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Heterogeneity of DSM-III antisocial personality disorder (ASP) diagnostic criteria
Disorders of Personality
BIOLF'SYCHIATRY 1989:25:84A479A
8lA
.05, two-tailed Fisher’s exact test). No such associations were found in the dysthymic group. Treatment response did not correlate with TRH./TSH test results in any group. Thus, AATSH seems to be a good diagnostic index of major depression, whereas DST may help in the choice of antidepressant drug treatment.
177 USEFULNESS OF LITHIUM FOR BORDERLINE Paul S. Links, Ingrid Boiago, Meir Steiner
PATIENTS
Hamilton, Ontario, Canada This double-blind random order placebo control crossover trial of lithium carbonate
and desipramine in Borderline Personality Disorder (BPD) examines (1) Are desipramine and lithium more effective than placebo in reducing the affective symptoms in BPD? (2) What are the perceptions of the patient and therapist regarding the usefulness of desipramine and lithium versus placebo? Consenting patients received, in random order, either placebo, lithium or desipramine for six week intervals with two week washout between each arm. Seventeen patients consented, two (11.8%) dropped out prior to receiving medication, five (29.4%) dropped out after completion of one arm, and ten (58.8%) completed two or more arms. To utilize the larger sample, the unpaired analyses are reported. Responses based on Hamilton Depression Scale and Carroll Scale for Depression indicated no significant differences between lithium versus placebo and desipramine versus placebo. Regarding impulsivity, on lithium 8/l 1 patients versus 4/11 patients on desipramine improved (X2 = 2.93, df = 1, p = .087). Therapists’ perceptions rated lithium significantly superior to placebo (X2 = 4.54, df = 1, p = .033). These initial results suggest that the improvement on lithium may be related to its effects on the impulsive aspects of BPD.
178 HETEROGENEITY OF DSM-III ANTISOCIAL DISORDER (ASP) DIAGNOSTIC CRITERIA L. Buydens-Branchey, M. Branchey
PERSONALITY
New York, iVY The DSM-III ASP diagnosis is based on the presence of a number of deviant behaviors
but does not differentiate behaviors involving violence from those involving no violence. Because antisocial behaviors are extensively bound up with heavy alcohol use, life long histories of these behaviors were obtained in 218 alcoholics. Relationships between childhood and adulthood behaviors based on DSM-III criteria were assessed. Childhood behaviors were divided into those that involved violence (physical fights, physical cruelty to others, etc.) and those that did not (truancy, running away, etc.). The adult categories were also divided into behaviors characterized by physical violence and behaviors with no violence (forgeries, drug dealing, shoplifting, etc.). We did not find any significant association between non-violent childhood deviant behaviors and adult deviant behaviors, violent or not, but observed that individuals who had displayed violence prior to age 15 were much more likely than others to display violence as adults (p < .OOl). In addition, a sizable percentage of patients who did not meet the full DSM-III ASP criteria reported violent behavior during childhood and adulthood. Thus, DSM-III ASP criteria seem to encompass two types of deviant behaviors, those that involve physical violence and those that do not. A tendency to display physical violence appears to be a trait persisting throughout life.
BIOLF'SYCHIATRY 1989:25:84A479A
8lA
.05, two-tailed Fisher’s exact test). No such associations were found in the dysthymic group. Treatment response did not correlate with TRH./TSH test results in any group. Thus, AATSH seems to be a good diagnostic index of major depression, whereas DST may help in the choice of antidepressant drug treatment.
177 USEFULNESS OF LITHIUM FOR BORDERLINE Paul S. Links, Ingrid Boiago, Meir Steiner
PATIENTS
Hamilton, Ontario, Canada This double-blind random order placebo control crossover trial of lithium carbonate
and desipramine in Borderline Personality Disorder (BPD) examines (1) Are desipramine and lithium more effective than placebo in reducing the affective symptoms in BPD? (2) What are the perceptions of the patient and therapist regarding the usefulness of desipramine and lithium versus placebo? Consenting patients received, in random order, either placebo, lithium or desipramine for six week intervals with two week washout between each arm. Seventeen patients consented, two (11.8%) dropped out prior to receiving medication, five (29.4%) dropped out after completion of one arm, and ten (58.8%) completed two or more arms. To utilize the larger sample, the unpaired analyses are reported. Responses based on Hamilton Depression Scale and Carroll Scale for Depression indicated no significant differences between lithium versus placebo and desipramine versus placebo. Regarding impulsivity, on lithium 8/l 1 patients versus 4/11 patients on desipramine improved (X2 = 2.93, df = 1, p = .087). Therapists’ perceptions rated lithium significantly superior to placebo (X2 = 4.54, df = 1, p = .033). These initial results suggest that the improvement on lithium may be related to its effects on the impulsive aspects of BPD.
178 HETEROGENEITY OF DSM-III ANTISOCIAL DISORDER (ASP) DIAGNOSTIC CRITERIA L. Buydens-Branchey, M. Branchey
PERSONALITY
New York, iVY The DSM-III ASP diagnosis is based on the presence of a number of deviant behaviors
but does not differentiate behaviors involving violence from those involving no violence. Because antisocial behaviors are extensively bound up with heavy alcohol use, life long histories of these behaviors were obtained in 218 alcoholics. Relationships between childhood and adulthood behaviors based on DSM-III criteria were assessed. Childhood behaviors were divided into those that involved violence (physical fights, physical cruelty to others, etc.) and those that did not (truancy, running away, etc.). The adult categories were also divided into behaviors characterized by physical violence and behaviors with no violence (forgeries, drug dealing, shoplifting, etc.). We did not find any significant association between non-violent childhood deviant behaviors and adult deviant behaviors, violent or not, but observed that individuals who had displayed violence prior to age 15 were much more likely than others to display violence as adults (p < .OOl). In addition, a sizable percentage of patients who did not meet the full DSM-III ASP criteria reported violent behavior during childhood and adulthood. Thus, DSM-III ASP criteria seem to encompass two types of deviant behaviors, those that involve physical violence and those that do not. A tendency to display physical violence appears to be a trait persisting throughout life.