alexa Relationship between Recurrent Mood Disorders and Personality Disorders?

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Relationship between Recurrent Mood Disorders and Personality Disorders?

The purpose of this study is to investigate whether there is a relationship between recurrent affective disorders classified as Axis I by Diagnostic and Statistical manual of Mental Disorders Fourth Edition (DSM-IV TM) and personality disorders classified as Axis II of the same manual [1]. This association has not been completely resolved as numerous studies have shown varying temporal associations (comorbidity) between recurrent affective disorders and personality disorders [2-6]. In psychiatry, the dimensional theory, which is used for assessments, considers personality disorders as clinical forms of recurrent affective disorders. This is especially true for borderline personality disorder (BPD). Other researchers consider it useful to promote BPD as Axis I of DSM-IV, anyway this approach could be not longer tenable because of DSM-5 section III dimensional model and no ‘’split’’ between Axis I-Axis II [7-9].

Classification of temperament traits (neurobiological and affective components of personality disorders) creates even more confusion. According to the Akiskal model [10-14]; some personality disorder subtypes appear as forms of syndromic or subsyndromic variants of affective disorders. Personality disorders seem to be reduced to four basic temperaments: 1) depressive; 2) hyperthymic, in which a person has a tendency to be in a euphoric mood; 3) cyclothymic oscillations between depression and an upbeat mood; and 4) irritable-explosive. The dimensional model may be useful to reduce countless nosological clinical symptoms and to study neurochemical, neuropshysiological (adding sleep and circadian pattern abnormalities) and pharmacological basics. It also leads to poor psychopathological specificity. For instance, some researchers consider cyclothymia or hypomanic personality disorder as a personality disorder, while other researchers judge these as a level of mood disorder [11,15,16].

The relationship between psychopathological states and abnormal traits of character is not a new issue. It appears in both classical psychiatry and in its most dynamic versions. The history of psychiatry goes back to the Hippocratic school trying to relate the prevalence of humors (black, yellow, sanguine, phlegmatic bile) with temperament and personality. Phlegmatic temperament and its blood type were related to the predisposition for four diseases: mania, melancholia, phrenitis or paranoia [17]. Kraepelin described several affective states, known as manic-depressive psychosis. This classification laid the basis for recognizing psychopathological subsyndromal states based on observable fluctuations in motor activity, emotions and thoughts (cognitions). Kraepelin, quoted by Akiskal, considered these manifestations temperamental (1992). From a dynamic point of view, [18] found that patients suffering from melancholy after the end of the episode also showed an obsessive-compulsive character.

Freud studied melancholy and considered the existence of "a pathological predisposition" that led to melancholy instead of mourning. He proposed a narcissistic type of relationship with the object, which now may apply to patients from cluster B (American Psychiatric Association, 1994) [1]. Freud seemed to relate melancholy with obsessional neurosis due to the degree of ambivalence present in both conditions and referred to it as " obsessive depression" [19].


Citation: Cohen D, Corral R (2015) Can Research Confirm Psychopathological Subtypes and Relationship between Recurrent Mood Disorders and Personality Disorders?. J Sleep Disord Ther 4:195. doi: 10.4172/2167-0277.1000195

 
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