General psychiatric management for adolescents (GPM-A) with borderline personality disorder

Ilagan, Gabrielle S.; Choi-Kain, Lois W.

doi:10.1016/j.copsyc.2020.05.006

Cited by 19 publications

(9 citation statements)

References 40 publications

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“…At the present time, no medications are approved by the U.S. Food and Drug Administration for the treatment of BPD, regardless of age, and there is a dearth of information concerning pharmacotherapy for this condition in youth. [9][10][11] Education on BPD was provided to the patient and parents. The reported hallucinations were put in the context of a "stress" response and were not considered to be related to schizophrenia.…”

Section: Case Descriptionmentioning

confidence: 99%

“…The patient was safely tapered off all medications without a change in her mental status or functioning. At the present time, no medications are approved by the U.S. Food and Drug Administration for the treatment of BPD, regardless of age, and there is a dearth of information concerning pharmacotherapy for this condition in youth 9–11 . Education on BPD was provided to the patient and parents.…”

Section: Case Descriptionmentioning

confidence: 99%

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Prodromal or Factitious Psychosis: A Cautionary Tale in the Era of Increasing Social Media Use by Vulnerable Individuals

Bastiaens,

Cristofano-Casella,

Bastiaens

2024

Journal of Psychiatric Practice

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Research on the prodromal phase of schizophrenia has been ongoing for several decades and, more recently, findings from this research are being incorporated into everyday psychiatric practice, such as the use of interviews to evaluate prodromal symptomatology. This evolution is happening in the midst of an explosion of social media use by teenagers and young adults, increasing the exposure of youth to portrayals of psychiatric experiences. For example, reports from around the world of “TIK-TOK tics” emphasize the role of social media in the “creation” of psychiatric symptoms. This case report highlights the importance of a full psychiatric evaluation in acute care settings where quick treatment of psychotic symptoms is the norm. A 15-year-old patient was initially diagnosed with prodromal schizophrenia but, after a more extensive evaluation during a second admission, she was diagnosed with borderline personality disorder. Her antipsychotic treatment regimen was stopped and appropriate education and treatment were started, without the recurrence of “psychotic symptoms” during follow-up. It may be that patients with borderline personality disorder, a frequent condition on inpatient units, are at particular risk of assimilating symptoms as represented on social media.

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Section: Case Descriptionmentioning

confidence: 99%

Section: Case Descriptionmentioning

confidence: 99%

Prodromal or Factitious Psychosis: A Cautionary Tale in the Era of Increasing Social Media Use by Vulnerable Individuals

Bastiaens,

Cristofano-Casella,

Bastiaens

2024

Journal of Psychiatric Practice

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“…DBT studies with adolescents have demonstrated it can significantly reduce suicide risk in most patients (Canadian Agency for Drugs and Technologies in Health, 2010; Linehan et al, 2015; McCauley et al, 2018). Other evidence-based treatments include mentalization based therapy (Griffiths et al, 2019), Transference-focussed psychotherapy (Normandin et al, 2021) and General Psychiatric Management for adolescents (Ilagan and Choi-Kain, 2021).…”

Section: Introductionmentioning

confidence: 99%

Acute mental health service use in adolescents with suicidal thoughts and behaviours: Impact on outpatient care

Sritharan

Dyce

Hughes

et al. 2022

Clin Child Psychol Psychiatry

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Introduction Youth with suicidal thoughts and behaviours often present to acute emergency care settings for assessment. Timely outpatient follow up may reduce return acute care visits. The primary aim of our study was to describe clinical and contextual differences between youth who do and do not use acute care once connected to outpatient services. Methods A 24-month retrospective chart review of suicidal youth aged 13–16 ( n = 45) presenting for outpatient mental health treatment. Youth who used acute services during the study period (ASU) or did not (non-ASU) were compared on demographic, risk profile, and mental health service use. Results The mean age of participants was 14.6 years (73% female). Suicide risk profile at baseline did not differ between groups, but was significantly higher in ASU youth at 24 months. There were more youth in service at the end of the study period in the ASU group compared to the non-ASU group (11% vs 55%). Conclusion Youth who do continue to access acute services may be at higher risk of suicidality even after outpatient treatment. Although it is unclear whether this is linked to outpatient engagement, it raises further questions about this population and how they respond to community based mental healthcare.

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“…Besides DBT-A, there are other age-adapted versions of most psychotherapeutic approaches for the treatment of BPD (Chanen et al, 2008; Foelsch et al, 2014; Ilagan & Choi-Kain, 2021; Rossouw & Fonagy, 2012; Schuppert et al, 2012). Although RCTs have been conducted for some of these (cognitive analytic therapy [CAT]: Chanen et al, 2008; mentalization-based therapy for adolescents: Rossouw & Fonagy, 2012; emotion regulation therapy: Schuppert et al, 2012; mentalization-based group therapy: Jørgensen et al, 2021), the empirical evidence for the efficacy of disorder-specific psychotherapy in adolescent BPD is still insufficient (Storebø et al, 2020; Wong et al, 2020).…”

mentioning

confidence: 99%

Effectiveness of adolescent identity treatment (AIT) versus DBT-a for the treatment of adolescent borderline personality disorder.

Schmeck

Weise²,

Schlüter-Müller

et al. 2023

Personality Disorders: Theory, Research, and Treatment

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Borderline personality disorder (BPD) is among the most severe mental health problems with long-lasting deterioration of functioning. According to a Cochrane review, evidence for methods focused on treatment for adolescent BPD patients is very limited. Aims of the study were to demonstrate the noninferiority of adolescent identity treatment (AIT) compared with dialectical behavior therapy for adolescents (DBT-A), and that intensive early treatment of BPD leads to significant improvement of psychosocial and personality functioning in adolescent patients. In a nonrandomized controlled trial using a noninferiority approach, we compared 37 patients treated with DBT-A with 23 patients treated with AIT. Both treatments included 25 weekly individual psychotherapy sessions and five to eight family sessions. Patients were assessed at four timepoints: baseline, posttreatment, 1-and 2-year follow-up. Primary outcome was psychosocial functioning at 1-year follow-up. We performed both intention-to-treat analyses and per-protocol analyses (completers). Baseline characteristics of both groups were not significantly different except for age and self-injurious behavior. In all, six AIT patients (26%) and 10 DBT-A patients (27%) dropped out of treatment. Both DBT-A and AIT significantly improved adolescents' psychosocial functioning (AIT: d = 1.82; DBT-A: d = 1.73) and personality functioning. BPD criteria and depression were significantly reduced by both treatments. Overall, AIT was found to be not inferior to DBT-A and even more efficient in reducing BPD criteria. Both treatments are highly effective in improving psychosocial functioning and personality functioning in adolescent BPD patients. AIT is a promising approach and not inferior to DBT-A in respect to treatment efficiency.

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General psychiatric management for adolescents (GPM-A) with borderline personality disorder

Cited by 19 publications

References 40 publications

Prodromal or Factitious Psychosis: A Cautionary Tale in the Era of Increasing Social Media Use by Vulnerable Individuals

Prodromal or Factitious Psychosis: A Cautionary Tale in the Era of Increasing Social Media Use by Vulnerable Individuals

Acute mental health service use in adolescents with suicidal thoughts and behaviours: Impact on outpatient care

Effectiveness of adolescent identity treatment (AIT) versus DBT-a for the treatment of adolescent borderline personality disorder.

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