2006

Curr Opin Psychiatry. 2006; 19(4):428031
"Personality disorders and medical comorbidity"
Individuals with personality disorders don't feel as well medically and are more likely to have medical problems when their psychiatric problems are more symptomatic.

J Personal Disord 2006; 20(1):9-15 (Drs. Zanarini and Gunderson at Harvard)
"Reported childhood onset of self-mutilation among borderline patients"
32.8% of self mutilators started mutilating prior to age 13. These individuals problems with self mutilation were much worse. (Since the BPD appears to start at puberty when the brain's limbic system revs up, it would be significant to determine if these self mutilators had already started puberty or if the self mutilation considerably predated puberty - possibly as a symptom of childhood onset bipolar disorder).

Brain Inj 2006; 20(1):67-81
"Inhibition and object relations in borderline personality traits after traumatic brain injury (TBI)"
This study of 30 individuals with moderate to severe TBI compared to 30 normals showed post injury BPD traits to be rare and to be more significant regarding moods and pre-injury BPD trains rather than problems with inhibition control. (Note: in the 3.5 years of doing weekly BPD support groups I frequently asked about serious head injuries - approximately 50% had experienced at least one serious head injury.)

Int Clin Psychopharmacol 2006: 21(6):345-53
"Efficacy of pharmacotherapy against core traits of borderline personality disorder: meta-analysis of randomized controlled trials."
"Pharmacotherapy can exert a modest beneficial effect on some core traits of BPD." (Dose and combinations of medications are crucial, there is no "borderline drug.")

Psychol Med 2006; 36(8):1163-72
"The influence of emotions on inhibitory functioning in BPD"
"Our data suggest that individuals with BPD have difficulties in actively suppressing irrelevant information when it is of an aversive nature."

Emotion 2006; 6(4):647-55
"Heightened sensitivity to facial expressions of emotion in BPD"
"Overall, results appear to support the contention that heightened emotional sensitivity may be a core feature of BPD."

J Clin Psychiatry 2006; 67(7):1042-6
"Efficacy and tolerability of quetiapine in the treatment of BPD: A pilot study"
Seroquel (quetiapine) is effective and well tolerated for the BPD, particularly when impulsive / aggressive symptoms are prominent. (Note: I have found Seroquel (quetiapine) to be disappointing overall. Zyprexa (olanzapine), Risperdal, and Abilify (aripiprazole) have been more useful in my practice).

Am J Psychiatry 2006; 163(5):833-8
"Aripiprazole in the treatment of patients with BPD: a double-blind, placebo-controlled study."
"Abilify (aripiprazole) appears to be a safe and effective agent in the treatment of patients with BPD." (Note: while not as effective as Risperdal (risperidone) or Zyprexa (olanzapine), Abilify (aripiprazole) doesn't cause the weight gain and is my antipsychotic of choice for chronic use when long term antipsychotic medication is necessary.)

next: Example of Dr. Heller's office notes when assessing and treating an individual with the BPD