Borderline Personality Disorder and Mental Healthcare Service Use Among Adolescents

Abstract

Borderline personality disorder (BPD) is believed to be frequent among adolescents. While several prospective studies have assessed the use of mental health services among adults who suffer from BPD, few studies have provided adolescent data. This paper presents findings from the first assessment point of the European Research Network on Borderline Personality Disorder (EURNET BPD) study. In this study, we describe lifetime treatment utilization for 85 adolescents with BPD (Mean age: 16.3 years old). In line with adult findings, adolescents with BPD reported greater mental healthcare service use (outpatient: 98%; inpatient: 79%) compared to controls. Phenothiazine, a sedative neuroleptic, was the most frequently prescribed treatment. 47% of patients had received psychotherapy; in one our of three cases this was psychodynamic therapy. Patients who had received psychotherapy did not differ on any psychopathological variables from those who did not receive psychotherapy; however, psychotherapy was more frequent among females.

Borderline Personality Disorder in Adolescence

“…Chanen and colleagues previously argued that being diagnosed with BPD at young age might indicate a more severe form of borderline personality disorderand/ora poorer prognosis. 8 This clinical severity might also contribute to the high prevalence of service use among this group 41 and might predict a possible lifelong functional impairment, high rates of usage of mental health services (including various forms of therapy, day treatment, and inpatient care) and emergency services, 42 and increased mortality by both physical illness and suicide. 43,44 THE DEVELOPMENT OF ADOLESCENT BPD BPD is increasingly seen as a life-span developmental disorder 23 that exists on a dimensional continuum of severity.…”

Practitioner Review: Borderline personality disorder in adolescence – recent conceptualization, intervention, and implications for clinical practice

“…Moreover, remission from a categorical diagnosis of BPD does not imply that remitted patients are healthy. As with adults, poor functional outcomes persist for years in individuals who showed borderline features in adolescence, including increased risk for substance use and mood disorders, interpersonal problems, poorer quality of life, and higher levels of general distress (Crawford et al., ; Winograd et al., ), service utilization (Cailhol et al., ), and increased rates of pain, physical illness, and mortality over time (Chen et al., ).…”

ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

“…Observational studies of inpatient and outpatient adolescents with BPD report high levels of psychotropic treatment use, with the prescription of psychotropic drugs being primarily symptom-orientated [137,138]. However, as evidence concerning the efficacy and safety of pharmacotherapy in the treatment of adolescents with BPD is sparse, a cautious stance should be adopted in the use of medications and limited to the treatment of co-occurring disorders [139].…”