An update on pharmacotherapy for personality disorders

Mazza, Marianna; Marano, Giuseppe; Janiri, Luigi

doi:10.1080/14656566.2016.1220542

Cited by 13 publications

(4 citation statements)

References 15 publications

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“…In their brief report, Williams et al highlighted that specific agents such as selective serotonin reuptake inhibitors, anticonvulsants, and antipsychotics are associated with low bone mass ( 88 ) and increased bone loss ( 89 ). In addition, they are commonly prescribed pharmacotherapy for PD ( 90 ). As such, further research is needed to determine if people with PDs may be susceptible to osteoporosis and fragility fractures, and to investigate possible mechanisms of which, is poorly understood.…”

Section: Discussionmentioning

confidence: 99%

Exploring the comorbidity between personality and musculoskeletal disorders among adults: A scoping review

et al. 2023

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IntroductionThere is growing awareness of the comorbidity between mental and musculoskeletal disorders (MSDs) and their associated burden. We aimed to explore what is known regarding the existing epidemiological clinical–and population– based literature on the comorbidity between personality disorders (PDs) and MSDs specifically. In addition, we aimed to investigate their associated burden by examining a range of outcomes including morbidity/mortality, patient- and clinical-reported outcomes, work-related outcomes, hospital admissions, and financial costs. Finally, we sought to identify gaps in the literature and provide recommendations for further research.MethodsStudies with participants 15 years of age were eligible. Categorical PDs/features (DSM-III/IV/5 or ICD 9/10), identified by a health care professional, medical records, diagnostic interviews, or self-administered questionnaires. The definitions/groupings of MSDs were guided by the ICD-10 including conditions of the back, joints, and soft tissue, and disorders of bone density and structure. Published peer-reviewed and gray literature were considered. Eligible study designs were cohort, case-control, and cross-sectional studies, and existing reviews of observational studies. Identification and selection of articles, data extraction and the presentation of the results was conducted according to the Joanna Briggs Institute methodological guidance and the PRISMA extension for scoping reviews.ResultsIn total, 57 articles were eligible including 10 reviews and 47 individual studies. Across clinical and population settings, we detected evidence of comorbidity between PDs and chronic back/neck/spine conditions, arthritis, and fibromyalgia, and emerging evidence of associations between PDs and reduced bone mineral density. In terms of knowledge gaps, the burden associated with PDs and MSDs is poorly understood, as is their underlying mechanisms.DiscussionThis scoping review might prompt further research into PDs and MSDs as separate groups of disorders, along with their comorbidity and the mechanisms that may link them.Systematic review registrationhttps://osf.io/mxbr2/registrations.

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Section: Discussionmentioning

confidence: 99%

Exploring the comorbidity between personality and musculoskeletal disorders among adults: A scoping review

et al. 2023

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“…A more substantive evidence base is needed to further uncover the clinical implications of a relationship between PD and bone health. It may be important to determine whether monitoring the bone health of people with PD and comorbidities is warranted, given polypharmacotherapy is often prescribed for the treatment of PD (22), and specific agents, such as selective serotonin reuptake inhibitors, anticonvulsants, and antipsychotics, are associated with decreased bone mass and increased risk for osteoporosis and related fractures (23). This may require a coordinated effort between primary and endocrinological care, given indications that psychological/behavioral symptoms of PD may be a barrier to general health treatment/compliance for some individuals (4).…”

Section: Discussionmentioning

confidence: 99%

Personality Disorder and Physical Health Comorbidities: A Link With Bone Health?

et al. 2020

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We examined whether personality disorders (PDs) (any, cluster A/B/C) were associated with bone mineral density (BMD) in a population-based sample of Australian women (n = 696). Personality and mood disorders were assessed using semi-structured diagnostic interviews. BMD was measured at the spine, hip, and total body using dual-energy x-ray absorptiometry (GE-Lunar Prodigy). Anthropometrics, medication use, physical conditions, and lifestyle factors were documented. The association between PDs (any, cluster A/B/C) and BMD (spine/hip/total body) was examined with multiple linear regression models. The best models were identified by backward elimination including age, weight, physical activity, smoking status, alcohol consumption, dietary calcium intake, mood disorders, physical multimorbidity, socioeconomic status, and medications affecting bone. The variables were retained in the model if p < 0.05. All potential interactions in final models were tested. Those with cluster A PD, compared to those without, had 6.7% lower hip BMD [age, weight adjusted mean 0.853 (95% CI 0.803–0.903) vs. 0.910 (95% CI 0.901–0.919) g/cm2, p = 0.027] and 3.4% lower total body BMD [age, weight, smoking, alcohol, calcium adjusted mean 1.102 (95% CI 1.064–1.140) vs. 1.139 (95% CI 1.128–1.150) g/cm2, p = 0.056]. No associations were observed between cluster B/C PDs and hip/total body BMD or between any of the PD clusters and spine BMD. To our knowledge, this study is the first to investigate the bone health of women with PD in a population-based sample. Given the paucity of literature, replication and longitudinal research including the examination of underlying mechanisms and sex differences are warranted.

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“…Symptomatic for this situation is the very recent question of some authors, whether pharmacotherapy is useful for PD (Stoffers-Winterling et al 2021a). Clearly, in clinical practice, antipsychotics and mood stabilizers are readily used for the treatment of impulsivity-related symptoms, while this procedure is not supported by experimental evidence, but this therapeutic strategy is based on hypotheses that behavioral traits associated with PD may be caused by neurochemical alterations (Mazza et al 2016;Tyrer and Bateman 2004).…”

Section: Pharmacotherapy Of Personality Disorders: General Aspectsmentioning

confidence: 99%

Pharmacotherapy of Personality Disorders

Baumann¹,

Herpertz²

2021

NeuroPsychopharmacotherapy

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Personality disorders (PD) represent a group of more than 10 disorders, depending on the diagnostic classification used, but most research on pharmacological treatments deals with borderline PD. International guidelines consider the evidence for the usefulness of psychopharmacotherapy for PD limited and therefore, their major recommendation is to center this therapeutic approach for the treatment of the frequent psychiatric comorbidities. Indeed, current evidence favors psychotherapy compared to psychopharmacotherapy in the treatment of personality disorders (PD). However, antipsychotic drugs, antidepressants, anticonvulsants, and other psychotropic drugs are widely used, very frequently as combination treatments, despite not any of them has been introduced by national P. Baumann

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An update on pharmacotherapy for personality disorders

Cited by 13 publications

References 15 publications

Exploring the comorbidity between personality and musculoskeletal disorders among adults: A scoping review

Exploring the comorbidity between personality and musculoskeletal disorders among adults: A scoping review

Personality Disorder and Physical Health Comorbidities: A Link With Bone Health?

Pharmacotherapy of Personality Disorders

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