境界線症候群 患者에 關한 臨床的 觀察

A Clinical Study on Borderline Syndrome

The authors intended to delineate the clinical characteristics of so-called borderline syndrome in this clinical study. The borderline syndrome, first described by R.R. Grinker, is often encountered in clinical practice by many psychiatrists. However the concept of the borderline has been ambiguous and controversial until today. Thus the authors reviewed the clinical manifestations of 26 of such patients admitted to the neuropsychiatric dept., Kyung Hee Univ. Hospital from Nov. 1971 to Aug. 1979. The clinical investigations were analyzed in terms of the Gunderson & Singer criteria for borderline patient. The results were as follows; 1. About 61.5% of all cases had the history of one or more previous hospitalizations at a psychiatric ward. 2. The premorbid personality of the patients was most frequently schizoid in 42.3% and passive- aggressive in 30.8% of the sample. 3. Several characteristics were noted in their clinical manifestations; anxiety, depression, emotional instability, fear and rage characterized their affect and impulsivity, sexual problems, alcohol or drug abuse and self mutilation characterized their behavior. Psychotic symptoms were manifested by transient psychotic episode (50%) in features of delusion, hallucination and alteration of consciousness. Their psychological test performances revealed normal intelligence but showed weak ego strength, unstable affect, poor reality testing, hostility, and paranoid tendency. Their interpersonal relationships were disturbed showing features of isolation, superficiality, and dependency. 4. The diagnostic impressions were various during their hospitalizations. Just after their admissions, those were usually simple or latent schizophrenia, depressive or anxiety neurosis, and personality disorder in those order then during the middle course of the hospitalizations, depressive neurosis, simple schizophrenia, personality disorder or anxiety neurosis, and at the time of discharge, pseudoneurotic schizophrenia and borderline schizophrenia were usual diagnoses given. 5. In respect to their outcome up to the point of discharge, half of them were moderately or much improved and the other half showed no improvement. 6. The follow-up treatments was never performed by 61. 5% of them and most of the remainder also discontinued the follow-up visits within about 6 months after discharge