Borderline Personality Disorder: A Review.

Area of Science:

• Psychiatry
• Clinical Psychology

Background:

• Borderline personality disorder (BPD) affects 0.7%–2.7% of US adults, leading to social and vocational impairments and increased healthcare utilization.
• BPD is characterized by identity instability, impulsivity, intense emotions, and self-harm, often co-occurring with mood, anxiety, or substance use disorders.

Approach:

• Diagnosis involves semistructured interviews by mental health specialists.
• Etiology is linked to genetic predispositions and adverse childhood experiences, including abuse.
• Psychotherapy, specifically dialectical behavior therapy and psychodynamic therapy, is the recommended treatment for BPD.

Key Points:

• Psychotherapies demonstrate medium effect sizes in reducing BPD symptom severity compared to usual care.
• No psychoactive medications consistently improve core BPD symptoms.
• Medications may be used for severe comorbid conditions or short-term crisis management.

Conclusions:

• Psychotherapy is the first-line treatment for BPD.
• Medications are not effective for primary BPD symptoms but can manage comorbidities or acute crises.
• Understanding BPD's impact and effective treatments is crucial for patient care.