Advertisement

Personality Disorders (Narcissistic, Antisocial, Borderline)

  • Kostas N. Fountoulakis
Chapter

Abstract

The concept of personality and of PDs is both essential and controversial for psychiatry. Most definitions of personality focus on motivation and mental adaptation. Personality refers to the way a person shapes and adapts to an ever-changing internal and external environment. Its basic functions are to feel (emotional responses), to think and perceive (cognitive interpretation of self, the others and the environment) and to incorporate these into purposeful behaviours (interpersonal functioning, impulse control).

Keywords

American Psychiatric Association Mood Disorder Personality Disorder Bipolar Spectrum Personality Focus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Abraham PF, Calabrese JR (2008) Evidenced-based pharmacologic treatment of borderline personality disorder: a shift from SSRIs to anticonvulsants and atypical antipsychotics? J Affect Disord 111(1):21–30. doi: 10.1016/j.jad.2008.01.024, S0165-0327(08)00063-3 [pii]PubMedCrossRefGoogle Scholar
  2. Akiskal HS, Chen SE, Davis GC, Puzantian VR, Kashgarian M, Bolinger JM (1985) Borderline: an adjective in search of a noun. J Clin Psychiatry 46(2):41–48PubMedGoogle Scholar
  3. Allport G, Odbert H (1936) Trait-names: a psycho-lexical study. Psychol Monogr 47(1):1–177CrossRefGoogle Scholar
  4. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn, DSM-5. American Psychiatric Publishing, Washington, DCGoogle Scholar
  5. Bassett D (2012) Borderline personality disorder and bipolar affective disorder. Spectra or spectre? A review. Aust N Z J Psychiatry 46(4):327–339. doi: 10.1177/0004867411435289, 0004867411435289 [pii]PubMedCrossRefGoogle Scholar
  6. Bellino S, Paradiso E, Bogetto F (2008) Efficacy and tolerability of pharmacotherapies for borderline personality disorder. CNS Drugs 22(8):671–692. doi:2285 [pii]PubMedCrossRefGoogle Scholar
  7. Bellino S, Rinaldi C, Bozzatello P, Bogetto F (2011) Pharmacotherapy of borderline personality disorder: a systematic review for publication purpose. Curr Med Chem 18(22):3322–3329. doi:BSP/CMC/E-Pub/2011/ 239 [pii]PubMedCrossRefGoogle Scholar
  8. Bieling PJ, MacQueen GM, Marriot MJ, Robb JC, Begin H, Joffe RT, Young LT (2003) Longitudinal outcome in patients with bipolar disorder assessed by life-charting is influenced by DSM-IV personality disorder symptoms. Bipolar Disord 5(1):14–21. doi:014 [pii]PubMedCrossRefGoogle Scholar
  9. Binks CA, Fenton M, McCarthy L, Lee T, Adams CE, Duggan C (2006) Pharmacological interventions for people with borderline personality disorder. Cochrane Database Syst Rev (1):CD005653. doi: 10.1002/14651858.CD005653
  10. Bolton S, Gunderson J (1996) Distinguishing borderline personality disorder from bipolar disorder: differential diagnosis and implications. Am J Psychiatry 153:1202–1207PubMedGoogle Scholar
  11. Brieger P, Ehrt U, Marneros A (2003) Frequency of comorbid personality disorders in bipolar and unipolar affective disorders. Compr Psychiatry 44(1):28–34. doi: 10.1053/comp.2003.50009, S0010440X03000294 [pii]PubMedCrossRefGoogle Scholar
  12. Cloninger C, Svrakic D (2009) Personality disorders. In: Sadock B, Sadock V, Ruiz P (eds) Kaplan & Sadock’s comprehensive textbook of psychiatry, vol 2, 9th edn. Lippincott Williams & Wilkins, Philadelphia, pp 2198–2240Google Scholar
  13. Coulston CM, Tanious M, Mulder RT, Porter RJ, Malhi GS (2012) Bordering on bipolar: the overlap between borderline personality and bipolarity. Aust N Z J Psychiatry 46(6):506–521. doi: 10.1177/0004867412445528, 0004867412445528 [pii]PubMedCrossRefGoogle Scholar
  14. Deltito J, Martin L, Riefkohl J, Austria B, Kissilenko A, Corless CMP (2001) Do patients with borderline personality disorder belong to the bipolar spectrum? J Affect Disord 67(1-3):221–228. doi:S0165032701004360 [pii]PubMedCrossRefGoogle Scholar
  15. Fan AH, Hassell J (2008) Bipolar disorder and comorbid personality psychopathology: a review of the literature. J Clin Psychiatry 69(11):1794–1803. doi:ej08r04175 [pii]PubMedCrossRefGoogle Scholar
  16. Feurino L 3rd, Silk KR (2011) State of the art in the pharmacologic treatment of borderline personality disorder. Curr Psychiatry Rep 13(1):69–75. doi: 10.1007/s11920-010-0168-9 PubMedCrossRefGoogle Scholar
  17. Fountoulakis KN, Kaprinis GS (2006) Personality disorders: new data versus old concepts. Curr Opin Psychiatry 19(1):90–94. doi: 10.1097/01.yco.0000196158.98540.b6, 00001504-200601000-00017 [pii]PubMedCrossRefGoogle Scholar
  18. Frankenburg FR, Zanarini MC (2002) Divalproex sodium treatment of women with borderline personality disorder and bipolar II disorder: a double-blind placebo-controlled pilot study. J Clin Psychiatry 63(5):442–446PubMedCrossRefGoogle Scholar
  19. Garno JL, Goldberg JF, Ramirez PM, Ritzler BA (2005) Bipolar disorder with comorbid cluster B personality disorder features: impact on suicidality. J Clin Psychiatry 66(3):339–345PubMedCrossRefGoogle Scholar
  20. George EL, Miklowitz DJ, Richards JA, Simoneau TL, Taylor DO (2003) The comorbidity of bipolar disorder and axis II personality disorders: prevalence and clinical correlates. Bipolar Disord 5(2):115–122. doi:028 [pii]PubMedCrossRefGoogle Scholar
  21. Grilo C, Sanislow C, Gunderson J, Pagano M, Yen S, Zanarini M, Shea M, Skodol A, Stout R, Morey L, McClashan T (2004) Two-year stability and change of schizotypal, borderline, avoidant and obsessive-compulsive personality disorders. J Consult Clin Psychol 72(5):767–775PubMedCentralPubMedCrossRefGoogle Scholar
  22. Grilo C, Skodol A, Gunderson J, Sanislow C, Stout R, Shea M, Morey L, Zanarini M, Bender D, Yen S, McClashan T (2005) Longitudinal diagnostic efficiency of DSM-IV criteria for obsessive-compulsive personality disorder: a 2-year prospective study. Acta Psychiatr Scand 110:64–68CrossRefGoogle Scholar
  23. Gunderson JG, Weinberg I, Daversa MT, Kueppenbender KD, Zanarini MC, Shea MT, Skodol AE, Sanislow CA, Yen S, Morey LC, Grilo CM, McGlashan TH, Stout RL, Dyck I (2006) Descriptive and longitudinal observations on the relationship of borderline personality disorder and bipolar disorder. Am J Psychiatry 163(7):1173–1178. doi: 10.1176/appi.ajp.163.7.1173, 163/7/1173 [pii]PubMedCrossRefGoogle Scholar
  24. Herpertz SC, Zanarini M, Schulz CS, Siever L, Lieb K, Moller HJ (2007) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of personality disorders. World J Biol Psychiatry 8(4):212–244. doi: 10.1080/15622970701685224, 783497647 [pii]PubMedCrossRefGoogle Scholar
  25. Ingenhoven TJ, Duivenvoorden HJ (2011) Differential effectiveness of antipsychotics in borderline personality disorder: meta-analyses of placebo-controlled, randomized clinical trials on symptomatic outcome domains. J Clin Psychopharmacol 31(4):489–496. doi: 10.1097/JCP.0b013e3182217a69 PubMedCrossRefGoogle Scholar
  26. Ingenhoven T, Lafay P, Rinne T, Passchier J, Duivenvoorden H (2010) Effectiveness of pharmacotherapy for severe personality disorders: meta-analyses of randomized controlled trials. J Clin Psychiatry 71(1):14–25. doi: 10.4088/JCP.08r04526gre PubMedCrossRefGoogle Scholar
  27. Joyce PR, Luty SE, McKenzie JM, Mulder RT, McIntosh VV, Carter FA, Bulik CM, Sullivan PF (2004) Bipolar II disorder: personality and outcome in two clinical samples. Aust N Z J Psychiatry 38(6):433–438. doi: 10.1111/j.1440-1614.2004.01380.x, ANP1380 [pii]PubMedCrossRefGoogle Scholar
  28. Kay JH, Altshuler LL, Ventura J, Mintz J (2002) Impact of axis II comorbidity on the course of bipolar illness in men: a retrospective chart review. Bipolar Disord 4(4):237–242PubMedCrossRefGoogle Scholar
  29. Kernberg O (1975) Borderline conditions and pathological narcissism. Jason Aronson, New YorkGoogle Scholar
  30. Krishnan KR (2005) Psychiatric and medical comorbidities of bipolar disorder. Psychosom Med 67(1):1–8. doi: 10.1097/01.psy.0000151489.36347.18, 67/1/1 [pii]PubMedCrossRefGoogle Scholar
  31. Lieb K, Vollm B, Rucker G, Timmer A, Stoffers JM (2010) Pharmacotherapy for borderline personality disorder: cochrane systematic review of randomised trials. Br J Psychiatry 196(1):4–12. doi: 10.1192/bjp.bp.108.062984, 196/1/4 [pii]PubMedCrossRefGoogle Scholar
  32. Mantere O, Melartin TK, Suominen K, Rytsala HJ, Valtonen HM, Arvilommi P, Leppamaki S, Isometsa ET (2006) Differences in axis I and II comorbidity between bipolar I and II disorders and major depressive disorder. J Clin Psychiatry 67(4):584–593PubMedCrossRefGoogle Scholar
  33. McGlashan T (1986) The chestnut lodge follow-up study III. Long-term outcome of borderline personalities. Arch Gen Psychiatry 43:20–30PubMedCrossRefGoogle Scholar
  34. McGlashan T, Grilo C, Sanislow C, Ralevski E, Morey L, Gunderson J, Skodol A, Tracie Shea M, Zanarini M, Bender D, Stout R, Yen S, Pagano M (2005) Two-year prevalence and stability of individual DSM-IV criteria for schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders: toward a hybrid model of axis II disorders. Am J Psychiatry 162:883–889PubMedCentralPubMedCrossRefGoogle Scholar
  35. Mercer D, Douglass AB, Links PS (2009) Meta-analyses of mood stabilizers, antidepressants and antipsychotics in the treatment of borderline personality disorder: effectiveness for depression and anger symptoms. J Pers Disord 23(2):156–174. doi: 10.1521/pedi.2009.23.2.156 [pii]PubMedCrossRefGoogle Scholar
  36. Paris J, Gunderson J, Weinberg I (2007) The interface between borderline personality disorder and bipolar spectrum disorders. Compr Psychiatry 48(2):145–154. doi: 10.1016/j.comppsych.2006.10.001, S0010-440X(06)00107-6 [pii]PubMedCrossRefGoogle Scholar
  37. Parnas J, Licht D, Bovet P (2005) Cluster A personality disorders: a review. In: Mai M, Akiskal H, JE M, Okasha A (eds) Personality disorders. Wiley, New York, pp 1–74CrossRefGoogle Scholar
  38. Perugi G, Akiskal HS (2002) The soft bipolar spectrum redefined: focus on the cyclothymic, anxious-sensitive, impulse-dyscontrol, and binge-eating connection in bipolar II and related conditions. Psychiatr Clin North Am 25(4):713–737PubMedCrossRefGoogle Scholar
  39. Perugi G, Toni C, Travierso MC, Akiskal HS (2003) The role of cyclothymia in atypical depression: toward a data-based reconceptualization of the borderline-bipolar II connection. J Affect Disord 73(1–2):87–98. doi:S0165032702003294 [pii]PubMedCrossRefGoogle Scholar
  40. Perugi G, Angst J, Azorin JM, Bowden C, Vieta E, Young AH (2012) Is comorbid borderline personality disorder in patients with major depressive episode and bipolarity a developmental subtype? Findings from the international BRIDGE study. J Affect Disord 144:72–78. doi: 10.1016/j.jad.2012.06.008, S0165-0327(12)00452-1 [pii]PubMedCrossRefGoogle Scholar
  41. Pica S, Edwards J, Jackson HJ, Bell RC, Bates GW, Rudd RP (1990) Personality disorders in recent-onset bipolar disorder. Compr Psychiatry 31(6):499–510PubMedCrossRefGoogle Scholar
  42. Preston GA, Marchant BK, Reimherr FW, Strong RE, Hedges DW (2004) Borderline personality disorder in patients with bipolar disorder and response to lamotrigine. J Affect Disord 79(1-3):297–303. doi: 10.1016/S0165-0327(02)00358-0, S0165032702003580 [pii]PubMedCrossRefGoogle Scholar
  43. Reich J, Frances A (1984) The structural interview method for diagnosing borderline disorders: a critique. Psychiatry Q 56(3):229–235CrossRefGoogle Scholar
  44. Schiavone P, Dorz S, Conforti D, Scarso C, Borgherini G (2004) Comorbidity of DSM-IV personality disorders in unipolar and bipolar affective disorders: a comparative study. Psychol Rep 95(1):121–128PubMedCrossRefGoogle Scholar
  45. Sorvaniemi M, Hintikka J (2005) Recorded psychiatric comorbidity with bipolar disorder–a Finnish hospital discharge register study. Nord J Psychiatry 59(6):531–533. doi: 10.1080/08039480500360773, VL0375G732718418 [pii]PubMedCrossRefGoogle Scholar
  46. Stinson FS, Dawson DA, Goldstein RB, Chou SP, Huang B, Smith SM, Ruan WJ, Pulay AJ, Saha TD, Pickering RP, Grant BF (2008) Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 69(7):1033–1045. doi:ej08m04183 [pii]PubMedCentralPubMedCrossRefGoogle Scholar
  47. Stoffers J, Vollm BA, Rucker G, Timmer A, Huband N, Lieb K (2010) Pharmacological interventions for borderline personality disorder. Cochrane Database Syst Rev (6):CD005653. doi: 10.1002/14651858.CD005653.pub2
  48. Stone M (1993) Long-term outcome in personality disorders. Br J Psychiatry 162:229–313CrossRefGoogle Scholar
  49. Swann AC (2011) Antisocial personality and bipolar disorder: interactions in impulsivity and course of illness. Neuropsychiatry (Lond) 1(6):599–610. doi: 10.2217/NPY.11.69 CrossRefGoogle Scholar
  50. Swann AC, Lijffijt M, Lane SD, Steinberg JL, Moeller FG (2010) Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness. Acta Psychiatr Scand 121(6):453–461. doi: 10.1111/j.1600-0447.2009.01528.x, ACP1528 [pii]PubMedCentralPubMedCrossRefGoogle Scholar
  51. Swann AC, Lijffijt M, Lane SD, Steinberg JL, Moeller FG (2011) Interacting mechanisms of impulsivity in bipolar disorder and antisocial personality disorder. J Psychiatr Res 45(11):1477–1482. doi: 10.1016/j.jpsychires.2011.06.009, S0022-3956(11)00125-7 [pii]PubMedCentralPubMedCrossRefGoogle Scholar
  52. Swann AC, Lijffijt M, Lane SD, Steinberg JL, Moeller FG (2012) Antisocial personality disorder and borderline symptoms are differentially related to impulsivity and course of illness in bipolar disorder. J Affect Disord. doi: 10.1016/j.jad.2012.06.027, S0165-0327(12)00490-9 [pii]PubMedCentralGoogle Scholar
  53. Turley B, Bates GW, Edwards J, Jackson HJ (1992) MCMI-II personality disorders in recent-onset bipolar disorders. J Clin Psychol 48(3):320–329PubMedCrossRefGoogle Scholar
  54. Vita A, De Peri L, Sacchetti E (2011) Antipsychotics, antidepressants, anticonvulsants, and placebo on the symptom dimensions of borderline personality disorder: a meta-analysis of randomized controlled and open-label trials. J Clin Psychopharmacol 31(5):613–624. doi: 10.1097/JCP.0b013e31822c1636 PubMedCrossRefGoogle Scholar
  55. Waller N (1999) Evaluating the structure of personality. In: Cloninger C (ed) Personality and psychopathology. American Psychiatric Press, Washington, DC, pp 155–197Google Scholar
  56. Weber NS, Fisher JA, Cowan DN, Niebuhr DW (2011) Psychiatric and general medical conditions comorbid with bipolar disorder in the National Hospital Discharge Survey. Psychiatr Serv 62(10):1152–1158. doi: 10.1176/appi.ps.62.10.1152, 62/10/1152 [pii]PubMedCrossRefGoogle Scholar
  57. Zanarini MC, Frankenburg FR, Hennen J, Silk KR (2003) The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder. Am J Psychiatry 160(2):274–283PubMedCrossRefGoogle Scholar
  58. Zanarini M, Frankenburg F, Vujanovic A, Hennen J, Reich D, Silk K (2004) Axis II comorbidity of borderline personality disorder: description of 6-year course and prediction to time-to-remission. Acta Psychiatr Scand 110:416–420PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Kostas N. Fountoulakis
    • 1
  1. 1.Division of Neurosciences 3rd Department of PsychiatryAristotle University of Thessaloniki School of MedicineThessalonikiGreece

Personalised recommendations