Personality Disorders June 9, 2011 Candace Mills Paul Felker Temple University - Harrisburg

Hudziak, J. J., Boffeli, T. J., Kriesman, J. J., Battaglia, M. M., Stanger, C., Guze, S. B. (1996, December) Clinical Study of the Relation of Borderline Personality Disorder to Briquets Syndrome (Hysteria), Somatization Disorder, Antisocial Personality Disorder, and Substance Abuse Disorders. American Journal of Psychiatry, 153 (12), 1598-1606. This article talks about the relationship between borderline personality disorder and Briquets Syndrome (hysteria), Somatization Disorder, Antisocial Personality Disorder, and Substance Abuse Disorder. Borderline personality disorder overlaps other clinical disorders, with the most prominent of these being affective disorders. After affective disorders comes anxiety disorders, Briquets syndrome, somatization disorder, alcohol abuse, and antisocial personality disorder. It has even been argued that schizophrenia can also overlap borderline personality disorder. The DSM-III-R criteria looked at patients with unstable interpersonal relationships, potentially self-damaging impulsivity, affective instability, inappropriate and intense anger, recurrent suicide threats, marked and persistent identity disturbance, chronic feelings of emptiness or boredom, and efforts to avoid real or imagine abandonment. It has been argued that there has not yet been a study with a big enough sample of patients to sufficiently set apart patients with other axis I and II conditions. This study that was done for the article was done because the criteria for borderline personality disorder seemed to only select patients with high rates of hysteria, somatization disorder, antisocial personality disorder, and substance abuse disorders. This was a way to determine whether a detailed assessment of patients with borderline personality disorder would reveal characteristic features of that condition which would distinguish it from these other disorders. Each patient had more than one DSM diagnosis, averaging at least four to five

additional diagnoses. It was concluded that the boundaries for the borderline condition were not specific and identify a high percentage of patients with these other disorders. The comorbidity rate closely resembles the psychiatric profiles of patients with these other disorders. During the presentation that was given by myself and our group participants, the discussion centered on whether or not borderline personality disorder was an axis II condition because so many other disorders seemed to be reflective of or in the disorder. The article concluded by stating that if the borderline syndrome is meant to include all of these other disorders, can it really be useful as its own diagnosis? Borderline personality disorder is a type of affective disorder and it has a high comorbidity rate to major depression. As was discussed in class, there is an uncertainty even in research as to whether or not the affective disorder should be the primary disorder or the secondary disorder. The overlap with other disorders is so strong, that the only way to treat a borderline disorder patient is to treat the other symptoms. The writers of this study recommend that clinicians carefully assess patients for these other diagnoses and that more effort should be made to change the borderline personality disorder criteria so that it shifts away from overlapping so much with the criteria from these other disorders.