Hysteroid borderline

AU – Stone MH
TI – Assessing vulnerability to schizophrenia or manic- depression in borderline states.
SO – Schizophrenia Bulletin 1979;5(1):105-10
AB – In a discussion of the article on genetic determinants of borderline conditions by Siever and Gunderson, a phenotypic continuum between pure schizotypal and pure affective conditions is postulated. Many “borderline” cases are seen as attenuated forms of schizophrenia, schizoaffective psychosis, or manic-depression. A Venn diagram illustrates differences among syndromes described by Gunderson, Kernberg, Spitzer, and Klein (“hysteroid dysphoria”). Evidence is presented suggesting that Gunderson’s borderline syndrome contains more schizotypal individuals than Kernberg’s, whereas hysteroid dysphoria is nearer the affective pole of the continuum. A second diagram illustrates how the strength and nature of the genetic factors vary according to the syndrome.

The treatment of personality disorders is one of the last areas in psychiatry to fully embrace a psychobiologic perspective. Although personality is traditionally defined as an integrated structure of biologic temperament and learned character, treatments for personality disorders have historically emphasized the psychodynamic or behavioral correction of maladaptive learning. Temperament was viewed as contributing a biologic basis to the regulation of perception, cognition, affect, and impulse, contributing to the phenomenology of behavior, not to interpersonal meaning. Advances in dimensional modeling of personality, and a growing body of empiric literature on the psychobiology of personality dimensions, have invigorated the search for pharmacologic treatments in personality disordered patients. The neurotransmitter mediation of important dimensions of personality provides a powerful theoretic framework for pharmacologic trials in patients with personality disorders.

Hysteroid dysphoria has been described in outpatient populations and is thought to be a subtype of atypical depression involving rejection sensitivity and therapeutic response to monoamine oxidase inhibitors. The presence of hysteroid dysphoria was assessed, using a semistructured interview, in 18 depressed inpatients. The 6 patients who met the criteria for hysteroid dysphoria did not differ from other depressed patients in severity, premorbid adjustment, number of atypical features, or presence of melancholia. Implications for treatment are discussed.

MAOIs started off due to the serendipitous discovery that iproniazid was a potent MAO inhibitor (MAOI). [41] Originally intended for the treatment of tuberculosis, in 1952, iproniazid's antidepressant properties were discovered when researchers noted that the depressed patients given iproniazid experienced a relief of their depression. Subsequent in vitro work led to the discovery that it inhibited MAO and eventually to the monoamine theory of depression . MAOIs became widely used as antidepressants in the early 1950s. The discovery of the 2 isoenzymes of MAO has led to the development of selective MAOIs that may have a more favorable side-effect profile. [42]

Hysteroid borderline

hysteroid borderline

MAOIs started off due to the serendipitous discovery that iproniazid was a potent MAO inhibitor (MAOI). [41] Originally intended for the treatment of tuberculosis, in 1952, iproniazid's antidepressant properties were discovered when researchers noted that the depressed patients given iproniazid experienced a relief of their depression. Subsequent in vitro work led to the discovery that it inhibited MAO and eventually to the monoamine theory of depression . MAOIs became widely used as antidepressants in the early 1950s. The discovery of the 2 isoenzymes of MAO has led to the development of selective MAOIs that may have a more favorable side-effect profile. [42]

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