title: [Diagnosis and psychoanalytic psychotherapy for personality disordered persons].
abstract: The author uses PubMed searches on clinical studies on personality disorders and finds that the borderline personality disorder is most extensively researched. Mary Zanarini summeries there are four kinds of psychotherapies that are proved to be effective in the treatment of BPD patients, including mentalization based treatment, transference focused therapy, dialectic behavior therapy and schema focused therapy. They are all effective to improve the severity of impulsivity and self-destructiveness. The author then reviews McGlashan's series of extensive follow-up studies on BPD and other mental disorders at Chestnut Lodge back in 1980's. The data tells us that both symptomatic stability and level of social adaptation in the long term outcome of BPDs varied to be very poor to recovered. The outcome seem to be heavily relied on the intimate relationship BPDs could enjoy or not. This finding was also noted in a five year Tokyo BPDs follow-up studies by Moriya, Ikuta and Minakawa in 1990's. Both impulsivity and self-destructiveness get always worse along with loss or threatened loss of love object. Therefore all psychotherapies for BPDs should be directed to improve their pathological object relations although it would be extremely difficult to attain. The author finally points it out that the primary prevention of BPDs should be designed and begin a program on a trial basis in a community soon because there are many empirical studies to show the mothers with BPD tend to be frightened by her baby and/or frighten her baby and this pattern of communication is the first epigenetic expression of BPDs.
authors.affiliation: Hosei University, Graduate School of Clinical Psychology.
authors.forename: Kuninao
authors.initials: K
authors.lastname: Minakawa
mesh_terms: D006801:Humans; D010554:Personality Disorders / Q000628:therapy*; D011575:Psychoanalytic Therapy