Borderline Personality Organization as an Aid in Differential Diagnosis.

ABSTRACT: There are subsets of patients whose presentations elude a precise diagnosis. All diagnoses are asymptotic to nature as they are constructs imposed on the world. Nonetheless, a greater degree of accuracy and precision is possible and beneficial for most patients. This is particularly true for patients with borderline personality organization (BPO) who present with psychotic symptoms. For the purposes of avoiding a misconstrual of the meaning of psychotic experiences in these patients, a brief synopsis of borderline personality organization, in contradistinction to borderline personality disorder, may prove to be of some clinical utility. The BPO construct presciently anticipates the trend toward a dimensional model of personality disorders and has the potential to enrich and inform these developments.

Bipolar Disorder, Religion, and Spirituality: A Scoping Review.

Mental health clinicians frequently study the religion and spirituality (R/S) of their patients. There is, however, a paucity of empirical research concerning R/S of patients with bipolar disorder. This lack is exacerbated by the absence of an evaluation of how these studies relate to each other. Reviews to date concern almost exclusively quantitative studies; a review that synthesizes quantitative and qualitative research is needed. The aim of this paper is to provide a synthesis of empirical studies that is useful in clinical practice. Systematic searches for relevant journal articles in SCOPUS, PubMed, and PsycInfo found 14 quantitative and four qualitative studies. The research reveals that intrinsic religiosity and positive religious coping are the dimensions of R/S that have the most positive correlations with improvement of bipolar disorder symptoms as revealed by measures of clinical outcomes. Patients struggle with their religious experiences, and they wish that R/S would be taken into account by mental health professionals. The quantitative studies are not in conflict with the patient/person-centered focus of qualitative studies. This integration of quantitative data with a patient/person-centered focus shows how belief and illness affect each other. The tensions inherent in such an integration provide new insights for research and treatment. Unfortunately, the qualitative literature has not caught up with quantitative approaches in terms of diagnostic rigor.