Psychiatric Disorders in the Families of Borderline Patients
The prevalence of psychiatric disorders was studied among the families of hospitalized borderline patients, defined by Gunderson and Singer's criteria, and compared with the families of schizophrenic and depressed control patients. Among borderline probands, 38.3% have a first-degree relative with depression, 25.5% had one with pathological mood swings, and 23.4% had one with "eccentric or peculiar behavior." There was no significant increase in the prevalence of schizophrenia among the relatives of borderline patients. Depression was more prevalent in the families of schizotypal borderlines compared with unstable or mixed-pattern patients. There were no schizophrenic diagnoses among the impaired relatives of schizotypal borderlines. A relationship is suggested between affective disorder and criteria-defined borderline disorders.
Available from: ncbi.nlm.nih.gov
- "These findings are consistent with the results of other family studies that have found coaggregation with major depressive disorder (Baron et al., 1985; Links et al., 1988; Loranger et al., 1982; Pope et al., 1983; Schulz et al., 1986; Schulz et al., 1989; Silverman et al., 1991; Soloff & Millward, 1983; Zanarini et al., 1988), with substance use disorders (Links et al., 1988; Loranger & Tulis 1985; Pope et al., 1983; Schulz et al., 1986; Schulz et al., 1989; Silverman et al., 1991; Zanarini et al., 1988), and APD (Links et al., 1988; Pope et al. 1983; Schulz et al., 1989; Silverman et al. 1991; Soloff & Millward 1983; Zanarini et al., 1988). As with previous studies (Baron et al., 1985; Links et al., 1988; Loranger et al., 1982; Loranger & Tulis 1985; Pope et al., 1983; Schulz et al., 1989; Silverman et al., 1991; Soloff & Millward, 1983; Zanarini et al., 1988), we failed to find significant coaggregation with schizophrenia but because of the low prevalence of schizophrenia among relatives, our study and others have had little power to detect coaggregation with this disorder. "
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ABSTRACT: The purpose of this study was to assess the familial coaggregation of borderline personality disorder (BPD) with a full array of axis I disorders and four axis II disorders (antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and sadistic personality disorder) in the first-degree relatives of borderline probands and axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial psychopathology using the Revised Family History Questionnaire-a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of axis II comparison subjects was assessed. Using structural models for familial coaggregation, it was found that BPD coaggregates with major depression, dysthymic disorder, bipolar I disorder, alcohol abuse/dependence, drug abuse/dependence, panic disorder, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, somatoform pain disorder, and all four axis II disorders studied. Taken together, the results of this study suggest that common familial factors, particularly in the areas of affective disturbance and impulsivity, contribute to borderline personality disorder.
Available from: Borwin Bandelow
- "Family and twin studies also converge to support an underlying genetic component to the disorder. A number of studies investigating first degree relatives found higher rates of familiality in BPD patients than in controls (Baron et al., 1985; Loranger et al., 1982; Silverman et al., 1991; Soloff and Millward, 1983b; Zanarini et al., 1988), while one study found only a trend towards familiality (Reich, 1989) and another found an association only in patients with comorbid depression (Pope et al., 1983). Also, the offspring of borderline mothers are at high risk of psychopathology (Weiss et al., 1996). "
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ABSTRACT: Patients with borderline personality disorder (BPD) were compared with a healthy control group with regard to traumatic life events during childhood. The patients (n=66) and controls (n=109) were investigated using a comprehensive retrospective interview with 203 questions about childhood traumatic life events, parental attitudes, family history of psychiatric disorders and birth risk factors. The frequency of reports of traumatic childhood experiences was significantly higher in patients than in controls, including sexual abuse, violence, separation from parents, childhood illness, and other factors. On a 0- to 10-point "severe trauma scale," patients had significantly more severe traumatic events (mean score=3.86, SD=1.77) than control subjects (0.61, SD=0.93). Only four (6.1%) of the BPD patients, but 67 (61.5%) of the controls did not report any severe traumatic events at all. Compared with controls, patients described the attitude of their parents as significantly more unfavorable in all aspects. Patients reported significantly higher rates of psychiatric disorders in their families in general, especially anxiety disorders, depression, and suicidality. Among birth risk factors, premature birth was reported more often in BPD subjects. In a logistic regression model of all possible etiological factors examined, the following factors showed a significant influence: familial neurotic spectrum disorders, childhood sexual abuse, separation from parents and unfavorable parental rearing styles. The present data support the hypothesis that the etiology of BPD is multifactorial and that familial psychiatric disorders and sexual abuse are contributing factors.
Available from: Larry J Siever
- "However, it is important to note that all information about the relatives was derived from the borderline personality disorder patients themselves. Soloff and Millward (1983) did not really study borderline personality disorder among relatives, but rather what they called «eccentric or peculiar behavior», in other words, personality features more similar to schizotypal personality disorder than borderline personality disorder. "
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ABSTRACT: Although it is generally acknowledged that borderline personality disorder (BPD) has a complex, multifactorial etiology with interacting genetic and environmental substrates, the specific genetic underpinnings of this disorder have not been extensively investigated. Family aggregation studies suggest the heritability for BPD as a diagnosis, but the genetic basis for this disorder may be stronger for dimensions such as impulsivity/aggression and affective instability than for the diagnostic criteria itself. Family, adoptive, and twin studies also converge to support an underlying genetic component to the disorder. An endophenotypic approach to defining the genetics of this complex disorder may be called for. Twin studies in an epidemiologic, non-clinically ascertained sample using both diagnostic measures and laboratory measures that can be operationalized, including neuropsychologic, psychophysiologic, and operationalized behavioral tests, may be useful. Large-scale family studies of clinically ascertained samples with careful diagnostic demarcation and measurement of endophenotypes in probands and relatives may also prove to be a promising approach. The use of laboratory paradigms for measures of aggression and affective instability are discussed in the context of such endophenotypic approaches.
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