European guidelines for personality disorders: past, present and future

AbstractPersonality disorders (PD) are common and burdensome mental disorders. The treatment of individuals with PD represents one of the more challenging areas in the field of mental health and health care providers need evidence-based recommendations to best support patients with PDs. Clinical guidelines serve this purpose and are formulated by expert consensus and/or systematic reviews of the current evidence. In this review, European guidelines for the treatment of PDs are summarized and evaluated. To date, eight countries in Europe have developed and published guidelines that differ in quality with regard to recency and completeness, transparency of methods, combination of expert knowledge with empirical data, and patient/service user involvement. Five of the guidelines are about Borderline personality disorder (BPD), one is about antisocial personality disorder and three concern PD in general. After evaluating the methodological quality of the nine European guidelines from eight countries, results in the domains of diagnosis, psychotherapy and pharmacological treatment of PD are discussed. Our comparison of guidelines reveals important contradictions between recommendations in relation to diagnosis, length and setting of treatment, as well as the use of pharmacological treatment. All the guidelines recommend psychotherapy as the treatment of first choice. Future guidelines should rigorously follow internationally accepted methodology and should more systematically inclu...
Source: Borderline Personality Disorder and Emotion Dysregulation - Category: Psychiatry Source Type: research

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Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Borderline Personality Schizophrenia The Psych Central Show Trauma Source Type: blogs
AbstractThe aim of this study was to investigate whether (a) baseline levels of panic-specific reflection function (PSRF; i.e. patients ’ capacity to reflect on their panic symptoms) and improvement in this capacity over treatment, (b) baseline borderline personality disorder (BPD) traits and pre–post treatment improvement in BPD traits predict change in patients’ quality of object relations (QORs). A subsample of 102 patients diagnosed with panic disorder from a larger randomized controlled trial received either Cognitive-Behavioral Therapy or Panic-Focused Psychodynamic Psychotherapy. We investigated wh...
Source: Journal of Contemporary Psychotherapy - Category: Psychiatry & Psychology Source Type: research
Authors: Farrés CCI, Elices M, Soler J, Domínguez-Clavé E, Martín-Blanco A, Pomarol-Clotet E, Salvador R, Martinez-Horta S, Pascual JC Abstract Patients with borderline personality disorder (BPD) present dysfunctions of the default mode network (DMN). Mindfulness training has proven effective to improve the symptoms of BPD. The present study examines the effect of mindfulness training on BPD symptomatology and DMN activity during the performance of a working memory task in patients with BPD. Sixty-five individuals with BPD were randomized to receive psychotherapy with either the Mindfuln...
Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Tags: Clin Psychol Psychother Source Type: research
ConclusionsThe current Australian mental health system is not designed to best meet the needs of people living with BPD, which remains highly stigmatised and misunderstood. Future research should consider how the system could be modified or restructured to better support recovery for these individuals and others with complex mental illness.
Source: Australian Psychologist - Category: Psychiatry & Psychology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conclusion It is clear that clinically, there is still much to be learnt about alexithymia and its relationship with a range of related phenomena. Firstly, is alexithymia a continuous and stable trait independent of psychological or somatic symptomology that is developed during childhood? Or is it instead a reactive state induced by trauma and distress at any age, which serves to defend against intense and upsetting emotions? This impacts on treatment options. For example, should we be focussing on early childhood interventions which target the child's emotional environment and parenting to encourage emotional exp...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Alexandra Neyazi1†, Vanessa Buchholz1†, Alexandra Burkert1, Thomas Hillemacher1,2, Martina de Zwaan3, Wolfgang Herzog4, Kirsten Jahn1, Katrin Giel5, Stephan Herpertz6, Christian A. Buchholz1, Andreas Dinkel7, Markus Burgmer8, Almut Zeeck9, Stefan Bleich1, Stephan Zipfel5† and Helge Frieling1*† 1Molecular Neuroscience Laboratory, Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany 2Department of Psychiatry and Psychotherapy, Paracelsus Medizinische Privatuniversität Nürnberg, Nuremberg, Germany 3Department of Psychos...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
This study, therefore, compares reappraisal of negative, positive, neutral, and alcohol-related images at a behavioral and neural level between ADPs and healthy controls (HCs).Thirty-nine ADPs and 39 age-, gender-, and education-matched HCs performed an emotion reappraisal task during functional magnetic resonance imaging (fMRI), and craving was measured before and after the reappraisal task. During the emotion reappraisal task, participants were instructed to either attend or reappraise positive, negative, neutral, or alcohol-related images, and to indicate their experienced emotion on a visual analogue scale (VAS).Both A...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
This study will be conducted in the city of Porto Alegre in the state of Rio Grande do Sul in far-southern Brazil. This region has Portuguese, Italian, German, and African influence. It has a population of 1.4 million, and it is the 10th most populous city in Brazil. Its ethnic distribution is as follows: White (79.2%), Black (10.2%), and Pardo (multiracial) people (10.6%). Its religious distribution is as follows: Catholic (83%), Protestant (9%), and others and atheists (8%). Brazil is a country with a high level of religiosity, and it is common for people to associate improvements in their health as being due to their fa...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Psychotherapy for borderline personality disorder is often lengthy and resource-intensive. However, the current length of outpatient treatments is arbitrary and based on trials that never tested if the treatme...
Source: Trials - Category: General Medicine Authors: Tags: Study protocol Source Type: research
Conclusions: A critical examination of the results of each study suggests that NA helps to identify, in an innovative way, important aspects of psychopathology like the centrality of the symptoms in a given disorder as well as the mutual dynamics among symptoms. Yet, despite these promising results, the clinical utility of NA is still uncertain as there are important limitations on the analytic procedures (e.g., reliability of indices), the type of data included (e.g., typically restricted to secondary analysis of already published data), and ultimately, the psychometric and clinical validity of the results.Psychother Psychosom
Source: Psychotherapy and Psychosomatics - Category: Psychiatry & Psychology Source Type: research
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