A current view of the interface between borderline personality disorder and depression

Article Abstract:

Borderline personality disorder and depression have been thought by many researchers to be related disorders. Until recently, most available evidence supported the hypothesis that the two were related in a nonspecific fashion. However, more recent evidence challenges this view. Although depression may occur in many patients with borderline personality disorder, depression occurs at the same or higher rate among patients with other axis II personality disorders. Also, the high prevalence of depression in borderline personality disorder patients may be partially attributed to shared diagnostic criteria. Recent studies have indicated that the symptoms of depression experienced by borderline personality disorder patients differ from those experienced by patients without borderline personality disorder. Depression in borderline personality disorder patients often appears to be triggered by interpersonal rejection. Previous studies examining the prevalence of affective disorders in families of patients with borderline personality disorder reported higher rates of affective disorders than expected. Such findings supported the relationship between depression and borderline personality disorder. These studies have since been reviewed and similar studies have been performed in which borderline personality disorder patients were subdivided into two groups, those with and those without an affective disorder. The results indicated the higher rates of depression in relatives were associated with a concurrent affective disorder, but not the borderline personality disorder. Studies have also compared the responses of borderline personality disorder and patients with classic depression to medication. Borderline personality disorder patients did show some response to antidepressant therapy, but the response was less specific and not as profound as the response of those with classic depression. Studies examining biological markers indicative of depression and borderline personality disorder have not shown a close biologic relationship between the two conditions. The present data indicate that although depression and borderline personality disorder can coexist, evidence for a relationship between the two is very weak. (Consumer Summary produced by Reliance Medical Information, Inc.)

Depression, Mental, Depression (Mood disorder)

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Cognitive features of borderline personality disorder

Article Abstract:

Although clinical interest in the borderline personality disorder has grown since it was first described 50 years ago, its cognitive characteristics have not been adequately described. The borderline personality subtype coded on Axis II of the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R) displays both neurotic and psychotic characteristics. The cognitive status and psychotic thought processes of outpatients with borderline personality disorder were compared with those of other Axis II patients, schizophrenics, and normal control subjects. All patients with borderline personality disorder reported having disturbed thoughts, while patients in the other two categories reported less thought disturbance (71 per cent for those with other Axis II disorders and 66 per cent for the schizophrenic patients). Odd thinking, unusual perceptions, and nondelusional paranoia were the three types of cognitive disturbance that composed the category of disturbed thought. The patients with borderline personalities also reported more quasi-psychotic thought (transient or limited delusions and hallucinations, in contrast to the frequent, persistent delusions typical of true psychosis that a schizophrenic experiences). It is possible that these characteristics, a high incidence of quasi-psychotic thought, general disturbed thought patterns, and a low incidence of true psychotic thought, are good criteria for the diagnosis of borderline personality. (Consumer Summary produced by Reliance Medical Information, Inc.)

Schizophrenia, Cognition disorders, Cognitive disorders

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Discriminating borderline personality disorder from other axis II disorders

Article Abstract:

A recent study compared 120 patients diagnosed with borderline personality disorder with 103 patients with a variety of other axis II disorders. Axis II refers to a general category consisting of a variety of personality disorders, including borderline personality disorder, which is described in the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R). A total of 22 clinical features were assessed for each individual. Overall, three major categories of clinical features emerged, including specific features, nonspecific but highly discriminating features, and common but nondiscriminating features. Seven characteristics that were specific to borderline personality disorder were as follows: quasi-psychotic thought; manipulative suicide efforts; self-mutilation; feelings of abandonment, engulfment, or concerns for annihilation; feelings of entitlement; regression in treatment; and difficulties in transference (substitution of another individual, such as the therapist, as the object of repressed impulses). These seven specific features may be considered useful markers for the condition, and these results support the belief that borderline personality disorder is a distinct illness with distinguishable clinical features. However, the several areas of nonspecificity that were evident indicate misdiagnosis of borderline personality disorder may frequently occur. (Consumer Summary produced by Reliance Medical Information, Inc.)

Personality disorders

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