American Psychiatric Association Practice Guideline for the Treatment of Patients With Borderline Personality Disorder

Overview

The most common personality disorder here and abroad, borderline personality disorder is often misdiagnosed or underdiagnosed. Left untreated, it causes marked distress and impairment in social, occupational, and role functioning, with high rates of self-destructive behavior (attempted and completed suicide). Its pervasive pattern of impulsivity and instability of interpersonal relationships, affects, and self-image begins in early adulthood and presents in a variety of ...

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Overview

The most common personality disorder here and abroad, borderline personality disorder is often misdiagnosed or underdiagnosed. Left untreated, it causes marked distress and impairment in social, occupational, and role functioning, with high rates of self-destructive behavior (attempted and completed suicide). Its pervasive pattern of impulsivity and instability of interpersonal relationships, affects, and self-image begins in early adulthood and presents in a variety of contexts.

Developed primarily by psychiatrists in active clinical practice, the revised edition of this popular work offers an updated synthesis of current scientific knowledge and rational clinical practice for patients with borderline personality disorder -- with the important caveat that clinicians should consider, but not limit themselves to, the treatments recommended here. The summary of treatment recommendations is keyed according to the level of confidence with which each recommendation is made and coded to show the nature of its supporting evidence.

Highly informative and easy to use, this eminently practical volume is organized into three major parts: Part A contains treatment recommendations (Section I, treatment summaries; Section II, treatment plans; Section III, special clinical considerations; and Section IV, risk management issues during treatment), Part B presents the evidence underlying these treatment recommendations (Section V, an overview of DSM-IV-TR criteria, prevalence rates, and natural history and course; and Section VI, a review of existing treatment literature), and Part C summarizes those areas in which better research data are needed.

Remarkably concise and comprehensive, this practice guideline continues to be an indispensable reference for every clinician who treats patients with this heterogeneous and complex disorder.

American Psychiatric Publishing

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Editorial Reviews

From The Critics
Reviewer: Corey Goldstein, MD (Rush University Medical Center)
Description: This book offers a relatively complete summary of borderline personality disorder including disease definition, natural history, treatment options, evidence underlying treatment options, and special features influencing treatment.
Purpose: The purpose is to set up practice guidelines or a set of patient care strategies to assist physicians in clinical decision-making regarding borderline personality disorder. This is an extremely worthy objective given the difficulty in treating patients diagnosed with this disorder. In addition, a comprehensive guide to treatment with an evidence-based approach is a welcome addition to the current body of literature. The authors meet their objectives without difficulty and are quick to point out that the book is not intended to serve as a standard of medical care.
Audience: According to the author, this book is written to assist physicians in clinical decision-making. The target audience seems to be general psychiatrists, although it would be helpful to a much wider audience including the extended field of mental health practitioners as well as primary care physicians. There is no question that the authors are credible.
Features: The book summarizes data regarding the care of patients with borderline personality disorder, including definitions, clinical features, natural history, evidence for treatments, and future research needs. Particularly well covered in thorough reviews are the areas of psychotherapy and medications, which are presented in concise, easy to read formats. The evidence-based approach is well organized and much appreciated. The algorithms for pharmacological treatments in the appendixes are a unique way of presenting the information.
Assessment: This book contains useful guidelines for the treatment of a disorder that is often misunderstood and poorly treated. It provides an evidence-based summary of the current body of literature to a wide audience of clinicians. It is a high quality resource for mental health practitioners in addition to any physician treating patients with borderline personality disorder.

5 Stars! from Doody
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Product Details

Table of Contents

Guide to using this Practice Guideline. Introduction. Development process. Part A: Treatment Recommendations for Patients with Borderline Personality Disorder. Executive Summary of Recommendations. Coding systems. General considerations. Summary of recommendations. Formulation and Implementation of a Treatment Plan. The initial assessment. Principles of psychiatric management. Principles of treatment selection. Specific treatment strategies for the clinical features of borderline personality disorder. Special Features Influencing Treatment. Comorbidity. Problematic substance use. Violent behavior and antisocial traits. Chronic self-destructive behavior. Childhood trauma and PTSD. Dissociative features. Psychosocial stressors. Gender. Cultural factors. Age. Risk Management Issues. General considerations. Suicide. Anger, impulsivity, and violence. Boundary violations. Part B: Background Information and Review of Available Evidence. Disease Definition, Epidemiology, and Natural History. Definition and core clinical features. Assessment. Differential diagnosis. Epidemiology. Natural history and course. Review and Synthesis of Available Evidence. Issues in interpreting the literature. Review of psychotherapy and other psychosocial treatments. Review of pharmacotherapy and other somatic treatments. Part C: Future Research Needs. Psychotherapy. Pharmacotherapy and other somatic treatments. Appendixes: Psychopharmacological treatment algorithms. Individuals and organizations that submitted comments. References.

American Psychiatric Publishing

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