The research Dr. Aguirre suggested is based on treatment histories and not rigorous study methodology. Most empirical evidence of personality disorders is strongly influenced by psychoanalytic literature regarding object relations, which is in flux because of emerging attention to attachment theory and progress in neurologic studies in the evaluation of temperamental variations related to the influence of mirror neurons.2
We also take issue with the comment that “BPD has a better prognosis than other serious men tal illn esses, such as bipolar disorder” There have been significant efforts in studying the role family can have in the outcomes of mood disorder treatment.3
Finally, there is evidence that in adults medication can be beneficial in treating the affective deregulation of patients with BPD who do not have comorbid disorders.4
Robert A. Kowatch, MD, PhD
Professor of Psychiatry and Pediatrics
Erin Monroe, CNS
Clinical Nurse Specialist
Division of Psychiatry
Sergio V. Delgado, MD
Associate Professor of Psychiatry
and Pediatrics
Cincinnati Children’s Hospital Medical Center
Cincinnati, OH