Practice Guideline for the Treatment of Patients with Borderline Personality Disorder

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American Psychiatric Pub, 2001 - 84 pagine

The most common personality disorder here and abroad, borderline personality disorder is often misdiagnosed or underdiagnosed. Left untreated, it causes marked distress and impairment in social, occupational, and role functioning, with high rates of self-destructive behavior (attempted and completed suicide). Its pervasive pattern of impulsivity and instability of interpersonal relationships, affects, and self-image begins in early adulthood and presents in a variety of contexts.

Developed primarily by psychiatrists in active clinical practice, the revised edition of this popular work offers an updated synthesis of current scientific knowledge and rational clinical practice for patients with borderline personality disorder -- with the important caveat that clinicians should consider, but not limit themselves to, the treatments recommended here. The summary of treatment recommendations is keyed according to the level of confidence with which each recommendation is made and coded to show the nature of its supporting evidence.

Highly informative and easy to use, this eminently practical volume is organized into three major parts: Part A contains treatment recommendations (Section I, treatment summaries; Section II, treatment plans; Section III, special clinical considerations; and Section IV, risk management issues during treatment), Part B presents the evidence underlying these treatment recommendations (Section V, an overview of DSM-IV-TR criteria, prevalence rates, and natural history and course; and Section VI, a review of existing treatment literature), and Part C summarizes those areas in which better research data are needed.

Remarkably concise and comprehensive, this practice guideline continues to be an indispensable reference for every clinician who treats patients with this heterogeneous and complex disorder.

 

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Sommario

TREATMENT RECOMMENDATIONS FOR PATIENTS WITH BORDERLINE PERSONALITY DISORDER
1
FORMULATION AND IMPLEMENTATION OF A TREATMENT PLAN
6
B Principles of Psychiatric Management
8
C Principles of Treatment Selection
12
D Specific Treatment Strategies for the Clinical Features of Borderline Personality Disorder
14
SPECIAL FEATURES INFLUENCING TREATMENT
27
C Violent Behavior and Antisocial Traits
28
D Chronic SelfDestruction Behavior
29
BACKGROUND INFORMATION AND REVIEW OF AVAILABLE EVIDENCE
38
B Assessment
40
C Differential Diagnosis
41
E Natural History and Course
42
REVIEW AND SYNTHESIS OF AVAILABLE EVIDENCE
43
B Review of Psychotherapy and Other Psychosocial Treatments
44
C Review of Pharmacotherapy and Other Somatic Treatments
55
FUTURE RESEARCH NEEDS
69

F Dissociative Features
31
GPsychosocial Stressors
32
H Gender
33
I Cultural Factors
34
RISK MANAGEMENT ISSUES
35
C Anger Impulsivity and Violence
36
D Boundary Violations
37
OTHER SOMATIC TREATMENTS
70
PSYCHOPHARMACOLOGICAL TREATMENT ALGORITHMS
71
INDIVIDUALS AND ORGANIZATIONS THAT SUBMITTED COMMENTS
74
REFERENCES
75
CATEGORY 1 CONTINUING MEDICAL EDUCATION CREDIT FOR
85
A QUICK REFERENCE GUIDE
1
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