longitudinal course of BPD, the McLean Study of Adult Development (MSAD), the symptoms of BPD assessed in MSAD, the long-term course of the symptoms of BPD, symptomatic remissions and recurrences of the borderline diagnosis, prevalence and predictors of physically self-destructive acts over time, additional symptom areas over time, psychosocial functioning over time, recovery from BPD, predictors of time-to-remission and recovery, co-occurring disorders over time, mental health treatment over time, physical health and medical treatment, adult victimization over time, sexual issues over time, defense mechanisms over time, and new directions.


JAMA ◽  
1979 ◽  
Vol 241 (19) ◽  
pp. 1983b-1983
Author(s):  
J. P. Callan
Keyword(s):  

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kjerrumgaard ◽  
E M Jacobsen ◽  
B L Hansen ◽  
B G Winkel ◽  
A H Christensen ◽  
...  

Abstract Background Guidelines recommend clinical assessment of relatives to young sudden cardiac death (SCD) victims (<50 years) to protect the surviving relatives by pre-symptomatic interventions, in case the SCD was due to an inherited cardiac disorder. The etiology is an inherited cardiac disease in about 50% of young SCD cases. The work-up of relatives is generally guided by findings in the SCD victim. If post-mortem examinations (autopsies) have not been performed the work-up of relatives is challenged. The diagnostic hit-ratio of screening of relatives under these circumstances is unclear. Purpose To assess the diagnostic yield of inherited cardiac diseases of cardiac work-up in relatives of SCD victims, where no autopsy had been performed. Methods This retrospective study consecutively included families referred to our tertiary referral centre, specialised in hereditary cardiac diseases, during the period 2005 to 2018 due to SCD in the family. No autopsy had been performed in any of the SCD victims. The relatives underwent standard cardiac work-up according to guidelines. Based on the findings in the relatives the families were categorised into: 1) definite diagnosis, 2) borderline diagnosis or 3) undiagnosed. Results We assessed 149 relatives (43±16 age, 48% men) to 84 SCD un-autopsied cases (44±11 age, 79% men). In 11 (13%) families a definite diagnosis was established, in 8 (10%) families a borderline diagnosis was found and the remaining 65 (77%) families remained undiagnosed. The most common diagnosis was premature IHD (36%) followed by cardiomyopathies (27%) and channelopathies (27%). A disease-causing mutation was identified in 3 families out of 15 genetically examined families. Conclusion Systematic cardiac work-up of relatives to not-autopsied SCD victims, revealed a definite hereditary cardiac disease in 13% of the referred families, and a borderline diagnosis in additionally 10% of the families. Despite a reduced diagnostic yield in family members of non-autopsied SCD victims, work-up of relatives is clearly still justified.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B L Hansen ◽  
E M Jacobsen ◽  
A Kjerrumgaard ◽  
B G Winkel ◽  
A C Christensen ◽  
...  

Abstract Background International guidelines recommend screening of relatives in families with sudden cardiac death (SCD) if the cause of death is suspected to be an inheritable cardiac disease. The inheritable cardiac diagnosis may either have been known before the death, established at the autopsy or identified through screening of relatives. Purpose To provide an estimate of the diagnostic yield of inherited cardiac disease in SCD victims. Methods In an observational study, we included all families consecutively referred to our tertiary unit for inheritable cardiac diseases in the period from 2005 to 2018 due to SCD. Families with SCD victims under 1 year of age were excluded. In total, 697 relatives from 305 families were included and all relatives underwent a standard screening protocol, which included clinical and genetic work-up. Premortem medical records and postmortem findings on the SCD victim were ascertained whenever possible. Results A definite inheritable cardiac disease was identified in 113 out of 305 SCD families prior to family screening. The diagnosis was established through autopsy findings (n=89), genetic analysis (n=3) or was established prior to death (n=21). In the remaining 192 families with no or a borderline diagnosis only, screening of the relatives yielded a diagnosis in additional 28 families (15%). On a family-basis, a total of 141 out of 305 families (46%) were diagnosed. Seventy-seven (11%) out of the 697 screened relatives received either a phenotype-positive and/or genotype-positive inheritable diagnosis and 70 (10%) relatives received a borderline diagnosis. The most common diagnoses in the relatives were ARVC (n=17) followed by DCM (n=10) (see figure). Conclusion Almost half of SCD families were diagnosed with an inheritable cardiac disease of which one fifth of the families were diagnosed as a result of family screening. In 11% of the screened relatives a probable inheritable diagnosis was identified.


Sign in / Sign up

Export Citation Format

Share Document