Associations of borderline personality with pain, problems with medications and suicidality in a community sample of chronic non-cancer pain patients prescribed opioids for pain

Campbell, Gabrielle; Bruno, Raimondo; Darke, Shane; Degenhardt, Louisa

doi:10.1016/j.genhosppsych.2015.05.004

Cited by 23 publications

(29 citation statements)

References 40 publications

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“…For instance, epidemiological research shows that individuals with chronic pain generally were more likely to screen positive for antisocial and borderline PD traits [20]. Similarly, disproportionately high rates of borderline PD (19%) have been found in chronic pain patients [21]; see [22]. In particular, patients who screened positive for borderline PD report more chronic back/neck problems, headache, fibromyalgia, visceral pain, and pain severity and interference [21].…”

Section: Pain-related Conditionsmentioning

confidence: 99%

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Recent advances in understanding physical health problems in personality disorders

Dixon‐Gordon

Conkey

Whalen

2018

Current Opinion in Psychology

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Personality disorders are associated with a range of adverse health outcomes, contributing to the high healthcare utilization seen in patients with these disorders. A growing literature supports a robust association of personality disorders and health problems. The primary aim of this article is to summarize the most recent research documenting the associations between personality disorders and health conditions. Extending past reviews, we discuss the association of personality disorders with chronic physical illnesses, sleep disturbances, pain conditions, and obesity. We provide recommendations for future research in this area.

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Section: Pain-related Conditionsmentioning

confidence: 99%

“…Similarly, disproportionately high rates of borderline PD (19%) have been found in chronic pain patients [21]; see [22]. In particular, patients who screened positive for borderline PD report more chronic back/neck problems, headache, fibromyalgia, visceral pain, and pain severity and interference [21].…”

Section: Pain-related Conditionsmentioning

confidence: 99%

Recent advances in understanding physical health problems in personality disorders

Dixon‐Gordon

Conkey

Whalen

2018

Current Opinion in Psychology

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“…These findings were confirmed in terms of Q-factors of the SWAP-200, given that chronic headache patients did not present any personality style (histrionic, dysphoric: emotionally dysregulated, or dysphoric: dependent-masochistic Q-factors) that is typically linked to BPD [41]. This aspect deserves further attention because epidemiological research shows that individuals who screened positive for BPD had a high prevalence rate of chronic pain (19%) and a 12-month headache rated in 42% of patients with BPD [53].…”

Section: Discussionmentioning

confidence: 99%

Personality and Personality Disorders in Medication-Overuse Headache: A Controlled Study by SWAP-200

Galli

Tanzilli

Simonelli

et al. 2019

Pain Research and Management

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Background. Medication-overuse headache (MOH) is a type of chronic headache, whose mechanisms are still unknown. The impact of psychological factors has been matter of debate from different perspectives. The role of personality and personality pathology in processes involved in MOH development has been advanced but was poorly studied. The hypothesis of addiction-like behaviors sustaining the drug misuse has been examined and reached contrasting findings. Objectives. This study is aimed at detecting personality and its disorders (PDs) in MOH, with a specific attention to the addiction aspect. Methods. Eighty-eight MOH patients have been compared with two clinical populations including 99 patients with substance use disorder (SUD) and 91 with PDs using the Shedler-Westen Assessment Procedure-200 (SWAP-200), a clinician-report tool that assesses both normal and pathological personality. MANCOVAs were performed to evaluate personality differences among MOH, SUD, and PD groups, controlling for age and gender. Results. MOH patients were predominantly women and older. They showed lower traits of the SWAP-200’s cluster A and B disorders than SUD and PD patients, who presented more severe levels of personality impairment. No differences in the SWAP-200’s cluster C have been found, indicating common personality features in these populations. At levels of specific PDs, MOH patients showed higher obsessive and dysphoric traits and better overall psychological functioning than SUD and PD patients. Conclusion. Although MOH, SUD, and PD populations have been evaluated in multiple sites with different levels of expertise, the study supported the presence of a specific constellation of personality in MOH patients including obsessive (perfectionist) and dysphoric characteristics, as well as good enough psychological resources. No similarities to drug-addicted and personality-disordered patients were found. Practitioners’ careful understanding of the personality characteristics of MOH patients may be useful to provide a road map for the implementation of more effective treatment strategies and intervention programs.

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“…For example, Campbell et al found a 19.1% rate of BPD amongst a sample of 978 people receiving opiates for non-cancer pain. 13 The individuals with BPD were more likely than the rest of the cohort to have a history of opioid dependence (OR 2.49; 95% CI 1.42–4.38) and they were also more likely to be using benzodiazepines daily. Those with BPD more commonly reported suicidal thoughts (OR 2.90; 95% CI 1.90–4.39) and suicide attempts (OR 3.19; 95% CI 2.16–4.72).…”

Section: The Pain Paradoxmentioning

confidence: 97%

The complexities of the borderline patient: how much more complex when considering physical health?

Castle

2019

Australas Psychiatry

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Objective: Borderline Personality Disorder is associated with a substantially reduced life expectancy, mostly due to physical health conditions that are life-shortening. This clinical review highlights pertinent risk issues for such conditions in Borderline Personality Disorder and suggests ways in which clinicians might address these. Methods: Selective literature review. Results: People with Borderline Personality Disorder have a reduced life expectancy of some 20 years, attributable largely to physical health maladies, notably cardiovascular. Risk factors include obesity, sedentary lifestyle, poor diet and smoking. Added to these are other physical health problems, including poor sexual health, self-harm, substance use and blood-borne viruses. Chronic pain and opioid and benzodiazepine use are also common in people with Borderline Personality Disorder. Some psychiatric medications commonly used in people with Borderline Personality Disorder – notably certain antipsychotic agents – can add to the metabolic burden. Barriers to care include self-stigma and erratic adherence to medical care, as well as stigma on the part of clinicians, who often do not screen or provide adequate care for the physical health problems suffered by people with Borderline Personality Disorder. Conclusions: Clinicians need to be aware of the physical health problems in people with Borderline Personality Disorder and ensure appropriate screening and interventions, both preventative and therapeutic, are offered routinely.

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Associations of borderline personality with pain, problems with medications and suicidality in a community sample of chronic non-cancer pain patients prescribed opioids for pain

Cited by 23 publications

References 40 publications

Recent advances in understanding physical health problems in personality disorders

Recent advances in understanding physical health problems in personality disorders

Personality and Personality Disorders in Medication-Overuse Headache: A Controlled Study by SWAP-200

The complexities of the borderline patient: how much more complex when considering physical health?

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