Borderline personality disorder–a comprehensive review of diagnosis and clinical presentation, etiology, management, and current controversies
Authors
Falk Leichsenring, Peter Fonagy, Nikolas Heim, Otto F Kernberg, Frank Leweke, Patrick Luyten, Simone Salzer, Carsten Spitzer, Christiane Steinert
Publication date
2023/10/1
Source
World Psychiatry
Publisher
Wiley-Blackwell
Description
Borderline personality disorder (BPD) was introduced in the DSM-III in 1980. From the DSM-III to the DSM-5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self-image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self-mutilation behavior, and transient stress-related paranoid ideation or severe dissociative symptoms. There is evidence that BPD can be reliably diagnosed and differentiated from other mental disorders by semi-structured interviews. The disorder is associated with considerable functional impairment, intensive treatment utilization, and high societal costs. The risk of self-mutilation and suicide is high. In the general adult population, the lifetime prevalence of BPD has been reported to be from 0.7 to 2.7%, while its prevalence is about 10% in outpatient and 20% in inpatient psychiatric services. BPD is significantly associated with other mental disorders, including depressive disorders, substance use disorders, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, bipolar disorder, bulimia nervosa, and other personality disorders. There is convincing evidence to suggest that the interaction between genetic factors and adverse childhood experiences plays a central role in the etiology of BPD. In spite of considerable research, the neurobiological underpinnings of the disorder remain to be clarified. Psychotherapy is the treatment of choice for BPD. Various techniques have been validated in randomized controlled trials (RCTs), including dialectical behavior therapy …
Scholar articles
F Leichsenring, P Fonagy, N Heim, OF Kernberg… - World Psychiatry, 2023