When Your Loved One Has Borderline Personality Disorder
In young and middle-aged humans caused brain atrophy, and the atrophy was reversed in several patients when steroids were no longer used 144 . As mentioned, patients with high Cortisol levels due to Cushing's syndrome have small hippocampal volumes 134 but hippocampal volumes increase after treatment to reduce Cortisol levels 135 . Smaller hippocampal volumes have been reported in patients with stress-related psychiatric disorders including PTSD 145 , borderline personality disorder with abuse 146 , and depression 147 , and dissociative identity disorder 148 .
Low MAO levels are also found in various forms of psychopathology, including attention-deficit hyperactivity disorder, antisocial and borderline personality disorders, alcoholism and drug abuse, pathological gambling disorder, and paranoid schizophrenia (see Table 3.2). With the possible excep- High sensation seeking (normal trait) Attention-deficit hyperactivity disorder Antisocial personality disorder Chronic criminality Borderline personality disorder Alcoholism
Similarly, even though the reductions in P300 amplitude observed during withdrawal from either heroin, cocaine or ethanol (Poijesz et al., 1987 Kouri et al., 1996 Bauer, 1997 Noldy and Carlen, 1997) are very similar to those observed in a number of psychiatric disorders including dementia (Pfefferbaum et al., 1984) schizophrenia (Roth et al., 1980), depression (Diner et al., 1985) and borderline personality disorder (Kutcher et al., 1987), this lack of diagnostic specificity of the P300 has provided important information on the similarities between acute withdrawal from drugs of abuse and these other psychiatric disorders.
Consistent with these sex differences in personality traits, there are sex differences in the epidemiology of stress-related psychiatric disorders, including personality disorders. Men are prone to externalizing disorders characterized by aggressive, dyscontrolled behaviors, such as substance use disorders and antisocial personality disorder. In contrast, women have higher rates of internalizing disorders, including anxiety disorders, depression, and borderline personality disorder (Sinha & Rounsaville, 2002 Paris, 2004). Sex differences in the literature on coping strategies provide further confirmation of the externalizing and internalizing trends, as men tend to respond to stress
Another topic of heated controversy is whether bipolar disorder is over-diagnosed at the expense of personality disorders, such as borderline personality disorder (Akiskal 2004 Birnbaum 2004 Magill 2004 Paris 2004 Smith et al. 2004). While this argument has been made based on case reports (Bolton and Gunderson 1996), no empirical evidence has been published to that effect. On the other hand, there is extensive re search that borderline personality disorder is overdiagnosed in patients with abnormal and or unstable moods, with frequent resolution of borderline traits when the mood episode resolves with antidepressants or mood stabilizers (Frankenburg and Zanarini 2002 Preston et al. 2004). Thus, the empirical evidence again seems to suggest a need to abstain from diagnosing borderline personality disorder in individuals with major depressive and manic or hypomanic episodes. Instead, it makes sense clinically to treat their mood episodes. If those episodes resolve and the individual...
Dysmorphic patients are those obsessively preoccupied with real or imaginary defects. They take great measures to point out defects which are not viewed by the physician. In general, those defects are minor but are perceived by them to be disfiguring. The inability to deal with unavoidable scars is also a warning that dissatisfaction may rise after the cosmetic procedure. Some patients do have a real psychiatric or emotional disorder. Patients with borderline personality, obsessive-compulsive and narcissistic disorders should be avoided.
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