Psychiatry - August 2008 - (Page 18)

The Interface such that proliferative psychiatric or medical symptoms are diagnostically relevant? We discuss these issues and conclude that the number of symptoms is an unacknowledged but important diagnostic feature in borderline personality disorder. INTRODUCTION Borderline personality is a dramatic Axis II disorder that affects anywhere from 2 to 10 percent of the general population.1,2 In primary care settings, the prevalence rate is around seven percent,3 whereas in psychiatric settings, the rates are considerably higher, up to 50 percent among inpatients.4 These data indicate that borderline personality disorder (BPD) is a relatively common psychiatric phenomenon—one that emerges frequently in both psychiatric and primary care settings. From a historical perspective, the diagnostic formulation of this disorder has been challenging. Specifically, various clinicians and investigators have attributed differing clinical characteristics to patients with BPD, which has contributed to the general diagnostic angst. In this article, we offer a possible explanation. BORDERLINE PERSONALITY DISORDER: Are Proliferative Symptoms Characteristic? by Randy A. Sansone, MD, and Lori A. Sansone, MD Psychiatry (Edgemont) 2008;5(8):18–21 This ongoing column is dedicated to the challenging clinical interface between psychiatry and primary care—two fields that are inexorably linked. THE HISTORICAL DIAGNOSIS OF BPD Understandably, clinicians have historically diagnosed patients with BPD in terms of specific psychological patterns and symptoms. However, the symptom constellations associated with BPD have varied considerably over time. For example, Stern5 identified 10 clinical symptoms associated with BPD, including narcissism, hypersensitivity, masochism, and disturbances in reality testing. Deutsch6 highlighted BPD symptomatology in the context of interpersonal functioning. Specifically, she noted that while individuals with BPD appear to function normally in brief social interactions (as if they were normal), they exhibit an underlying pathological style of relatedness with ABSTRACT Borderline personality is an Axis II disorder that has historically encompassed a number of different psychiatric symptoms. In empirical studies, these multiple psychiatric symptoms appear to manifest as 18 Psychiatry 2008 [ A U G U S T ] numerous comorbid Axis I and II diagnoses. In echoing these findings in primary care settings, individuals with borderline personality exhibit prolific somatic symptoms. Rather than the type of symptom, are the number of symptoms suggestive of this disorder,

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Psychiatry - August 2008 Editor’s Message Editorial Advisory Board Contents Borderline Personality Disorder: Are Proliferative Symptoms Characteristic? Short-acting versus Long-acting Medications for the Treatment of ADHD Baby Stimuli and the Parent Brain: Functional Neuroimaging of the Neural Substrates of Parent-Infant Attachment These Boots Are Made for Stalking: Characteristics of Female Stalkers Managing Attention Deficit Hyperactivity Disorder in the Emergency Department Obstructive Sleep Apnea, Hypoxia, and Metabolic Syndrome in Psychiatric and Nonpsychiatric Settings Improving the Quality of Life in Patients with Alzheimer’s Disease The Process of Getting New Drugs to Market Journal Watch Classified Advertising Information for Authors

Psychiatry - August 2008

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