Psychopathology and treatment of borderline personality disorder

Abstract

Borderline personality disorder (BPD) is a serious psychiatric disorder. Suicidality, self-injury, and severe impairment of self-esteem cause considerable distress to affected individuals and their social environment. With a prevalence of approximately 1.5%, BPD is more common than schizophrenic disorders and accounts for about 30% of total inpatient psychiatric treatment costs in Germany. In recent years, knowledge of the psychopathology, etiopathogenesis, and treatment options for BPD has improved considerably. Most researchers now regard a generalized disorder of affect regulation as central to the disorder, with causes involving interactions among genetic factors, traumatic biographical experiences, and dysfunctional coping strategies. Disorder-specific therapies, particularly dialectical behavior therapy (DBT) according to M. Linehan, supplemented by psychopharmacological treatment, show good outcomes in both inpatient and outpatient settings. However, comprehensive access to trained medical and psychological psychotherapists is still in its early stages, so specialized centers often need to be used.