Mental Health Service Utilization by Borderline Personality Disorder Patients and Axis II Comparison Subjects Followed Prospectively for 6 Years

Zanarini, Mary C.; Frankenburg, Frances R.; Hennen, John; Silk, Kenneth R.

doi:10.4088/jcp.v65n0105

Cited by 257 publications

(181 citation statements)

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“…Psychosocial impairment, particularly with social relationships, also seems relatively stable over time [6] Research has also examined the impact that PD diagnoses have on psychiatric and medical treatment utilization. Previous studies on individuals with PD diagnoses demonstrated that BPD individuals differ in usage of outpatient, inpatient, and psychopharmacologic treatments when compared to other PD groups [7,8] and when compared to major depression groups without PD [9]. Patients with BPD also receive more psychotropic medications when compared to all other non-PD diagnostic groups [10,11].…”

Section: Introductionmentioning

confidence: 96%

Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group

Ansell

Sanislow

McGlashan

et al. 2007

Comprehensive Psychiatry

123

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This study compared psychosocial functioning and treatment utilization in 130 participants who were diagnosed with a borderline personality disorder (BPD), a non-BPD personality disorder (OPD), a mood and/or anxiety disorder (MAD), or had no current psychiatric diagnosis and served as a healthy comparison group. Diagnostic and Statistical Manual of Mental Disorders (4th Edition) diagnoses, psychosocial functioning, and treatment utilization were determined by using well-established semistructured research interviews conducted by trained doctoral-level clinicians. Analysis of variance revealed the most severe deficits in functioning characterized the BPD group across areas of global functioning with more moderate impairments in functioning occurring in OPD and MAD groups. The BPD group was characterized by significantly greater psychiatric and nonpsychiatric treatment utilization than the other groups. These findings indicate that BPD as well as other personality disorders are a source of considerable psychologic distress and functional impairment equivalent to, and at times exceeding, the distress found in mood and anxiety disorders. The public health impact of BPD diagnosis is highlighted by the high rates of psychiatric and nonpsychiatric treatment utilization. D

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Section: Introductionmentioning

confidence: 96%

Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group

Ansell

Sanislow

McGlashan

et al. 2007

Comprehensive Psychiatry

123

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“…Although drug treatment is widely used in the treatment of personality disorder -indeed, polypharmacy is sadly almost the norm in borderline personality disorder 22 -there is little evidence of substantial benefit either in the short or longer term with any of the drugs -antipsychotics, mood stabilisers and selective serotonin reuptake inhibitors (SSEIs) commonly used to treat any of the individual personality disorders. This does not mean drugs are not of help at times; it is just that the evidence base is very limited at present and may have been oversold.…”

Section: Drug Treatmentsmentioning

confidence: 99%

Personality disorder and public mental health

Tyrer

2008

Clinical Medicine

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-The diagnosis of personality disorder often appears to tell as much about the diagnoser as the diagnosed. For many it describes those who are deemed personally offensive, and as such it is not so much a diagnosis as a value judgment, the product of a negative interaction between two people that is given spurious respectability by a medical label. It is argued that these attitudes constitute a disastrous misperception of the truth, as personality disturbance (diathesis) in its many forms, including the unsatisfactory term 'disorder', is a highly significant contributor to human misery and handicap and a major cost to public mental health. It achieves this sorry record largely through stealth, because the current categorical system fails to embrace the breadth and heterogeneity of abnormal personality and the notion of offensive immutability makes the diagnosis a stigmatic one. This can be avoided by recoding personality in terms of severity. New treatments are now beginning to show evidence of efficacy and it is not unreasonable to hope that a condition that has been muttered about for years in parentheses will now be better recognised and defined, exposed without misunderstanding, and managed appropriately and well.

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“…l trastorno límite de la personalidad (TLP) supone un considerable sufrimiento tanto para la persona que lo padece como para su entorno, así como un elevado consumo de recursos sanitarios (Bender et al, 2001;Zanarini, Frankenburg, Hennen & Silk 2004), no solo por su prevalencia del 1-2% en población general (APA, 2000;Lieb, Zanarini, Schmahl, Linehan & Bohus, 2004) y del 10-20% en pacientes psiquiátricos (Torgersen, Kringlen, Cramer, 2001), sino también por su naturaleza (Linehan, Heidi, Heard, Hubert & Armstrong, 1993). Las características del comportamiento lí-mite y la resistencia a los tratamientos farmacológicos hacen de la psicoterapia el elemento clave para la mejoría de estos pacientes.…”

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Eficacia de la psicoterapia para el tratamiento del Trastorno Límite de la Personalidad: Una revisión

Juanmartí¹,

Lizeretti²

2017

Pap. Psicol.

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148l trastorno límite de la personalidad (TLP) supone un considerable sufrimiento tanto para la persona que lo padece como para su entorno, así como un elevado consumo de recursos sanitarios (Bender et al., 2001;Zanarini, Frankenburg, Hennen & Silk 2004), no solo por su prevalencia del 1-2% en población general (APA, 2000;Lieb, Zanarini, Schmahl, Linehan & Bohus, 2004) y del 10-20% en pacientes psiquiátricos (Torgersen, Kringlen, Cramer, 2001), sino también por su naturaleza (Linehan, Heidi, Heard, Hubert & Armstrong, 1993). Las características del comportamiento lí-mite y la resistencia a los tratamientos farmacológicos hacen de la psicoterapia el elemento clave para la mejoría de estos pacientes.Actualmente existen múltiples psicoterapias para el tratamiento del TLP con estudios que avalan su eficacia sobre los diferentes desórdenes que conforman el trastorno. A partir de aquí, una posible pregunta a plantear es saber qué psicoterapia es la más eficaz y por qué. Las más estudiadas y con mayor apoyo empírico son: la Terapia Dialectico-Conductual (TDC) (Linehan, Armstrong, Suarez, Allmon, & Heard, 1991), la Terapia basada en la Mentalización (TBM) (Bateman & Fonagy, 2004), la Terapia basada en la Transferencia (TBT) (Clarkin, Kernberg, & Yeomans, 1999), la Terapia basada en Esquemas (TBE) (Ball & Young, 1999), la Terapia Cognitivo-Analítica (TCA) (Ryle, 1991), la Terapia Conversacional de Hobson (TCH) (Hobson, 1985) y la Terapia Cognitivo-Conductual (TCC) La TDC es una psicoterapia manualizada, que combina estrategias conductuales, cognitivas y de apoyo, basada en la dualidad de aceptar al otro en su condición presente a la vez que se promueve un cambio (Heard & Linehan, 1994). Por el contrario, la TBM y la TBT son psicoterapias psicoanalíticas que se centran en el afecto, la comprensión y la interpretación, aunque también hay importantes diferencias entre ellas. La TBT presta especial atención a la transferencia y centra su acción terapéutica en las externalizaciones del paciente en terapia. Sin embargo, la TBM

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Mental Health Service Utilization by Borderline Personality Disorder Patients and Axis II Comparison Subjects Followed Prospectively for 6 Years

Cited by 257 publications

References 0 publications

Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group

Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group

Personality disorder and public mental health

Eficacia de la psicoterapia para el tratamiento del Trastorno Límite de la Personalidad: Una revisión

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