The prevalence of borderline personality features and borderline personality disorder during the perinatal period: a systematic review and meta-analysis

Prasad, Divya; Kuhathasan, Nirushi; Cardoso, Taiane de Azevedo; Suh, Jee Su; Frey, Benício N.

doi:10.1007/s00737-022-01218-8

Cited by 12 publications

(9 citation statements)

References 45 publications

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“…Heterogeneity of test measures for assessing psychopathology is noted in the current review, as is heterogeneity regarding stage of perinatal period within and between studies for participants. In non-clinical samples, there are high prevalence rates of BPD symptomatology in pregnant women (6.9–26.7%; Prasad et al, 2022 ), yet postpartum prevalence rates remain unknown. As traumatic memories can be triggered by the anticipation of childbirth (Blankley et al, 2015 ; De Genna et al, 2012 ; Newman, 2015 ), symptom remission could be seen upon completion of labour.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Interventions for perinatal borderline personality disorder and complex trauma: a systematic review

May

Balzan

Williams

et al. 2023

Arch Womens Ment Health

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Perinatal borderline personality disorder (BPD) and complex post-traumatic stress disorder (cPTSD) are associated with significant impairment to interpersonal functioning, and risk of intergenerational transmission of psychopathology. Evaluation of interventions, however, is scarce. To date, no systematic review has addressed interventions for perinatal BPD, cPTSD, and associated symptomatology. Given the modest evidence to support informed clinical guidelines, the objective of this systematic review is to synthesise the literature on interventions for perinatal BPD and cPTSD, and to generate future directions for research. A comprehensive literature search following PRISMA guidelines was conducted in PsycInfo, MEDLINE, Emcare, Scopus, and ProQuest Dissertations and Theses Global databases. Seven original studies were included, of which only two were randomised controlled trials, using less intensive comparison conditions. Results suggest an association between Dialectical Behavioural Therapy (DBT) group skills training, a multimodal therapeutic approach at a Mother-Baby Unit (MBU), and Child-Parent Psychotherapy with improved perinatal mental health outcomes and remission of symptoms. MBU admission and home-visiting programs were associated with healthy postpartum attachment relationships. Home-visiting programs and DBT group skills were additionally associated with improved maternal parenting capabilities. Conclusions to inform clinical guidelines are limited by a lack of credible comparison conditions, and low quantity and quality of evidence. The feasibility of implementing intensive interventions in real-world settings is dubious. Hence, it is suggested that future research considers utilising antenatal screening to identify at-risk mothers, and the implementation of early intervention, using robust designs that can inform robust conclusions.

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Section: Discussionmentioning

confidence: 99%

“…Presentation of perinatal BPD ranges from 2.0 to 35.2%, and BPD symptomatology ranges from 9.7 to 34% (Prasad et al, 2022 ). Yet, screening and intervention are not offered in routine antenatal care.…”

Section: Introductionmentioning

confidence: 99%

Interventions for perinatal borderline personality disorder and complex trauma: a systematic review

May

Balzan

Williams

et al. 2023

Arch Womens Ment Health

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“…While prevalence estimates for BPD in the general population vary widely from .7% to 1% (Petfield et al, 2015) to 5.9% (Florange & Herpertz, 2019), around 75% of BPD presentations in clinical settings are women, most commonly in their child-bearing years (Stepp et al, 2012). Significantly, Prasad et al (2022) in their recent review, found pooled prevalence rates of BPD was 14% in perinatal women presenting in clinical settings. Furthermore, a significant percentage of women presenting to a motherbaby unit with post-natal depression, a very common condition, were found (albeit on self-report scales) to have co-morbid personality difficulties, particularly BPD, which continued to cause effects at the time of discharge (Bittner et al, 2020).…”

Section: Parenting With Borderline Personality Disordermentioning

confidence: 99%

“…Significantly, Prasad et al. (2022) in their recent review, found pooled prevalence rates of BPD was 14% in perinatal women presenting in clinical settings. Furthermore, a significant percentage of women presenting to a mother‐baby unit with post‐natal depression, a very common condition, were found (albeit on self‐report scales) to have co‐morbid personality difficulties, particularly BPD, which continued to cause effects at the time of discharge (Bittner et al., 2020).…”

Section: Parenting With Borderline Personality Disordermentioning

confidence: 99%

Reflective functioning and mother–infant relationships among mothers with Borderline Personality Disorder post‐therapy

Osborne

Mattiske

Winter

et al. 2023

Infant Mental Health Journal

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The stressful nature of parenting infants exacerbates the characteristics of Borderline Personality Disorder (BPD). Consequently, mothers with BPD tend to be emotionally dysregulated, respond impulsively to their infants, and have poorer mother–infant relationships. Few parenting interventions target the specific skill deficits observed in mothers with BPD. This study explored the differences in parental reflective functioning (PRF) and mother–infant relationship quality at baseline and following a 24‐week, group parenting intervention for mothers with BPD. PRF and mother‐infant relationship quality were assessed from quantitative (N = 23) and qualitative (N = 32) perspectives. Quantitative data (Parental Reflective Functioning Questionnaire) showed a significant improvement in one of the three subscales, Interest and Curiosity, between baseline and post‐intervention, and a significant moderate positive association between the subscale Certainty of Mental States and maternal‐infant interaction quality post‐intervention. Improvements in mother‐infant relationship quality were not evident from the observational measure, Nursing Child Assessment Satellite Teaching scale. In contrast, semi‐structured interview qualitative data found maternal improvements in parental reflection, coping strategies implemented post‐intervention, and quality of mother–infant relationships. Overwhelmingly positive intervention feedback suggested perceived maternal benefits of group format and skills taught. Future studies with larger sample sizes would allow further clarification of such parenting interventions for mothers with BPD.

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“…BPD is also a disorder that commonly affects women of reproductive age, with presentations often occurring in the perinatal setting with potential downstream consequences on the development of their offspring. Prasad et al 5 found the pooled prevalence of BPD in perinatal women to be 14% while Nagel et al 6 in their study at a tertiary maternity hospital found 10.1% met BPD criteria while 19.5% had BPD traits. To the best of our knowledge there have been only four studies examining the obstetric, neonatal, and social outcomes for pregnant women with BPD.…”

mentioning

confidence: 95%

Outcomes for pregnant women with Borderline Personality Disorder who attended a specialist antenatal service

Nguyen,

Frayne,

Watson

et al. 2023

Australas Psychiatry

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Objective Our study focussed on the obstetric and psychosocial outcomes of pregnant women with Borderline Personality Disorder (BPD) who received care via a specialist antenatal clinic in Western Australia. Method This study is a retrospective examination of outcomes for 80 women with a confirmed diagnosis of BPD, with findings compared with published population outcome data for the state. Results Pregnant women with BPD appeared to be at a risk of complications including pre-eclampsia and special care nursery admission for their newborns when compared to population data. Furthermore, the studied women had elevated rates of psychiatric admissions during pregnancy, child protection involvement, and domestic violence. Polypharmacy exposure was frequent, with the likely impact on obstetric and neonatal outcomes requiring further study. Conclusion The findings reinforced the notion that pregnant women with BPD experience complex multifaceted vulnerabilities and require enhanced multidisciplinary care. Our study further calls for the development of clinical practice guidelines for managing BPD in the perinatal period.

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The prevalence of borderline personality features and borderline personality disorder during the perinatal period: a systematic review and meta-analysis

Cited by 12 publications

References 45 publications

Interventions for perinatal borderline personality disorder and complex trauma: a systematic review

Interventions for perinatal borderline personality disorder and complex trauma: a systematic review

Reflective functioning and mother–infant relationships among mothers with Borderline Personality Disorder post‐therapy

Outcomes for pregnant women with Borderline Personality Disorder who attended a specialist antenatal service

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