borderline-personality-disorder

Borderline Personality Disorder in the ED

January 7, 2022

Victor Hong, MD.
Clinical Assistant Professor, Department of Psychiatry, University of Michigan, Ann Arbor, MI.

Dr. Hong has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Patients with borderline personality disorder often show up in emergency rooms multiple times and can trigger frustration and countertransference reactions in clinicians. Dr. Hong tells us how to help these patients and their families develop the skills needed to manage their emotions.

Working With Severe Personality Disorders

January 4, 2022

Dan H. Buie, MD and Interview by Marcia L. Zuckerman, MD.

Dan H. Buie, MD Psychiatrist, psychoanalyst, and associate professor of psychiatry, Tufts Medical School, Boston, MA. Author of numerous publications on empathy, aggression, suicide, and borderline personality disorder, including the classic article “Countertransference Hate in the Treatment of Suicidal Patients,” which he coauthored with Terry Maltsberger in 1974 (Maltsberger JT and Buie DH, Arch Gen Psychiatry 1974;30(5):625–633).

Interview by Marcia L. Zuckerman, MD. Board member of The Carlat Psychiatry Report; outpatient psychiatrist, Hallmark Health, Medford, MA; clinical assistant professor in psychiatry, Tufts School of Medicine. Dr. Buie and Dr. Zuckerman have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Psychoanalyst Dan Buie, MD, addresses the powerful emotions that can build up – or tear down – the therapeutic relationship when working with severe personality disorders and other “difficult” patients.

Overdiagnosis in Psychiatry

September 10, 2021

Joel Paris, MD

Joel Paris, MD

Professor emeritus at McGill University, and senior psychiatrist and research associate at Sir Mortimer B. Davis-Jewish General Hospital. Dr. Paris is the former editor of the Canadian Journal of Psychiatry and the author of 25 books including Overdiagnosis in Psychiatry, 2nd ed. (Oxford University Press; 2020). Dr. Paris has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Joel Paris explains why adult ADHD, depression, bipolar II, PTSD, and borderline personality are overdiagnosed in psychiatry at the expense of schizophrenia.

CLINICAL UPDATE

Deliberate Foreign Body Ingestion

April 12, 2021

Adrienne Grzenda, MD, PhD.

Adrienne Grzenda, MD, PhD. Clinical Assistant Professor of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine and UCLA-Olive View Medical Center. Dr. Grzenda has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Why would anyone deliberately swallow a nondigestible object? What items require emergent removal, vs simple monitoring? And how can you help patients who repeatedly swallow foreign bodies?

CLINICAL UPDATE

How to Use Lamotrigine

January 1, 2021

Chris Aiken, MD.

Chris Aiken, MD. Editor-in-Chief of TCPR. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Lamotrigine is approved for the prevention of bipolar episodes, but Dr. Aiken explains why it may also treat active bipolar depression. This mood stabilizer is among the most tolerable in its class, and has additional benefits in OCD, borderline personality disorder, and depersonalization disorder.

Take a Breather: A Mindful Tactic for Borderline Dysphoria

June 10, 2020

Greg Sazima, MD.

Greg Sazima, MD. Senior Behavioral Faculty, Stanford/O’Connor Family Medicine Residency Program, San Jose, CA. Dr. Sazima has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dysphoric states cause intense anxiety and an urgent need to get relief. They can drive patients to self-harm, substance abuse, and suicide. Greg Sazima describes a breathing technique that helps patients pass safely through these crises.

EXPERT Q&A

A Pragmatic Approach to Borderline Personality Disorder

June 10, 2020

Lois Choi-Kain, MEd, MD

Lois Choi-Kain, MEd, MD
Director of the Gunderson Personality Disorders Institute at McLean Hospital, Belmont, MA. Co-editor of Applications of Good Psychiatric Management for Borderline Personality Disorders: A Practical Guide (APA, 2019) with the late John Gunderson, MD (1942–2019). Dr. Choi-Kain has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

You don’t need to be a psychoanalyst or DBT specialist to help patients with borderline personality disorder. Lois Choi-Kain developed a psychotherapeutic approach that can be woven into just about any psychiatric treatment, from the medication visit to the hospital wards.

CLINICAL Q&A

The Modafinils in Bipolar Depression

June 10, 2020

Chris Aiken, MD.

Chris Aiken, MD. Editor-in-Chief of TCPR. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Provigil and Nuvigil, the modafinils, may not work for full depressive episodes, but they do something else in bipolar disorder that’s important to patients. This article explores their cognitive effects, as well as their potential to cause addiction and mania.

Evaluating for Borderline Personality Disorder

May 9, 2019

According to DSM-5, BPD is “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity.” Based on the eight DSM-5 criteria for BPD, here are some questions you can ask patients to confirm a diagnosis:Identity disturbanceAsk patients, “Do you have a sense of where you’re going...