Early Detection and Outcome in Borderline Personality Disorder

Abstract

Borderline personality disorder (BPD) is a severe and heterogeneous mental disorder that is known to have the onset in young age, often in adolescence. For this reason, it is of fundamental importance to identify clinical conditions of childhood and adolescence that present a high risk to evolve in BPD. Investigations indicate that early borderline pathology (before 19 years) predict long-term deficits in functioning, and a higher percentage of these patients continue to present some BPD symptoms up to 20 years. There is a general accordance among investigators that good competence in both childhood and early adulthood is the main predictive factor of excellent recovery in BPD patients. Some authors suggest that specific childhood personality traits can to be considered precursors of adult BPD, as well as some clinical conditions: disruptive behaviours, disturbance in attention and emotional regulation, conduct disorders, substance use disorders, and attention-deficit-hyperactivity disorder. Unfortunately, diagnosis and treatment of BPD is usually delayed, also because some clinicians are reluctant to diagnose BPD in younger individuals. Instead, the early identification of BPD symptoms have important clinical implications in terms of precocious intervention programs, and guarantees that young people with personality disorders obtain appropriate treatments. This review is aimed to collect the current evidences on early risk and protective factors in young people that may predict BPD onset, course, and outcome.

Distressing psychotic-like experiences, cognitive functioning and early developmental markers in clinically referred young people aged 8–18 years

“…In a recent study [7], we found that for young people referred to child and adolescent mental health services who completed the UEQ at initial screening (85%), only one third of males compared to two thirds of females reported distressing PLEs, which highlights potential sex variation in referral patterns and research/treatment access for young people reporting PLEs. However, the fact that we did not find associations between cognitive-developmental markers and severity of distressing PLEs in this sample possibly indicates a later mood and emotional dysregulation model of distressing PLEs in females, which is consistent with previous research [8,46]. This means that associations of distressing PLEs with specific aspects of cognitive and developmental functioning may become less pronounced with age and vary according to sex, with other emotional, cognitive and behavioural processes becoming more pertinent in distress maintenance over time.…”

Early identification of personality disorder: Helping to understand youth suicide risk

“…7 However, health professionals can show reluctance to diagnose young people with BPD. 10 This reluctance has potential to not only limit the types of services individuals can access, but also delay access to effective treatment, 8,10 and it may increase the risk of suicide for this population. 11,12 It is recommended that GPs screen for BPD and refer young people to adolescent psychiatric services for further assessment if BPD traits are present.…”

STEPPS (System Training of Emotional Predictability and Problem Solving) in einer vernetzten ambulanten Hilfe für Menschen mit Borderline Persönlichkeitsstörung

“…Besonders problematisch ist die berufliche Integration (Zanarini et al 2010;Kramer et al 2017;Álvarez-Tomás et al 2018). Für die Entwicklung der psychosozialen Funktionseinschränkungen ist offensichtlich nicht nur die Störung selbst, sondern auch die prämorbide Entwicklung beteiligt, etwa durch Ausbildung maladaptiver Schemata, Folgen komplexer Traumatisierung und ungünstiger psychosozialer Entwicklungsbedingungen (Bozzatello et al 2019).…”