Personality Disorders Carlat Reports

Expert Q&A

Personality Changes Later in Life: Diagnostic and Treatment Considerations

From The Carlat Geriatric Psychiatry Report, Diagnostic Challenges in Older Adults

CGPR: What is the course of personality disorders as people age? Dr. Tampi: Personality usually doesn’t change much. People with borderline personality disorder (BPD), for example, don’t usually experience significant changes once they reach middle age. Experiences over a person’s lifespan may teach them skills that blunt their sharp edges, but

Expert Q&A

An Update on Neuromodulation Techniques for Older Adults

From The Carlat Geriatric Psychiatry Report, Anxiety

CGPR: One of the more interesting neuromodulation interventions is magnetic seizure therapy (MST). How does it work? Dr. Lisanby: MST is an investigational form of treatment for depression. Similar to electroconvulsive therapy (ECT), MST induces seizures with the intention of therapeutic benefit, but the big difference between MST and ECT is how the se

Expert Q&A

Borderline Personality Disorder in the ED

From The Carlat Hospital Psychiatry Report, Testifying

CHPR: What are some common issues that you encounter with patients with borderline personality disorder (BPD) in the psychiatric emergency department (ED)? Dr. Hong: First, we should remember that individuals with BPD are prevalent in every psychiatric setting, but especially the ED. About 10%–15% of all psychiatric ED patients have BPD, and these pa

Clinical Update

Deliberate Foreign Body Ingestion

From The Carlat Hospital Psychiatry Report, Psychiatric Emergencies

During morning rounds at your inpatient unit, you are informed by staff that your patient M, a 32-year-old woman with bipolar disorder and borderline personality disorder, has swallowed a small pencil. This is her fourth swallowing episode since her admission to the unit 2 weeks ago. Even though you had restricted her access to sharp objects, she has ma

Expert Q&A

Mental Illness and Flourishing

From The Carlat Psychiatry Report, Living With Mental Illness

Topics: Depression | Mood | Personality Disorders | Psychotherapy

TCPR: You and other psychiatrists at Johns Hopkins have a way of viewing mental illness that differs from the biopsychosocial model. Tell us about that. Dr. Chisolm: We use a model called “perspectives of psychiatry” that was developed by Paul McHugh and Phillip Slavney in the 1970s. It’s really a framework that considers the origin of patients�

Expert Q&A

Working With Severe Personality Disorders

From The Carlat Psychiatry Report, The Difficult Patient

TCPR: People with severe personality disorders are notoriously difficult to treat. Can they benefit from psychotherapy? Dr. Buie: Nearly all seriously ill patients can benefit from some form of psychotherapy. Supportive psychotherapy, group skills training, and behavioral treatments can be helpful in almost any illness, including psychotic disorders. P

Clinical Update

The Modafinils in Bipolar Depression

From The Carlat Psychiatry Report, Borderline Personality Disorder

Your patient has recovered enough from bipolar depression to leave the hospital, but not enough to return to work. He is inactive, he can’t concentrate, and it takes him 4 hours to wake up in the morning. What can you add to his regimen of lithium, lamotrigine, and lurasidone? Modafinil (Provigil) and armodafinil (Nuvigil) are wakefulness-promoting

Article

Diagnosing and Treating Borderline Personality Disorder

From The Carlat Psychiatry Report, Personality Disorders

Topics: Personality Disorders | Psychopharmacology

By and large, psychiatrists aren’t terribly comfortable when it comes to diagnosing and treating borderline personality disorder (BPD). The clinical picture is challenging, and the stigma attached to the term makes it difficult for patients to hear—in fact, many clinicians end up not making the diagnosis at all! But BPD, characterized by DSM-5 as

From , Obesity 7029

Topics: Personality Disorders | Research Updates

From , Dialectical Behavior Therapy 6386

Topics: Personality Disorders | Psychotherapy

Who Can Benefit From DBT?

From , Dialectical Behavior Therapy 6386

Topics: Personality Disorders | Psychotherapy

Recent research has demonstrated that dialectical behavior therapy (DBT) works for treating adolescent, young adult, and adult populations diagnosed with borderline personality disorder (BPD) (Rizvi SL et al, Prof Psychol-Res Pr 2013;44(2)73–80), though data pertaining to its superiority over other treatments remain mixed. Psychologist Marsha L

Dialectical Behavior Therapy: A Primer

From , Dialectical Behavior Therapy 6386

Topics: Personality Disorders | Psychotherapy

Half a century ago, a suicidal young woman named Marsha Linehan spent more than two years in a psychiatric hospital. Locked as tightly in her own personal torment as in her seclusion room, she vowed not only that she would get out, but that she would get well and help others escape the same torment. Today, Dr. Linehan, the psychologist who developed dia

From , Positive Psychology 5702

Topics: Personality Disorders | Research Updates

Article

Dialectical Behavior Therapy: A Primer

From The Carlat Psychiatry Report, Personality Disorders

Topics: Personality Disorders

A young woman with borderline personality disorder (BPD) calls your office for the third time in one week and reports she’s been cutting again. You are discharging a middle-aged alcoholic to residential treatment in another state, and you are afraid he might relapse on the plane. You are asked to consult on an orthopedic patient whose outrageous deman

Article

Differentiating Borderline Personality Disorder from Bipolar Disorder

From The Carlat Psychiatry Report, Personality Disorders

Topics: Personality Disorders

Borderline personality disorder (BPD) and bipolar disorder frequently co-occur (numbers range from 8% to 18%), although they are distinct clinical entities (Paris J et al, Compr Psychiatry 2007;48(2):145–154). A proper diagnosis guides the most effective treatment, but you’ve probably faced the difficult challenge of diagnosing these conditions, whi

Article

What you Need to Know About Callous-Unemotional Traits and Disruptive Behavioral Disorders

From The Carlat Child Psychiatry Report, Behavioral Disorders

Topics: Child Psychiatry | Personality Disorders

Recently, researchers in the field of conduct disorder (CD) have proposed including a specifier to the diagnosis of CD in DSM-5 based on the presence of callous-unemotional (CU) traits. Where does this idea come from, what is the evidence to support it, and why is it controversial? (Alphabet soup alert to readers: be forewarned that I will be using a lo

Article

How Effective Are the Newest Antipsychotics?

From The Carlat Child Psychiatry Report, Behavioral Disorders

Topics: Child Psychiatry | Free Articles | Personality Disorders

Four new antipsychotics are beginning to gain some traction in the adult market. To be absolutely clear, among these only paliperidone (Invega) has been approved for use in children and adolescents (those age 12 and older). None of the other medications have been tested in this age group. But for those of us who see transitional age youth to whom we pre

Research Update

Does Stealing in Childhood Predict Future Psychiatric Illness?

From The Carlat Child Psychiatry Report, Behavioral Disorders

Topics: Child Psychiatry | Personality Disorders

Research Update

Most Kids’ Chest Pain Does Not Have Cardiac Causes

From The Carlat Child Psychiatry Report, Behavioral Disorders

Topics: Child Psychiatry | Personality Disorders

Research Update