Borderline personality disorder aggressive symptoms

Beck et al. (38) reported that hopelessness in the context of major depression was the MDD symptom most often associated with suicide. This finding was replicated by Fawcett et al. (39), who found that hopelessness with anhedonia, mood cycling within an episode, loss of mood reactivity, and psychotic delusions were high-risk factors for a subsequent suicide. Soloff and associates ( 40) also found that hopelessness and impulse aggression independently increased the risk of suicidal behavior in patients with borderline personality disorder and in patients with major depression. Negative life events (e.g., the death of a loved one or humiliating events such as financial ruin) often precede suicide. 

FIGURE 10-5. Aggressive symptoms and hostility are associated with several conditions in addition to schizophrenia, including bipolar disorder, attention deficit hyperactivity disorder (ADHD) and conduct disorder (conduct dis.), childhood psychosis, Alzheimer s and other dementias, and borderline personality disorder, among others. 

Although aggressive symptoms are common in schizophrenia, they are far from unique to this condition. Thus, these same symptoms are frequently associated with bipolar disorder, childhood psychosis, borderline personality disorder, drug abuse, Alzheimer and other dementias, attention deficit hyperactivity disorder, conduct disorders in children, and many others (Fig. 10—5). 

In an 8-week, double-blind, placebo-controlled study of topiramate 250 mg/day in the treatment of aggression in 42 men with borderline personality disorder there was significant weight loss of 5.0 kg (95% Cl = 3.4, 6.5) (1129). There were no psychotic symptoms or other... 

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