Psychopathy and bline personality dis

PSYCHOPATHY AND BLINE PERSONALITY DIS

INTRODUCTION

Personality diss constitute a major group in the classification of mental diss . According to the Diagnostic and Statistical Manual of Mental Diss , fourth edition , text revision (DSM-IV-TR ,1 these conditions are defined by maladaptive personality characteristics

beginning early in life that have consistent and serious effects on functioning . Bline personality dis (BPD ) is frequently seen in clinical practice .2 Characterized by emotional turmoil and chronic suicidality (suicide ideation and attempts , this type of personality dis presents some of the most difficult and troubling problems

in all of psychiatry . The majority of patients with BPD are seen in psychiatric clinics or in primary care . The keys to successful management include making an accurate diagnosis , maintaining a supportive relationship with the patient and establishing limited goals Although BPD may persist for years , it does not last forever , and one can be reasonably optimistic that most patients will recover with time . Psychotherapy can help speed up the recovery from BPD . The most effective forms of treatment have been developed by psychologists , and therefore when making a referral , physicians should consider a patient 's ability to pay for such therapy . More research into the causes of BPD is needed , the results of which may help to develop evidence-based approaches to treatment that are practical and specifically designed for this challenging dis

REVIEW OF LITERATURE

THE EPIDEMIOLOGY OF BLINE PERSONALITY DIS

Epidemiologic studies of personality diss are at an early stage of development . Community surveys of adults have indicated that the prevalence of BPD is close to 1 (similar to that of schizophrenia .3 ,4 About 80 of patients receiving therapy for BPD are women ,2 but sex differences are less striking in community samples .4 As is the case for personality diss in general , BPD is associated with lower social class and lower levels of education .3 ,4

THE ETIOLOGY OF BLINE PERSONALITY DIS

We are only beginning to understand the causes of BPD . As with most mental diss , no single factor explains its development , and multiple factors (biological , psychological and social ) all play a role The biological factors in personality diss consist of temperamental (inborn or heritable ) characteristics that present in adulthood as stable personality traits : patterns of thought , affect and behaviour that characterize individuals and are stable over time .5 Heritable factors account for about half of the variability in virtually all traits that have been studied .6 Specifically , both affective instability6 and impulsivity7 have a heritable component of this magnitude , and studies involving twins have demonstrated that BPD itself shows a similar genetic influence .8 Also , family history studies have found that impulsive diss such as antisocial personality and substance abuse are particularly common among firstdegree relatives of patients with BPD .9 Studies of central neurotransmitter activity have shown that impulsive traits , a major component of BPD , are associated with deficits in central serotonergic functioning .10 ,11 However , the biological correlates of affective instability are unknown , and no markers specific to the overall dis have...