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Discussion

Question re terminology

As a student nurse I thought borderline personality was someone with a nonpsychotic illness that had some symptoms of psychosis. For example, a depressed person hearing voices, or someone with OCD that thought God would punish them if they didn't keep to their routine.

Now I understand borderline to be someone with personal boundary issues, and black/white thinking, usually with no psychotic symptoms.

What is the correct word for the first type of patient, and do they usually get treated for psychosis separate from the original illness, or fix the psychotic symptoms by ramping up on treatment for the original disorder?

Thanks for the help.

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    • Expert

    canoehead:

    The easiest way to answer your enquiry would be to direct you to the DSM-IV. I can't seem to find my handy-dandy one at this time. And my old Windows98 won't allow me to move from one site to another easily. So, I'll try to convey an answer off the top of my head:

    Axis I is a Psychiatric Dx, e.g. MDD, Bipolar d/o, Paranoid Schizophrenia, etc.

    Axis II refers to a Personality d/o, e.g. Borderline Personality.

    Psychosis is a symptom and can accompany any Axis I Dx. For example, MDD with Psychotic features conveys that the Individual is depressed and suffers from delusions or what have you.

    So, to answer your first question, the Dx of Borderline Personality does not deal with psychosis.

    So, basically, your second paragraph is correct.

    I believe I've answered your third paragraph question in my explanation.

    If not, let me know. BTW: good questions. It's a confusing situation.

    Dave

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    • Author

    Thank you! I even have a lead on where to look to learn more. Gotta go look up the different axis types. Thanks.

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    • Expert

    Don't forget schizoaffective disorder, which combines some elements of schizophrenia (typically, the positive sxs, i.e., delusions and/or hallucinations) with an affective (mood) disorder.

    Since psychiatrists now seem to put anyone who stands still long enough on an antipsychotic medication, regardless of their symptoms (inc. those with mood disorders who have never had a psychotic sx in their lives), it's pretty safe to say that people with shizoaffective disorder (or anyone else) are having their psychotic sxs and and mood disorder sxs treated simultaneously (love that polypharmacy!!)

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    before I looked at elkpark's post, I was going to say that your first paragraph sounded like schizoaffective disorder type personality. As far as tx, I would say that would be individualized depending on which methods have already been tried and have failed, or by the patient's symptoms. Schizoaffective can be of a bipolar type, so they can be tx for the bipolar as well as given an antipsychotic for the psychotic symptoms. I hope that didn't confuse you! lol

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