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borderline schizophrenia wiki

日期:2020-12-13 来源: 浏览:0

Compared to those diagnosed with other personality disorders, people with BPD showed a higher rate of also meeting criteria for[120]. Dialectical behavior therapy has similar components to CBT, adding in practices such as meditation. ", "Interventions for smoking cessation and reduction in individuals with schizophrenia", "Schizophrenia: manifestations, incidence and course in different cultures. [109][110][111] Perceived barriers to the diagnosis of BPD during adolescence included concerns about the validity of a diagnosis in young people, the misdiagnosis normal adolescent behaviour as symptoms of BPD, the stigmatising effect of a diagnosis for adolescents, and whether personality during adolescence was sufficiently stable for a valid diagnosis of BPD. [21], In addition to intense emotions, people with BPD experience emotional "lability" (changeability, or fluctuation). [5] Substance abuse, depression, and eating disorders are commonly associated with BPD. [274], The word schizophrenia translates roughly as "splitting of the mind" and is Modern Latin from the Greek roots schizein (σχίζειν, "to split") and phrēn, (φρεν, "mind")[275] Its use was intended to describe the separation of function between personality, thinking, memory, and perception. In an interview with reporters before a talk in Baton Rouge on Nov. 4, 2014, Darrell opened up about his difficulties with mental health issues. [228], Exercise including aerobic exercise has been shown to improve positive and negative symptoms, cognition, working memory, and improve quality of life. [41] Phenomenologically, research suggests that auditory verbal hallucinations found in patients with BPD cannot be reliably distinguished from those seen in schizophrenia. [277] A similar change was made in South Korea in 2012 to attunement disorder. [209][non-primary source needed] Indeed, mental health professionals frequently refuse to provide services to those who have received a BPD diagnosis. This approach is known as assertive community treatment (ACT) and has been shown to achieve positive results in symptoms, social functioning and quality of life. This condition is a chronic mental illness known as schizotypal personality disorder (SPD). [3][7] There is no objective diagnostic test; diagnosis is based on observed behavior, a history that includes the person's reported experiences, and reports of others familiar with the person. [65], Prevention of schizophrenia is difficult as there are no reliable markers for the later development of the disorder. [236] Vitamin B12 is also often deficient and this is linked to worse symptoms. [218] The film Single White Female (1992), like the first example, also suggests characteristics, some of which are actually atypical of the disorder: the character Hedy had markedly disturbed sense of identity and reacts drastically to abandonment. [52] Cognitive symptoms are not secondary to positive symptoms, or to the side effects of antipsychotics. [5] However, the term "borderline" has been described as uniquely inadequate for describing the symptoms characteristic of this disorder. [22], People with BPD can be very sensitive to the way others treat them, by feeling intense joy and gratitude at perceived expressions of kindness, and intense sadness or anger at perceived criticism or hurtfulness. [309][310] A 2015 Cochrane review found unclear evidence of benefit. [67] An estimated 70% of those with schizophrenia have cognitive deficits, and these are most pronounced in early onset, and late-onset illness. [234] Primary polydipsia, or excessive fluid intake, is relatively common in people with chronic schizophrenia. [76] However, DSM-5 points out that most people with schizophrenia have no family history of psychosis. [295] In 2013 with the reviewed DSM-5, the DSM-5 committee was in favor of giving a new name to schizophrenia but they referred this to WHO. [210] This finding also supports the involvement of dopamine in the development of schizophrenia. [38] They may also tend to dissociate, which can be thought of as an intense form of "zoning out". [84] The DSM-5 defines the main features of BPD as a pervasive pattern of instability in interpersonal relationships, self-image, and affect, as well as markedly impulsive behavior. [282][283] In the 1930s a number of shock therapies were introduced which induced seizures (convulsions) or comas. [258] These conclusions have been questioned. Issues of particular note are suicidal ideations, experiences with self-harm, and thoughts about harming others. [289], Subtypes of schizophrenia classified as paranoid, disorganized, catatonic, undifferentiated, and residual type were difficult to distinguish between and are no longer recognized as separate conditions by DSM-5 (2013)[290] or ICD-11. [7] Schizophrenia occurs along with obsessive-compulsive disorder (OCD) considerably more often than could be explained by chance, although it can be difficult to distinguish obsessions that occur in OCD from the delusions of schizophrenia. [197] However, Marsha Linehan notes that doing so relies upon the assumption that people with BPD who communicate intense pain, or who engage in self-harm and suicidal behavior, do so with the intention of influencing the behavior of others. [5] Up to a third of people do not respond to initial antipsychotics, in which case the antipsychotic clozapine may be used. ", "Axis One/Axis Two: A disordered borderline", "Neural correlates of emotion processing in borderline personality disorder", "Rejection Sensitivity and Executive Control: Joint predictors of Borderline Personality features", "A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory", "Personality Disorders: Tests and Diagnosis", "Emotionally unstable personality disorder", International Statistical Classification of Diseases and Related Health Problems, "Prescribing and borderline personality disorder", "Borderline Personality Disorder Symptoms in College Students: The Complex Interplay between Alexithymia, Emotional Dysregulation and Rumination", "Fact or fiction: diagnosing borderline personality disorder in adolescents", "Borderline personality disorder in adolescence", "The Lifetime Course of Borderline Personality Disorder", "Application of the ICD-11 classification of personality disorders", "Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies", "Overview | Borderline personality disorder: recognition and management | Guidance | NICE", "Guía de práctica clínica sobre trastorno límite de la personalidad", "Diagnosing BPD in Adolescents: More good than harm", "Diagnosis of personality disorders in adolescents: a study among psychologists", "Borderline Personality Disorder in Young People: Are We There Yet? [86] To address this issue, Linehan has grouped the symptoms of BPD under five main areas of dysregulation: emotions, behavior, interpersonal relationships, sense of self, and cognition. The mental status examination is an important part of the assessment. 10. [187][188] Borderline personality disorder was included in DSM-III (1980) despite not being universally recognized as a valid diagnosis.[189]. [202] Another way in which people with BPD avoid expressing their anger through violence is by causing physical damage to themselves, such as engaging in non-suicidal self-injury. [36] Reasons for self-harm include expressing anger, self-punishment, generating normal feelings (often in response to dissociation), and distracting oneself from emotional pain or difficult circumstances. Although these functions are separable, their dysfunction in schizophrenia may reflect an underlying deficit in the ability to represent goal related information in working memory, and to utilize this to direct cognition and behavior. [132], Because the two conditions have a number of similar symptoms, BPD was once considered to be a mild form of bipolar disorder[133][134] or to exist on the bipolar spectrum. [134] Severity of negative symptoms has been linked to reduced thickness in the left medial orbitofrontal cortex. The coexistence of intense, divergent moods within an individual was recognized by Homer, Hippocrates, and Aretaeus, the latter describing the vacillating presence of impulsive anger, melancholia, and mania within a single person. [4][5] The disorder is often stigmatized in both the media and the psychiatric field. [284] Insulin shock therapy involved the injecting of large doses of insulin in order to induce comas, which in turn produced hypoglycemia and convulsions. [205][211] It is further suggested that if the subtypes could be distinguished at an early stage significant implications could follow for treatment considerations, and for research. In approved models of circuits that mediate predictive coding, reduced NMDA receptor activation, could in theory result in the positive symptoms of delusions and hallucinations.[146][147][148]. [162], Experience of services varies. [120][122][123] In one study, 38% of participants with BPD met the criteria for a diagnosis of ADHD. [46] Negative symptoms are less responsive to medication and the most difficult to treat. An earlier documentary was made with the title A Brilliant Madness. Although that term suggests rapid changes between depression and elation, mood swings in people with BPD more frequently involve anxiety, with fluctuations between anger and anxiety and between depression and anxiety. [284][283] The use of electricity to induce seizures was developed, and in use as electroconvulsive therapy (ECT) by 1938. People with BPD may feel emotions with greater ease and depth and for a longer time than others do. [168] There is some evidence that early intervention in those with first-episode psychosis may improve short-term outcomes, but there is little benefit from these measures after five years. This phenomenon is sometimes called splitting. Twice as many women as men in the community suffer from depression (Weissman & Klerman, 1985). In DSM-II, this disorder is called Schizophrenia, latent type For more information, see Schizophrenia This category is for patients having clear symptoms of schizophrenia but no history of a psychotic schizophrenic episode. Some researchers have suggested classifying these BPD symptoms as “true” psychosis, or even eliminating the distinction between pseudo-psychosis and true psychosis altogether. [7], Negative symptoms are deficits of normal emotional responses, or of other thought processes. [53] Visual processing impairments include an inability to perceive complex visual illusions. [216], The films Play Misty for Me (1971)[217] and Girl, Interrupted (1999, based on the memoir of the same name) both suggest the emotional instability of the disorder. [51] Even so, the researchers of one study concluded that personality disorders "seem to be more strongly influenced by genetic effects than almost any Axis I disorder [e.g., depression, eating disorders], and more than most broad personality dimensions". [4] Adverse life events appear to also play a role. [10][247] Side effects of antipsychotics may also increase the risk. This can cause people with BPD to feel "empty" and "lost". [3][7][11] Onset before the age of 17 is known as early-onset,[64] and before the age of 13, as can sometimes occur is known as childhood schizophrenia or very early-onset. [50] That is, 37% to 69% of the variability in liability underlying BPD in the population can be explained by genetic differences. [178][179], Tobacco smoking increases the metabolism of some antipsychotics, by strongly activitating CYP1A2, the enzyme that breaks them down, and a significant difference is found in these levels between smokers and non-smokers. They are also more likely to develop other forms of long-term social disabilities. [22][79][206] Between 12 and 20 per cent will not respond to clozapine and this group is said to have ultra treatment resistant schizophrenia. Rather than a disorder of thought, BPD is a disorder of emotional regulation. [7] Treatments should be based on the needs of the individual, rather than upon the general diagnosis of BPD. Zanarini MC, Frankenburg FR, Dubo ED, et al. [27], The first-line treatment for schizophrenia is an antipsychotic. [207] A review concluded that this use only has an effect on medium-term TRS and that there is not enough evidence to support its use other than for this group. [221][222] Psychiatrists Eric Bui and Rachel Rodgers argue that the Anakin Skywalker/Darth Vader character in the Star Wars films meets six of the nine diagnostic criteria; Bui also found Anakin a useful example to explain BPD to medical students. [198][199] A systematic review of clozapine-associated pulmonary embolism indicates that this adverse effect can often be fatal, and that it has an early onset, and is dose-dependent. [30] Hallucinations most commonly involve the sense of hearing as hearing voices but can sometimes involve any of the other senses of taste, sight, smell, and touch. As a result, people with BPD often evoke intense emotions in those around them. [39] Others can sometimes tell when someone with BPD is dissociating because their facial or vocal expressions may become flat or expressionless, or they may appear distracted. [94][95][96][97] However, ongoing misconceptions about the diagnosis of BPD in adolescence remain prevalent among mental health professionals. Distortions of self-experience such as feeling as if one's thoughts or feelings are not really one's own, to believing that thoughts are being inserted into one's mind, sometimes termed passivity phenomena, are also common. [5] Those affected typically use a high amount of healthcare resources. [93] Symptoms among adolescents that predict the development of BPD in adulthood may include problems with body-image, extreme sensitivity to rejection, behavioral problems, non-suicidal self-injury, attempts to find exclusive relationships, and severe shame. People with BPD tend to have trouble seeing their identity clearly. Researchers disagree about whether dissociation, or a sense of detachment from emotions and physical experiences, impacts the ability of people with BPD to recall the specifics of past events. Thus, researchers examine developmental causes in addition to childhood trauma. Its campaigns have shown a reduction in negative reporting. [62], Individual differences in women's estrogen cycles may be related to the expression of BPD symptoms in female patients. They are distinguishable by the timing and duration of symptoms, which are markedly different: the symptoms of PMDD occur only during the luteal phase of the menstrual cycle,[140] whereas BPD symptoms occur persistently at all stages of the menstrual cycle. [33] Delusions are bizarre or persecutory in nature. [125][126][124] Post-mortem studies consistently find that a subset of these neurons fail to express GAD67 (GAD1),[127] in addition to abnormalities in brain morphometry. 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