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The members of our chapter have decided in the last few years to move toward clinical research. After analyzing some reference papers in psychoanalytic research (Emde & Fonagy, 1997; Williams, 1999), we decided to probe some long-standing clinical and psychopathological assertions or those in which the most recent data are inconclusive. We therefore initiated a study to assess the presence or absence of personality disorder during periods of remission in patients with different clinical forms of bipolar disorder (BPD). We have been particularly interested in the theories of Abraham and Kernberg regarding personality organization.
In two Buenos Aires hospitals, we examined a pool of patients with SCID-I and II interviews to determine Axis I and II diagnoses, respectively. Among the patients with bipolar I and bipolar II, some of these patients were determined to have no personality disorders, while other patients did merit an additional diagnosis of personality disorder, including dependent, borderline, obsessive-compulsive, histrionic, and narcissistic personality disorders. Our findings will be submitted for publication in the near future. We believe our findings demonstrate a high degree of association between bipolar disorder and personality disorder. We did not find evidence to support Abraham's hypothesis (1955/1994) about a high degree of association between cyclic disorder and obsessive organization, although Abraham was referring to melancholy (now severe forms of unipolar depression) and our number of cases is low when compared to that form of disorder. We will argue that our findings did partially confirm Kernberg's (1984) hypothesis about the association between bipolar disorder and borderline personality. Patients without personality disorder, it is worth clarifying, still did not necessarily qualify as “normal,” but pathology was not detected by the instrument employed for the assessment.
In a time when there is a great degree of neurobiological dominance