Theory of Mind in Borderline Personality Disorder: A Possible Endophenotypic Factor?

The purpose of this study is to examine whether theory of mind (ToM) is an endophenotypic marker of borderline personality disorder (BPD), thus constituting an etiopathogenic factor of the disease. This would suggest familial vulnerability to BPD. This was a case-control study involving 146 individuals with 57 BPD patients, 32 first-degree relatives, and 57 controls (median age of BPD and control = 33.4 years; relatives = 52.9 years; BPD females and controls = 91.2%; female relatives = 62.5%). All the participants completed the Spanish version of the Movie for the Assessment of Social Cognition test to evaluate the ToM subclassification: interpretation of emotions, thoughts and intentions. BPD patients and their healthy first-degree relatives exhibited significant deficits in the correct interpretation of emotions and intentions compared to healthy controls. Both patients with BPD and their healthy first-degree relatives exhibited significant deficits in ToM, which suggests that it may be an etiopathogenic factor of BPD, and ToM (interpretation of emotions, thoughts and intentions) is a possible endophenotypic marker of BPD, suggesting a genetic predisposition to the disorder. Therefore, ToM could be considered as an indicator for the early detection of the disorder of and intervention for BPD.

Social cognition and social functioning in people with borderline personality disorder and their first-degree relatives.

BACKGROUND: A few papers studying healthy, first-degree relatives of people with borderline personality disorder (BPD) have found that this group presents attention and memory problems. However, current research has not analyzed their social cognition. MATERIALS AND METHODS: We designed an age-, gender- and education-level matched case-control study involving 57 people with BPD, 32 of their first-degree relatives, and 57 healthy controls in Spain in 2018-2019. All were assessed for social cognition and functioning using the Movie for Assessment of Social Cognition and the Social Functioning Scale; other potential confounders were also collected (marital status, occupation and household variables). RESULTS: There were differences in the social cognition domain of overmentalizing errors, with the BPD group scoring significantly higher than controls; however, there was no significant difference with relatives; in the social functioning domain of family relationships, with the controls showing the highest scores. Social engagement/withdrawal, interpersonal behavior, independence-competence, prosocial activities, full scale and categorization domains showed the same pattern: the BPD group had lower scores than their relatives and the controls. Relatives were significantly different from BPD patients in family relationships, social engagement/withdrawal and interpersonal behavior, as well as on the full Social Functioning Scale (both as a linear and categorical variable). However, only controls showed differences with relatives in family relationships. CONCLUSIONS: All in all, relatives show similar levels of social cognition and functioning compared with controls, and people with BPD show some alterations in different domains of both social cognition and functioning.

Ciencias de la salud basada en la evidencia: hechos y reflexiones para la práctica clínica / No disponible

Actualmente, el ejercicio clínico de los profesionalessanitarios se basa, por un lado, en el conocimientoclínico personal acumulado en el paso de los añosy, por otro, en el afecto a procedimientos estándarsustentados largamente en el tiempo, es decir, enlo que se podría llamar como “ciencias de la saludbasada en la experiencia”. Esto es un problema queafecta generalmente a todas las ciencias de la salud;medicina, terapia ocupacional, fisioterapia, podología,...y produce que la atención podológica, eneste caso, varíe mucho entre un podólogo y otro. Elproblema es que es prácticamente imposible para unprofesional sanitario mantenerse actualizado, ya quela nueva información que aparece cada año es muygrande. Algunos autores establecieron hace unos 10años que, para mantenerse al día, actualmente unmédico de medicina general debe leer 19 artículosal día los 365 días del año. Esto plantea algunos problemasal podólogo que quiera tomar una decisiónactualizada con respecto al diagnóstico, pronósticoo tratamiento de un paciente. Más aún, si tenemosen cuenta que muchos artículos no tienen una relevanciaclínica de importancia o presentan erroresmetodológicos, o no son publicados en revistas deimpacto. La respuesta la podemos encontrar en laciencias de la salud basada en la evidencia o en nuestrocaso de la Podología basada en la evidencia, queproviene de la practica de la medicina basada en laevidencia, la que ha sido definida como el uso racionalde la mejor evidencia posible, según la experiencia clínicay el conocimiento de las preferencias del paciente ypara recomendar el tratamiento correcto, al tiempo correcto para el paciente indicado...(AU)

Currently the exercise of clinical health professionalsis based on the one hand on the knowledge accumulatedclinical staff in the years pass and another onaffection to standard procedures based on the longtime that is, in what might be called as a “experiencebased health sciences” This is a problem that usuallyaffects all health sciences, medicine, occupationaltherapy, physiotherapy, podiatry, ... And producesthat podiatry attention, in this case, differ greatlyfrom one another and podiatrist. The problem is thatit is virtually impossible for health care professionalskeep up, because the new information that appearsevery year is very large. Some authors establishedsome 10 years ago that to keep up, now a general practitionermust read 19 articles a day, 365 days a year.This raises some problems podiatrist who wants totake a decision with regard to the current diagnosis,prognosis or treatment of a patient. Moreover, if weconsider that many items have no clinical relevanceor importance of methodological errors, or are notpublished in journals impact. The answer can befound in the Evidence-based Health Sciences or inour case of Evidence-based Podiatry, which comesfrom the practice of evidence-based medicine, whichhas been defined as the rational use of the best evidencepossible, according to the clinical experienceand knowledge of the preferences of the patient andrecommend the proper treatment, the time is rightfor the patient indicated. The evidence-based healthsciences allows us to maintain a continuing education,avoiding falling into the routine clinical, clearlyidentifying what is not known about a particular topic. Restructuring at the same time, the mannerby which we solve the clinical problems(AU)

Temas valorados críticamente: un aprendizaje basado en la evidencia / No disponible

En la práctica clínica diaria, se nos plantean dudasconstantes sobre la etiología, diagnóstico, tratamientoo pronóstico de las distintas afecciones de los piesde nuestros pacientes. Para resolver estas dudas,proponemos utilizar los Temas Valorados Críticamente,del inglés Critical Appraisal Topic. Aunqueesta metodología requiere de un esfuerzo mayorque el que requiere solventar dudas mediante otrosmétodos, sigue una sistemática de trabajo basada enla Medicina Basada en la Evidencia, la cual le otorgauna gran validez. Los Temas Valorados Críticamenteson documentos en forma de resumen breve de laspruebas científicas más relevantes, en relación a unapregunta clínica específica. Mediante este métodose intenta formular preguntas correctas, surgidasdurante la práctica clínica diaria, para buscar lamejor evidencia disponible, una vez encontrada seorganiza, resume, integra y se lleva a la práctica.Dando respuesta, en tiempo real, a cuestiones quesurgen durante la práctica diaria, facilitando elproceso de toma de decisiones(AU)

In the daily clinical practice, constant doubts appearon the etiology, diagnosis, treatment or predictionof the different affections of the feet of our patients.To solve these doubts, we propose to use the CriticalAppraisal Topic. Though this methodology needsof a major effort that the one that it needs to settledoubts by means of other methods, follows the systematicalone of work based on the Evidence BasedMedicine, which grants a great validity to him. TheTopics Valued Critically are documents in the shapeof brief summary of the most relevant scientifictests, in relation to a clinical specific question. Bymeans of this method one tries to formulate correctquestions arisen during the clinical daily practice, tolook for the best available evidence, once opposingone organizes, summarizes, integrates and removesto the practice. Giving response, in real time, toquestions that arise during the daily practice, facilitatingthe process of capture of decisions(AU)

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