[Stability of borderline personality disorder from childhood to adulthood: a literature review]. / Stabiliteit van de borderlinepersoonlijkheidsstoornis van de kinderjaren tot in de volwassenheid: Een literatuuronderzoek.

BACKGROUND: Borderline personality disorder (BPD) is a severe and frequent disorder. Little is known about its early stages, which can be in childhood or adolescence. AIM: To investigate to what extent BPD is stable from childhood through to adulthood. METHOD: The literature was systematically reviewed with the help of Medline, Psycinfo, embase and the Cochrane Library. RESULTS: Of children known to have BPD in the primary school age-group, 80% met the criteria for a personality disorder in adulthood and 16% met the criteria for BPD. In a population study of adults with bpd, 30% still met the criteria two years later. In groups of adolescents at risk the criteria were met by 15-30 % after two to three years. These groups also showed a low dimensional stability for BPD. The most stable symptoms were feelings of emptiness, anger, affect-instability and identity problems. Less stable symptoms were suicidality, self-harm, impulsiveness, unstable relationships, derealisation and paranoid thinking. CONCLUSIONS: Research into the stability of BPD that starts in children of primary school age has been too limited in a methodological sense for us to draw any firm conclusions. Research into BPD that starts in adolescence shows a low categorial and dimensional stability. Research into the onset of BPD in adults shows comparable low stability, but only after six years. In adolescents and adults impulsive and self-harm behaviour are probably the least stable symptoms and affective symptoms the most stable ones.

The ability of YSR scales to predict DSM/DISC-C psychiatric disorders among incarcerated male adolescents.

OBJECTIVE: To investigate whether the empirical or DSM-oriented scales of the Youth Self-Report (YSR) can be used to screen for DSM psychiatric disorders among incarcerated boys. DSM-oriented scales have recently been developed by Achenbach to enhance comparability of YSR results with DSM diagnostic categories. METHOD: A representative sample (N = 196) of incarcerated boys aged 12-18 was assessed with the child version of the Diagnostic Interview Schedule for Children (DISC-C) to diagnose DSM psychiatric disorders, and with the Youth Self-Report (YSR). RESULTS: Only 22% had YSR total problem scores in the clinical range, whereas 90 % met criteria of at least one DSM/DISC-C psychiatric disorder. Weak associations between both empirical and DSM-oriented YSR scale scores and DSM/DISC-C diagnoses were found. CONCLUSIONS: Neither the empirical nor the DSM-oriented YSR scales adequately screen for DSM/DISC-C psychiatric disorders among incarcerated boys. The use of the YSR and the DISC-C to assess DSM constructs results in, at least partially, different diagnostic information.

Comparison of the parasitologic efficacy of amodiaquine and sulfadoxine-pyrimethamine in the treatment of Plasmodium falciparum malaria in the Bungoma District of western Kenya.

The efficacy of amodiaquine (AQ) and sulfadoxine-pyrimethamine (SP) was assessed in 310 symptomatic children from western Kenya with uncomplicated Plasmodium falciparum malaria. A non-blinded, randomized, 14-day study was performed and parasitologic criteria were used. Of 310 patients included, 238 (77%) completed the study: 120 received AQ and 118 received SP. In those treated with AQ, there were sensitive (S) infections in 107 patients (89.2%, 95% confidence interval [CI] = 82.2, 94.1%), RI resistance in 10 (8.3%, 95% CI = 4.1, 14.8%), RII resistance in 1 (0.8%, 95% CI = 0, 4.6%), and RIII resistance in 2 (1.7%, 95% CI = 0.2, 5.9%). In those treated with SP, there were S infections in 74 patients (62.7%, 95% CI = 53.3, 71.4%), RI resistance in 21 (17.8%, 95% CI = 11.4, 25.9%), RII resistance in 11 (9.3%, 95% CI = 4.7, 16.1%), and RIII resistance in 12 (10.2%, 95% CI = 5.4, 17.1%). Resistance rates were consistently higher in the SP-treated patients (P < 0.001). Resistance to SP in this area has reached such levels that it should no longer be the first-line treatment. Alternative treatment, such as SP plus AQ combination treatment or artemisinin combination treatment, is urgently needed.