Pharmacological treatment of borderline personality disorder [Tratamiento farmacológico del trastorno límite de personalidad]
Por:
Chávez-León E., Ng B., Ontiveros-Uribe M.P.
Publicada:
1 ene 2006
Resumen:
Temperament and character are terms utilized to delineate the participation of biologic and psychosocial factors in the development of normal and disordered personality. At times, biological factors, and in others rearing, education, psychological and social events at an early age are the main determinants. The American Psychiatric Association describes Borderline Personality Disorder (BPD) as characterized by a pattern of interpersonal, self-image and affective instability, as well as notable impulsivity. In this disorder, temperament as an inherited factor plays an important role, as demonstrated by familial studies in which the disorder is more frequently present in the families of probands than non-probands. Other disorders where impulsivity is an outstanding feature, such as antisocial personality disorder and substance abuse, are also frequent in first degree relatives of patients with BPD. Psychological factors, such as sexual abuse during childhood, are particularly high in this disorder. This is believed to generate features such as emotional instability, distrust, and dissociative states. From this point of view, it is possible that BPD is a form of "adaptation" not only psychological and behavioral, but also biological. Changes in the volume of the amygdala and hippocampus have been described in the brain of women abused during childhood, and those with BPD. BPD is frequently present in clinical practice, either or not associated to other psychiatric disorders; it can be found anywhere from 11 to 40.4% according to the setting studied. This incidence is even higher in patients with multiple suicide attempts. The term "borderline" was established when this pathological condition was conceptualized to originate between neurosis and psychosis. However, current understanding of personality is better explained with a psychobiological model based on various dimensions. There is one related to schizophrenia (cognitive-perceptual organization dimension) and others related to mood disorders (mood regulation dimension), impulse control (impulsivity-aggression dimension), and anxiety disorders (anxiety-inhibition dimension). Patients with BPD show persistent disturbance on the four dimensions. The combination of these disturbances, along with specific defense mechanisms and coping strateg
Filiaciones:
Chávez-León E.:
Asociación Psiquiátrica Mexicana, Mexico
Area Clínica, Escuela de Psicología, Universidad Anahuac México Norte, Av. Lomas Anahuac s/n, Lomas Anahuac, 52786, Huixquilucan, Spain
Ng B.:
Universidad de California, San Diego, CA, United States
Centro Médico Sun Valley Behavioral, El Centro, CA, United States
Ontiveros-Uribe M.P.:
Asociación Psiquiátrica Mexicana, Mexico
Hospitalización Y Urgencies, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
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