P-942 - Clinical-dynamic approach to borderline personality disorders systematic

Abstract

Current difficulties in systematic of borderline personality disorders are associated not only with work within ICD-10, in the essence ignoring contribution of Russian researchers in the field of mental and behavioral pathology, but also with removal of its clinical-dynamic and methodological approaches. We have based proposed by us (Semke V.Ya., 1982, 1994, 2005) classification on etiologic, pathogenetic and clinical-dynamic principles. Depending on genesis (predominant role of constitutional-biological, psychogenic, exogenous-organic and somatogenic factors), degree of severity and length of symptoms, we have distinguished 4 groups of borderline states: neurotic, pathocharacterological, neurosis-like, psychopath-like. Everything from them is characterized by gradual formation of clinical symptoms: initial stage (pre-neurotic, pre-psychopathic); stage of structuring; period of relative stabilization of personality pathology (formation of neurotic, pathocharacterological, pathological development of the personality). Proposed working grouping of borderline personality disorders reflects, in our opinion, current state of conceptual principles and methodical approaches in the field of modern study of borderline personality disturbances. The idea is to identify cause-effect interrelationships reflecting clinical-pathogenetic and clinical-dynamic stages of formation of variable - according to genesis, course, prediction, and outcome - abnormal symptoms. Special attention has been deserved by early “pre-nosological stage” of their development: abnormal personality reactions are nosologically non-specific and can further transform into neurotic (neurosis-like) and psychopathic (psychopath-like) states, developments.