Q. My eleven year old son was some months ago diagnosed Obsessive Compulsive Disorder through a SPECT Cerebral HMPAO and upon further recommendation from the doctor at the clinic and my son’s psychiatrist he also had the SPEC Cerebral Wisconsin done. The second test showed that the Obsessive Compulsive area diminished but another area was revealed showing Slight Borderline Symptoms. He scored 98 % on the Wisconsin Card Sorting Test. The treatment suggested by the psychiatrist and the psychologist is a combination of medication and psychotherapy. My son has now been taking Haldol (3/4 of a 0,5mg. tablet in the morning and the same doses at night.) Psychotherapy is once a week. I have with great interest read the answers you have given to a lot of letters. None however mentions the SPECT-test as a way of making a diagnose. My son’s clinical symptoms began September last year when he started to have some problems in school with a specific teacher. He started to have breathing problems and chest-pains and for the first time in life he did not want to go to school. I ended up in the emergency-room first time he had what I was told was an anxiety-attack. His life-attitude became negative, he started to have destructive thoughts and claimed that nobody loved him. He would a outbursts of anger from small incidents and hardly slept at night. The school admitted that they had not handled his incident with the teacher the correct way, they harassed him for quite some time. My son has his whole life been a very active child, who has slept extremely little(5 hours till he was app.3.5 years old) and badly. He is very intelligent, has always been one of the best students academically but the kind of boy who drives certain teachers up the wall and for that same reason is punished verbally and by being sent to the director’s office. He is hyper-hyper-sensitive even though he gives the impression of being a tough little boy with very strong opinions. How can I be sure that we are on the right road. I have read a lot about Borderline personality. I agree my son has some of the symptoms but then at the same time I think he could be suffering from a Post Traumatic Disorder. How much can I trust the SPECT.
Haldol has done him good, he himself claims that too. "Now I do not get angry and I sleep much better" .He has ,after quite a battle agreed to collaborate with the psychologist .
We live in Chile, and I am afraid, we do not have too much information about Borderlines down here. I get most of my information from Internet.
I would really appreciate if you could give me your opinion about the SPECT and the combination-treatment we have been told to follow.
A. To my knowledge no medical or psychological tests are available to accurately diagnose the BPD.
PTSD (post traumatic stress disorder) and the BPD have an enormous correlation, but the details have not been worked out yet.
As with everyone else he needs a thorough diagnostic evaluation and plan of medical treatment. Common problems he may be experiencing include panic and dysthymia with rejection sensitivity - they warrant your investigation.