Attention deficit hyperactivity disorder and borderline personality disorder

Department of Psychiatry and Psychotherapy, University of Duisburg-Essen - Rhine Clinics Essen - Virchowstrasse 174, 45147 Essen, Germany.
Progress in Neuro-Psychopharmacology and Biological Psychiatry (Impact Factor: 3.69). 08/2005; 29(6):865-77. DOI: 10.1016/j.pnpbp.2005.04.033
Source: PubMed


To evaluate the association between attention deficit hyperactivity disorder (ADHD) and the diagnosis of borderline personality disorder (BPD) in adulthood, a systematic review of published follow-up data, mainly from observational studies was done. Electronic databases Medline, PsychInfo and PSYNDEXplus were searched from their earliest entries. All studies suggested significant relationships between ADHD and BPD. From a phenomenological point of view there seem to exist some similarities between these two disorders: deficits in affect regulation and impulse control, substance abuse, low self esteem and disturbed interpersonal relationship are common in both conditions. From a neuropsychological point of view dissociation in BPD might be regarded as a special form of behavioral inhibition and sustained attention comparable to ADHD. Possible therapeutic strategies of comorbid ADHD and BPD are discussed.

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    • "ADHD is another disorder marked by impulse and anger control problems, which can lead to impairments in social functioning (Sacchetti and Lefler, 2014; Wender et al, 2001). As BPD and ADHD often co-occur, this may further increase the likelihood of increased impulsivity in BPD (Davids and Gastpar, 2005; Krause-Utz et al, 2013; Philipsen et al, 2008). A recent study (Krause-Utz et al, 2013) demonstrated that "
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    ABSTRACT: Borderline Personality Disorder (BPD) and Attention Deficit Hyperactivity Disorder (ADHD) are both characterized by high impulsivity and difficulties in controlling anger and aggression. In BPD, comorbid ADHD may further increase impulsivity. For both disorders, altered MR spectroscopy levels of the neurotransmitters glutamate and GABA as well as some correlations with impulsivity were previously reported. The objective of this study was to investigate the neurotransmitters glutamate and GABA in relation to impulsivity and aggression as expressed in the anterior cingulate cortex (ACC) in groups of female patients with BPD and ADHD, respectively. Associations of glutamate and GABA levels with further BPD (symptom severity) and ADHD aspects (hyperactivity and inattention) were exploratively evaluated. 1H MRspectra were acquired at 3 T to determine glutamate to total creatine ratios (Glu/tCr) and GABA levels from the ACC in a BPD group (n=26), an ADHD group (n=22), and a healthy control (HC) group (n=30); all participants were females. Both patient groups showed higher scores on self-reported impulsivity, anger, and aggression compared to HCs. ACC GABA levels were significantly lower in ADHD than HC. While measures of impulsivity were positively related to glutamate and negatively to GABA, for aggression only a negative correlation with GABA could be demonstrated. These data provide human in vivo evidence for the role of ACC Glu/tCr and GABA in impulsivity and aggression. If distinct associations of Glu/tCr and GABA for BPD and ADHD can be confirmed in future studies, this might yield implications for more specific pharmacological treatments.Neuropsychopharmacology accepted article preview online, 04 June 2015. doi:10.1038/npp.2015.153.
    Neuropsychopharmacology 06/2015; DOI:10.1038/npp.2015.153 · 7.05 Impact Factor
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    • "Among these symptoms, impulsivity has been identified as one of the most common traits occurring within this behavioral overlap (Davids and Gastpar, 2005). Impulsivity and related dimensions, such as inhibitory deficits, are part of the impaired executive functions that have been found in ADHD subjects leading researchers to consider ADHD as an " executive disorder " (Willcutt et al., 2005). "
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    ABSTRACT: Adult attention deficit hyperactivity disorder (ADHD) is frequently associated with borderline personality disorder (BPD). As both disorders share some core clinical features they are sometimes difficult to distinguish from one another. The present work aimed to investigate differences in the expression of impulsivity, anger and aggression, quality of life as well as the number and severity of the comorbidities between ADHD, BPD, comorbid BPD-ADHD and control subjects. ADHD and BPD-ADHD patients showed a higher level of impulsivity than BPD and control subjects. BPD-ADHD patients had higher levels of substance abuse/dependence and higher levels of aggression than the other groups. Comorbid BPD-ADHD patients showed high levels of impulsivity and aggression, a characteristic that should draw the attention of clinicians on the necessity of providing an accurate diagnosis. The question also arises as to whether they represent a distinct clinical subgroup with specific clinical characteristics, outcomes and vulnerability factors.
    03/2014; 217(1-2). DOI:10.1016/j.psychres.2014.03.006
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    • "Nonetheless, diagnoses of ADHD are more frequent in survivors of interpersonal trauma (Briscoe-Smith & Hinshaw, 2006; Davids & Gastpar, 2005; Endo et al., 2006; Husain, Allwood, & Bell, 2008; Mulsow, O'Neal, & Murry, 2001; Weinstein, Staffelbach , & Biaggio, 2000). Given the prevalence of ADHD in environments where community trauma is common (Ford, Goodman, & Meltzer, 2004; Heiervang et al., 2007; Luna, 2006; Perry-Burney, Logan, Denby, & Gibson, 2007), the dysregulated affective and behavioral patterns found in ADHD following interpersonal trauma may be better conceptualized as one facet of an adaptation to extreme stress. "
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    ABSTRACT: Childhood exposure to victimization is prevalent and has been shown to contribute to significant immediate and long-term psychological distress and functional impairment. Children exposed to interpersonal victimization often meet criteria for psychiatric disorders other than posttraumatic stress disorder (PTSD). Therefore, this article summarizes research that suggests directions for broadening current diagnostic conceptualizations for victimized children, focusing on findings regarding victimization, the prevalence of a variety of psychiatric symptoms related to affect and behavior dysregulation, disturbances of consciousness and cognition, alterations in attribution and schema, and interpersonal impairment. A wide range of symptoms is common in victimized children. As a result, in the current psychiatric nosology, multiple comorbid diagnoses are necessary-but not necessarily accurate-to describe many victimized children, potentially leading to both undertreatment and overtreatment. Related findings regarding biological correlates of childhood victimization and the treatment outcome literature are also reviewed. Recommendations for future research aimed at enhancing diagnosis and treatment of victimized children are provided.
    American Journal of Orthopsychiatry 04/2012; 82(2):187-200. DOI:10.1111/j.1939-0025.2012.01154.x · 1.36 Impact Factor
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