Structural Brain Abnormalities In Those With BPD
Frontolimbic brain abnormalities in patients with borderline
personality disorder: a volumetric magnetic resonance imaging
study.
We found a significant reduction of hippocampal and amydgala
volumes in borderline personality disorder. There was a
significant 24% reduction of the left orbitofrontal and a 26%
reduction of the right anterior cingulate gyrus.
Biol Psychiatry 2003 Jul 15;54(2):163-71
A study of 21 women with BPD showed that
those with BPD had a 16% reduction in
size of a crucial limbic system component - the
hippocampus. This may partly explain the
memory problems those with BPD usually experience
since the hippocampus is a critical
location for memory. The reduction in
hippocampus size was directly correlated with the
severity of childhood trauma.
The amygdala may have a reduced size as well,
but this has not been
scientifically proven at this time. The
amygdala is another limbic system structure
strongly correlated with an emotional response
to the environment, particularly anger and
rage.
Archives of General Psychiatry, December 2000.
2004
Int J Psychophysiol 2004 Jun;53(1):57-70
"Effects of BPD features and a family history of alcohol or drug dependence on P300 in adolescents."
The "P300 amplitude" (a measurement found on a brain wave test - EEG) is associated with BPD symptoms during adolescence.
Psychiatry Res 2004 Jul 30;131(2):125-33
"Anatomical MRI study of BPD patients"
This study also found diminished hippocampal volumes. Putamen enlargement seems to be due to substance use disorders.
Prog Neuropsychopharmacol Biol Psychiatry 2004 Mar;28(2):329-41
"Neurocognitive function in BPD."
Neuropsychological testing implied a dysfunction in the right hemisphere frontotemporal region in BPD individuals.
Psychiatry Res 2004 Jan 1;121(3):239-52
"Neurobiological correlates of diagnosis and underlying traits in patients with BPD compared with normal controls."
Psychological and neurotransmitter testing suggest that serotonin system abnormalities are associated with impulsive traits.
Biol Psychiatry 2004 Apr 1;55(7):759-65 (from Germany)
"A positron emission tomography study of memories of childhood abuse in BPD"
"Dysfunction of dorsolateral and medial prefrontal cortex, including anterior cingulate, seems to be correlated with the recall of traumatic memories in women with BPD. These brain areas might mediate trauma-related symptoms, such as dissociation or affective instability, in patients with BPD."
2005
Curr Psychiatry Rep. 2005; 7(1):65-72
"Neuroimaging and personality disorders"
"Functional and structural studies provide support for
dysfunction in fronto-limbic circuits in BPD and APD, whereas temporal
lobe and basal striatal-thalamic compromise is evident in schizotypal
personality disorder.
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)
2007
J Neuropsychiatry Clin Neurosci 2007 Fall;19(4):383-90
"Frontal white matter integrity in BPD with self-injurious
behavior"
"Women with BPD self-injurious behavior exhibit decreased white
matter microstructural integrity in inferior frontal brain regions
that may include components of orbito-frontal circuitry."
(Another study showing BPD neurological abnormalities. The
orbito-frontal cortex is part of the limbic system.)
Psychiatry Res 2007 Nov 15;156(2):139-49 (from Germany)
"Size abnormalities of the superior parietal cortices are
related to dissociation in BPD"
"Recent evidence suggests that BPD is related to reduced size of
the parietal lobe. Dissociative symptoms occur in the majority of
individuals with BPD. ...Compared with control subjects, BPD subjects
had significantly smaller right-sided precuneus (-9%) volumes. The
left postcentral gyrus of BPD subjects with the comorbid diagnosis of
dissociative amnesia or dissociative identity disorder (DID) was
significantly increased compared with controls (+13%) and compared
with BPD subjects without these disorders (+11%). In BPD subjects,
stronger depersonalization was significantly related to larger right
precuneus size. Possibly, larger precuneus size in BPD is related to
symptoms of depersonalization. Increased postcentral gyrus size in
BPD may be related to the development of dissociative amnesia or
dissociative identity disorder (DID) in the presence of severe
childhood abuse."
(Note: most borderlines do not have dissociative symptoms or
dissociative amnesia, and DID is extremely rare, although everyone
I’ve treated for DID also had the BPD. None-the-less this is an
important study furthering the biological basis of the BPD. The
"precuneus" is a portion of the brain’s parietal lobe,
believed by many to be part of the limbic system.)
J Psychiatr Res 2007 Sep 7 (e-published, published in July 2008)
"Frontolimbic structural changes in BPD"
"Frontolimbic dysfunction is observed in BPD, with responses to
emotional stimuli that are exaggerated in the amygdala and impaired
in the anterior cingulate cortex (ACC)." CONCLUSIONS:
"This sample of BPD patients exhibits gross structural changes
in gray matter in cortical and subcortical limbic regions that
parallel the regional distribution of altered functional activation
to emotional stimuli among these same subjects."
Actas Esp Psiquiatr 2007 Aug 13 (from Spain)
"Association between the serotonin transporter gene and
personality traits in BPD patients evaluated with Zuckerman-Kuhlman
Personality Questionnaire (ZKPQ)"
"The results suggest a significant association between the 5-HTT
(serotonin transporter) gene and some personality traits in
BPD."
J Psychiatry Neurosci 2007 Jul;32(4):234-40 (from Germany)
"[I-123] ADAM and SPECT in patients with BPD and healthy control
subjects"
"The study provides evidence of a serotonergic dysfunction in
patients with BPD and suggests a serotonergic component in the
pathophysiology of the disorder SERT (serotonin transporter) binding
reflected the level of impulsiveness as a common feature in
BPD."
(Note: low spinal fluid serotonin metabolite levels are strongly
associated with suicidal and impulsive homicidal behavior with or
without the BPD, and borderlines without strong suicidal ideation
have normal levels)
Psychiatry Res 2007 Aug 15;155(3);231-43
"Fronto-limbic dysfunction in response to facial emotion in BPD:
an event-related fMRI study"
"We conclude that adults with BPD exhibit changes in
fronto-limbic activity in the processing of fear stimuli, with
exaggerated amygdala response and impaired emotion-modulation of
anterior cingulate cortex activity.
Actas Esp Psiquiatr 2007 Nov-Dec;35(6):387-92 (from Spain)
"Serotonin transporter polymorphism and fluoxetine effect on
impulsiveness and aggression in BPD"
"L-allele carriers responded better to fluoxetine than S
carriers, in a way as in depression."
(Note: this study compared the "short allele {S}" to the
{L} allele for the serotonin transporter gene. In my experience
Prozac (fluoxetine) is extraordinarily important for BPD treatment,
although sometimes high doses are needed. Some individuals with BPD
need Tegretol (carbamazepine) in combination with Prozac
(fluoxetine), and a genetic study of this combination with the S
allele should be interesting. A similar study with high doses of
Effexor (venlafaxine) warrants investigation).
Biol Psychiatry 2007 Sep 15;62(6):580-7
"5HT2A receptor binding is increased in BPD"
"Postmortem studies in suicide victims demonstrate an increase
in the number of post synaptic 5-HT(2A) receptor binding sites in
ventral lateral and orbital frontal cortex. Diminished metabolic
responses to serotonergic activation are noted in these areas in
impulsive subjects with BPD, a group at high risk for suicidal
behavior." Conclusions: "5HT(2A) receptor binding is
increased in the hippocampus of BPD subjects independent of depressed
mood, impulsivity, aggression, suicidality or childhood
abuse."
Psychiatr Genet 2007 Jun 17(3):153-7 (from Canada)
"Monoamine oxidase a gene is associated with BPD"
"We found that the BPD patients had a high frequency of the high
activity VNTR alleles and a low frequency of the low activity
haplotype."
Br J Psychiatry 2007 Apr; 190:357-8 (from Spain)
"Hypothalamic-pituitary-adrenal axis response in BPD without
post-traumatic features."
"Baseline cortisol levels in the patients were ... lower than in
the controls. The 0.25mg dexamethasone suppression test reveals
increased feedback inhibition of the HPA in BPD."
Neurosci Lett 2007 Apr 24;417(1):36-41 (from Germany)
"Evidence of disturbed amygdalar energy metabolism in patients
with BPD"
"Confirming earlier reports we found a significant 11-17%
reduction of amygdalar volumes in patients with BPD. In addition
there was a significant 17% increase in left amygdalar creatine
concentrations in BPD patients."
Psychiatry Res 2007 Feb 28;154(157-70) (from Germany)
"Hippocampal volume reduction and history of aggressive behavior
in patients with BPD"
"Hippocampal grey matter volume was significantly decreased in
BPD patient: the reduction was more pronounced in patients with
multiple hospitalizations."
Neuroimage 2007 Apr 1;35(2):738-47 (from Germany)
"Inferior frontal white matter microstructure and patterns of
psychopathology in women with BPD and comorbid ADHD"
"Inferior frontal white matter microstructural abnormalities may
be linked to key aspects of psychopathology in women with BPD and
comorbid ADHD and add to alternations in orbitofrontal and limbic
areas. The relationship between neuropsychological functioning and
white matter structure remains unclear. "
Biol Psychiatry 2007 Aug 1:62(3):250-5
"Exaggerated affect-modulated startle during unpleasant stimuli
in BPD"
"The BPD patients exhibited larger startle eyeblink during
unpleasant but not neutral words, indicating exaggerated
physiological affect. This finding remained significant when we
controlled for comorbid diagnoses, including generalized anxiety
disorder and PTSD (post traumatic stress disorder). Greater symptom
severity was associated with greater affective-startle difference
scores. CONCLUSIONS: Consistent with the symptom of affective
dysregulation, these results suggest an abnormality in the processing
of unpleasant emotional stimuli by BPD patients."
Psychol Med 2007 Jul;37:971-81 (from Germany)
"Enhanced emotion-induced amnesia in BPD"
"BPD patients displayed enhanced retrograde and anterograde
amnesia in response to presentation of negative stimuli, while
positive stimuli elicited no episodic memory-modulating effects.
Neuropsychopharmacology 2007 Jul, 32 (7):1629-40
"Amygdala-prefrontal disconnection in BPD"
"We demonstrated a tight coupling of metabolic activity between
right orbitofrontal cortex and ventral amygdala in healthy subjects
with dorsoventral differences in amygdala circuitry, not present in
impulsive aggressive BPD. We demonstrated no significant differences
in amygdala volumes or metabolism between BPD patients and
controls."
Psychiatry Res 2007 Jan 15;149(1-3):139-45
"Early visual information processing deficit in depression with
and without BPD"
"Poor early information processing appears to be a feature of
BPD, and may play a role in the impulsive behavior that is
characteristic of the disorder"
2009
J Pers Disord 2009 Dec;23(6):555-62 (from Hungary)
"The neuropsychology of BPD (borderline personality disorder):
relationship with clinical dimensions and comparison with other
personality disorders."
"Borderline patients showed deficient attention, immediate and delayed
memory, and relatively spared visuospatial and language functions
compared with controls. ... The neuropsychological deficit significantly
correlated with the impulsivity sector score of the Zanarini Rating
Scale for Borderline Personality Disorder. ... These results suggest the
borderline patients are impaired in neuropsychological domains sensitive
for frontal and temporal lobe functioning, and this deficit is related
to impulsivity."
J Neural Transm 2009 Sep;1185-8 (from Germany)
"Association analysis of serotonin receptor 1B (HTR1B) and brain-derived
neurotrophic factor gene polymorphisms in borderline personality
disorder."
"Logistical regression analyses revealed an over-representation of the
BDNF 196A allele in HTR1B A-161 allele carrying BPD patients."
J Psychiatry Neurosci 2009 Jul;34(4):289-95 (from Germany)
"Hippocampus and amygdala volumes in patients with borderline
personality disorder with or without posttraumatic stress disorder."
"Comorbid PTSD may be related to volumetric alterations in brain regions
that are of central importance to our understanding of borderline
psychopathology."
J Psychiatry Neurosci 2009 May;34(3):214-22 (from Germany)
"Emotional learning during dissociative states in borderline personality
disorder"
"Emotional, amygdala-based learning processes seem to be inhibited
during state dissociative experience."
Psychiatry Res 2009 Feb 28;171(2):94-105 (from Germany)
"Neural correlates of episodic and semantic memory retrieval in
borderline personality disorder: an fMRI study."
"Our findings suggest that BPD patients may need to engage larger brain
areas to reach a level of performance in episodic and semantic retrieval
tasks that is comparable to that of healthy controls."
Psychoneuroendocrinology 2009 Apr;34(3):353-7
"Angiogenic factors in patients with current major depressive disorder
comorbid with borderline personality disorder"
"Depressive episodes in the context of borderline personality disorder
may be accompanied by increased serum concentrations of VEGF (vascular
endothelial growth factor) and FGF-2 (fibroblast growth factor-2).
Similar findings have been observed in patients with major depression
without a borderline personality disorder. A dysregulation of angiogenic
factors may be another facet of the endocrine and immunologic
disturbances frequently seen in patients with depressive episodes."
Biol Psychiatry 2009 May 1;65(9):819-22 (from Germany)
"Amygdala deactivation as a neural correlate of pain processing in
patients with borderline personality disorder and co-occurrent post
traumatic stress disorder"
"Amygdala deactivation seems to differentiate patients who meet criteria
for both BPD and PTSD from BPD patients without co-occurrent PTSD."
Psychoneuroendocrinology 2009 May;34(4):571-86 (from Germany)
"Neural correlates of the individual emotional Stroop in borderline
personality disorder"
"These results provide further evidence for a dysfunctional network of
brain areas in BPD, including the anterior cingulate cortex and frontal
brain regions."
Am J Med Genet B Neuropsychiatr Genet 2009 Jun 5;150B(4):487-95 (from
Germany)
"Interaction between gene variants of the serotonin transporter promoter
region (5-HTTLPR) and catechol O-methyltransferase (COMT) in borderline
personality disorder."
"These data suggest an involvement of altered dopaminergic and/or
noradrenergic neurotransmission as well as an interactive effect of COMT
and 5-HTTLPR gene variants in the etiology of BPD, and underline the
usefulness of analyses of gene-gene effects in disease of complex
inheritance with multiple genes involved."
Psychol Med 2009 May;39(5):855-64 (from Germany)
"Negative bias in fast emotion discrimination in borderline personality
disorder"
"Our data suggest a selective deficit in BPD patients in rapid and
direct discrimination of negative and neutral emotional expressions that
may underlie difficulties in social interactions."
2010
Pain Res Manag 2010
Nov-Dec;15(6):369-70
"Disability and borderline
personality disorder in chronic pain
patients"
"Findings suggest that among chronic
pain patients, there may be no
meaningful relationship between
having every been on medical
disability and borderline
personality symptomatology"
J Nerv Ment Dis. 2010
Dec;198(12):914-5
"Self-harm behaviors in borderline
personality: an analysis by gender"
Head banging and losing a job on
purpose were more common in men,
otherwise there were no gender
differences.
Am J Psychiatry 2010
Oct;167(10:1210-7
"Impact of co-occurring
posttraumatic stress disorder on
suicidal women with borderline
personality disorder"
The results indicate greater
impairment among individuals with
both disorders.
J Pers Disord 2010 Dec:24 (6):812-22
"Co-morbid ADHD in borderline
patients defines an impulsive
subtype of borderline personality
disorder"
In this study from Spain they found
ADHD was comorbid with BPD 38% of
the time (I suspect that number is
higher). The combination had a 55%
higher risk of substance abuse.
Interestingly they found that those
with the combination didn't have the
avoidant personality disorder.
Biol Psychiatry 2010 Dec 20 (From
Germany)
"Neuronal correlates of cognitive
reappraisal in borderline patients
with affective instability.
"Patients demonstrated enhanced
activation of left amygdala and
right insula during the initial
viewing of aversive stimuli."
While
attempting to diminish the excessive
reaction, the left orbitofrontal
cortex didn't respond as well as
normal and there was increased
activation of the insula on both
sides.
J Clin Psychiatry (Primary Care
Companion) 2010; 12(5)
"Sleep quality in borderline
personality disorder: a cross
sectional study"
"Individuals with borderline
personality symptomatology
demonstrate a poorer overall quality
of sleep..."
Am J Psychiatry 2010 Aug;167(8):
925-33
"Dysregulation of regional
endogenous opioid function in
borderline personality disorder"
"Differences exist between patients
with borderline personality disorder
and comparison subjects in baseline
in vivo mu-opioid receptor
concentrations and in the endogenous
opioid system response to a negative
emotional challenge..."
J Psychiatr Res 2010 Nov;44 (15):
1075-81
"Tryptophan-hyroxylase 2 haplotype
(TPH2) association with borderline
personality disorder and aggression
in a sample of patients with
personality disorders and healthy
controls."
This gene is associated with
increased risk of borderline
personality disorder, impulsive
aggression, mood swings, suicidal
behavior, and self-mutilation.
Psychiatr Genet 2010 Feb;20(1):25-30
"Fluoxetine response in
impulsive-aggressive behavior and
serotonin transporter polymorphism
in personality disorder"
Some types of serotonin genes are
more responsible for impulsive and
aggressive behavior than others,
particularly the response to Prozac
(fluoxetine).
Biol Psychiatry 2010 Mar
1;67(5):399-405
"Metabolic alterations in the
amygdala in borderline personality
disorder: a proton magnetic
resonance spectroscopy study"
"Decreased tNAA (N-acetylaspartate)
and tCr (total creatine) might
indicate disturbed affect regulation
and emotional information processing
in the amygdala of BPD patients."
Eur Psychiatry 2010 Oct 6
"Hippocampal volume in borderline
personality disorder with and
without comorbid posttraumatic
stress disorder: A meta-analysis"
"...hippocampal volumes are reduced
in patients with BPD, relative to
healthy controls, but particularly
in cases in which patients are
diagnosed with comorbid PTSD."
Int J Psychophysiol 2010
Dec;78:257-64
"Processing of visual stimuli in
borderline personality disorder: a
combined hehavioral and
magnetoencephalographic (MEG) study.
"This MEG study provides evidence
for disturbances in cortical visual
perception in BPD patients
regardless of emotional salience of
the stimulus. In line with previous
studies, subtle deficits in visual
perception might be related to
impairment in interpersonal
communication in BPD."
Psychiatry Res 2010 Apr
30;182(1):73-6
"Superior temporal gyrus volume in
teenagers with first-presentation
borderline personality disorder"
Individual with violent episodes had
smaller left STG (superior temporal
gyrus) volumes compared to those
without violent episodes.
World J Biol Psychiatry 2010
Mar;11:372-81
"Neurochemical alterations in women
with borderline personality disorder
and comorbid attention deficit
hyperactive disorder"
"Glutamatergic changes in the
anterior cingulate may be associated
with BPD and comorbid ADHD.
Increased anterior cingulate tNAA
(total N-acetylaspartate) may
indicate disturbed energy metabolism
or impaired frontal maturation."
World J Biol Psychiatry 2010
Mar;11(:364-71
"Pain sensitivity is reduced in
borderline personality disorder, but
not in PTSD (post traumatic stress
disorder) and bulimia nervosa."
These findings "may differentiate
the BPD from other stress-related
psychiatric conditions."
Psychiatry Res 2010 Feb
28;181(2):151-4
"Reduced interhemispheric structural
connectivity between anterior
cingulate cortices in borderline
personality disorder"
Decreased communication between both
sides of the brain was discovered in
those with BPD.
J Clin Psychiatry 2010 Jan;71 (1):
26-31
"Psychiatric diagnoses in patients
previously overdiagnosed with
bipolar disorder"
"Psychiatric outpatients
overdiagnosed with bipolar disorder
were characterized by more Axis I
and Axis II diagnostic comorbidity
in general, and borderline
personality disorder in particular."
J Psychopharmacol 2010 Mar;24 (3):
333-9
"Efficacy and tolerability of
duloxetine (Cymbalta) in the
treatment of patients with
borderline personality disorder: a
pilot study"
There was improvement in
impulsivity, anger outbursts, mood
instability and physical symptoms.
(This is an expensive medication,
very similar to Effexor
(venlafaxine). I've switched many
patients from Cymbalta (duloxetine)
to Prozac (fluoxetine) and seen
significant improvement by this
change.)
J Pers Disord 2010 Dec;24(6): 785-99
"Impulsivity in borderline
personality disorder: reward-based
decision-making and its relationship
to emotional distress"
"...the BPD is characterized by a
preference for immediate
gratification and tendency to
discount longer-term rewards."
J Pers Disord 2010 Dec;24(6): 763-72
"A comparison of depressed patients
with and without borderline
personality disorder: implications
for interpreting studies of the
validity of the bipolar spectrum"
"Our results do NOT support
inclusion of borderline personality
disorder as part of the bipolar
spectrum."
J Psychiatr Res 2010 Dec 1 (Mary
Zanarini from Harvard)
"Predictors of self-mutilation in
patients with borderline personality
disorder: a 10 year follow up
study."
Female gender, severity of dysphoric
ideas, severity of dissociation
(deja vu, unreality), major
depression, history of childhood
sexual abuse and sexual assaults as
an adult were significant risk
factors.
Personal Disord 2010 Oct 1;1 (4):
239-249
"Does comorbid substance use
disorder exacerbate borderline
personality features?: a comparison
of borderline personality disorder
individuals with versus without
current substance dependence."
"Our results do not support the
notion that BPD individuals with
substance use disorder display more
severe BPD features than individuals
with BPD alone."
Compr Psychiatry 2010 Sep-Oct;
51(5):458-61
"Being bullied in childhood:
correlations with borderline
personality in adulthood."
"A history of being bullied in
childhood demonstrates a positive
correlation with BPD in
adulthood..."
Int J Psychiatry Med 2010;40(1):21-9
"Road rage: relationships with
borderline personality and driving
citations"
Individuals with BPD have a 250%
higher risk of road rage and a
significantly higher risk of driving
citations.
J Pers Disord 2010 Jun;24(3): 365-76
(Mary Zanarini)
"A Longitudinal study of the 10 year
course of interpersonal features in
borderline personality disorder"
"The interpersonal features slowest
to remit were affective responses to
being alone, active caretaking,
discomfort with care and
dependency."
Psychiatr Serv 2010 Jun;61(6): 612-6
(Mary Zanarini)
"Ten-year use of mental health
services by patients with borderline
personality disorder and other axis
II disorders."
"...patients with borderline
personality disorder tend to use
outpatients treatments without
interruption over prolonged periods.
They also suggest that inpatient
treatment is used far more
intermittently by patients with
borderline personality disorder."
Ann Clin Psychiatry 2010 May;22(2):
121-8
"Impact on suicidality of borderline
personality traits impulsivity and
affective instability."
Impulsivity rather than mood
instability is more strongly
associated with suicidality.
Am J Psychiatry 2010
Jun;167(6):618-9 (Mary Zanarini)
"Time to attainment of recovery from
borderline personality disorder and
stability of recovery: A 10-year
prospective follow-up study."
"...the results of this study
suggest that recovery from
borderline personality disorder,
with both symptomatic remission and
good psychosocial functioning, seems
difficult for many patients to
attain. The results also suggest
that once attained, such a recovery
is relatively stable over time."
Clin J Pain 2010 May;26(4):348-53
"Borderline personality disorder
features and pain: the mediating
role of negative affect in a pain
patient sample."
"...individuals with higher levels
of BPD features reported greater
severity of pain and somatic
complaints...this association was no
longer significant after controlling
for affect scales. In particularly,
depression was strongest in
accounting for this association."
J Clin Psychiatry 2010
Sep;71(9):1212-7
"Screening for bipolar disorder and
finding borderline personality
disorder"
"Positive results on the MDQ (mood
disorder questionnaire) were as
likely to indicate that a patient
has borderline personality disorder
as bipolar disorder."
Clin Psychol Psychother 2010 Feb 25
"Dialectic behavioural therapy has
an impact on self-concept clarity
and facets of self-esteem in women
with borderline personality
disorder"
"...in BPD patients, self-esteem and
the diagnostic criteria identity
disturbance...can be influenced with
short-term psychotherapy."
Psychiatry Res 2010 Mar
30;181(3):233-6
"Medial prefrontal cortex
hyperactivation during social
exclusion in borderline personality
disorder"
"BPD subjects showed left medial
prefrontal cortex hyperactivation
during social exclusion suggesting
potential dysfunction of
frontolimbic circuitry."
J Psychiatry Res 2010
Oct;44(13):847-52
"Incidence of polycystic ovaries and
androgen serum levels in women with
BPD."
"Polycystic ovaries and excessive
testosterone have been found in a
number of women with BPD compared to
depressed patients."
J Clin Psychopharmacol 2010
Feb;30(1):44-7
"olanzapine (Zyprexa) versus
haloperidol (Haldol) in the
management of borderline personality
disorder: a randomized double-blind
trial."
Chronic use of both medications
showed no difference in
effectiveness regarding anxiety,
tension, depressive mood, and
hostility. (Note: there are pluses
and minuses for chronic use of both
medications. In my experience,
Haldol (haloperidol) works much more
quickly, Zyprexa is better for
severe acute stresses)
Br J Psychiatry 2010 Jan;196(1):4-12
"Pharmacotherapy for borderline
personality disorder: Cochrane
systematic review of randomized
trials."
There is limited scientific data for
medical treatment of BPD. (Even
more limited are medication
combination studies such as Prozac
with Tegretol, Prozac with as needed
Haldol, etc. This report confirms
the lack of good medication trials,
which makes current treatment of the
BPD more art than science. There
are some studies confirming
medication effectiveness, therefore
backing up most treatment approaches
to some degree. Lack of scientific
studies does not prove lack of
effectiveness.)
J Psychiatr Res. 2010
Apr;44(6):405-8
"Borderline personality disorder and
misdiagnosis of bipolar disorder"
"Patients with borderline
personality disorder, regardless of
how they meet criteria, may be at
increased risk of being misdiagnosed
with bipolar disorder."
