Resources for Clinicians

On this page we have listed a number of resources (guidelines, policy and strategy, reports and articles) for General Practitioners and other clinicians.  

NICE clinical guidelines for borderline personality disorder (CG78)

This guideline covers recognising and managing borderline personality disorder. It aims to help people with borderline personality disorder to manage feelings of distress, anxiety, worthlessness and anger, and to maintain stable and close relationships with others. This guideline includes recommendations on:

NICE Personality disorders: borderline and antisocial – Quality Standard (QS88)

This quality standard covers assessing and managing borderline and antisocial personality disorders. It describes high-quality care in priority areas for improvement.

British Journal of Medical Practitioners – A review of NICE guidelines on the management of Borderline Personality Disorder

This report aims to review the current guidelines regarding the management of Borderline Personality Disorder and explore the literature according to the research recommendations. The psychological/psychosocial and pharmacological aspects will be the focus of this review.

Mental Welfare Commission for Scotland – Capacity, Consent and Compulsion for Young People with Borderline Personality Disorder: Good Practice Guide

This new good practice guide for professionals working with young people with a diagnosis of borderline personality disorder (BPD) focuses on the crucial issue of a young person’s capacity to make decisions when they are unwell or in serious distress, and how that affects the ability of health and social work professionals to best treat that young person.

Quality of Life in Borderline Personality Disorder

This report aims to review the literature on quality of life (QoL) in borderline personality disorder (BPD) by examining the use of QoL instruments, the extent of QoL impairments in BPD, and the impact of treatment on QoL in BPD.

Living with Borderline Personality Disorder. The experience of people with the diagnosis, families and services in Scotland

This report looks at the care, treatment and support of people with borderline personality disorder (BPD), often known as emotionally unstable personality disorder (EUPD).

Under the radar: women with borderline personality disorder in prison

Borderline personality disorder (BPD) is a serious condition characterised by pervasive instability in moods, relationships, self-image and behaviour. People suffering from this disorder often struggle with a mixture of emotions and engage in risky, impulsive behaviours. Under the Radar shows that women prisoners with borderline personality disorder often come from an unstable family environment. The report calls for better diversion from custodial sentences for women with a personality disorder and increased training for prison staff.

The Use of Psychotropic Medication in Patients With Emotionally Unstable Personality Disorder Under the Care of UK Mental Health Services

Guideline recommendations for the pharmacologic treatment of personality disorder lack consensus, particularly for emotionally unstable personality disorder (EUPD), and there is limited information on current prescribing practice in the United Kingdom.

Personality Disorders and Psychopathy

Discover how a personality disorder and psychopathy is defined by reading designated Personality disorders in psychopathy page. The ICD-10 (World Health Organization 1992) defines a personality disorder as: a severe disturbance in the characterological condition and behavioural tendencies of the individual, usually involving several areas of the personality and nearly always associated with considerable personal and social disruption.

Psychological therapies for people with borderline personality disorder

Psychotherapy is regarded as the first‐line treatment for people with borderline personality disorder. In recent years, several disorder‐specific interventions have been developed. This is an update of a review published in the Cochrane Database of Systematic Reviews (CDSR) in 2006 and it was superseded by a new review (with the same title) in the CDSR in 2020.

Pharmacological interventions for borderline personality disorder

Pharmacologicial Interventions for Borderline Personality Disorder. Drugs are widely used in borderline personality disorder (BPD) treatment, chosen because of properties known from other psychiatric disorders (“off‐label use”), mostly targeting affective or impulsive symptom clusters.

Missed diagnosis: The emerging crisis of borderline personality disorder in older people

Clinical experience suggests a growing prevalence of borderline personality disorder in aged residential care and psychiatric facilities with attendant difficulties in their management. This paper reviews the literature concerning the prevalence, phenomenology and diagnosis of borderline personality disorder in old age. The aim is to elucidate the phenomenological differences in old age and thus improve identification of the disorder.

Psychological therapies including dialectical behaviour therapy for borderline personality disorder

Psychological therapies including dialectical behaviour therapy for borderline personality disorder: a systematic review and preliminary economic evaluation. The evidence for the effectiveness and cost-effectiveness of psychological therapies for borderline personality disorder is promising, however, at this stage it is inconclusive.

Impulsivity and its Therapeutic Management in Borderline Personality Disorder: a Systematic Review.

No treatment has been approved and recognized as effective in borderline personality disorder (BPD). Impulsivity is a key dimension because it is a predictor of remission but also suicide. The purpose of this review is to establish an inventory on the management of impulsivity in BPD and determine the effective treatments. A systematic review on the PubMed and Ovid databases was conducted up to September 2019 to December 2019 using the PRISMA guidelines.

Specialized psychotherapies for adults with borderline personality disorder: A systematic review and meta-analysis

Borderline personality disorder affects up to 2% of the population and is associated with poor functioning, low quality of life and increased mortality. Psychotherapy is the treatment of choice, but it is unclear whether specialized psychotherapies (dialectical behavior therapy, mentalization-based treatment, transference-focused therapy and schema therapy) are more effective than non-specialized approaches (e.g. protocolized psychological treatment, general psychiatric management). The aim of this systematic review is to investigate the effectiveness of these psychotherapies.

Use of Dialectical Behavior Therapy in Inpatient Treatment of Borderline Personality Disorder: A Systematic Review

Dialectical behavior therapy (DBT) is an empirically supported treatment for outpatients with borderline personality disorder. However, the utility of DBT strategies for inpatients with the disorder is unclear. This review summarizes and synthesizes findings from trials of DBT in inpatient settings.

Mechanisms of change in dialectical behaviour therapy and cognitive behaviour therapy for borderline personality disorder: a critical review of the literature

Little is known about the “active ingredients” of psychological therapy for Borderline Personality Disorder (BPD) despite a growing evidence base documenting its clinical effectiveness. This information can be used by clinicians to inform service planning and care pathways. The aim of this study was to review published empirical research investigating the potential mechanisms underlying therapeutic change in Dialectical Behaviour Therapy (DBT) and Cognitive Behaviour Therapy (CBT) for BPD.

Services for people diagnosable with personality disorder

In 2003 the National Institute for Mental Health England published the landmark document Personality Disorder: no longer a diagnosis of exclusion. The document recognised the systemic failings of statutory services to meet the needs of those given a diagnosis of personality disorder. It made a range of recommendations for health and social care services as well as the criminal justice system. The document described a vision for
national coverage of specialist personality disorder services targeted at those in most need, whilst ensuring that colleagues in mainstream services were more effectively trained and supported in their practice. This paper was written in a truly collaborative
way and heralded a programme of co-produced clinical, training and research projects to address the paper’s aims.

Factors predicting the outcome of psychotherapy for borderline personality disorder: A systematic review

There is substantial variation between individuals with borderline personality disorder (BPD) in the degree of benefit gained from psychotherapy. Information on factors predicting the outcome of therapy for this group could facilitate identification of those at risk for poor outcome, and could enable helpful therapy processes to be identified. A systematic search of PsycInfo, EMBASE, CINHAL and Medline identified research on factors predicting symptom change during therapy for patients with a BPD diagnosis. Non-English language papers and dissertations were included.

Living with borderline personality disorder (The BMJ)

Lucie Langford, from Ontario, Canada, is an aspiring researcher/clinician. Now 25, she was diagnosed with borderline personality disorder (BPD) at the age of 17. Lucie recently spent just over a year working at the Children’s Hospital of Eastern Ontario as a programme facilitator for young people with mental illness.

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