Borderline personality disorder (BPD) is characterized by instability in the area of one’s own self and affective reactions, instability in relationships, and impulsive behavior. BPD patients experience dissociative or quasi-psychotic symptoms much more often than the general population. These symptoms directly affect the daily functioning of patients, often preventing them from taking up professional work or having a stable family life. The etiology of dissociative experiences in BPD patients is still unknown. One of the biological models suggests that biological changes in the brain occur on the basis of a traumatic experience, which can produce symptoms. The arcuate fasciculus (AF) is a structure of white matter that interconnects Broca’s area and Wernicke’s area in the brain. AF is often considered in the context of research on psychotic symptoms. For this reason, we hypothesize that AF may be related to dissociative symptoms in BPD patients.

The aim of our study was to investigate a relationship between the integrity of AF and symptomatology of dissociation in patients with borderline personality disorder.

45 BPD subjects and 43 healthy controls (HC) participated in the study. A DTI analysis was performed on all study participants. The psychopathology of BPD was assessed using the Dissociative Experiences Scale - Taxon (DES-T). The AF analysis was then conducted using fractional anisotropy (FA) parameter.

BPD significantly more often than the control group experienced dissociative experiences. We could not identify differences in the integrity of the AF between the two groups. Nevertheless, we examined the correlation between the quality of the AF structure and the severity of dissociative symptoms (r=-0.0299, p=0.039).

The attenuation of the structure of AF may be involved in symptomatology of dissociation in patients with BPD. Further structural brain studies are needed in the BPD population.

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Psychotic symptoms are frequently observed in individuals with borderline personality disorder. Numerous case reports in the scientific literature support this finding. This symptoms can significantly impair the patients daily functioning and quality of life. Antipsychotic medications have demonstrated efficacy in managing both psychotic symptoms and emotional dysregulation in this population.

This case report aims to explore the use of cariprazine in managing psychotic symptoms in patients with borderline personality disorder.

This case report describes a 28-year-old woman who sought mental health treatment for symptoms including emotional instability, lability, irritability, anxiety, and impulsivity. Her history includes childhood sexual abuse, which she identified as a significant source of distress. She also reported chronic auditory pseudo-hallucinations with derogatory content and visual pseudo-hallucinations of “small spiders.” She reported these experiences as distressing and disruptive to her daily life. The patient recognized the unreal nature of these hallucinations.

After initiating treatment with cariprazine 2.5mg, the patient demonstrated significant clinical improvement, including a reduction in the severity and impact of psychotic symptoms and a decreased risk of self-harm. Due to this positive response, cariprazine was continued, and the patient experienced increased emotional stability without requiring further acute care.

Studies have suggested the efficacy of second-generation antipsychotics in treating patients with borderline personality disorder. Beyond the remission of psychotic symptoms, these medications can lead to improvements in both affective and behavioral functioning.

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Personality disorders are often comorbid with anxiety and depression disorders, complicating the diagnostic process. Cancer patients with personality disorders who face the anxiety and discomfort associated with the diagnosis, symptoms, and medical treatment may encounter challenges. They might distort reality as a means of emotional self-preservation or display aggression.

This review seeks to delve into the challenges in cancer patients exhibiting dysfunctional personality traits or personality disorders.

A non-systematized literature review was carried out on PubMed and Google Scholar. The following terms were searched: (“personality disorders” OR “personality traits”) AND (“cancer” OR “cancer patients”).

Personality traits persistently influence behavior patterns, choices, environmental interactions, and stress responses. Personality can impact cancer development and progression through multiple avenues: by perpetuating unhealthy lifestyle behaviors rooted in personality traits; through negative affect such as depressive or anxious symptoms, as well as ineffective coping mechanisms; and by serving as an etiological factor for somatic diseases or mental disorders that predispose individuals to cancer. While some epidemiological studies have reported a positive association between personality and cancer development or progression, the majority find no significant correlation, leading researchers to conclude that there is no substantial link between personality and an increased risk of cancer.

Meeting the diverse challenges associated with cancer requires adaptability, flexibility, and resourcefulness. Research suggests that specific personality traits, like neuroticism and negative affectivity, are linked to lower quality of life among cancer patients, while extraversion and optimism are correlated with more favorable outcomes.

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Borderline Personality Disorder (BPD) was historically an underdiagnosed condition in Kyrgyzstan, often identified only in extreme cases, such as when individuals engaged in self-harm or displayed severe emotional instability. Traditionally, psychiatric consultations for BPD were initiated not by the individuals themselves but by concerned family members, typically parents. As mental health was heavily stigmatized in Kyrgyz society, especially personality disorders, many individuals likely went undiagnosed or untreated.

From 2020 to 2022, the Institute of Behavioral Health at the American University of Central Asia (AUCA) identified only 15 cases of BPD, However, since 2022, there has been a significant rise in BPD diagnoses, with over 70 cases recorded in just two years.

This study aims to examine the factors contributing to the increase in BPD diagnoses in the Kyrgyz Republic over the past two years.

The study’s methodology includes the analysis of secondary data provided by mental health organizations, including the AUCA Institute of Behavioral Health, which has tracked BPD cases in recent years. Additionally, anecdotal reports from practicing clinicians offer insights into the evolving nature of mental health diagnoses and treatments in Kyrgyzstan.

Several key factors have contributed to the rise in BPD diagnoses in Kyrgyzstan over the past two years. First, socio-economic stressors have intensified, particularly following the political and economic challenges of 2022. Financial instability and high unemployment rates have exacerbated psychological stress for many individuals. These conditions often worsen emotional dysregulation, a core feature of BPD, particularly for those already predisposed to the disorder. Second, the proliferation of social media has played a notable role in shaping mental health patterns, especially among young people. Increased social media exposure has been linked to feelings of inadequacy, identity confusion, and emotional instability—all key components of BPD. Third, domestic violence and trauma remain significant public health concerns in Kyrgyzstan. BPD has long been associated with adverse childhood experiences, including emotional neglect, sexual abuse, and physical violence, making trauma a significant factor in the development of the disorder. As trauma rates rise, so too does the likelihood of developing BPD, especially in those with preexisting vulnerabilities. Moreover, the reduction in stigma surrounding mental health in recent years has also contributed to the rise in diagnoses. Consequently, mental health professionals are now diagnosing BPD earlier and more frequently than in previous years.

The sharp increase in BPD cases in Kyrgyzstan can be attributed to a combination of socio-economic, psychological, and cultural shifts. Addressing underlying socio-economic and trauma-related factors remains crucial.

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Borderline Personality Disorder (BPD) is primarily characterized by emotional dysregulation, impulsivity, and unstable relationships. While much of the research on BPD focuses on its impairments, recent studies suggest a possible link between certain BPD traits and enhanced creativity. Emotional intensity, cognitive disinhibition, and non-linear thinking—common in individuals with BPD—are also characteristics frequently associated with creative processes. This review aims to synthesize existing literature exploring the connection between BPD traits and creativity.

The primary objective is to review and summarize the existing literature on the association between BPD traits and creativity, focusing on how emotional and cognitive aspects of BPD may facilitate creative thinking.

A non-systematic review of the literature was conducted by searching academic databases such as PubMed, PsycINFO, and Google Scholar for articles published up to 2023. Search terms included “Borderline Personality Disorder,” “creativity,” “personality traits,” and “emotion regulation.” Articles were selected based on relevance to the topic, focusing on studies that explored the link between BPD traits and creativity.

The review identified studies showing a nuanced relationship between BPD traits and creativity. Individuals with BPD traits may access a wider range of emotional experiences, which can enhance creative expression. Impulsivity was linked to spontaneous idea generation and creative risk-taking, although it may also hinder the focus needed for refining creative work. Some research points out that the extreme emotional dysregulation associated with BPD can undermine creative productivity. While emotional intensity might inspire originality, it can also lead to difficulty in structuring ideas, or an inability to complete creative tasks. A few studies even suggest that high levels of interpersonal difficulties, common in individuals with BPD, may further complicate the consistent pursuit of creative projects, as social conflicts or emotional crises might divert focus and energy. In contrast, a smaller body of literature found that individuals with BPD traits might excel in creative fields that value expression, such as art, music, or writing, where emotional intensity and non-linear thinking can be channeled into meaningful creative outputs.

While the reviewed literature suggests that certain BPD traits may enhance creativity, the relationship is complex and multifaceted. Emotional intensity and impulsivity, while potentially beneficial for creative output, can also disrupt focus and long-term creative endeavors. Overall, while BPD traits may foster creativity, they also pose challenges to sustaining long-term creative productivity.

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Hostility is defined as an enduring tendency in individuals to perceive the opinions and actions of others as negative or to anticipate aggression. This study examines how the Intensive Care Unit (ICU) admission of a critically ill family member influences the hostility levels of their relatives.

This study aims to assess the hostility levels of family members of ICU patients, focusing on their sociodemographic characteristics and the closeness of their relationship to the patient.

The study included first-degree relatives, close relatives, and intimate friends of ICU patients. Data were collected via written questionnaires completed by relatives during the first week of the patient’s ICU stay. Instruments used were a sociodemographic questionnaire and the Hostility and Direction of Hostility Questionnaire (HDHQ).

A total of 223 family members (mean age: 41.5 ± 11.9 years), representing 147 critically ill patients, participated. Among the participants, 81 (36.3%) were male and 142 (63.7%) were female. The majority were the patients’ children (40.8%), siblings (19.3%), or companions (16.1%). The mean hostility scores for male and female relatives were 20.54 ± 8.16 and 19.36 ± 7.43, respectively, with no statistically significant difference (P = 0.271). However, a statistically significant difference (P = 0.030) was found between relatives living in the same household as the patient (21.38 ± 8.47) and those living separately (18.92 ± 7.13).

This study highlights elevated hostility levels among relatives of ICU patients, suggesting that hostility may fluctuate in response to external stressors such as the critical illness of a loved one. The findings support the notion that hostility, while a personality trait, may also function as an adaptive behavior influenced by situational challenges, such as those faced when a family member is admitted to intensive care.

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The study of the neurobiological characteristics of borderline personality disorder (BPD) in youth is actual due to its high prevalence, but quantitative EEG studies of BPD have yielded mixed results.

The aim of the study was to assess the EEG features in patients with different clinical subtypes of borderline personality disorder (BPD).

Total of 52 patients aged 16-25 years (mean age 20.4±3.2 years) with BPD (F60.31 by ICD-10) were enrolled in the study. Three groups of patients with different subtypes of BPD (with predominance of “affective storm”, “addictive adrenalin mania” and “cognitive dissociation”) were identified based on clinical and psychopathological characteristics. A pre-treatment multichannel resting EEG was recorded with measurements of EEG spectral power and coherence in narrow frequency sub-bands. Between-group differences in clinical and neurophysiological parameters were identified using Mann-Whitney criteria.

The groups did not differ in EEG spectral power values, but significant (p<0.05) differences between the groups were revealed in the spatial organization of the EEG namely in the number of “highly coherent” functional connections (with coherence coefficients above 0.9) that was the least in the group with “cognitive dissociation”. Low values of the number of such connections in the alpha2 EEG sub-band (9-11 Hz) in the frontal-central-temporal brain regions reflect a relatively poor functional state of the prefrontal cortex in this group.

The noted features of the spatial functional organization of brain activity in patients with different BPD subtypes may underlie differences in their clinical conditions, in control of emotions and behavior.

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Tattoos, once viewed primarily as symbols of rebellion or cultural affiliation, have become increasingly prevalent and socially accepted across diverse populations. This shift raises questions about the psychological motivations behind body art, particularly in individuals with personality disorders.

These case studies explore the potential significance of tattoos in the context of personality psychopathology, examining how tattoos may serve as externalized representations of inner conflicts, identity fragmentation, and unmet emotional needs.

Through the lens of theory, we will discuss how tattoos can function as a form of self-expression and self-regulation, offering insight into defense mechanisms such as splitting, projection, and sublimation in individuals with borderline, narcissistic, and antisocial personality disorders.

The presentation will also explore the therapeutic implications of tattoos, considering their potential as entry points for understanding the symbolic and emotional worlds of patients with personality disorders. We will also reflect on the clinician’s role in addressing tattoos in psychotherapy, balancing sensitivity with inquiry, and understanding how body art may influence the therapeutic alliance.

Through the session we aim to deepen our understanding of tattoos as meaningful psychological markers in modern psychiatric practice.

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Considering the need to conduct studies on the treatment of BPD and considering the high prevalence of this disorder and its negative effect on the quality of life, especially in young age range and possibility of this disorder being in the Bipolar spectrum, it is necessary to investigate the effect of lithium on mood improvement in patients with BPD. So, this study aimed to investigate the effect of lithium on mood improvement in these patients.

Due to the lack of an FDA approved treatment, as well as discussed in the introduction, we dicided to compare the effect of lithiumin mood improvement in this disorder with the effect of other mood stabilizers and antipsychotics.

For this reason, we reviewed the published articles on the effects of other mood stabilizers and antipsychotics on improving the mood of this patints and compare them with those related to lithium in order to make better treatment decision.

This study presents a comprehensive review of the studies conducted related to the effect of lithium in improving mood in BPD patients. We conducted a systematic review based on PRISMA guidelines of published and indexed articles from the following databases;

EMBASE, MEDLINE, Google scholar, SCOPUS.Cochrane Library, PsycINFO.

KEY WORD: Lithium, Mood stabilizer, borderline personality disorder. Of the 131 retrieved articles, 9 included our inclusion criteria.

The review of 9 selected studies showed that lithium is useful in reducing emotional and impulsive behaviors, mood stabilization and suicidal tendencies and was more effective than placebo in preventing recurrence of mood disorders. In the study significant heterogeneity was found between all group of patients which could be due to the difference in the selection of participants and different exposure in the pre-study phase. Quantitative data on participants general health and social functioning were not reported and the direction of effect was the same in all studies.

No studies reported a negative effect for lithium and compared to other mood stabilization, it is more effective in controlling emotional and mood changes and aggression, also its side effects are less if controlled regularly and consistently. However, due to the small number of studies in this field and small sample size in studies, we suggest that more studies be conducted in all age groups.

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The biopsychosocial theory (Paris, 1996) considers the complex interaction of biological, psychological, and social factors in the development and manifestation of borderline personality disorder. Among the environmental factors are unstable family relationships, unresolved traumatic experiences, and adverse life events that can foster alexithymia and dissociative defense mechanisms, as supported by several studies in the literature (Carano et al., 2011; Caretti et al., 2005; Macrì et al., 2022).

The present study aims to investigate these constructs in a population of borderline patients admitted to the Psychiatry Department at Bufalini Hospital in Cesena.

The sample was selected using the SCID PD (Structured Clinical Interview for DSM-5), followed by the administration of the following scales: TAS-20 (Toronto Alexithymia Scale), DES II (Dissociative Experiences Scale), SHI (Self-Harm Inventory), and BSQ (Body Shape Questionnaire). Multivariate analyses were applied, including non-parametric correlations (Spearman’s Rho) between variables using SPSS software.

The sample consisted of 20 individuals (F = 17; M = 3) with a mean age of 27.57 years (SD = 7.83). Regarding the TAS, 85% of the participants reported clinically significant scores (Tot >50) compared to the healthy adult population, whose Italian mean is 44. For the DES, 70% of the sample reached clinically significant scores (Tot >30), whereas the healthy adult population scores below 10.

The data revealed a statistically significant positive correlation between high TAS-20 and DES II scores, indicating a relationship between alexithymia and dissociative symptoms. Furthermore, while a trend toward correlation was observed between TAS-20 and BSQ, as well as DES II and BSQ, and SHI and BSQ, these correlations were not statistically significant.

In line with previous literature, most individuals with borderline personality disorder exhibit alexithymia (85%) and experience dissociative episodes (70%). The present findings demonstrate a significant relationship between alexithymia and dissociative symptoms, highlighting how individuals with greater difficulty recognizing and describing their emotions tend to report more frequent episodes of depersonalization and derealization. This suggests that those with such difficulties may use dissociation as a defensive strategy to avoid intense emotions and stressful situations. Additionally, it would be valuable to further explore the relationship between body satisfaction, dissociative symptoms, alexithymia, and self-harm, as these manifestations may be linked to emotional processing difficulties. These findings contribute to a better understanding of emotional and dissociative dynamics in patients with borderline personality disorder and underscore the importance of integrated assessment during treatment.

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Hysteria has been historically linked primarily to women; however, its importance in men has recently gained attention. This is why we found it interesting to study male hysteria. Therefore, understanding psychopathological theories offers a valuable framework for highlighting its clinical characteristics.

Describe the main psychopathological theories of male hysteria and its key clinical specifications referring to the theories.

We conducted a narrative literature review of articles and thesis published between 2009 and 2022, using databases such as PubMed, Google Scholar, and HAS (Haute Autorité de Santé) with predefined keywords such as “men”, “hysteria”, “masculine” and “conversion”. This review culminated in a narrative synthesis that aims a cohesive discussion integrating key findings from the literature.

The bibliography first distinguished between two pairs in order to define masculine hysteria: Anatomical (male/female) and psychological (feminine/masculine), highlighting that masculine hysteria can occur in both men and women. Therefore, a male may identify with either masculine hysteria or feminine hysteria, the latter of which can be related to male homosexuality.

Research indicates that masculine hysteria is associated with theories of sexual identity conflict, which involve the repression of feminine traits and fears of castration. Additionally, cultural norms often restrict men’s emotional expression, favoring strength over vulnerability, along with personal, relational, and environmental influences.

Clinical observations suggest that masculine hysteria typically presents with physical symptoms and dramatic expressions. The type and intensity of these symptoms may vary based on different early life experiences.

Referring to literature, the specific clinical signs leading to a diagnosis of men hysteria seem to be difficult to identify and not well developed. We also concluded that hysteria is too much related to lived gender rather than anatomical gender.

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Autism spectrum disorders (ASD) are underdiagnosed in women due both to diagnostic bias, and the quieter, less visible signs and symptoms of female autism. Distress generally only becomes manifest during mid childhood and adolescence, when mental illness gets misidentified as the primary cause. The symptomatic overlap of ASD and Borderline Personality Disorder (BPD) has been noted and at the cognitive level, ASD includes difficulties in reading others emotions and core cognitive features of BPD also include altered social cognition.

The aims of this paper are to present a case report of a patient diagnosed with BPD and ASD and to provide a summary of the current literature concerning this double diagnosis.

A description of the case is made and relevant articles were identified by searching the following terms: “borderline personality disorder” and “autism/autism spectrum disorders”. Research was restricted to articles concerning humans and published between 2014 and 2024 in English.

The case report describes a young female of 19 years old that was evaluated in an emergency context due to suicidal ideation and was then referred to both psychiatry and psychology. She was diagnosed with BPD and ASD in adolescence while she was seeing a child psychiatrist. In the consultations she reports marked emotional dysregulation, irritability, difficulties in tolerating some textures and increased sensitivity to noise and light, as well as frequent worries about peer relationships and self-image with a need to do things differently to fit in.

Despite some controversial results and lack of homogeneity in the methods used for the diagnostic assessment, subjects with BPD reported higher scores on tests evaluating the presence of ASD compared to a non-clinical population and hypothesized the presence of unrecognized ASD in some BPD patients or vice versa, while also describing a shared vulnerability towards traumatic events.

This case illustrates a common and complex clinical challenge, where the double doses of emotional dysregulation and disrupted social interchange overwhelm either ASD or BPD approaches considered separately. Diagnostic differentiation is crucial toward targeted therapeutic interventions (psychopharmacological and psychosocial). It is still difficult to draw accurate conclusions based on the recent literature. Research in sex/gender difference is still limited, with heterogeneous results, and further studies are needed to enlighten the clinical similarities and diagnostic overlap between ASD females and BPD.

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Recent literature shows that childhood trauma might be associated with developing an eating disorder (ED) or borderline personality disorder (BPD) on the long term. These two disorders have a great comorbidity, and they share many common symptoms.

The aim of this study is to test if childhood trauma could be a transdiagnostic factor for both diagnostics, as well as analysing if trauma could be related to the severity of impulsive and instability symptomatology which characterize both of these diagnoses.

The sample consisted of 45 patients with a diagnosis of either ED (n=21) or BPD (n=24). Childhood trauma was assessed using the CTQ (Childhood Trauma Questionnaire). Impulsive-unstable symptomatology was assessed using the BIS (Barrat’s Impulsivity Scale), CSV (Feeling of Emptiness Questionnaire) and STAXI (State-Trait Anger Expression Inventory), HARS (Hamilton’s Anxiety Rating Scale), MADRS (Montgomery-Asberg Depression Rating Scale). Differences between groups were measured for the CTQ using the t test. The relationship between test results and trauma was measured via regression analyses.

Both groups had high scores of emotional and sexual abuse, and the BPD group also showed high scores in emotional negligence. There were no statistically significant differences between groups relating to trauma symptoms (see Figure 1) Moreover, significant relationships were found between childhood trauma and higher levels of impulsivity (R2adj = 0.14; p = .006), feelings of emptiness (R2adj = 0.15; p = .005), anxiety (R2adj = 0.13; p = .008) and depression (R2adj = 0.08; p = .037).

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Out preliminary study shows that childhood trauma is a transdiagnostic factor between BPD and EDs, and it’s related to the aggravation of impulsivity and instability symptomatology.

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The Dark Tetrad of Personality includes factors commonly recognized as socially aversive. So far, they have been recognized as psychopathy, narcissism and Machiavellianism. Nowadays, sadism has also been included in the scope of dark personality traits. There are many tools for examining the Dark Triad of Personality, while tools dedicated to the Dark Tetrad are under development. One such tool is The Short Dark Tetrad scale (SD4) by Paulhus et al. (2021), which, due to its popularity, may enable cross-cultural research in the future.

The aim of the study was to assess the preliminary psychometric properties of the Short Dark Tetrad tool - Polish version (SD4-PL).

972 people with an average age of 34.39±11.09 SD years were recruited for the study. The 28-item Short Dark Tetrad scale (SD4) was translated into Polish (SD4 Pl) and used for a study. As part of the statistical analyses, a confirmatory factor analysis (CFA) was used, based on the structural equation modeling. The internal consistency of the tool was also assessed.

Confirmatory factor analysis (CFA) parameters turned out to be satisfactory. The original structure of the tool was maintained, which consists of four 7-item scales dedicated to psychopathy, narcissism, Machiavellianism and sadism. The obtained psychometric parameters turned out to be similar to the results obtained in several countries where the Short Dark Tetrad scale has already been introduced. Satisfactory measures confirming the reliability of the tool (Cronbach’s α) were also obtained, ranging between 0.68 and 0.79.

Short Dark Tetrad - Polish version (SD4-PL) presents satisfactory psychometric properties. By maintaining the original structure of the tool, it opens the possibility of examining its equivalence with other language versions and, in the future, the possibility of conducting international research focusing on factors such as psychopathy, narcissism, Machiavellianism and sadism.

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Borderline personality disorder (BPD) often results in recurrent acute hospitalisations, significantly burdening healthcare systems. Specialised intervention programs aim to stabilise patients and reduce hospital admissions. This study investigates the impact of a structured BPD Intervention Program at the Local Health Unit of São João on reducing the need for acute hospitalisations.

The objective of this study is to assess the effect of integration into the BPD Intervention Program on the frequency of acute hospitalizations. Furthermore, we aim to investigate the relationship between clinical and sociodemographic factors, as well as the need for inpatient care.

This is a retrospective longitudinal study with quantitative statistical analysis of data from 293 patients referred for suspected BPD at the São João Local Health Unit. The analysis included 163 patients who had their BPD diagnosis confirmed. We collected data from hospital records, focusing on the number of hospitalisations before and after program admission. We also analysed variables such as the program’s follow-up duration.

The mean age at the time of the first evaluation was 24.6 years, with symptoms typically starting at a mean age of 14.2 years. The majority of participants (94%) were female. The program’s integration led to a significant reduction in hospital admissions. Prior to the program, patients had an average of 1.01 hospitalisations per patient (median = 0). After integration, the average decreased to 0.66 hospitalisations per patient (median = 0). We are conducting further analyses to explore associations between additional factors and hospitalisation outcomes.

Integration into the BPD Intervention Program is associated with a decrease in acute hospitalizations. This clearly supports the idea that specific interventions can help stabilise BPD patients. The findings also highlight how personalised care can reduce strain on healthcare costs. Future research should evaluate the long-term benefits of the program, including its impact on the duration of hospital stays and the lasting effects of reduced hospitalisation rates after program completion.

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Children born to mothers with mental health disorders are at a significantly increased risk of developing insecure attachment patterns.

Demonstrate with clinical case that mothers with schizotypal personality disorder tend to be less sensitive and responsive, and more intrusive in their interactions and caregiving (Høivik et al. BMC Psychiatry Int 2018; 18, 198; Willinger et al. ANZJP Int 2002, 36, 5; Vebeke et al. al. APA Int 2017, 8 54-63; Ripoll et al.).

The clinical case presented below highlights functional decline in a woman with schizotypal personality disorder during pregnancy and the transition to motherhood.

The 39-year-old mother of a 16-month-old son, employed as a saleswoman, has been in outpatient psychiatric treatment for 6 years. She has been hospitalized 6 times, 4 of which occurred in the year after childbirth.

Her psychiatric history began at age 33, when she was first admitted due to an impulsive outburst, involving aggression toward objects. Psychological evaluation revealed impulsivity alongside paranoid ideation. Treatment (aripiprazole, quetiapine, and paroxetine) led to clinical improvement, and she continued psychotherapy for psychosis. For 5 years, she maintained regular employment, entered a relationship, and became pregnant, at which point she discontinued pharmacotherapy.

At 32 weeks of pregnancy, she became disorganised, refusing food and gynecological examinations, leading to psychiatric hospitalization. A combination of haloperidol, quetiapine, and lorazepam stabilized her condition, although negative symptoms, cognitive impairments and schizotypal features persisted. She gave birth to a healthy son via planned cesarean section and continued postnatal care under a psychiatrist and clinical psychologist.

Within the year postpartum, she experienced 4 additional hospitalizations, primarily due to mood destabilization linked to non-adherence to oral and depot pharmacotherapy. Each time, her condition improved upon reintroduction of therapy. By her penultimate discharge, a social coordinator was appointed, as she struggled with childcare, expressing emotional detachment from her child. Her fourth hospitalization was characterized by disorganization and impulsivity, after which she ended her relationship with her partner. Currently, she resides with her mother and remains on quetiapine, clozapine, and aripiprazole. With her consent, her partner and his mother assumed childcare responsibilities. The patient reports feeling emotionally relieved and stable, and has agreed to resume depot pharmacotherapy.

This case underscores the importance of early identification and timely intervention in perinatal psychiatry. Effective treatment of maternal mental illness, doesn’t necessarily lead to secure attachment formation between mother and child, nor does it guarantee better cognitive or socio-emotional outcomes in the offspring.

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Personality disorders (PD) are defined as enduring and pervasive patterns of internal experience and behavior that deviate markedly from the expectations of the individual’s culture, causing distress and functional impairment (APA, 2013). Pharmacological therapy can be crucial to manage specific symptoms or psychiatric comorbidities, improving the quality of life of these patients. Adherence to pharmacological treatment is often reduced in patients with PD, representing a significant challenge for clinicians (Åkerblad et al., 2008). Few studies have explored this topic, highlighting the need for further research.

The aim of the present study was to assess medication adherence in patients with primary diagnosis or comorbidity of PD in different clinical settings of an Italian psychiatric department, considering clinical and socio-demographic differences.

A sample of 200 patients diagnosed with PD was recruited from various psychiatric services from the Department of Psychiatry at Luigi Sacco University Hospital, in Milan. Diagnoses were made through a structured clinical interview based on DSM-5 criteria (APA, 2013). The patient’s adherence to treatment was evaluated using the Clinician Rating Scale (CRS), with a cut-off of ≥ 5 defining adherence subgroups [Positive Adherence (A+): score ≥ 5; Negative Adherence (A-): score < 5].

Positive adherence to pharmacological treatment was observed in 64.5% of the sample, with significantly higher rates in patients with Cluster C(15.5% vs. 5.6%, p<0.005)(Figure 1). Furthermore, higher rates of positive adherence emerged in patients with a positive family history (60.3% vs 45.5%, p < 0.005). Finally, the analyzes between the different clusters revealed a significantly higher lifetime prevalence of suicidal thoughts in Cluster B (63.0%, p<0.05) and that the majority of Cluster A (60%, p<0.05) came from territorial mental health services, while the majority of Cluster C (66.7%, p<0.05) from day hospital services (Figure 2).

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The study found significantly higher treatment adherence rates in Cluster C patients, suggesting a possible link between the anxious traits characteristic of this group and greater compliance. Furthermore, a positive family history was associated with higher adherence rates, highlighting the role of family influences in adherence. Analyzing the differences between socio-demographic and clinical variables in the different clusters, it emerged that the prevalence of lifetime suicidal thoughts was significantly higher in Cluster B and that the patients in Cluster A mainly came from local mental health services and those in Cluster C from day hospital services. These findings highlight the importance of personalized interventions to meet the specific needs of each Cluster in order to optimize treatment adherence and therapeutic outcomes.

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Transcranial Magnetic Stimulation is non-invasive neuromodulation technique that manages various mental disorders, including Borderline Personality Disorder (BPD) that is characterized by impulsive behavior, emotional lability, aggressiveness and unstable mood. TMS may decreases some core symptoms of borderline personality disorder by targeting specific brain regions involved in emotion regulation, aggression management and impulse control.

magnetic fields stimulate nerve cells in prefrontal cortex, involved in emotional regulation, also influences neural circuitry, that diminish symptoms like aggressiveness, dysregulation and problems in interpersonal relationships.

• - Treatment effectiveness assessment in reducing symptoms like problems in interpersonal relationships, mood swings, impulsivity, aggressiveness, sometimes paranoid ideations

• - management of affect, anxiety and depressive states

• - Changes in neural circuitry: alterations in brain activity patterns

• - Safety profile of TMS in individuals with BPD, also adverse reactions

• - self assessment of the pationt regarding symptom relief

• - Compare with medications

Type of Study: Randomized controlled trial (RCT)

10-14 weeks

Outpatient department of Todua clinic

• - Adults aged 18-65 y

• - Diagnosis of Borderline Personality

• - Contraindications (e.g., metal implants in the skull or brain)

• - substance abuse disorder or psychiatric illness ( cognitive disorder, schizophrenia, bipolar disorder)

The results have shown a really promising outcome:

1. 1. reduced symptom severity: impulsivity, aggressiveness, self-harming, emotional instabiliyu, mood swings, improved mood and decreased anxiety and depressive states.

2. 2. Changes in neuronal circuits: TMS changed total brain activity in a positive way, it regulated limbic system functioning tha correspondingly improved the symptoms.

3. 3. This technique is really safe and very well tolerated with few side effects, most of them were mild, such as headache.

4. 4. Improved Quality of Life

In conclusion, Transcranial Magnetic Stimulation leads to significant reductions in main symptoms, such as mood swings, impulsivity, aggressiveness, emotional dysregulation and self harm. moreover, this technique is very well-tolerated, with minimal side effects, like mild headache.

Changes in brain activity shows how TMS facilitates symptom improvement, especially when combined with psychotherapy or medications.

TMS promises to be an innovative technique nin the management of core symptoms of BPD and improving patients’ quality of life.

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Severe personality disorders have a significative impact not only on patients but also among their families, causing emotional distress and relevant burden related to care giving. Psycho-educational intervention targeting family members can improve their understanding of the disorder and their ability to cope with symptoms.

Forlì Mental Health Centre multi-professional team undertake this study with the scope to evaluate the efficacy of a nine sessions’ psycho-educational program targeting a group of family members, based on the dialectical behavioral therapy (DBT) principles and skills.

12 participants completed the program and filled self report questionnaires administered at the first (t0) and ninth (t1) session: Symptom Checklist - 90 (SCL-90) and Zarit Burden Interview (ZBI). They also answered a qualitative format investigating their subjective experience.

Results at baseline (t0) indicate high scores on the SCL-90 subscales such as Somatisation (mean = 1,21; st. dev = 0,91), Depression (mean = 1,08; st. dev = 0,86), Sleep disturbances (mean = 1,39; st. dev = 1,03).

Statistical analysis suggest an increase of SCL-90 subscales, at the end of the program (t1), such as Somatisation (mean = 1,38; st. dev = 0,85), Obsessions and compulsions (mean = 1,19; st. dev = 0,78), Depression (mean = 1,40; st. dev = 0,93), Paranoia (mean = 0,93; st. dev = 0,78), Sleep disturbances (mean = 2,18; st. dev = 1,03). ZBI questionnaire total scores indicate an increase of perceived caregiving burden(mean = 42; st. dev = 24,7). Qualitative indicators were administered at the end of the program showing a general satisfaction for the intervention described as “useful”, “important”, “helpful”, “comforting”. The most liked session was the one about “validation” skill.

Despite the perceived psychological distress and burden’ increase, participants have intended the psycho-educative program as useful and worth it. Results suggest that their learnings may be paired with complementary skills and their generalization to enable a significative reduction of psychological impact of caregiving. Future development will include a follow up session to explore this possibility.

None Declared

Pathological traits according to the dimensional diagnostic system for personality disorders include a certain set of emotional, cognitive and behavioral features. In different people, a certain trait manifests itself in a different behavioral form, while the same trait can manifest itself in several people similarly.

To analyze shoplifting in individuals with borderline personality disorder through pathological traits.

A non-systematized literature review was performed, with keywords: borderline personality disorder, shoplifting, and a case series was presented.

This is a series of three cases of people with borderline personality disorder, who were also assessed according to ICD 11 criteria with LPFS-BF 2.0, PSQ-11 and BPS. The first person is a female, 20 years old, a student, LPFS-BF 2.0 - 34, on PSQ-11 elevated values for all pathological traits, except for anankastia and BPS – 47. She is occasionally depressed and continuously abuses marijuana for a long period of time. The second person is the also female, age 21, student, LPFS-BF 2.0 - 31, on PSQ-11 elevated values for negative affectivity and disinhibition and BPS – 46. Occasionally has obsessive controlling and criticizing thoughts and several episodes of self-harm, incidental substance abuse. The third person is a 20-year-old male, unemployed, LPFS-BF 2.0 - 32, PSQ-11 elevated values for negative affectivity and disinhibition and BPS – 41. He is occasionally paranoid, has a history of self-harm and occasional excessive use of benzodiazepines. All three give information that they occasionally steal from markets and large stores, but they do not steal from people. As a reason for stealing, they cite a lack of funds at a given moment for a particular item they wanted, but also the need to steal, the inability to refrain and the excitement they feel at that moment.

Negative affectivity and disinhibition appear as common pathological traits in all three people. Disinhibition, characterized by impulsivity due to a rush of immediate emotions and thoughts, without thinking about the consequences and the need for immediate gratification, manifests itself in these individuals through shoplifting. Occasional shoplifting, without practice of other forms of stealing, is a disinhibitory phenomenon.

None Declared