Improvement in borderline personality disorder in relationship to age

OBJECTIVE

It is commonly believed that some features of borderline personality disorder (BPD) improve as individuals reach their late 30s and 40s. This study examined age-related change in borderline criteria and functional impairment, testing the hypothesis that older age would be associated with relatively more improvement than younger age.

METHOD

A total of 216 male and female participants with BPD were followed prospectively with yearly assessments over 6 years.

RESULTS

Participants showed similar rates of improvement in borderline features regardless of age. A significant age by study year interaction showed functioning in older subjects to reverse direction and begin to decline in the latter part of the follow-up, in contrast to younger subjects who maintained or continued improvement over the 6 years. Despite the decline, functioning for the older subjects was comparable with or slightly better at year 6 than at year 1.

CONCLUSION

Improvement in borderline features is not specific to the late 30s and 40s. There may be a reversal of improvement in functioning in some borderline patients in this older-age range.

Nimodipine in migraine prophylaxis

Nimodipine is a compound that is thought to block the influx of calcium through channels in vascular smooth muscle. This paper describes a double-blind parallel-group comparison of 40 mg nimodipine three times a day and placebo. Sixty-eight patients received treatment after a run-in period of 2 months, and of these, 57 completed 8 weeks or more of the trial. All but five of these completed the full 6-month trial. The nimodipine and placebo groups showed no significant differences in the frequency of attacks, severity or duration of headache, or gastrointestinal or other symptoms.

Beta-adrenoceptor and epoprostenol (prostacyclin) responsiveness of lymphocytes in migraine patients

Beta-adrenoceptor blocking drugs are of prophylactic value in some patients with migraine. Beta-adrenoceptor responsiveness as measured by lymphocyte cAMP responsiveness to isoprenaline has, therefore, been compared in ten untreated classical migraine patients and ten matched non-migraine control subjects. Lymphocyte responsiveness to epoprostenol (prostacyclin, PGI2) was also compared. No difference in response to either agent was found between the two groups. A generalized abnormality of beta-adrenoceptor function does not appear to be present in classical migraine, but a defect localized to specific vascular regions cannot be excluded.