Inhaled Loxapine for The Treatment of agitation in Borderline Personality Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S444-S444
Author(s):  
R. Puente ◽  
M.F. Rabito alcon ◽  
S. Garcìa Jorge ◽  
H. Dolengevich Segal ◽  
M. Benítez alonso ◽  
...  

Introductioninhaled loxapine has shown efficiency in the treatment of the mild-moderate agitation syndrome of schyzophrenia and mania patients. Its rapid response and calming effect non-sedative allow to hypothesize reasonable efficiency and tolerability in borderline personality disorder diagnosed patients.aimsanalyze the efficiency and tolerability of inhaled loxapine as a pharmacological approach in the treatment of agitation in borderline personality disorder (BPD) clinical diagnosed patients.Materials and methodan application was administered for every agitation episode in BPD patients treated with inhaled loxapine in the emergency room or the psychiatric ward, which included B aRS and CGI-S scales for the evaluation of each episode and its severity, before and after its use. Other secondary measures of efficiency were taken into account, such as requirement of physical restrain.Resultsin the majority of evaluated episodes inhaled loxapine decreased notably initial B aRS and CGI-S values and no serious clinical side effects attributable to this medication were observed.Conclusionin our sample, inhaled loxapine was efficiency and well tolerated pharmacological intervention for agitation in BPD patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2019 ◽  
pp. 1-20 ◽  
Author(s):  
Ulrike Dinger ◽  
Magdalena Fuchs ◽  
Johanna Köhling ◽  
Henning Schauenburg ◽  
Johannes C. Ehrenthal

This study examines emotional experience in major depressive disorder (MDD) with and without comorbid borderline personality disorder (BPD). It investigates if depression severity or personality functioning mediates group differences and which aspects of emotional experience change during psychotherapy. The emotional experience of MDD-BPD patients (n = 44) was compared to MDD-only patients (n = 35) before and after multimodal short-term psychotherapy. Emotions were classified based on valence and an active/passive polarity. MDD-BPD patients exhibited more active-negative emotions. This group difference was mediated by the level of personality functioning, but not by depression severity. Although passive-negative emotions decreased and positive emotions increased during therapy, there was no significant change in active-negative emotions. The two patient groups did not significantly differ in the change of emotional experience. Lower levels of personality functioning in depressed patients with BPD are associated with a broader spectrum of negative emotions, specifically more active-negative emotions.


2017 ◽  
Vol 41 (S1) ◽  
pp. S47-S47
Author(s):  
B. Völlm ◽  
J. Stoffers-Winterling ◽  
J. Mattivi ◽  
E. Simonson ◽  
O.J. Storebø ◽  
...  

BackgroundDespite the relatively weak evidence base, individuals with borderline personality disorder are often treated with pharmacological interventions. Amongst the drugs, which have shown most promise, are mood stabilizers, which were one of the two drug classes with the most beneficial effects in a previous cochrane review though the robustness of findings was described as low (Stoffers et al., 2010). Here we present data on the latest evidence for mood stabilizers based on an updated cochrane review currently underway.MethodsA systematic review and meta-analysis of randomized controlled trials was conducted. All randomized comparisons of drug vs. placebo, drug vs. drug, or drug vs. a combination of drugs in adult BPD patients were eligible for inclusion. Outcomes comprised BPD core pathology as depicted by DSM criteria, associated pathology, i.e., depression and anxiety, general measures of overall psychopathology severity, tolerability, and adverse effects. Two researchers selected trials, assessed quality and extracted data independently.ResultsOnly a limited number of additional trials using mood stabilizers was identified since the publication of the last cochrane review, mainly utilizing Sodium Valproate. This added to the evidence base for mood stabilizers though the overall evidence remains very limited.ConclusionMood stabilizers show some initial evidence for their effectiveness in borderline personality disorder. However, these have to be replicated before wider conclusions can be drawn for clinical practice.Disclosure of interestThe authors declare that they have no competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. s233-s233
Author(s):  
E. Gimeno ◽  
C. Chiclana

IntroductionCognitive Analytic Therapy (CAT) has emerged as an integrative new approach with promising results in the treatment of personality-disordered patients, particularly in borderline personality disorder. Although this approach has already demonstrated its effectiveness in adults, increasingly studies try to validate it in young population, which has meant a turning point in research.Aim and objectivesThe goal of this study is to know the whole production about CAT in a double way:–articles that describes the main theoretical concepts underlying CAT theory;–articles with evidence supporting its effectiveness in different mental disorders.MethodsA bibliometric review of 397 scientific articles extracted from research databases including Dialnet, EBSCO, PUBMED, Unika and Scholar Google was conducted.ResultsThe results indicate an exponential growth in published studies on CAT, from first publications in the late 1960s, particularly strong in the last two decades and reaching its peak in 2008. Total research includes 247 literature reviews, 109 clinical studies, 47 case studies, 17 letters and comments from authors, 4 studies on diagnostic tests and 1 meta-analysis. Most research has focused on borderline personality disorder or other personality disorders (35% and 12% respectively) and eating disorders (11%). Studies have been conducted with adults (49%) the same as children and adolescents (46%) whereas only the 4% has been developed for elderly population.ConclusionsCognitive analytic therapy represents a well-documented psychotherapy with a proven efficacy in a wide range of clinical contexts.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. s270-s270
Author(s):  
A. Abdelkarim ◽  
D. Nagui Rizk ◽  
M. Esmaiel ◽  
H. Helal

IntroductionDialectical behavior therapy (DBT) is a comprehensive psycho-social treatment developed by Marsha Linehan and originally designed for persons meeting criteria for borderline personality disorder (BPD). DBT is considered as a standard evidence based treatment for suicidal BPD patients in most international guidelines. Although its effectiveness has been proved in multiple studies across different patient populations but almost all the research was conducted in North American or European countries. The current study was the first trial to apply DBT in Egypt with a different language and culture than where the treatment was originally developed.ObjectivesAssessment of incidence of suicidal attempts and non-suicidal self-injury (NSSI) among a sample of Egyptian BPD patients enrolled in an outpatient DBT program.AimThe aim of the current study was to estimate impact of comprehensive DBT on suicidal attempts and NSSI when applied to Egyptian BPD patients.MethodsTwenty-five BPD patients, 4 males and 21 females, were included in a comprehensive outpatient DBT program for one year and incidence of suicidal attempts and NSSI were calculated.ResultsFive patients only attempted suicide again with an incidence of 20% and a mean of one attempt/patient. Seven patients attempted NSSI with an incidence of 28%, an overall 22 incidents and a mean of 3 incidents/patient.ConclusionAlthough this was the first time to apply DBT in an Egyptian population, DBT proved to be an effective psycho-therapeutic intervention for suicidal BPD patients across regardless of different language or culture.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. s783-s784
Author(s):  
G. Tasic ◽  
S. Anakiev

Treatment of borderline personality disorder has some specifics relative to other disorders, which are deriving from nature and structure of those people. Treatment is very slow, often with interruptions, and it presents a special challenge for contratransferal feelings but at the same time offers a possibility of continuous learning, for the patient and the therapist. Main characteristics of this personality disorder are the diffusion of identity, primitive defence mechanisms concentrated around the cleft and relatively preserved ability to rest reality. As classical psychoanalysis and psychoanalytical psychotherapy did not give results in therapy of this disorder, Otto Kernberg took its basic techniques but used them adjusted for borderline personality disorder, developing so called transfer focused psychotherapy. This paper will present the main principles of this modification, applied in practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 124 (S1) ◽  
pp. 99-107 ◽  
Author(s):  
Sara Lena Weinhold ◽  
Robert Göder ◽  
Astrid Pabst ◽  
Anna-Lena Scharff ◽  
Maggie Schauer ◽  
...  

2016 ◽  
Vol 33 (S1) ◽  
pp. S211-S212
Author(s):  
S. Marini ◽  
C. Ranalli ◽  
C. Di Gregorio ◽  
E. Cinosi ◽  
M. Corbo ◽  
...  

Purpose of the studyThe purpose of this study was to investigate cognitive functioning in Borderline Personality Disorder subjects, with particular reference to the Working Memory functioning. The Working Memory seems to be relate to core features of the disturb. The final aim was to better understand the disorder and to implement a cognitive training to improve the deficits.MethodsA literature search was conducted in April 2015. Pubmed and Scopus databases were used to find studies to include in the systematic review. The keywords used for the literature search were: “borderline personality disorder”, “borderline personality”, “working memory”, “executive functioning”. In each search, the keywords were used together with the logical operator “and”.SummaryThree studies were included in this systematic review (Table 1). In each study, the working memory was investigated using N-back test. In two of those studies significantly differences were found between patients and healthy group in N-back task. In the third study, which used more tests to investigate working memory domain, no differences were found between the two groups.ConclusionsBorderline personality disorder patients performed significantly worse on the N-back test compared to healthy controls and the impairment increased with increasing working memory load. In the third study the working memory domain was investigated using four different tests and single scores were not included therefore it was impossible to compare N-back data.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. s232-s232 ◽  
Author(s):  
M. Abdelhameed ◽  
R. Mahfouz ◽  
A. Kamal ◽  
M. Taha

IntroductionThe four-step integrative model of psychotherapy is concerned with individual's needs, wants, rights and decisions in that order. It may carry a promise for deep and changing vision for patients with borderline personality disorder (BPD).ObjectivesThe study of the illuminating and changing effect of dealing with BPD patients in view of their needs, wants, rights and decisions.AimsTo evaluate the effect of group work through the hierarchy of the four-step integrative model with BPD patients and to help them explore false and true elements of their femininity.MethodsForty-three female patients (age range: 19-37) diagnosed according to DSM-IV diagnostic criteria for BPD were enrolled in a dynamic psychotherapy group. Their progress was evaluated using Borderline evaluation of severity over time (BEST) and they wrote down detailed comments about their experience quarterly.ResultsResults of regular attendants for 2 years were included (35 = 81.4%). The results of BEST showed a significant reduction of BPD severity at the end of 1 and 2 years. During psychotherapy sessions and within their quarterly comments, patients expressed their change in terms of moving from a state of cunning, manipulation, aggression, arrogance, envy and rejection (as stemming from their false femininity) into wisdom, confrontation, patience, pride, healthy competition and containment respectively (as stemming from their true femininity).ConclusionsPatients with BPD may gain a better insight and genuine change as they realize what is false and what is true about their femininity in the context of attending four-step integrative model group psychotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S505-S505
Author(s):  
E. Gimeno ◽  
C. Chiclana

IntroductionBorderline personality disorder begins in adolescence, however, its diagnosis is subject to some controversy and tends to be underdiagnosed. Stigma associated with its diagnosis, comorbidity with other axis I disorders or the changeable sense of identity during adolescence are some of the elements that obscure the diagnosis. Increasingly, recent studies have shown the utility of prevention programs as well as instituting early intervention in adolescents, with very hopeful outcomes.ObjectivesThe aim of this study is to review the benefits derived from early prevention and intervention programs in adolescents with borderline symptoms from a cognitive analytic approach.MethodsA systematic review for scientific articles extracted from research databases including Dialnet, EBSCO, Pubmed, Unika and Scholar Google was conducted. Other high-impact studies in the field were also included.ResultsEvidence reported by reviewed articles supports Cognitive analytical therapy as one of the most successful approaches, the same as Mentalization based therapy, in the treatment of Borderline personality disorder. From this approach, prevention and early intervention have shown their effectiveness in reducing borderline symptoms and risk factors besides they contribute to interpersonal functioning improvement.ConclusionsPrevention and early intervention constitute the main pillars to prevent the potential development of Borderline personality disorder or its evolution in more complex and irreversible forms. But this intervention must be carried not only in young already diagnosed, but also in those who are on the diagnostic threshold, presenting risk factors for further development.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. S46-S46
Author(s):  
O.J. Storebø ◽  
J. Stoffers-Winterling ◽  
J. Mattivi ◽  
B. Völlm ◽  
M.L. Kielsholm ◽  
...  

IntroductionBorderline personality disorder (BPD) is a common and disabling personality disorder associated with difficulties in controlling emotions and impulses, self-injury, feelings of emptiness and abandonment. It is associated with problems in many areas of life, most notably relationships. Psychotherapy is the first-line treatment for people with borderline personality disorder widely used; however, the evidence is not thoroughly investigated. In addition, several specific short-term interventions have been developed during the last decades.ObjectivesWe are currently updating this cochrane collaboration review on psychological interventions for BPD. First findings on the up-to-date evidence relating to short-term psychological interventions will be presented.MethodsWe conducted a cochrane systematic review and meta-analysis of randomized controlled trials (RCTs). Any randomized comparisons of psychological interventions versus unspecific control interventions, waitlist or specific psychotherapeutic interventions in adult BPD patients were eligible. Primary outcomes were BPD core pathology as depicted by DSM criteria. Secondary outcomes included depression, anxiety, general psychopathology, dropouts and adverse events. Two independent researchers selected trials, assessed quality and extracted data independently.ResultsThe current evidence of short-term psychological interventions in general and the different types of interventions for which RCT evidence is currently available will be evaluated.Disclosure of interestThe authors declare that they have no competing interest.


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