PATHOPHYSIOLOGY AND EFFECTIVE THERAPEUTIC APPROACHES IN THE TREATMENT OF BORDERLINE PERSONALITY DISORDER: A LITERATURE REVIEW
DOI:
https://doi.org/10.47820/recima21.v5i3.5031Keywords:
Borderline Personality Disorder. Pathophysiology. Therapeutic approach. Cognitive-behavioral therapy. Neurobiology.Abstract
Introduction: Borderline Personality Disorder (BPD) is recognized as a complex and debilitating mental condition, characterized by significant emotional instability, unstable patterns of interpersonal relationships and a distorted perception of oneself and the world around. Objective: This literature review seeks to explore the pathophysiology of BPD and examine effective therapeutic approaches, with the aim of providing a comprehensive and up-to-date overview of this challenging mental condition. Methods: A literature review was conducted using academic databases, searching for studies published in the last 15 years that investigated the pathophysiology and therapeutic approaches in BPD. Forty-one studies met the inclusion criteria and were included in the analysis. Results and Discussion: Advances in understanding the pathophysiology of Borderline Personality Disorder (BPD) highlight neurobiological dysfunction, especially in emotional regulation. Traditional therapeutic approaches, such as Cognitive-Behavioral Therapy (CBT), and mindfulness-based interventions have shown efficacy in reducing BPD symptoms. In addition, pharmacotherapy and complementary interventions such as acupuncture and yoga offer additional treatment options, highlighting the need for an integrated and personalized approach to optimize clinical outcomes. Early diagnosis, management of comorbidities and reduction of stigma are important challenges that must be addressed in order to improve the treatment and overall functioning of individuals with BPD. Final Considerations: This review highlights the importance of integrated and personalized approaches to the treatment of BPD, with the aim of improving both symptoms and the overall functioning and quality of life of affected patients.
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References
AMERICAN PSYCHIATRIC ASSOCIATION et al. *DSM-5: Manual diagnóstico e estatístico de transtornos mentais*. Porto Alegre: Artmed, 2014.
BALARATNASINGAM, Sivasankaran; JANCA, Aleksandar. Recovery in borderline personality disorder: Time for optimism and focused treatment strategies. *Current Opinion in Psychiatry*, v. 33, n. 1, p. 57-61, 2020. DOI: https://doi.org/10.1097/YCO.0000000000000564
BARNICOT, Kirsten; CRAWFORD, Mike. Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder. *Psychological Medicine*, v. 49, n. 12, p. 2060-2068, 2019. DOI: https://doi.org/10.1017/S0033291718002878
BARNICOT, Kirsten et al. Factors predicting the outcome of psychotherapy for borderline personality disorder: A systematic review. *Clinical Psychology Review*, v. 32, n. 5, p. 400-412, 2012. DOI: https://doi.org/10.1016/j.cpr.2012.04.004
BHOME, Rohan; FRIDRICH, Pavel. Borderline personality disorder. *British Journal of Hospital Medicine*, v. 76, n. 1, p. C14-C16, 2015. DOI: https://doi.org/10.12968/hmed.2015.76.1.C14
CAMPBELL, Katrina et al. Borderline Personality Disorder: To diagnose or not to diagnose? That is the question. *International Journal of Mental Health Nursing*, v. 29, n. 5, p. 972-981, 2020. DOI: https://doi.org/10.1111/inm.12737
CHANEN, Andrew M. et al. Diagnosis and treatment of borderline personality disorder in young people. *Current Psychiatry Reports*, v. 22, p. 1-8, 2020. DOI: https://doi.org/10.1007/s11920-020-01144-5
D'ABATE, Ludovica et al. Borderline personality disorder, metacognition, and psychotherapy. *Journal of Affective Disorders*, v. 276, p. 1095-1101, 2020. DOI: https://doi.org/10.1016/j.jad.2020.07.117
DEL CASALE, Antonio et al. Current clinical psychopharmacology in borderline personality disorder. *Current Neuropharmacology*, v. 19, n. 10, p. 1760, 2021. DOI: https://doi.org/10.2174/1570159X19666210610092958
FASSBINDER, Eva et al. PRO* BPD: effectiveness of outpatient treatment programs for borderline personality disorder: a comparison of Schema therapy and dialectical behavior therapy: study protocol for a randomized trial. *BMC Psychiatry*, v. 18, p. 1-17, 2018. DOI: https://doi.org/10.1186/s12888-018-1905-6
FRIBORG, Oddgeir et al. Comorbidity of personality disorders in mood disorders: a meta-analytic review of 122 studies from 1988 to 2010. *Journal of Affective Disorders*, v. 152, p. 1-11, 2014. DOI: https://doi.org/10.1016/j.jad.2013.08.023
GUENDELMAN, Simón; GARAY, Loreto; MIÑO, Viviana. Neurobiología del trastorno de personalidad límite. *Revista Médica de Chile*, v. 142, n. 2, p. 204-210, 2014. DOI: https://doi.org/10.4067/S0034-98872014000200009
GUNDERSON, John G. et al. Borderline personality disorder. *Nature Reviews Disease Primers*, v. 4, n. 1, p. 1-20, 2018. DOI: https://doi.org/10.1038/nrdp.2018.29
HOOD, Philippa et al. The role of mindfulness and emotion regulation in dialectical behavioral therapy for borderline personality disorder. *Personality Disorders: Theory, Research, and Treatment*, 2023. DOI: https://doi.org/10.1037/per0000640
KARAS, Karolina H.; BAHARIKHOOB, Paria; KOLLA, Nathan J. Borderline personality disorder and its symptom clusters: A review of positron emission tomography and single photon emission computed tomography studies. *Psychiatry Research: Neuroimaging*, v. 316, p. 111357, 2021. DOI: https://doi.org/10.1016/j.pscychresns.2021.111357
KAESS, Michael; BRUNNER, Romuald; CHANEN, Andrew. Borderline personality disorder in adolescence. *Pediatrics*, v. 134, n. 4, p. 782-793, 2014. DOI: https://doi.org/10.1542/peds.2013-3677
KEHR, Timea; HAEYEN, Suzanne. Drawing your way out: Imagery rehearsal based art therapy (IR-AT) for post-traumatic nightmares in borderline personality disorder. *Journal of Clinical Psychology*, 2024. DOI: https://doi.org/10.1002/jclp.23638
KEUROGHLIAN, Alex S. et al. Interactions of borderline personality disorder and anxiety disorders over 10 years. *The Journal of Clinical Psychiatry*, v. 76, n. 11, p. 9240, 2015. DOI: https://doi.org/10.4088/JCP.14m09748
KIENAST, Thorsten et al. Borderline personality disorder and comorbid addiction: epidemiology and
treatment. *Deutsches Ärzteblatt International*, v. 111, n. 16, p. 280, 2014.
KONSTANTINOU, Gerasimos N. et al. Repetitive transcranial magnetic stimulation in patients with borderline personality disorder: A systematic review. *Psychiatry Research*, v. 304, p. 114145, 2021. DOI: https://doi.org/10.1016/j.psychres.2021.114145
KOUNIDAS, Georgios; KASTORA, Stavroula. Mindfulness training for borderline personality disorder: A systematic review of contemporary literature. *Personality and Mental Health*, v. 16, n. 3, p. 180-189, 2022. DOI: https://doi.org/10.1002/pmh.1529
LEICHSENRING, Falk et al. Borderline personality disorder. *The Lancet*, v. 377, n. 9759, p. 74-84, 2011. DOI: https://doi.org/10.1016/S0140-6736(10)61422-5
LIMANDRI, Barbara J. Psychopharmacology for borderline personality disorder. *Journal of Psychosocial Nursing and Mental Health Services*, v. 56, n. 4, p. 8-11, 2018. DOI: https://doi.org/10.3928/02793695-20180319-01
LINEHAN, Marsha M. *Cognitive-behavioral treatment of borderline personality disorder*. New York: Guilford Press, 2018.
MCCOMMON, Benjamin; HERSH, Richard. Good Psychiatric Management and Transference-Focused Psychotherapy for Borderline Personality Disorder: A spectrum of psychodynamically informed treatments. *Psychodynamic Psychiatry*, v. 49, n. 2, p. 296-321, 2021. DOI: https://doi.org/10.1521/pdps.2021.49.2.296
MENDEZ-MILLER, Megan; NACCARATO, Julianna; RADICO, Julie A. Borderline personality disorder. *American Family Physician*, v. 105, n. 2, p. 156-161, 2022.
OLABI, Bayanne; HALL, Jeremy. Borderline personality disorder: current drug treatments and future prospects. *Therapeutic Advances in Chronic Disease*, v. 1, n. 2, p. 59-66, 2010. DOI: https://doi.org/10.1177/2040622310368455
PARKER, Justin D.; NAEEM, Aimen. FPIN's Help Desk Answers: Pharmacologic Treatment of Borderline Personality Disorder. *American Family Physician*, v. 99, n. 5, 2019.
PARIS, Joel. Differential diagnosis of borderline personality disorder. *Psychiatric Clinics of North America*, v. 41, n. 4, p. 575-582, 2018. DOI: https://doi.org/10.1016/j.psc.2018.07.001
PEREZ-RODRIGUEZ, Maria Mercedes et al. The neurobiology of borderline personality disorder. *Psychiatric Clinics of North America*, v. 41, n. 4, p. 633-650, 2018. DOI: https://doi.org/10.1016/j.psc.2018.07.012
PRASAD, Divya et al. The prevalence of borderline personality features and borderline personality disorder during the perinatal period: a systematic review and meta-analysis. *Archives of Women's Mental Health*, v. 25, n. 2, p. 277-289, 2022. DOI: https://doi.org/10.1007/s00737-022-01218-8
RAO, Sathya; HEIDARI, Parvaneh; BROADBEAR, Jillian H. Developments in diagnosis and treatment of people with borderline personality disorder. *Current Opinion in Psychiatry*, v. 33, n. 5, p. 441-446, 2020. DOI: https://doi.org/10.1097/YCO.0000000000000625
RIEGLER, Alisa et al. Does the Augmentation of Trauma Informed Hatha Yoga Increase the Effect of Dialectical Behavior Therapy for Substance Use Disorders on Psychopathological Strain of Patients with Borderline Personality Disorder and Comorbid Substance Use Disorder? Results of a Quasi-Experimental Study. *European Addiction Research*, v. 29, n. 1, p. 1-8, 2023. DOI: https://doi.org/10.1159/000526670
RUOCCO, Anthony C.; CARCONE, Dean. A neurobiological model of borderline personality disorder: systematic and integrative review. *Harvard Review of Psychiatry*, v. 24, n. 5, p. 311-329, 2016. DOI: https://doi.org/10.1097/HRP.0000000000000123
SCHEIBNER, Hannah J. et al. Self-compassion mediates the relationship between mindfulness and borderline personality disorder symptoms. *Journal of Personality Disorders*, v. 32, n. 6, p. 838-856, 2018. DOI: https://doi.org/10.1521/pedi_2017_31_331
SHAH, Ravi; ZANARINI, Mary C. Comorbidity of borderline personality disorder: current status and future directions. *Psychiatric Clinics of North America*, v. 41, n. 4, p. 583-593, 2018. DOI: https://doi.org/10.1016/j.psc.2018.07.009
STOFFERS-WINTERLING, Jutta M. et al. Psychological therapies for people with borderline personality disorder. *Cochrane Database of Systematic Reviews*, n. 8, 2012. DOI: https://doi.org/10.1002/14651858.CD009668
SVERAK, Tomas et al. Brain connectivity and symptom changes after transcranial magnetic stimulation in patients with borderline personality disorder. *Frontiers in Psychiatry*, v. 12, p. 770353, 2022. DOI: https://doi.org/10.3389/fpsyt.2021.770353
TALBOTT, John A. Borderline personality disorder. *The Journal of Nervous and Mental Disease*, v. 201, n. 2, p. 83, 2013. DOI: https://doi.org/10.1097/NMD.0b013e31827f626b
TOMKO, Rachel L. et al. Characteristics of borderline personality disorder in a community sample: comorbidity, treatment utilization, and general functioning. *Journal of Personality Disorders*, v. 28, n. 5, p. 734-750, 2014. DOI: https://doi.org/10.1521/pedi_2012_26_093
YEOMANS, Frank E.; LEVY, Kenneth N. Borderline Personality Disorder. *Psychiatric Clinics of North America*, v. 41, n. 4, p. xiii-xv, 2018. DOI: https://doi.org/10.1016/j.psc.2018.09.001
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