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Child Sexual Abuse has a wide range of connotations. Psychiatric implications often include depression, post-traumatic stress disorder, and also self-harming behavior. Moreover it often determines personality correlates (in particular Borderline Personality Disorder). In this contribution we report an explicative case of the consequences linked to child sexual abuse. Patient: Male, 40 ys, divorced, one son (11 ys). He reports child sexual abuse by both parents (7 to 12 ys). Abuses ended when he fight with his father using a knife. He worked for an airline company, but was fired for an excess of work absence due to pathology. Since adolescence he presented obsessive-compulsive behavior, anxiety, mood instability, impulsiveness, flash backs, nightmares, attention difficulties and sleep disorder (linked to the idea of his own death during sleeping). Clinical diagnoses: Post Traumatic Stress Disorder and Obsessive Compulsive Disorder (Axis I), and Personality Disorder NAS with obsessive compulsive and narcissistic traits (Axis II). He complains about side effects due to many drugs (different antidepressants, antipsychotics and mood stabilizers), but shows small responsiveness. Test: WAIS-R: I.Q.=105 RORCHACH: a personality organized with narcissistic defenses due to relational defects linked to self and identity definition. SCID-II: Personality Disorder NAS with obsessive compulsive and narcissistic traits. [Copyright &y& Elsevier]

Daily clinical practice shows that most admissions due to depressive symptoms are established more by personality (PD) - in particular borderline - than mood disorders (even if the prevalence of unipolar depression is assessed as 10 times higher than borderline PD). Both have a higher incidence in the female populace. Methods: During the 6 months of recruitment, the patients admitted for depressive symptom complaints were screened with a medical history and socio-demographic inventory, the SCID II, the Hamilton Depression Rating Scale (HAM-D), the Beck Anxiety Interview (BAI), and the Beck Depression Interview (BDI). The patients will be retested through a follow-up after 3 and 6 months with HAM-D, BDI and BAI. Only the feminine part of the sample was considered (n=60) and divided by SCID II results in Borderline Personality Disorder [B] (n=33), Other PD [O] (n=14) and negative [N](n=9); 4 patients refused to complete the tests [R]. Results: Statistically, there were no significant differences among the groups, if the same test is compared at the same moment; however, during follow-up B improves in a statistically significant way compared to others. Moreover, those of B who underwent psychotherapy statistically had significantly lower scores than those of B who did not. Conclusion: Research clearly demonstrates the importance of PD, and in particular borderline, in determining admissions due to depressive symptomathology. Moreover, Borderline PD patients improve more than other patients after an admission, particularly if they underwent psychotherapy. [Copyright &y& Elsevier]