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

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