Sleep-EEG in borderline patients without concomitant major depression: a comparison with major depressives and normal control subjects.

The link between borderline personality disorder (BPD) and the affective disorders remains controversial. The aim of this study was to examine the relationships between BPD and major depression (MD) from the perspective of sleep parameters and to contribute to the characterisation of the sleep-EEG in BPD. We compared 20 off-medication BPD in-patients without co-existing MD with 20 sex- and age-matched MD patients without BPD and 20 sex- and age-matched control subjects. BPD patients had a greater prevalence of drug or alcohol abuse and suicide attempts than MD patients. MD patients had higher scores on the Hamilton Depression Rating Scale (HDRS). Both BPD and MD patients had less total sleep time, more prolonged sleep onset latency, and a greater percentage of wakefulness than control subjects. BPD patients and control subjects had more stage 2 sleep than MD patients. BPD patients had a longer duration of rapid eye movement (REM) sleep, and less stage 3, stage 4 and slow wave sleep than MD patients and control subjects. REM latency did not differentiate the three groups. BPD and MD patients shared sleep-continuity characteristics, but sleep architecture differentiated the two groups. BPD patients with a past history of MD had more wakefulness and less slow wave sleep than BPD patients without a history of MD; other sleep parameters, age, sex and HDRS scores were not statistically different in the two BPD subgroups. Although BPD and MD may coexist, the present study offers more arguments favouring the concept that they are not biologically linked and that BPD patients with depressive symptoms often experience an affective syndrome different from that in MD patients without BPD, in terms of quality and duration of symptoms and of the biological substrate.

Brain glucose metabolism in borderline personality disorder.

We searched for regional cerebral metabolic disturbances in patients with borderline personality disorder (BPD). Ten inpatients with BPD, no current DSM-IIIR Axis I diagnosis and free of any psychotropic substances, were compared with 15 age-matched control subjects using positron emission tomography with 2-deoxy-2-[18F]fluoro-D-glucose and semiquantitative analysis of regional glucose metabolic activity. We found relative hypometabolism in patients with borderline personality disorder at the level of the premotor and prefrontal cortical areas, the anterior part of the cingulate cortex and the thalamic, caudate and lenticular nuclei. This study shows significant cerebral metabolic disturbances in patients with borderline personality disorder. These metabolic disturbances, which are similar to some of those described in other psychiatric entities, may help to understand the characteristic clinical aspects of this disorder.

[An electromagnetic problem]. / Un problema electromágnetico.

Induced psychotic disorder in infrequent. We report a case in which four members of the same family were affected. The bibliography is reviewed and certain etiological factors implicated in our case are discussed.