Pharmacological treatment for borderline personality disorder: comparing data from routine clinical care with recommended guidelines

2017 ◽  
Author(s):  
Friedrich Riffer
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Pharmacological Treatment ◽  
Clinical Care ◽  
Borderline Personality ◽  
Routine Clinical Care ◽  
Recommended Guidelines

Bridging the gap: the assessment and treatment of adolescent personality disorder in routine clinical care

2016 ◽  
Vol 102 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Carla Sharp
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Empirical Evidence ◽  
Treatment Guidelines ◽  
Clinical Care ◽  
Borderline Personality ◽  
Treatment Resistant ◽  
Routine Clinical Care ◽  
Assessment And Treatment ◽  
Personality Disturbance

Despite a marked increase in research supporting the assessment, diagnosis and treatment of personality disorder (PD) in adolescence, clinicians continue to be reluctant to apply treatment guidelines and psychiatric nomenclature in routine clinical care. This gap arises from several beliefs: (1) psychiatric nomenclature does not allow the diagnosis of PD in adolescence; (2) certain features of PD are normative and not particularly symptomatic of personality disturbance; (3) the symptoms of PD are better explained by other psychiatric syndromes; (4) adolescents' personalities are still developing and therefore too unstable to warrant a PD diagnosis; and (5) because PD is long-lasting, treatment-resistant and unpopular to treat, it would be stigmatising to label an adolescent with borderline personality disorder (BPD). In this paper, the empirical evidence challenging each of these beliefs is evaluated in the hope of providing a balanced review of the validity of adolescent PD with a specific focus on BPD. The paper concludes with recommendations on how routine clinical care can integrate a PD focus.

Forensic Issues in Borderline Personality Disorder

2017 ◽  
Author(s):  
Alexander L. Chapman ◽  
André Ivanoff
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Behavioral Problems ◽  
Mental Health Treatment ◽  
Clinical Care ◽  
Borderline Personality ◽  
Comprehensive Treatment ◽  
Psychopharmacological Treatment ◽  
Correctional Settings

Borderline personality disorder (BPD) is a severe, complex, and costly disorder requiring comprehensive treatment. Correctional settings commonly include mental health treatment and on-site mental health clinicians providing psychosocial and psychopharmacological treatment; however, the mandate of prison settings in particular often conflicts directly with providing clinical care to those with complex mental health needs. The necessary emphasis on security, safety, and, in some cases, retribution, can create invalidating environments that both elicit and reinforce the serious behavioral problems often observed among those with BPD, such as self-injury and suicidal behavior. When effective treatments are available, considerable challenges emerge with regard to the training and preparation of clinical staff to treat and line staff to manage inmates with BPD. This chapter discusses these and other issues and provides suggestions for continued work to better understand and treat individuals with BPD in forensic settings.

Generalist psychiatric treatments for borderline personality disorder: the evidence base and common factors

2015 ◽  
Author(s):  
Anthony W. Bateman ◽  
Roy Krawitz
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Management ◽  
Clinical Care ◽  
Relevant Literature ◽  
Common Factors ◽  
Evidence Base ◽  
Borderline Personality ◽  
Outcome Studies ◽  
Supportive Psychotherapy

Chapter 2 discusses generalist psychiatric treatments for borderline personality disorder (BPD). It introduces the rationale for seeking common factors in treatment and provide a brief overview of some relevant literature, outlines the four generalist treatments that have been shown to be effective (structured clinical management (SCM), general psychiatric management (GPM), good clinical care (GCC), and supportive psychotherapy (SP)), describes the outcome studies of the four treatments, and reviews commonalities of the treatments.

scholarly journals Factors Associated With Pharmacological and Non-pharmacological Treatments Adherence in Patients With Borderline Personality Disorder in Iran

2022 ◽  
Author(s):  
Motahareh Sadat Mirhaj Mohammadabadi ◽  
Homa Mohammadsadeghi ◽  
Mehrdad Eftekhar Adrebili ◽  
Zahra Partovi Kolour ◽  
Fatemeh Kashaninasab ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Side Effects ◽  
Personality Disorder ◽  
Treatment Adherence ◽  
Pharmacological Treatment ◽  
Borderline Personality ◽  
Psychiatric Institute ◽  
Good Adherence ◽  
Medication Side Effects ◽  
Medication Side

Abstract BackgroundBorderline personality disorder is a major mental illness characterized by a sustained relationship instability, impulsive behavior and intense affects. Adherence is a complex behavior, from minor refusals of treatment to inappropriate use of health services or even abandonment of treatment, which can be affected by various factors. Therefore, the present study aimed to investigate the factors affecting pharmacological and non-pharmacological adherence in patients with borderline personality disorder referred to an outpatient referral clinic in Tehran, Iran.MethodsThe study was a retrospective cohort. The files of patients with borderline personality disorder referred to the outpatient clinic of the Tehran Psychiatric Institute were reviewed as the first step. In the next step, we contacted the patients and asked them to fill out the questionnaires. Data were collected using the Drug Attitude Inventory (DAI) questionnaire and a researcher made questionnaire to determine the attitude of patients toward pharmacological and non-pharmacological treatment and therapeutic adherence. After collecting data, patients’ therapeutic acceptance was divided into three groups: poor, partial, good compliance. The data were analyzed by SPSS software version-22.Results Ninety-four patients were involved in the study and fifty four of them were women. In terms of psychotherapy adherence, patients with higher education and hospital admission history have better compliance. Medication attitudes were negative in 54 patients (57.4%), while 40.4% of them stated that psychotherapy or counselling did not help their condition and showed a negative attitude toward non-pharmacological treatment. Additionally, psychotherapy good adherence of the patients (44.7%) was higher than medication good adherence (31.9%). The most common reasons for discontinuation of treatment were medication side effects (53.1%), dissatisfaction with the therapist (40.3%) and then fear of medication dependence (40%). The results showed no relationship between other demographic factors and treatment adherence.ConclusionsResults of the current study show that attitude toward psychotherapy is more positive than pharmacotherapy. In addition, according to the results, working on changeable factors such as patients’ fear of dependence to medication, dissatisfaction with the therapist, and medication side effects may improve patients' treatment adherence.

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.

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