The Role of Pharmacotherapy and Psychotherapy in Borderline Personality Disorder - a literature review
DOI:
https://doi.org/10.12775/JEHS.2024.57.015Keywords
borderline personality disorder (BPD), psychotherapy, pharmacotherapyAbstract
Borderline personality disorder (BPD) is a severe and heterogeneous psychiatric disorder known to begin at a young age, often in adolescence. It is associated with suicidal behaviour and self-harm. Up to 10 per cent of BPD patients die by suicide, so it is very important to find effective methods to alleviate the symptoms of this disorder [1]. A combination of psychotherapy and pharmacotherapy seems reasonable. An obstacle to widespread access to psychotherapy is the relatively high costs associated with the salaries of highly qualified psychotherapists. Another impediment is the long time required for effective psychotherapy and the frequent phenomenon of patients with unstable emotions discontinuing therapy prematurely. On the other hand, pharmacotherapy is necessary during periods of aggravation of the disorder, such as increased emotional lability, dysphoric states associated with aggression, impulsive behaviour and the presence of pseudopsychotic symptoms. This paper is a compilation of available treatments for borderline disorder. In the context of considering effective therapies for BPD, an important aspect is the need to increase the length of therapy and the availability of professional help for patients. In addition, research points to the benefits of combining psychotherapy with pharmacotherapy to more effectively alleviate the symptoms of this heterogeneous disorder. It is noteworthy that the relatively high cost of psychotherapy and the need to decrease.
References
Paris J. Suicidality in Borderline Personality Disorder. Medicina (Kaunas). 2019 May 28;55(6):223. doi: 10.3390/medicina55060223. PMID: 31142033; PMCID: PMC6632023.
Cierpiałkowska, L., & Soroko, E. (2014). Zaburzenia osobowości w modelach me-dycznych iw psychologii różnic indywidualnych. W: L. Cierpiałkowska, E. Soroko (red.), Zaburzenia osobowości. Problem diagnozy klinicznej, 15-34.
Gaebel W, Zielasek J, Reed GM. Mental and behavioural disorders in the ICD-11: concepts, methodologies, and current status. Psychiatr Pol. 2017 Apr 30;51(2):169-195. English, Polish. doi: 10.12740/PP/69660. Epub 2017 Apr 30. PMID: 28581530.
Bach B, First MB. Application of the ICD-11 classification of personality disorders. BMC Psychiatry. 2018 Oct 29;18(1):351. doi: 10.1186/s12888-018-1908-3. PMID: 30373564; PMCID: PMC6206910.
Kokoszka A, Golec S, Curyło A. Psychoterapia i farmakoterapia: alternatywne czy komplementarne metody leczenia? [Psychotherapy and pharmacotherapy: alternative or complimentary methods of treatment?]. Psychiatr Pol. 1997 Nov-Dec;31(6):739-44. Polish. PMID: 9515305.
Ogłodek E, Araszkiewicz A. Farmakoterapia pacjentów z zaburzeniami osobowości borderline [Pharmacotherapy of patients with the borderline personality disorders]. Pol Merkur Lekarski. 2011 Dec;31(186):381-3. Polish. PMID: 22239012.
Mosiołek A, Gierus J, Koweszko T, Szulc A. Evaluation of the relationship between cognitive functioning in patients with borderline personality disorder and their general functioning. Psychiatr Pol. 2018 Feb 28;52(1):33-44. English, Polish. doi: 10.12740/PP/OnlineFirst/62657. Epub 2018 Feb 28. PMID: 29704412.
Alliani D, Tarantelli S. Farmacoterapia nel trattamento del disturbo borderline di per-sonalità [Pharmacotherapy in the treatment of borderline personality disorder]. Riv Psichiatr. 2009 Nov-Dec;44(6):357-73. Italian. PMID: 20218215.
Stoffers-Winterling J, Storebø OJ, Lieb K. Pharmacotherapy for Borderline Personality Disorder: an Update of Published, Unpublished and Ongoing Studies. Curr Psychiatry Rep. 2020 Jun 5;22(8):37. doi: 10.1007/s11920-020-01164-1. PMID: 32504127; PMCID: PMC7275094.
Gartlehner G, Crotty K, Kennedy S, Edlund MJ, Ali R, Siddiqui M, Fortman R, Wines R, Persad E, Viswanathan M. Pharmacological Treatments for Borderline Personality Disorder: A Systematic Review and Meta-Analysis. CNS Drugs. 2021 Oct;35(10):1053-1067. doi: 10.1007/s40263-021-00855-4. Epub 2021 Sep 8. PMID: 34495494; PMCID: PMC8478737.
Binks CA, Fenton M, McCarthy L, Lee T, Adams CE, Duggan C. Pharmacological in-terventions for people with borderline personality disorder. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD005653. doi: 10.1002/14651858.CD005653. Update in: Cochrane Database Syst Rev. 2010;(6):CD005653. PMID: 16437535.
Hermens ML, van Splunteren PT, van den Bosch A, Verheul R. Barriers to imple-menting the clinical guideline on borderline personality disorder in the Netherlands. Psychiatr Serv. 2011 Nov;62(11):1381-3. doi: 10.1176/ps.62.11.pss6211_1381. PMID: 22211222.
Stoffers-Winterling JM, Storebø OJ, Kongerslev MT, Faltinsen E, Todorovac A, Se-doc Jørgensen M, Sales CP, Edemann Callesen H, Pereira Ribeiro J, Völlm BA, Lieb K, Simonsen E. Psychotherapies for borderline personality disorder: a focused syste-matic review and meta-analysis. Br J Psychiatry. 2022 Sep;221(3):538-552. doi: 10.1192/bjp.2021.204. PMID: 35088687.
Leichsenring F, Leibing E, Kruse J, New AS, Leweke F. Borderline personality disor-der. Lancet. 2011 Jan 1;377(9759):74-84. doi: 10.1016/S0140-6736(10)61422-5. PMID: 21195251.
Chakhssi F, Zoet JM, Oostendorp JM, Noordzij ML, Sommers-Spijkerman M. Effect of Psychotherapy for Borderline Personality Disorder on Quality of Life: A Systematic Review and Meta-Analysis. J Pers Disord. 2021 Apr;35(2):255-269. doi: 10.1521/pedi_2019_33_439. Epub 2019 Oct 14. PMID: 31609187.
Popiel A. Zaburzenie osobowości z pogranicza–współczesne standardy psychoterapii.
Jańczak, M. Mentalizacja w praktyce klinicznej–perspektywa psychodynamiczna. Psychoterapia, 4(187), 5-17. 2018
Yeomans F, Delaney JC, Renaud A. La psychothérapie focalisée sur le transfert [Transference focused psychotherapy]. Sante Ment Que. 2007 Spring;32(1):17-34. French. doi: 10.7202/016507ar. PMID: 18253659.
Bozzatello P, Bellino S, Bosia M, Rocca P. Early Detection and Outcome in Border-line Personality Disorder. Front Psychiatry. 2019 Oct 9;10:710. doi: 10.3389/fpsyt.2019.00710. PMID: 31649564; PMCID: PMC6794381.
Burkhart PV, Sabaté E. Adherence to long-term therapies: evidence for action. J Nurs Scholarsh. 2003;35(3):207. PMID: 14562485.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Alicja Poloczek, Jakub Szczerba
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 467
Number of citations: 0