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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors review the literature on the diagnosis of borderline personality disorder and describe the core dynamic features that account for its unstable phenomenology and explain in part the complexity of and the controversies associated with the diagnosis. A review of differential diagnosis suggests that the boundary with schizophrenia is well established, that the boundary with affective disorder is becoming clearer, and that the most subtle boundary distinctions lie with other forms of personality disorder. A growing body of evidence about antecedents to and longitudinal aspects of borderline personality disorder confirms its diagnostic validity.
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PMID:Current overview of the borderline diagnosis. 330 24

The empiric literature reports few distinctive features among patients discharged against medical advice (AMA) or absent without leave and regularly discharged inpatients. Interactive relationships between predictors of discharge status and diagnosis have not been studied, however. This study used discriminant function analyses to test for predictors of discharge with medical advice, AMA, and by transfer for inpatients with schizophrenia (N = 132), schizoaffective disorder (N = 61), borderline personality disorder (N = 69), and unipolar affective disorder (N = 42) from a follow-up study. Results showed that indexes of chronic psychosis predicted transfer for all diagnoses. Angry, impulsive behavior and unstable relationships predicted AMA discharge in all but the unipolar patients. For the latter, being married was most powerfully associated with AMA status.
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PMID:Predicting hospital discharge status for patients with schizophrenia, schizoaffective disorder, borderline personality disorder, and unipolar affective disorder. 335 22

The prognosis of self-discharged inpatients has seldom been studied, especially by diagnosis, and is frequently assumed to be poor. This study evaluated the long-term (15-year average) outcome of inpatients discharged with medical advice (WMA), against medical advice (AMA), or by transfer for patients with schizophrenia (N = 113), schizoaffective disorder (N = 46), borderline personality disorder (N = 63), and unipolar affective disorder (N = 33) from a follow-up study. Results showed that outcome among discharge cohorts varied considerably depending on diagnostic category. Within each diagnostic cohort, outcome of transferred patients was poorest. The outcome of AMA-discharged patients was poorer than the outcome of patients discharged with medical advice only in the unipolar cohort, except that AMA discharge in schizoaffective patients correlated significantly with suicide.
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PMID:Hospital discharge status and long-term outcome for patients with schizophrenia, schizoaffective disorder, borderline personality disorder, and unipolar affective disorder. 335 23

The external validity of 10 schizoid personality scales was assessed against dimensional measures of DSM-III borderline (BPD) and schizotypal (SPD) personality disorders in a sample of 37 top-security prisoners. Significant relationships with SPD or BPD emerged for schizophrenism, withdrawn-disturbed relationships, hallucinatory predisposition, schizoidia, disordered thinking and perceptual aberration (r = 0.30-0.66). The first four of these scales were significantly related to SPD (r = 0.29-0.51) after partialling out the effects of BPD, indicating an intrinsic link between these scales and SPD which may constitute the genetic affinity of SPD with schizophrenia. It is suggested that scales which assess the construct of schizophrenism or 'interpersonal aversiveness' may be the most central to Meehl's (1962) 'integrative neural defect' or genetic predisposition to schizotypy.
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PMID:Validation of schizoid personality scales using indices of schizotypal and borderline personality disorder in a criminal population. 342 52

An intriguing question in modern psychopathology is the relationship of borderline syndrome disorders to other psychopathological conditions and to each other. The present study compared groups of DSM-III defined Borderline Personality Disorder (N = 51), Schizotypal Personality Disorder (N = 14), and Mixed Borderline-Schizotypal Personality Disorder (N = 17), with CATEGO diagnosed Schizophrenic Disorder of recent onset (N = 30) and nonpsychiatric controls (N = 20) on the MMPI. Profile and individual scale analyses revealed gross elevations on multiple scales in each of the patient groups, as compared with controls. Subtle differences in test performance between the borderline personality and schizotypal personality groups are noted and are consistent with their separation as disorders in DSM-III. Multivariate profile analyses distinguished the borderline, schizotypal, and early schizophrenic groups from each other, but not from the mixed personality group. Thus, this latter group may serve to bridge these diverse populations.
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PMID:Relationship of borderline syndrome disorders to early schizophrenia on the MMPI. 357 98

Admission and mean 14-year follow-up Global Assessment Scale functioning were studied in 237 inpatients meeting DSM-III criteria for borderline (BPD) and schizotypal (SPD) personality disorders and compared to major affective disorder, schizophrenia and other diagnoses. BPD patients also meeting criteria for SPD functioned more poorly than other BPD or SPD patients at admission but improved their functioning at follow-up. Two BPD and SPD criteria which were associated with good follow-up functioning in BPD with SPD patients were found to predict poor admission functioning but good follow-up functioning in 18 of 237 former inpatients regardless of diagnosis.
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PMID:The significance of borderline and schizotypal overlap. 365 42

DSM-III borderline personality disorder defines a group of patients who are characterised by impulsivity and unpredictable behaviour, inappropriate aggression, intense and unstable relationships and are often associated with repeated suicidal behaviour. A substantial body of research has established an association between disturbance of serotonin and also dopamine and suicidal behaviour in depression. A similar relationship is also seen in studies of personality disorders which suggests the association is not specific to depression. A placebo controlled study of low dose flupenthixol has been shown to significantly reduce subsequent suicidal behaviour in patients with personality disorders without depression or schizophrenia. Evidence points to a biological basis for suicidal behaviour and borderline personality disorder and possibly of pharmacotherapy.
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PMID:The psychopharmacology of borderline personality disorders. 367 29

Forty-six inpatients were independently diagnosed according to the DSM-III concept of borderline personality disorder, the diagnostic interview for borderlines (DIB) and the concept of borderline personality organization, which is linked to Kernbergs structural interview. The interviews were videotaped. Satisfactory inter-rater reliability was demonstrated for the DIB, which furthermore showed high sensitivity and specificity in identifying patients with a clinical DSM-III diagnosis of borderline personality disorder from patients with a other personality disorders or schizophrenic disorders. Discriminant features, demographic profile and earlier treatment history for the patients with a borderline personality disorder are described and discussed. The structural interviews were scored according to a specified format. Inter-rater reliability was satisfactory but not too impressive. Borderline personality organization turned out to be a very broad concept and only half of the patients within this concept received a syndrome diagnosis of borderline personality disorder. A general conclusion was that borderline personality organization should not be considered as a diagnostic entity but rather as a different diagnostic dimension representing an intermediate level of personality structure.
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PMID:An empirical comparison of three different borderline concepts. 367 51

The follow-up studies of borderline schizophrenia, the borderline syndrome and borderline personality disorder are examined in the light of modern methodological demands. Few studies reach these standards. The outcome of borderline schizophrenia is variable and close to schizophrenia. Approximately 20% of the cases develop true schizophrenia over time. Grinker's borderline syndrome has also a variable outcome but mostly a poor prognosis. Borderline personality disorder has a variable outcome but better than for schizophrenia. Concomitant major affective disorder is frequently present in borderline personality disorder and influences outcome. The wide range of outcome does not support a single 'natural history' of these disorders. Few predictive factors have been identified. Better studies with the aim of identifying predictive factors are mandatory.
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PMID:Prognosis of the borderline disorders. 371 42

Psychiatric disorders are common in medical inpatient and outpatient populations. As a result, internists commonly are the first to see psychiatric emergencies. As with all medical problems, a good history, including a collateral history from relatives and friends, physical and mental status examination, and appropriate laboratory tests help establish a preliminary diagnosis and treatment plan. Patients with suicidal ideation usually have multiple stressors in the environment and/or a psychiatric disorder (i.e., a major affective disorder, dysthymic disorder, anxiety or panic disorder, psychotic disorder, alcohol or drug abuse, a personality disorder, and/or an adjustment disorder). Of all patients who commit suicide, 70% have a major depressive disorder, schizophrenia, psychotic organic mental disorder, alcoholism, drug abuse, and borderline personality disorder. Patients who are at great risk have minimal supports, a history of previous suicide attempts, a plan with high lethality, hopelessness, psychosis, paranoia, and/or command self-destructive hallucinations. Treatment is directed toward placing the patient in a protected environment and providing psychotropic medication and/or psychotherapy for the underlying psychiatric problem. Other psychiatric emergencies include psychotic and violent patients. Psychotic disorders fall into two categories etiologically: those that have an identifiable organic factor causing the psychosis and those that have an underlying psychiatric disorder. Initially, it is essential to rule out organic pathology that is life-threatening or could cause irreversible brain damage. After such organic causes are ruled out, neuroleptic medication is indicated. If the patient is not agitated or combative, he or she may be placed on oral divided doses of neuroleptics in the antipsychotic range. Patients who are agitated or psychotic need rapid tranquilization with an intramuscular neuroleptic every half hour to 1 hour until the agitation and combativeness are under control. Haloperidol (Haldol) is the safest neuroleptic. Chlorpromazine (Thorazine), perphenazine (Trilafon), and, in the elderly, thiothixene (Navane) can also be useful if haloperidol (Haldol) is not effective and more sedation is needed; these drugs, however, produce more side effects. Violent patients need to be physically restrained and then given antipsychotic medication or, in the case of drug abuse or alcohol withdrawal, the appropriate drug management.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Psychiatric emergencies. 373 71


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