Cognitive therapy, originally conceived for the treatment of emotional illnesses, has been successively used also in treating patients with more severe mental disorders. In this article, the results obtained by Shearin & Linehan (this volume) in a few controlled trials of dialectical behavior therapy in patients with borderline personality disorders are discussed. Differences between the treatment approach followed by Shearin & Linehan, which focuses on the modification of specific behaviors, and that favored by the author, which is aimed at restructuring dysfunctional working models of self and environment, are highlighted. In the conclusion it is emphasized that the use of a structured, didactic and cognitive‐behaviorally oriented approach focused on personal growth might represent an important and much wanted breakthrough in the treatment of the most disturbed patients with a borderline personality disorder.

In a previous article in this Journal, the suggestion was made, based on attachment theory and developed within the theoretical framework of a multifactorial conception of individual vulnerability, that personality disorders could be conceptualized as personality-related disorders of interpersonal behaviour. In this article a sketch is made of how such a conceptualization might have an impact on the conduct of therapy. Accordingly, a condensed description is given of a developmental-constructivist cognitive psychotherapy approach to the treatment of patients with this kind of disorder.

Serum dopamine-β-hydroxylase (DBH) activity was tested in 160 psychiatric patients suffering from affective disorders. The patients were divided into subgroups according to strict diagnostic criteria and clinical state at the time of the examination. Since no relationship was found between DBH activity and age or sex, these variables have been discarded from further analyses. Bipolar (manic-depressive) patients had lower (p < 0.05) DBH mean values than patients suffering from unipolar, recurrent depressive psychoses. No other differences were found either among groups or in relation to the clinical state. As such a wide range of DBH values was recorded in all the groups examined, measurements of DBH activity do not seem to be useful as a diagnostic aid, or as an indicator of the clinical state of patients suffering from affective disorders.

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