FISIOPATOLOGIA E ABORDAGENS TERAPÊUTICAS EFICAZES NO TRATAMENTO DO TRANSTORNO DE PERSONALIDADE BORDERLINE: UMA REVISÃO BIBLIOGRÁFICA DE LITERATURA
DOI:
https://doi.org/10.47820/recima21.v5i3.5031Palavras-chave:
Trastorno Límite de la Personalidad. Fisiopatología. Enfoque terapêutico. Terapia cognitivo-conductual. Neurobiología.Resumo
Introdução: O Transtorno de Personalidade Borderline (TPB) é reconhecido como uma condição mental complexa e debilitante, caracterizada por uma instabilidade emocional significativa, padrões instáveis de relacionamentos interpessoais e uma percepção distorcida de si mesmo e do mundo ao redor. Objetivo: esta revisão bibliográfica busca explorar a fisiopatologia do TPB e examinar abordagens terapêuticas eficazes, com o objetivo de fornecer uma visão abrangente e atualizada sobre esta condição mental desafiadora. Metódos: Foi realizada uma revisão bibliográfica utilizando bases de dados acadêmicas, buscando estudos publicados nos últimos 15 anos que investigassem a fisiopatologia e abordagens terapêuticas no TPB. Foram 41 estudos que preencheram os critérios de inclusão e foram incluídos na análise. Resultados e Discussão: Os avanços na compreensão da fisiopatologia do Transtorno de Personalidade Borderline (TPB) destacam a disfunção neurobiológica, especialmente na regulação emocional. Abordagens terapêuticas tradicionais, como a Terapia Cognitivo-Comportamental (TCC), e intervenções baseadas em mindfulness têm demonstrado eficácia na redução dos sintomas do TPB. Além disso, a farmacoterapia e intervenções complementares, como acupuntura e yoga, oferecem opções adicionais de tratamento, destacando a necessidade de uma abordagem integrada e personalizada para otimizar os resultados clínicos. O diagnóstico precoce, o manejo das comorbidades e a redução do estigma são desafios importantes que devem ser abordados para melhorar o tratamento e o funcionamento global dos indivíduos com TPB. Considerações Finais: Essa revisão importância de abordagens integradas e personalizadas para o tratamento do TPB, visando melhorar tanto os sintomas quanto o funcionamento global e a qualidade de vida dos pacientes afetados.
Downloads
Referências
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
Downloads
Publicado
Licença
Direitos de Autor (c) 2024 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.
