A review of NICE guidelines on the management of Borderline Personality Disorder (original) (raw)
Related papers
European Journal of Interdisciplinary Studies, 2018
This literature review aims to evaluate the evidence in the extant literature of practical and evidence-based psychotherapy methods for overcoming personality disorders and to compare them with one another. For a systematic review, we used the following databases: ScienceDirect, ResearchGate, Cochrane, PsyNet, CrossRef, PubMed. As a result, 33 articles were selected. Dialectic Behavioral Therapy (DBT), Mentalization-based Therapy (MBT) and Schema-focused Therapy (SFT) have better evidence-based efficacy in the context of therapeutic effects on reducing the severity of diagnostic criteria and comorbid states. In the context of application in an outpatient setting the highest positive effect and compliances are demonstrated by DBT and SFT. The majority of trials of DBT and TFP showed the effectiveness of psychotherapy with a treatment duration of at least 12 months. The longest term without recurrence of comorbid states and drop out (36 months) was observed with the use of Transfer-focused Psychotherapy (TFP) and SFT, which in the context of the long-term therapeutic effect may give people benefits along with other therapies. The present review shows initial evidence that long-term psychotherapy can be a useful and evidence-based intervention for people with borderline personality disorder. These results provide promising evidence to support people who suffer from a personality disorder. DBT, MBT, and SFT can be proposed as methods of the first line as a nonpharmacological intervention.
An Integrative Perspective on Psychotherapeutic Treatments for Borderline Personality Disorder
Journal of Personality Disorders, 2008
Although there is an abundance of literature on the psychotherapeutic treatment of borderline pathology, little is known about differences and similarities between treatments of borderline personality disorder (BPD). Potential differences and similarities are especially important in the absence of evidence of the superiority of one treatment over the other (e.g., Livesley, 2004). This article offers an overview of the theory and practice of contemporary psychotherapeutic treatments of BPD, and delineates similarities and differences between the specific treatments. Results show that similarities concerning (1) the formal characteristics, and (2) the importance of therapeutic techniques in treatments for BPD, outnumber the differences. This article concludes by viewing the similarities and differences from an integrative perspective, and recommendations are given for future work in treating patients with and research on the effectiveness of treatments and treatment techniques for BPD. From Universiteit van Amsterdam. The authors would like to thank Dawn Bales,
Developments in diagnosis and treatment of people with borderline personality disorder
Current Opinion in Psychiatry, 2020
Purpose of review Borderline personality disorder (BPD) attracts significant attention from clinicians and researchers alike. Despite increased recognition and willingness to diagnose BPD, most effective treatment approaches remain inaccessible to most. We consider recent developments in the diagnosis and treatment of BPD. Recent findings A literature search of EMBASE and PsychINFO, using the search terms 'borderline personality disorder,' 'diagnosis' and 'treatment' for publications since October 2018, yielded over 300 articles and reviews. The literature highlights the increasing awareness of the diagnostic complexity of BPD as well as the emerging significance of 'common factors' and stepped care approaches for managing and treating the disorder. Summary Clinical practice is evolving to embrace more holistic diagnostic approaches, generalist treatment frameworks and stepped-care models that can be tailored to fit individual needs and service resources. The new frontiers in this field include expansion of timely treatment options, improved knowledge regarding the expression and management of BPD in men, adolescents and the elderly, and bridging cultural divides to create a worldwide population approach.
Issues in Mental Health Nursing, 2020
There is now compelling evidence that a range of psychotherapeutic treatments are effective in the treatment of borderline personality disorder (BPD). Such treatments are often lengthy, expensive, subject to high rates of incompletion and are rarely available to people with sub-threshold symptoms. There is broad agreement that some combination of vulnerability, invalidating environment, childhood adversity, disrupted attachment in childhood or trauma play a role in the aetiology of the syndrome of BPD. These factors also contribute to problems with the capacity to mentalise, regulate emotions, tolerate distress and impact on psychosocial development with or without self-damaging and suicidal behaviour. This column takes as a given that people with BPD should receive evidence-based psychological treatments such as dialectical behaviour therapy (DBT), interpersonal therapy and cognitive behavioural therapy in a sufficient dose to be helpful. However, to avert an escalating trajectory which may lead to a diagnosis of BPD the right dose of the right therapy at the right time is necessary. Under-dosing or ineffective psychotherapy can be potentially harmful. This column reviews the evidence, such as it is, for therapeutic approaches which may contribute to more skilful negotiation of life's difficulties and which may avert deterioration in mental health and quality of life in vulnerable individuals and families.
Current Psychiatry Reports, 2010
Recent clinical trials support the conclusion that patients with borderline personality disorder are best treated with structured and specifically designed forms of psychotherapy. The strongest evidence from clinical trials favors dialectical behavior therapy and mentalization-based treatment. These methods, which have several similarities, could be shortened to make them more accessible. Successful psychotherapy in individuals with borderline personality disorder should not
Psychopharmacologic treatment of borderline personality disorder
Dialogues in clinical neuroscience, 2013
The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evi...
European Neuropsychopharmacology, 2015
Patients with borderline personality disorder (BPD) are usually prescribed a variety of psychotropic drugs; however, none is recommended in the guidelines nor has any been approved for this indication. As data on drug prescriptions for BPD are sparse, cross-sectional data from the European Drug Safety Project AMSP were used to analyse drug prescriptions of 2195 in-patients with BPD between 2001 and 2011, and the mean values, confidence intervals and regression analyses were calculated. 70% of all BPD patients were medicated with antipsychotics and/or antidepressants, 33% with anticonvulsants, 30% with benzodiazepines, and 4% with lithium; 90% received at least one, 80% Z2, and 54% Z3 psychotropic drugs concomitantly (mean: 2.8). Prescription rates for quetiapine, the single drug most often used in BPD (22%), increased significantly over time. In view of the high percentage of young females with BPD, 18-40 year-old female patients with BPD were compared with patients of the same age but with depression (unipolar and bipolar) and schizophrenia. Typical sedative antipsychotics and anticonvulsants were prescribed more often in BPD than in the other diagnostic groups,
Understanding and Treating Borderline Personality Disorder
The authors have worked to ensure that all information in this book is accurate at the time of publication and consistent with general psychiatric and medical standards, and that information concerning drug dosages, schedules, and routes of administration is accurate at the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family.
PSYCHOTHERAPY OF BORDERLINE PERSONALITY DISORDER
Romanian Journal of Experimental Applied Psychology, 2014
Borderline personality disorder (BPD) is both a common and serious psychiatric disorder, associated with high level of psychiatric care and high levels of psychosocial impairment. The individuals with this disorder can have negative and distorted views of themselves, along with feelings of low self-worth; they might easily become argumentative, moody and impulsive. SSRI may be a good pharmacotherapy for BPT, but psychotherapy is considered the primary treatment for this personality disorder. The aim of this paper is to describe the basic treatment strategies used in DBT. There are two psychotherapeutic approaches that have been shown to have efficacy in randomized controlled trials: psychoanalytic/psychodynamic therapy and dialectical behavior therapy. Dialectical behavior therapy (DBT) is a cognitive-behavioral approach to treating borderline personality disorder, developed by Marsha Linehan.
[Diagnosis and treatment of borderline personality disorder: a professionals' survey]
PubMed, 2004
Borderline personality disorder (BPD) is a frequent mental disorder whose affected present high levels of stress and suffering. Diverse diagnostic criteria exist for this disorder. Objective: The objective of our study was to establish which are the most sensitive symptoms to diagnose BPD at the present time together with the expectations and treatments of choice of mental health professionals of Buenos Aires city. Methods: A voluntary auto survey was completed by 116 mental health professionals from private and public institutes of Buenos Aires city . Results: Impulsivity, affective instability and boredom or emptiness were the symptoms referred as the most important to make the diagnosis of BPD. More than half of the people polled reported that the DSM IV was useless to establish the diagnosis of this disorder. Individual psychoanalytic psychotherapy was chosen by the majority of the surveyed as the most important treatment for these patients. Mood stabilizers are the drugs of choice for the pharmacological treatment of impulsivity. Conclusions: It is important to elaborate in our country diagnostic criteria and treatment guidelines that consider the knowledge and local experience with these patients.