Medline Research on the Borderline Personality Disorder
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Written by Dr. Leland Heller
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May 03, 2007 |
A + A - RESET
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Page 17 of 18
Neuroreport 2005; 16(3):289-93
"Distinct pattern of P3a event-related potential in BPD"
"...distinctive disturbances in P3a in (unmedicated) BPD patients were found: abnormally enhanced amplitude, failure to habituate and a loss of temporal locking with P3b."
Dev Psychopathol. 2005; 17(4):1197-206
"Defining the neurocircuitry of BPD: functional neuroimaging approaches"
"Functional neuroimaging...is beginning to identify abnormal frontolimbic circuitry..."
Clin Neurophysiol. 2005; 116(6):1424=32
"BPD features in adolescent girls: P300 evidence of altered brain maturation."
"The present findings suggest abnormal brain maturation among adolescent girls exhibiting features of BPD."
J Psychiatr Res. 2005; 39(5);489-98
"Increased delta power and discrepancies in objective and subjective sleep measurements in BPD"
"BPD patients showed a tendency for shortened REM latency and significantly decreased NonREM sleep (stage 2)...There was a marked discrepancy between objective and subjective sleep measurements, which indicates an altered perception of sleep in BPD."
Am J Psychiatry 2005; 162(12):2360-73
"BPD, impulsivity, and the orbitofrontal cortex"
"The patients with orbitofrontal cortex lesions and the patients with BPD performed similarly on several measures. Both groups were more impulsive and reported more inappropriate behaviors."
(Note: the orbitofrontal cortex is considered part of the limbic system)
Am J psychiatry. 2005; 162(3):621-4
"Impact of trait impulsivity and state aggression on divalproex versus placebo response in BPD"
Depakote (divalproex, valproic acid or valproate) was superior to placebo for impulsive aggressiveness.
Psychiatr Serv. 2005; 56 (2): 193-7
"Intensive dialectical behavior therapy for outpatients with BPD who are in crisis"
"The three-week, intensive version of dialectical behavior therapy was found to be an effective treatment. Treatment completion was high, and patients showed statistically significant improvements in depression and hopelessness measures."
J Clin Psychiatry 2005; 66(9):1111-5
"Oxcarbazepine in the treatment of BPD: a pilot study"
Trileptal (oxcarbazepine), a variation of the Tegretol (carbamazepine) molecule, is an option for treating the BPD. 25% of those with significant side effects from Tegretol (carbamazepine) can have the same side effects from Trileptal (oxcarbazepine). (low sodium, low magnesium and allergic reactions are concerns).
Am J Psychiatry. 2005; 162(5):883-9
"Two-year prevalence and stability of individual DSM-IV criteria for schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders: toward a hybrid model of axis II disorders."
"The most prevalent and least changeable criteria over 2 years were mood swings (affective instability) and anger for BPD. The least prevalent and most changeable criteria were self-injury and behaviors defending against abandonment for BPD."
Am J Psychiatry 2006; 163(5);827-32
"Prediction of the 10-year course of BPD"
88% of 290 inpatients studied achieved remission over 10 years. The best predictors of remission were younger age, absence of childhood sexual abuse, no family history of substance use disorder, good vocational record, absence of an anxious cluster personality disorder, low neuroticism, and high agreeableness.
("Remission" is a challenging concept in dealing with the BPD. Some authorities base it on prevalence of DSM criteria, some the absence of suicide attempts or self mutilation, others on interviews, sometimes it's based on the severity of symptoms. Mood swings, anger (which can be self directed) and episodes of dysphoria (anxiety, rage, depression and despair) generally persist. In my experience, the medical BPD symptoms persist for most patients throughout life unless medically treated, although they can be expressed differently. Stress can bring on symptoms that are under control without that stress. The 88% statistic may be based to a large degree on preadmission substance problems, especially alcohol. Alcohol alone can cause BPD symptoms, can markedly worsen the BPD, and frequently leads to hospital admission. In the 18 years I've been treating BPD patients, I've found psychiatric hospitalization to be a rare phenomenon. The patients studied in this group may represent a skewed population).
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Last Updated( Feb 18, 2010 )
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reviewed by:
Harry Croft, MD (Psychiatrist)
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