Abstract
The diagnostic criteria of borderline personality disorder (BPD) were provided by DSM-III and its concept was made clear. However, there has been very little biological or electroencephalographical study of BPD. Most cases of BPD show affective instability and impulsivity as their characteristic symptoms. We have previously reported that cases of attempted suicide had a high rate of EEG abnormalities. Accordingly, we examined the EEGs and Rorschach tests of cases with BPD, in order to investigate the correlation between the biological and psychological characteristics of BPD.
The subjects (BPD group) were 32 cases (3 males and 29 females), who satisfied the diagnostic criteria for BPD. They presented to Juntendo Hospital from 1979 to 1985 and their ages ranged from 15 to 37 (average 21.3). We examined the EEGs of all cases and the Rorschach tests of 29 cases. As a age matched control group, 75 schizophrenic patients who were hospitalized during the same period, were selected (schizophrenic group). We also examined their EEGs and then compared the two groups.
The BPD group showed 27 (84.4%) definite and 3 (9.4%) marginal EEG abnormalities, characterized by a slowing of the basic rhythm and a 6 Hz spike and wave pattern (phantom spike and wave), which occurred significantly more often in the BPD group than in the schizophrenic group. In the BPD group, the 21 cases with paroxysmal discharges showed a significantly increased tendency to perform “physically self-damaging acts” (e. g. suicidal gestures) compared with the 11 cases without such discharges. In the results of the Rorschach tests, inclinations toward impulsivity (e. g. suicide indicator) were recognized.
Twenty four patients in the BPD group with EEG abnormalities were given antiepileptic drugs (e. g. Carbamazepine, Valproic acid, Phenytoin), singly, or together with psychotropic drugs.
Sixteen cases showed improvements such as an increased emotional stability and a cessation of suicidal tendencies.
It is concluded that BPD subjects show a high rate of EEG abnormalities associated with their affective instability and impulsivity. Therefore, the author emphasizes that the neurophysiological approach is valuable as well as the psychological approach in the diagnosis and treatment of BPD.
