Transition from Attention-Deficit/Hyperactivity Disorder (ADHD) to Borderline Conditions with Self-Harm, Affective Dependency, and Refractory Depression: Role of Dopamine, Secondary Gains, and Integrated Therapeutic Strategies

Patients—often female—with a prior diagnosis of ADHD evolve, in adolescence or adulthood, into borderline personality conditions, characterized by affective instability, self-harm, intense emotional dependency, refractory depressive episodes, and recurrent psychoactive substance use. The central hypothesis is the existence of a dopaminergic dependence syndrome, associated with temperamental and constitutional vulnerabilities, with an overlap between DSM Axis II aspects and neurochemical imbalances. This article proposes an integrated approach, involving typical antipsychotics (such as haloperidol), lithium, and intensive psychiatric psychotherapy, advocating Henri Ey's organic-dynamic model as an explanatory paradigm