Mood and global functioning in borderline personality disorder: Individual regression models for longitudinal measurements

1992 ◽  
Vol 26 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Lizbeth A. Hoke ◽  
Philip W. Lavori ◽  
J. Christopher Perry
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Regression Models ◽  
Borderline Personality ◽  
Global Functioning ◽  
Longitudinal Measurements

Current Clinical Psychopharmacology in Borderline Personality Disorder

2021 ◽  
Vol 19 ◽  
Author(s):  
Antonio Del Casale ◽  
Luca Bonanni ◽  
Paride Bargagna ◽  
Francesco Novelli ◽  
Federica Fiaschè ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Psychopharmacology ◽  
Treatment Strategies ◽  
Borderline Personality ◽  
Global Functioning ◽  
Comprehensive Overview ◽  
Pubmed Database ◽  
Second Generation Antipsychotics ◽  
Core Symptoms

Background: Patients with Borderline Personality Disorder (BPD) manifest affective and behavioural symptoms causing personal distress, relationship difficulties, and reduced quality of life with global functioning impairment, mainly when the disease takes an unfavourable course. A substantial amount of healthcare costs is dedicated to addressing these issues. Many BPD patients receive medications, mostly those who do not respond to psychological interventions. Objective: Our aim was to assess the efficacy of the most used strategies of pharmacological interventions in BPD with a comprehensive overview of the field. Methods: We searched the PubMed database for papers focused on the most used psychotropic drugs for BPD. We included randomized controlled trials and open studies in adult patients with BPD, focusing on the efficacy and tolerability of single classes of drugs with respect to specific clinical presentations that may occur during the course of BPD. Results: Specific second-generation antipsychotics (SGAs) and/or serotonergic antidepressants can be effective for different core symptoms of BPD, mainly including mood symptoms, anxiety, and impulse dyscontrol. Some atypical antipsychotics can also be effective for psychotic and dissociative symptoms. Specific antiepileptics can be useful in some cases in treating specific BPD symptoms, mainly including mood instability, impulsiveness, and anger. Conclusions: No medication is currently approved for BPD, and clinicians should carefully assess the benefits and risks of drug treatment. Further studies are needed to identify specific personalized treatment strategies, also considering the clinical heterogeneity and possible comorbidities of BPD.

scholarly journals Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: randomised controlled trial

2008 ◽  
Vol 193 (6) ◽  
pp. 477-484 ◽  
Author(s):  
Andrew M. Chanen ◽  
Henry J. Jackson ◽  
Louise K. McCutcheon ◽  
Martina Jovev ◽  
Paul Dudgeon ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Randomised Controlled Trial ◽  
Personality Disorder ◽  
Controlled Trial ◽  
Borderline Personality ◽  
Global Functioning ◽  
Significant Difference ◽  
Analytic Therapy ◽  
Randomised Controlled ◽  
Cognitive Analytic Therapy

BackgroundNo accepted intervention exists for borderline personality disorder presenting in adolescence.AimsTo compare the effectiveness of up to 24 sessions of cognitive analytic therapy (CAT) or manualised good clinical care (GCC) in addition to a comprehensive service model of care.MethodIn a randomised controlled trial, CAT and GCC were compared in out-patients aged 15–18 years who fulfilled two to nine of the DSM–IV criteria for borderline personality disorder. We predicted that, compared with the GCC group, the CAT group would show greater reductions in psychopathology and parasuicidal behaviour and greater improvement in global functioning over 24 months.ResultsEighty-six patients were randomised and 78 (CAT n=41; GCC n=37) provided follow-up data. There was no significant difference between the outcomes of the treatment groups at 24 months on the pre-chosen measures but there was some evidence that patients allocated to CAT improved more rapidly. No adverse effect was shown with either treatment.ConclusionsBoth CAT and GCC are effective in reducing externalising psychopathology in teenagers with sub-syndromal or full-syndrome bipolar personality disorder. Larger studies are required to determine the specific value of CAT in this population.

Dissemination of DBT for borderline personality disorder in Egypt, facts and challenges

2017 ◽  
Vol 41 (S1) ◽  
pp. S334-S335
Author(s):  
A. Abdelkarim ◽  
D. Nagui Rizk ◽  
A. Ivanoff
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychiatric Hospitalization ◽  
Training Model ◽  
Borderline Personality ◽  
Global Functioning ◽  
Intensive Training ◽  
Evidence Based Treatments ◽  
Competing Interest ◽  
Scientific Meetings

BackgroundDBT proved to be effective in reducing suicidal behavior, non-suicidal self-injury, psychiatric hospitalization, treatment dropout, substance use, anger, and depression and improving social and global functioning in Borderline personality disorder. As a step towards increasing utilization of evidence based treatments in the Egyptian healthcare system, the team at Alexandria university started a comprehensive DBT program.AimTo describe the implementation and dissemination experience of DBT in Egypt.MethodsThe implementation of DBT is examined quantitatively. Numbers were calculated retrospectively from the records at the implementation start in December 2013 and after 3 years in September 2016.ResultsNumber of therapists increased from one team of 2 therapists and one observer to 16 therapists organized in 3 teams plus 4 observers. The initial team, 7 psychiatrists and 2 clinical psychologists, could host and attend the first DBT Intensive Training in the middle east in 2014. DBT intensive training is the official training model developed by Dr. Linehan. We started with 8 clients one group for adults in Alexandria at 2013, increasing to 150 clients in 12 groups for adults, adolescent and SUD patients in 2016 with an average increase of 18.75 folds. The team participated and presented about DBT in 23 local and regional scientific meetings and hosted two workshops in collaboration with BehavioralTech, the official training institute.ConclusionsAlthough the DBT implementation in Egypt represented a great challenge, results are showing a promising increase in the number of trained therapists and participating clients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The weight of borderline intellectual functioning on the capacity of integration and social adaptation of patients with borderline personality disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S192-S192 ◽  
Author(s):  
D. Galletta ◽  
A.I. Califano ◽  
N. Vangone ◽  
S. De Simone ◽  
A.M. Mastrola ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Social Life ◽  
Significant Risk ◽  
Intellectual Functioning ◽  
Borderline Personality ◽  
Global Functioning ◽  
Borderline Intellectual Functioning ◽  
The Relationship

From the analysis of current scientific literature are still few studies on the relationship between personality disorders and borderline intellectual functioning, since the latter, without its own specificity, has always been considered as a kind of undefined zone between intellectual functioning medium and intellectual disabilities. Several studies have shown the presence of comorbidity of the personality disorders with BIF, emphasizing a higher frequency of Borderline Personality Disorder. BIF is considered a significant risk factor for the development of a broad spectrum of neuropsychiatric disorders, in particular in our observations ongoing since 2003, it assumes an important weight on the global functioning of patients with personality disorder as we have stated in the intervention SOPSI 2012. In detail, this study focuses on the relationship between BPD and BIF, noting the weight the latter on the social adaptability, job placement and creation of bonds of individuals with Borderline Personality Disorder. Patients included in this study were 52 (40 F and 12 M), of which 27 belonging to the first group had a borderline intellectual functioning in comorbidity with BPD and 25 individuals belonging to the second group with BPD without BIF. The results show that 33% of individuals included in the first group did not find a job working compared to 16% of the second group, showing further falls in attention and concentration, therefore, in the ability to anticipate and generalization, impacting strongly on the degree of adaptation to social life, while there are not significant differences in the ability to create emotional ties between the two groups.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Searching in the dark: Shining a light on some predictors of non-response to psychotherapy for borderline personality disorder

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255055
Author(s):  
Jane Woodbridge ◽  
Samantha Reis ◽  
Michelle L. Townsend ◽  
Lucy Hobby ◽  
Brin F. S. Grenyer
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Community Treatment ◽  
Reliable Change Index ◽  
Global Functioning ◽  
Reliable Change ◽  
Relationship Style ◽  
Preoccupied Attachment

Background Borderline Personality Disorder (BPD) is a prevalent and serious mental health condition. People can experience recovery or remission after receiving psychotherapy for BPD; however, it is estimated that about 45% of people in well conducted treatment trials do not respond adequately to current psychological treatments. Aim To further advance psychotherapies for BPD by identifying the factors that contribute to the problem of non-response. Method 184 consecutive participants with BPD in community treatment were naturalistically followed up over 12 months and measures of personality and social functioning were examined. Logistic regressions were used to determine which baseline factors were associated with the likelihood of being a non-responder after 12 months of psychotherapy. After 12 months, 48.4% of participants were classed as non-responders due to a lack of reduction in BPD symptoms according to the Reliable Change Index (RCI) method. Results At baseline intake, patients who endorsed an adult preoccupied attachment relationship style and increased anger were more likely to be a non-responder regarding BPD symptoms at 12 months. In addition, those with preoccupied attachment patterns in their adult relationships were more likely to be non-responders regarding general psychological distress at follow up. Higher baseline levels of paranoia and endorsement of a dismissive adult relationship style was associated with being a non-responder in regard to global functioning. Conclusions Consistent with previous research, almost half of the sample did not achieve reliable change at 12-month follow up. A relationship style characterised by preoccupied insecurity and high anger seemed to be particularly challenging in being able to benefit from psychotherapy. This style may have affected both relationships outside, but also inside therapy, complicating treatment engagement and alliance with the therapist. Early identification and modification of treatment based on challenges from these relationship styles may be one way to improve psychotherapy outcomes for BPD.

Early Intervention for Adolescents with Borderline Personality Disorder: Quasi-Experimental Comparison with Treatment as Usual

2009 ◽  
Vol 43 (5) ◽  
pp. 397-408 ◽  
Author(s):  
Andrew M. Chanen ◽  
Henry J. Jackson ◽  
Louise K. McCutcheon ◽  
Martina Jovev ◽  
Paul Dudgeon ◽  
...  
Keyword(s):  
Early Intervention ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Care ◽  
Borderline Personality ◽  
Experimental Comparison ◽  
Global Functioning ◽  
Treatment As Usual ◽  
Quasi Experimental ◽  
Rate Of Improvement

Objective: The aim of the present study was to compare the effectiveness of specialized team-based early intervention for borderline personality disorder (BPD) with treatment as usual. Method: In a quasi-experimental design, 32 outpatients who received historical treatment as usual (H-TAU) were compared with 78 participants from a recently published randomized controlled trial of cognitive analytic therapy (CAT; n = 41) versus manualized good clinical care (GCC; n = 37), conducted in a specialized early intervention service for BPD (the Helping Young People Early (HYPE) programme). All participants were 15–18-year-old outpatients who fulfilled 2–9 DSM-IV BPD criteria. It was predicted that, compared with H-TAU, HYPE + GCC and HYPE + CAT would show greater reductions in psychopathology and parasuicidal behaviour and greater improvement in global functioning over 24months. Results: At 24month follow up: (i) HYPE + CAT had lower standardized levels of, and a significantly faster standardized rate of improvement in, internalizing and externalizing psychopathology, compared with H-TAU; and (ii) HYPE + GCC had lower standardized levels of internalizing psychopathology and a faster rate of improvement in global functioning than H-TAU. HYPE + CAT yielded the greatest median improvement on the four continuous outcome measures over 24months. No adverse effects were shown with any of the treatments. Conclusions: Specialized early intervention for subsyndromal or full-syndrome BPD is more effective than TAU, with HYPE + CAT being the most effective intervention. Reform of existing services using the HYPE model might yield substantial improvements in patient outcomes.

Predictors of 18-month outcome for patients with borderline personality disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1026-1026 ◽  
Author(s):  
D. Karaklic ◽  
J. Thuile ◽  
B. Granger ◽  
I. Secret ◽  
C. Bungener
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Life Events ◽  
Borderline Personality ◽  
Self Report ◽  
Global Functioning ◽  
Borderline Patients

IntroductionFor quite a long time, borderline personality disorder (BPD) has been viewed as a chronic disorder and borderline patients as extremely difficult to treat. However, those views are changing and there is an increasing recognition that the BPD has a far more benign course than previously thought, but predictors of its outcome remain poorly explored.Objective and aimsThe purpose of this study was to determine the most clinically relevant predictors of the outcome of BPD at the 18-month follow-up.MethodsBorderline patients (n = 75) were compared to patients with other personality disorders (OPD) (n = 40). All subjects were assessed at baseline and 6, 12, and 18 months with a series of semi structured interviews (personality disorders, global functioning, mental disorders, life events, …) and self-report measures (alexithymia and impulsivity). Logistic regression was used to estimate hazard ratios.ResultsAt the 18-month follow up, 57 BPD patients and 22 with OPD have been evaluated, 45% of borderline subjects and 50% of the OPD subjects achieved remission. Low impulsivity, low alexithymia, good global functioning, and older age at onset of symptoms were found to be significant predictors of good outcome of BPD. Our clinical data suggest that life events and the quality of current relationships are determinant in the outcome of BPD.Conclusions45% of patients with BPD are likely to improve in 18-months. Specific factors, such as impulsivity, alexithymia, life events and quality of current relationships, determine the short-term outcome of this disorder.

Global functioning and suicide risk in patients with depression and comorbid borderline personality disorder

2019 ◽  
Vol 31 ◽  
pp. 37-42
Author(s):  
Zeinab Abd Elsalam Sarhan ◽  
Hanan Anwer El Shinnawy ◽  
Mohamed Elsayed Eltawil ◽  
Yassmin Elnawawy ◽  
Wegdan Rashad ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Risk ◽  
Borderline Personality ◽  
Global Functioning

Abandonment Psychotherapy and Psychosocial Functioning Among Suicidal Patients With Borderline Personality Disorder: A 3-Year Naturalistic Follow-Up

2019 ◽  
pp. 1-11
Author(s):  
Antonio Andreoli ◽  
Yvonne Burnand ◽  
Laura Frambati ◽  
Donna Manning ◽  
Allen Frances
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychosocial Functioning ◽  
Randomized Study ◽  
Borderline Personality ◽  
Psychotic Symptoms ◽  
Global Functioning ◽  
Treatment As Usual ◽  
Treatment Conditions

The authors present the results from a 3-year follow-up among 170 patients who had participated in the original randomized study, which consisted of three treatment conditions: (a) 3-month abandonment psychotherapy (AP) delivered by certified psychotherapists, (b) AP delivered by nurses, and (c) treatment as usual in a psychiatric crisis center. All subjects were recruited at the emergency room after a suicide attempt and met diagnostic criteria for borderline personality disorder and major depression. Psychotic symptoms, bipolar disorder, and mental retardation were exclusion criteria. At 3-year follow-up, 134 (78.8%) subjects had blind, reliable assessment by clinical psychologists. The intent-to-treat analysis indicated that those patients who had received AP during acute treatment had better global functioning, improved work adjustment, and less unemployment/disability at 3-year follow-up. No differences were found as a function of type of therapist delivering AP. The data confirm that short-term AP gains in psychosocial functioning are sustained over the longer term.

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