How does borderline personality disorder affect management and treatment response of patients with major depressive disorder? A comprehensive review

Ceresa, Alessandro; Esposito, Cecilia Maria; Buoli, Massimiliano

doi:10.1016/j.jad.2020.11.111

Cited by 25 publications

(16 citation statements)

References 40 publications

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“…However, optimization of therapeutic strategies seems to be necessary to avoid the persistence of residual depressive symptoms after ECT. In the literature, some elements seem to indicate that the combined treatment of major depression and BPD promotes a better clinical outcome in individuals with major depression and BPD 35,39–41 . Among the therapeutic strategies available to potentially optimize the response to ECT in this subpopulation, psychotherapeutic treatments (dialectical behavior therapy and mentalization-based treatment) should be considered as first-line treatments given their proven positive results with regard to psychosocial functioning, depressive symptoms, and the severity of BPD symptoms and self-aggressive behaviors 42–44 .…”

Section: Discussionmentioning

confidence: 99%

Nonremission After Electroconvulsive Therapy in Individuals With Major Depression

Hein

Mungo

Loas

2022

J ECT

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ObjectivesThe aim of the present study was to investigate the risk of nonremission following electroconvulsive therapy (ECT), as associated with borderline personality disorder, in individuals with major depression in the context of the contradictory data available in the literature.MethodsWe analyzed demographic and clinical data from 210 individuals with major depression who were treated with ECT. Study participants were recruited from the medical records database of the Psychiatry Department at Erasme Hospital. Only individuals with major depression who were in remission, as demonstrated during the systematic psychiatric interview performed at the end of ECT (ie, with a >60% reduction in their 24-item Hamilton Depression Rating Scale score, combined with a score of <10), were included in the “remission” group. Logistic regression analyses were used to determine the risk of nonremission following ECT.ResultsNonremission following ECT occurred frequently (42.9%) in our sample. Moreover, after adjusting for major confounding factors, multivariate logistic regression analyses demonstrated that borderline personality disorder was a risk factor for nonremission following ECT in individuals with major depression.ConclusionsWe demonstrated that borderline personality disorder was associated with a higher risk of nonremission following ECT in individuals with major depression. This finding seems to justify more systematic screening as well as more adequate management of this personality disorder in individuals with major depression who are treated with ECT to allow for attaining better remission rates in this subpopulation.

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Section: Discussionmentioning

confidence: 99%

Nonremission After Electroconvulsive Therapy in Individuals With Major Depression

Hein

Mungo

Loas

2022

J ECT

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“…MDD severely affects the patients themselves and their families. Negative emotions have a negative impact on patients, and patients may lose their enthusiasm, immerse themselves in negative emotions, and fail to live a normal life [ 15 , 16 ]. With the continuous progress of science and technology, imaging is also developing rapidly.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Neural Activity among Abnormal Brain Regions in Patients with Major Depressive Disorder by Magnetic Resonance Imaging Features

Wang

Jia

Zhao

et al. 2022

Computational and Mathematical Methods in Medicine

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In order to explore the diagnostic value of magnetic resonance imaging (MRI) for neural activity among abnormal brain regions in patients with major depressive disorder (MDD), thirty patients with MDD (observation group) were selected for comparison with 30 healthy people without MDD (control group). The included subjects were examined by MRI to compare the MRI features and were analyzed for regional homogeneity (ReHo) and amplitude low-frequency fluctuations (ALFF). The results showed that compared with the control group, the brain regions with increased ReHo and ALFF in the observation group were medial frontal gyrus (right), middle temporal lobe (left), inferior parietal lobe (left), and posterior cerebellar lobe (right); the brain region with increased ReHo and ALFF in the observation group was the middle temporal gyrus (right). Compared with the control group, there were significant differences in ReHo and ALFF in the observation group. It was found that the brain function of patients with MDD was abnormal compared with that of the normal subjects, and the brain network activity was also abnormal. MRI features can be used to explore abnormal brain regions in patients with MDD and have positive guiding value.

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“…As an example, a recent study reviewed this topic in patients presenting a major depression and borderline PD and submitted to psychotherapy and/or psychopharmacotherapy. The authors concluded that the presence of comorbid borderline PD may result in a poorer response, but additional studies are needed (Ceresa et al 2021). On the other hand, the combination of SSRIs with different psychological approaches such as dialectical behavior therapy (DBT), interpersonal psychotherapy (IPT), or cognitive-behavioral therapy (CBT) could be a promising treatment strategy.…”

Section: Cluster C In Particular Anxious-avoidant Personality Disordermentioning

confidence: 99%

Pharmacotherapy of Personality Disorders

Baumann¹,

Herpertz²

2021

NeuroPsychopharmacotherapy

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Personality disorders (PD) represent a group of more than 10 disorders, depending on the diagnostic classification used, but most research on pharmacological treatments deals with borderline PD. International guidelines consider the evidence for the usefulness of psychopharmacotherapy for PD limited and therefore, their major recommendation is to center this therapeutic approach for the treatment of the frequent psychiatric comorbidities. Indeed, current evidence favors psychotherapy compared to psychopharmacotherapy in the treatment of personality disorders (PD). However, antipsychotic drugs, antidepressants, anticonvulsants, and other psychotropic drugs are widely used, very frequently as combination treatments, despite not any of them has been introduced by national P. Baumann

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How does borderline personality disorder affect management and treatment response of patients with major depressive disorder? A comprehensive review

Cited by 25 publications

References 40 publications

Nonremission After Electroconvulsive Therapy in Individuals With Major Depression

Nonremission After Electroconvulsive Therapy in Individuals With Major Depression

Diagnosis of Neural Activity among Abnormal Brain Regions in Patients with Major Depressive Disorder by Magnetic Resonance Imaging Features

Pharmacotherapy of Personality Disorders

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