Narcissism as a protective factor against the risk of self-harming behaviors without suicidal intention in Borderline Personality Disorder.

The spectrum of suicidal behavior is a core factor of the prognosis and care of Borderline Personality Disorder (BPD). The aim of this study is to identify possible BPD specific personality traits that could act as protective factors of nonsuicidal self-injuries (NSSI.

Antisocial traits and neuroticism as predictors of suicidal behaviour in borderline personality disorder: A retrospective study.

INTRODUCTION: The spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. METHODS: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ2 test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. RESULTS: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. CONCLUSIONS: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.

Physical and mental illness comorbidity among individuals with frequent self-harm episodes: A mixed-methods study.

Background: Research has indicated an increased risk of self-harm repetition and suicide among individuals with frequent self-harm episodes. Co-occurring physical and mental illness further increases the risk of self-harm and suicide. However, the association between this co-occurrence and frequent self-harm episodes is not well understood. The objectives of the study were (a) to examine the sociodemographic and clinical profile of individuals with frequent self-harm (regardless of suicidal intent) episodes and, (b) the association between physical and mental illness comorbidity, self-harm repetition, highly lethal self-harm methods, and suicide intent. Methods: The study included consecutive patients with five or more self-harm presentations to Emergency Departments across three general hospitals in the Republic of Ireland. The study included file reviews (n = 183) and semi-structured interviews (n = 36). Multivariate logistic regression models and independent samples t-tests were used to test the association between the sociodemographic and physical and mental disorders comorbidity on highly lethal self-harm methods and suicidal intent, respectively. Thematic analysis was applied to identify themes related to physical and mental illness comorbidity and frequent self-harm repetition. Findings: The majority of individuals with frequent self-harm episodes were female (59.6%), single (56.1%), and unemployed (57.4%). The predominant current self-harm method was drug overdose (60%). Almost 90% of the participants had history of a mental or behavioral disorder, and 56.8% had recent physical illness. The most common psychiatric diagnoses were alcohol use disorders (51.1%), borderline personality disorder (44.0%), and major depressive disorder (37.8%). Male gender (OR = 2.89) and alcohol abuse (OR = 2.64) predicted the risk of a highly lethal self-harm method. Suicide intent was significantly higher among those with a diagnosis of major depressive disorder (t = 2.43; p = 0.020). Major qualitative themes were (a) the functional meaning of self-harm (b) self-harm comorbidity (c) family psychiatric history and (d) contacts with mental health services. Participants described experiencing an uncontrollable self-harm urge, and self-harm was referred to as a way to get relief from emotional pain or self-punishment to cope with anger and stressors. Conclusion: Physical and mental illness comorbidity was high among individuals with frequent self-harm episodes. Male gender and alcohol abuse were associated with highly lethal self-harm methods. The mental and physical illness comorbidity of individuals with frequent self-harm episodes should be addressed via a biopsychosocial assessment and subsequent indicated treatment interventions.

Rasgos antisociales y neuroticismo como predictores de conducta suicida en trastorno límite de la personalidad: un estudio retrospectivo

Introducción: El espectro de la conducta suicida (CS) es nuclear en la clínica y el tratamiento del trastorno límite de personalidad (TLP). Los rasgos patológicos del TLP intervienen como factores de riesgo de CS en confluencia con otras variables clínicas y sociodemográficas asociadas con el TLP. El objetivo del presente trabajo consiste en evaluar los rasgos de personalidad específicos del TLP que se relacionan con la CS. Métodos: Se realiza un estudio transversal, observacional y retrospectivo, de una muestra de 134 pacientes con diagnóstico de TLP según los criterios del DSM-5. Se utilizan los cuestionarios de Millon-II, Zuckerman-Kuhlman y Barrat para valorar distintos parámetros de la personalidad. Se realizan comparaciones por variables mediante las pruebas de la x2 y de la t de Student. La asociación entre variables se analiza mediante regresión logística multivariada. Resultados: Se objetivan diferencias estadísticamente significativas entre la CS y relacionadas y la dimensión neuroticismo-ansiedad en el test de Zuckerman-Kuhlman. Asimismo se relaciona de manera significativa con la subescala fóbica y antisocial del Millon-II. La impulsividad medida con las pruebas de Zuckerman-Kuhlman y Barrat no aparece relacionada con la CS. Conclusiones: Los resultados presentados plantean el papel de los rasgos fóbicos, antisociales y del neuroticismo como posibles rasgos de personalidad del TLP relacionados con la CS. Incluso se propone una importancia mayor que el de la impulsividad dentro de la relación del TLP con la CS. De cara al futuro, estudios longitudinales permitirían aumentar la evidencia científica de los hallazgos presentados. © 2021 Asociación Colombiana de Psiquiatría. Publicado por Elsevier Espafña, S.L.U. Todos los derechos reservados.

Introduction: The spectrum of suicidal behaviour (SB) is nuclear in the clinic andmanagement of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. Methods: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. Results: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. Conclusions: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings. © 2021 Asociacio´n Colombiana de Psiquiatria. Published by Elsevier España, S.L.U. All rights reserved.

Narcisismo como variable protectora frente al riesgo de conductas autolesivas sin intención suicida en Trastorno Límite de la Personalidad / Narcissism as a protective variable against the risk of self-injurious behaviour without suicidal intent in Borderline Personality Disorder

Introducción y objetivos: El espectro de la conducta suicida tiene un carácter nuclear en el pronóstico y manejo delTrastorno Límite de la Personalidad (TLP). El objetivo de esteestudio es identificar posibles rasgos de personalidad específicos del TLP que puedan actuar como protectores de lasautolesiones sin finalidad suicida (ASFS).Método. Se realiza un estudio transversal, observacionaly retrospectivo, de una muestra de 134 pacientes de entre 18y 56 años con TLP. La evaluación clínica se llevó a cabo conun cuestionario que valoraba la presencia o no de conductas suicidas (CS) y ASFS y distintas variables sociodemográficas. También se realizaron cuestionarios de personalidad:Inventario Clínico Multiaxial de Millon II, Cuestionario dePersonalidad de Zuckerman-Kuhlman y la entrevista ClínicaEstructurada para el eje II del DSM (SCID). La asociación entre variables se analizó a través de un modelo de regresiónlogística multivariado y binomial negativaResultados. Se encuentra una asociación estadísticamente significativa entre la CS con las ASFS y entre realizarmayor número de intentos de suicidio y la presencia de ASFS.Respectivamente, las ASFS se asocian de forma estadísticamente significativa con los intentos de suicidio. Por otrolado, se objetivan diferencias estadísticamente significativasen la asociación de ASFS con las variables en el SCID Trastorno Narcisista, apareciendo como variable con efecto protector. Los resultados presentados proporcionan una idea de larelación dinámica entre NSSI y SB en una población TLP concaracterísticas de gravedad. Conclusiones. El papel de los rasgos de personalidad narcisistas puede ser importante a la hora de identificar factoresprotectores para las NSSI y SB en TLP y podría ser objeto dedesarrollo de ulteriores proyectos de investigación. (AU)

Background and Objectives: The spectrum of suicidalbehavior is a core factor of the prognosis and care ofBorderline Personality Disorder (BPD). The aim of this study isto identify possible BPD specific personality traits that couldact as protective factors of nonsuicidal self-injuries (NSSI).Methods. We performed a cross-sectional, observationaland retrospective study of a sample of 134 BPD patients agedfrom 18 to 56. We assessed the presence or absence of suicidalbehavior and NSSI as well as different sociodemographicvariables. Millon, Zuckerman-Kuhlman and StructuredClinical Interview for DSM personality questionnaires werealso applied. The analysis of the association between variableswas carried out with a multivariate negative binomial logisticregression model.Results. A statistically significant associationbetween NSSI and suicidal behavior was found. Elseways,statistically significant differences were also found inthe association between NSSI and the SCID variables forNarcissistic Disorder, which appears as protective variables. These results provide an idea of the dynamic relationshipbetween NSSI and suicidal behavior in a BPD populationwith particularly severe characteristics.Conclusions. The role of narcissistic personality traitsappears to be important in identifying protective factors forNSSI and suicidal behavior in BPD patients and could be thesubject of further research projects. (AU)

Association between non-suicidal self-injury and suicidal behavior in Borderline Personality Disorder: a retrospective study.

Suicidal behavior (SB) spectrum is nuclear in the clinic and management of Borderline Personality Dis- order (BPD). Although in recent research papers non-suicidal self-injury behavior (NSSI) and suicidal behavior (SB) differ in intentionality, frequency and lethality; these two behaviors have been described concurrently with a controversial distinction. Few works talk about the reason for the co-occurrence between both entities in the psychiatric population in general and in BPD in particular. The aim of the report is to analyze the link between SB and NSSI in BPD.

Organic bipolar disorder secondary to central neurocytoma resection: a case report.

entral neurocytoma is a neuroepithelial tumor described by Hassoun in 1982, predominantly located in the midline at the level of the septum pellucidum, or in the lateral ventricles wall1. They represent approximately 50% of intraventricular lesions in adults, and they are in total 0.25-0.5% of intracranial tumors.

Asociación entre las autolesiones sinfinalidad suicida y la conducta suicidaen trastorno límite de personalidad: un estudio retrospectivo / Association between non-suicidal self-injury and suicidal behavior in Borderline Personality Disorder: a retrospective study

Introducción: El espectro de la conducta suicida (CS) esnuclear en la clínica y el manejo del trastorno límite de personalidad (TLP). Aunque en trabajos de investigación recienteslas autolesiones sin finalidad suicida (ASFS) y la CS se diferencian en intencionalidad, frecuencia y letalidad, se ha descritoque estos dos comportamientos a menudo ocurren de maneraconcurrente, siendo la distinción entre ambas un tema controvertido. Pocos trabajos hablan del porqué de la coocurrenciaentre ambas entidades en población psiquiátrica en general yen TLP en particular. El objetivo del presente trabajo es analizarla relación entre CS y ASFS en TLP.Metodología. Se realiza un estudio transversal, observacional y retrospectivo de una muestra de 134 pacientes deentre 18 y 56 años, con diagnóstico de TLP de acuerdo concriterios DSM-5. La asociación entre variables se analizó através de un modelo de regresión logística multivariado ybinomial negativa.Resultados. El 77,6 % refieren antecedentes de al menosun IS, mientras que el 22,4 % ninguno. La media del númerode IS es de 2,69. Para las ASFS, el 64,2 % las presentaban,mientras que el 35,8 % no. Se encuentra una asociación estadísticamente significativa entre ambas. Los ASFS también serelacionan de manera significativa con realizar mayor númerode IS según el análisis multivariante.Conclusiones. Los resultados apuntan a que estas conductas son nucleares y frecuentes en el TLP. Ambas aparecenrelacionadas entre sí de forma significativa. De cara al futuro,estudios longitudinales permitirían esclarecer la dirección dedicha relación. (AU)

Introduction: Suicidal behavior (SB) spectrum is nuclear inthe clinic and management of Borderline Personality Disorder(BPD). Although in recent research papers non-suicidal selfinjury behavior (NSSI) and suicidal behavior (SB) differ inintentionality, frequency and lethality; these two behaviorshave been described concurrently with a controversialdistinction. Few works talk about the reason for the cooccurrence between both entities in the psychiatric populationin general and in BPD in particular. The aim of the report is toanalyze the link between SB and NSSI in BPD.Methods. A cross-sectional, observational and retrospectivestudy was carried out on a sample of 134 patients between18 and 56 years old, diagnosed with BPD according to DSM-5criteria. The association between variables was analyzed througha negative binomial and multivariate logistic regression model.Results. 77.6% report a history of at least one suicideattempt (SA), while 30.4% none. The average number ofSA is 2.69. For NSSI, 64.2% presented them, while 35.8%did not. A statistically significant association is found between both of them. NSSI are also significantly relatedto performing a greater number of SA according to the multivariate analysis. Conclusions. The results suggest that these behaviors arenuclear and frequent in BPD. Both appear significantly related to each other. Looking ahead, longitudinal studies are needed to confirm the relationship between these variables. (AU)

Investigating the relationship between childhood sexual abuse, self-harm repetition and suicidal intent: mixed-methods study.

BACKGROUND: Research into the association between childhood sexual abuse (CSA) and self-harm repetition is limited. AIMS: We aimed to examine the association between self-harm repetition, mental health conditions, suicidal intent and CSA experiences among people who frequently self-harm. METHOD: A mixed-methods study was conducted including consecutive patients aged ≥18 years, with five or more self-harm presentations, in three Irish hospitals. Information was extracted from psychiatric records and patients were invited to participate in a semi-structured interview. Data was collected and analysed with a mixed-methods, convergent parallel design. In tandem, the association between CSA and self-harm repetition, suicidal intent and mental health conditions was examined with logistic regression models and independent sample t-test, with psychiatric records data. Thematic analysis was conducted with interview data, to explore CSA experiences and self-harm repetition. RESULTS: Between March 2016 and July 2019, information was obtained on 188 consecutive participants, with 36 participants completing an interview. CSA was recorded in 42% of the total sample and 72.2% of those interviewed. CSA was positively associated with self-harm repetition (odds ratio 6.26, 95% CI 3.94-9.94, P = 0.00). Three themes emerged when exploring participants' CSA experiences: CSA as a precipitating factor for self-harm, secrecy of CSA accentuating shame, and loss experiences linked to CSA and self-harm. CONCLUSIONS: CSA was frequently reported among people who frequently self-harm, and associated with self-harm repetition. Identification of patients at risk of repetition is key for suicide prevention. This is an at-risk group with particular characteristics that must be considered; comprehensive patient histories can help inform and tailor treatment pathways.

Antisocial Traits and Neuroticism as Predictors of Suicidal Behaviour in Borderline Personality Disorder: a Retrospective Study. / Rasgos antisociales y neuroticismo como predictores de conducta suicida en trastorno límite de la personalidad: un estudio retrospectivo.

INTRODUCTION: The spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. METHODS: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ2 test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. RESULTS: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. CONCLUSIONS: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.

Depresión en el anciano, síntomas psicológicos y conductuales asociados a la demencia y síndrome paraneoplásico: dificultades diagnósticas. A propósito de un caso / Depression in the elderly, psychological and behavioral symptoms associated with dementia and paraneoplastic syndrome: diagnostic difficulties. A case report

El síndrome depresivo del anciano tiene unas características específicas, como un mayor predominio de la clínica motora y una menor sensación subjetiva de tristeza. El diagnóstico conlleva una dificultad añadida por la frecuente polimedicación, comorbilidades médicas y el deterioro funcional y cognitivo propios de este grupo etario. Se presenta el caso de un paciente de 83 años en el que se plantea un diagnóstico diferencial entre los síntomas psicológicos y conductuales asociados a la demencia y el síndrome depresivo del anciano, en un caso en el que la positividad a un anticuerpo onconeuronal actuó como factor distractor

Depression in the elderly is characterized by specific features such as a greater predominance of motor symptoms and a less subjective feeling of sadness. Diagnosis involves an added difficulty due to frequent polymedication, medical comorbidities, and functional and cognitive impairment typical of this age group. The case of an 83 year old patient is presented. Differential diagnosis is discussed between behavioural and psychological symptoms of dementia and depression in the elderly, in a case where positivity to an onconeuronal antibody acted as a distracting factor

International Mental Health perspectives on the novel coronavirus SARS-CoV-2 pandemic / Perspectivas Internacionales en Salud Mental ante la pandemia por el nuevo coronavirus SARS-CoV-2

No disponible

Bullying and childhood trauma events as predictive factors of suicidal behavior in borderline personality disorder: Preliminary findings.

Traumas in childhood could present a significant association with suicidal behavior in BPD. The aim of the report is to study the link between a traumatic childhood involving school bullying and the different forms and degrees of suicidal behavior in BPD. A cross-sectional study was carried out on a sample of 109 BPD patients. It is divided into two groups whether or not there is a history of suicidal behavior. The clinical variables are compared with Chi square and Student's T tests. Traumatic childhood history and bullying, in particular, showed a statistically significant association with the incidence of suicidal behaviors.

Emocionalidad y temperamento en el trastorno por déficit de atención con o sin hiperactividad / Emotionality and temperament in attention deficit disorder with or without hyperactivity

Introducción: Existe en el trastorno por déficit de atención con o sin hiperactividad (TDAH) una dificultad para dirigir las emociones para resolver retos o problemas. Esta alteración en la autorregulación emocional implica mayor discapacidad que las atribuidas a las dos dimensiones tradicionales, déficit de atención e hiperactividad, con un impacto notorio sobre el desarrollo de la personalidad. Objetivo: Revisar cómo la confluencia de pobres habilidades de autorregulación, conciencia y autonomía emocional, y un perfil de temperamento determinado potencian el riesgo de los niños diagnosticados con TDAH para el desarrollo de una diversidad de problemas de ajuste en la infancia y la adolescencia. Desarrollo: El perfil temperamental típico de los niños con TDAH se caracteriza por una alta reactividad emocional y pobres habilidades de autorregulación. Los efectos de la interacción de la emocionalidad y el temperamento en el TDAH pueden ser directos en el propio niño o indirectos sobre el entorno, de interacción por encaje o desajuste con las expectativas ambientales y transaccionales por su relación dinámica con otras características del entorno del menor. Conclusiones: La confluencia de pobres habilidades de autorregulación, conciencia y autonomía emocional, y un perfil de temperamento con una búsqueda de la novedad más elevada y persistencia más baja potencian el riesgo de los niños diagnosticados con TDAH para el desarrollo de una serie de problemas de ajuste y adaptación en la infancia y la adolescencia

Introduction: Those who suffer from attention deficit disorder with or without hyperactivity (ADHD) find it difficult to direct their emotions in order to solve challenges or problems. This alteration in emotional self-regulation implies greater disability than that attributed to the traditional dimensions -attention deficit and hyperactivity- with an evident impact on the development of personality. Aim: To review how the confluence of poor self-regulatory skills, emotion awareness and autonomy, and a particular temperament profile increase the risk of children diagnosed with ADHD for the development of a range of adjustment problems in childhood and adolescence. Development: The typical temperamental profile of children with ADHD is characterised by high emotional reactivity and poor self-regulatory skills. The effects of the interaction of emotionality and temperament in ADHD can be either direct on the child himself or indirect on the environment, interactional by fitting or mismatch with environmental expectations, and transactional due to their dynamic relation with other characteristics in the child’s environment. Conclusions: The confluence of poor self-regulation skills, emotion awareness and autonomy, and a temperament profile with a higher novelty seeking and lower persistence increase the risk of children diagnosed with ADHD for the development of a series of adjustment and adaptation problems in childhood and adolescence

Confusion, dissociation and bizarre behaviour as the onset of an early Susac syndrome.

A 47-year-old woman presented an episode of confusion and disorientation. According to remarkable psychiatric records, she had been treated for major depression and obsessive-compulsive disorder; however, no other relevant background was known. After preliminary examinations, blood analysis and neurological tests were unspecific and inconclusive. Therefore, the case was treated as a possible psychiatric episode related to her previous psychiatric disorders. However, due to the atypical presentation of the case, a cerebral MRI was performed, which demonstrated multiple central lesions of the corpus callosum ('snowball lesions'), as well as several supratentorial white matter lesions. As a result of the follow-up of the case, sensorineural hearing loss and branch retinal artery were detected, which concluded in the classic triad and the confirmation of the diagnosis of a Susac syndrome.

Personalidad en pacientes con trastorno alimentario en función de la presencia/ausencia de comorbilidad con trastorno límite de la personalidad / Personality in patients with eating disorders depending on the presence/absence of comorbidity with borderline personality disorder

Resumen Los estudios sobre comorbilidad entre los trastornos de la conducta alimentaria (TCA) y los trastornos de la personalidad reportan tasas del 20-80%, condición que dificulta el diagnóstico y ensombrece el pronóstico, especialmente respecto a su comorbilidad con el trastorno límite de la personalidad (TLP). El objetivo de este estudio fue valorar si las alteraciones patológicas de la personalidad permiten distinguir no solo entre distintos tipos de TCA, sino además en función de su comorbilidad con el TLP. Participaron 29 pacientes con TCA, 10 con TCA comórbido con TLP [TCAc], 27 con TLP y 22 controles sanas, quienes completaron el Inventario Clínico Multiaxial de Millon (MCMI-II) y otras dos medidas, una sobre impulsividad y otra dirigida a evaluar síntomas de bulimia nerviosa (BN). El grupo TCA se caracterizó por mayor compulsividad, principalmente el subgrupo con anorexia nerviosa vs. los grupos TLP y TCAc; no obstante, estos dos últimos compartieron un amplio número de rasgos indicativos de inestabilidad emocional, y también -aunque en menor medida− con el subgrupo con BN. Los hallazgos apoyan un continuum de gravedad en función de la compulsividad-impulsividad, con importantes implicaciones etiopatogénicas, diagnósticas y psicoterapéuticas.

Abstract Studies on comorbidity between eating disorders (ED) and personality disorders yield rates of 20-80%, a condition that makes difficult the diagnosis and complicates prognosis, especially regarding their comorbidity with borderline personality disorder (BPD). The objective of this study was to assess whether pathological personality alterations make it possible to distinguish not only between different types of ED, but also in terms of their comorbidity with BPD. Participants included 29 patients with ED, 10 with comorbid ED with BPD (EDc), 27 with BPD and 22 healthy controls, who completed the Millon Multiaxial Clinical Inventory (MCMI-II), and two other measures, one on impulsivity and other aimed at assess symptoms of bulimia nervosa (BN). The ED group was characterized by greater compulsivity, mainly in the subgroup with anorexia nervosa vs. BPD and EDc groups; however, these last two groups shared many features that show emotional instability, although less that the subgroup with BN. These findings support a continuum of severity in terms of compulsivity-impulsivity, with important etiopathogenic, diagnostic and psychotherapeutic implications.