H W Koenigsberg — Page 2

PubMed1983

Diagnosing borderline conditions in an outpatient setting.

Application of the Gunderson-Kolb Diagnostic Interview for Borderline to a population of psychiatric outpatients suggested two complicating factors in diagnosing borderline conditions in an ambulatory setting: the reduced level of borderline symptoms and the confounding presence of recompensated psychotic patients. Overlap between the Gunderson and Kernberg borderline constructs, which is relatively high in the inpatient setting, is diminished in the outpatient setting. Contrary to expectation, distinguishing borderline patients from patients with other personality disorders was not a source of difficulty.

Adolescent↗

PubMed1982

A comparison of hospitalized and nonhospitalized borderline patients.

The author compared 14 hospitalized borderline patients with 24 nonhospitalized patients given the same diagnosis. Twenty-nine clinical features of borderline patients were examined using the semistructured Diagnostic Interview for Borderlines. Although a few specific differences emerged in such areas as drug abuse, self-mutilation, and psychotherapy experience, both hospitalized and nonhospitalized patients manifested characteristic borderline traits of disturbed impulse-action patterns, psychotic experiences, poor regulation of affect, and disturbed interpersonal relationships. These findings are consistent with those of other studies and suggest that hospitalized and nonhospitalized borderline patients represent the same diagnostic entity.

Adolescent↗

PubMedDate not supplied

Affective instability and impulsivity in borderline personality and bipolar II disorders: similarities and differences.

OBJECTIVES: many studies have reported a high degree of comorbidity between mood disorders, among which are bipolar disorders, and borderline personality disorder and some studies have suggested that these disorders are co-transmitted in families. However, few studies have compared personality traits between these disorders to determine whether there is a dimensional overlap between the two diagnoses. The aim of this study was to compare impulsivity, affective lability and intensity in patients with borderline personality and bipolar II disorder and in subjects with neither of these diagnoses. METHODS: patients with borderline personality but without bipolar disorder (n=29), patients with bipolar II disorder without borderline personality but with other personality disorders (n=14), patients with both borderline personality and bipolar II disorder (n=12), and patients with neither borderline personality nor bipolar disorder but other personality disorders (OPD; n=93) were assessed using the Affective Lability Scale (ALS), the Affect Intensity Measure (AIM), the Buss-Durkee Hostility Inventory (BDHI) and the Barratt Impulsiveness Scale (BIS-7B). RESULTS: borderline personality patients had significantly higher ALS total scores (P<0.05) and bipolar II patients tended to have higher ALS scores than patients with OPD (P<0.06). On one of the ALS subscales, the borderline patients displayed significant higher affective lability between euthymia and anger (P<0.002), whereas patients with bipolar II disorder displayed affective lability between euthymia and depression (P<0.04), or elation (P<0.01) or between depression and elation (P<0.01). A significant interaction between borderline personality and bipolar II disorder was observed for lability between anxiety and depression (P<0.01) with the ALS. High scores for impulsiveness (BISTOT, P<0.001) and hostility (BDHI, P<0.05) were obtained for borderline personality patients only and no significant interactions between diagnoses were observed. Only borderline personality patients tended to have higher affective intensity (AIM, P<0.07). CONCLUSIONS: borderline personality disorder and bipolar II disorder appear to involve affective lability, which may account for the efficacy of mood stabilizers treatments in both disorders. However, our results suggest that borderline personality disorder cannot be viewed as an attenuated group of affective disorders.

Adult↗