Filling the gap between theory and practice: A pilot study on parents' perceptions of integrated care for patients with borderline personality disorder

Antipsychotics are recommended for the treatment of impulsive dyscontrol and cognitive perceptual symptoms of borderline personality disorder (BPD). Three reports supported the efficacy of oral risperidone on BPD psychopathology. Paliperidone ER is the metabolite of risperidone with a similar mechanism of action, and its osmotic release reduces plasmatic fluctuations and antidopaminergic effects. The aim of this study is to evaluate efficacy and safety of paliperidone ER in BPD patients. 18 outpatients with a DSM-IV-TR diagnosis of BPD were treated for 12 weeks with paliperidone ER (3–6 mg/day). They were assessed at baseline, week 4, and week 12, using the CGI-Severity item, the BPRS, the HDRS, the HARS, the SOFAS, the BPD Severity Index (BPDSI), and the Barratt Impulsiveness Scale (BIS-11). Adverse events were evaluated with the DOTES. Paliperidone ER was shown to be effective and well tolerated in reducing severity of global symptomatology and specific BPD symptoms, such as impulsive dyscontrol, anger, and cognitive-perceptual disturbances. Results need to be replicated in controlled trials.

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Effects of a Painful Stimulus on Stress Regulation in Male Patients With Borderline Personality Disorder: A Pilot Study

Journal of Personality Disorders ◽

10.1521/pedi_2018_32_351 ◽

2019 ◽

Vol 33 (3) ◽

pp. 394-412

Author(s):

Janina Naoum ◽

Nikolaus Kleindienst ◽

Ulf Baumgärtner ◽

Franziska Willis ◽

Falk Mancke ◽

...

Keyword(s):

Heart Rate ◽

Borderline Personality Disorder ◽

Pilot Study ◽

Personality Disorder ◽

Borderline Personality ◽

Pain Stimulus ◽

Self Injury ◽

Significant Difference ◽

Pain Ratings ◽

Male Patients

Pain processing in relation to stress has so far not been investigated in male patients with borderline personality disorder (BPD). This experimental pilot study examined 17 male BPD patients and 20 male healthy controls (HCs) to assess the effects of a pain stimulus on arousal, aggression, pain (ratings), and heart rate. At baseline, BPD patients showed significantly higher arousal and aggression; however, there was no significant difference in heart rate compared to the HC group. Following stress induction, a noninvasive mechanical pain stimulus was applied. No significant differences in pain ratings or heart rates were found between the groups. For arousal, a significantly stronger decrease was revealed in the BPD group compared to the HC group (t = 2.16, p = .038). Concerning aggression, the BPD group showed a significantly greater decrease after the pain stimulus than the HC group (t = 3.25, p = .002). This data showed that nonsuicidal self-injury can reduce arousal and aggression in male BPD.

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EMOTEO: A Smartphone Application for Monitoring and Reducing Aversive Tension in Borderline Personality Disorder Patients, a Pilot Study

Perspectives In Psychiatric Care ◽

10.1111/ppc.12178 ◽

2016 ◽

Vol 53 (4) ◽

pp. 289-298 ◽

Cited By ~ 14

Author(s):

Paco Prada ◽

Ido Zamberg ◽

Gérald Bouillault ◽

Naya Jimenez ◽

Julien Zimmermann ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Pilot Study ◽

Personality Disorder ◽

Smartphone Application ◽

Borderline Personality

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Borderline personality disorder, therapeutic privilege, integrated care: is it ethical to withhold a psychiatric diagnosis?

Journal of Medical Ethics ◽

10.1136/medethics-2021-107216 ◽

2021 ◽

pp. medethics-2021-107216

Author(s):

Erika Sims ◽

Katherine J Nelson ◽

Dominic Sisti

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Integrated Care ◽

Clinical Psychiatry ◽

Psychiatric Diagnosis ◽

Patient Population ◽

Borderline Personality ◽

Prognostic Information ◽

Diagnostic Disclosure ◽

Therapeutic Privilege

Once common, therapeutic privilege—the practice whereby a physician withholds diagnostic or prognostic information from a patient intending to protect the patient—is now generally seen as unethical. However, instances of therapeutic privilege are common in some areas of clinical psychiatry. We describe therapeutic privilege in the context of borderline personality disorder, discuss the implications of diagnostic non-disclosure on integrated care and offer recommendations to promote diagnostic disclosure for this patient population.

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