Wu Tina, Hu Jennifer, Davydow Dimitry, Huang Heather, Spottswood Margaret, Huang Hsiang
Warren Alpert Medical School, Brown University, Providence, RI, United States.
Butler Hospital, Providence, RI, United States.
Front Med (Lausanne). 2022 Nov 3;9:1024022. doi: 10.3389/fmed.2022.1024022. eCollection 2022.
Borderline personality disorder (BPD) is a common mental health diagnosis observed in the primary care population and is associated with a variety of psychological and physical symptoms. BPD is a challenging disorder to recognize due to the limitations of accurate diagnosis and identification in primary care settings. It is also difficult to treat due to its complexity (e.g., interpersonal difficulties and patterns of unsafe behaviors, perceived stigma) and healthcare professionals often feel overwhelmed when treating this population. The aim of this article is to describe the impact of BPD in primary care, review current state of knowledge, and provide practical, evidence-based treatment approaches for these patients within this setting. Due to the lack of evidence-based pharmacological treatments, emphasis is placed on describing the framework for treatment, identifying psychotherapeutic opportunities, and managing responses to difficult clinical scenarios. Furthermore, we discuss BPD treatment as it relates to populations of special interest, including individuals facing societal discrimination and adolescents. Through this review, we aim to highlight gaps in current knowledge around managing BPD in primary care and provide direction for future study.
边缘型人格障碍（BPD）是在初级保健人群中常见的心理健康诊断，与多种心理和身体症状相关。由于初级保健环境中准确诊断和识别存在局限性，BPD是一种难以识别的疾病。由于其复杂性（例如人际困难和不安全行为模式、感知到的污名），治疗也很困难，医疗保健专业人员在治疗这类人群时常常感到不知所措。本文的目的是描述BPD在初级保健中的影响，回顾当前的知识状态，并在此背景下为这些患者提供实用的、基于证据的治疗方法。由于缺乏基于证据的药物治疗，重点在于描述治疗框架、确定心理治疗机会以及应对困难临床情况。此外，我们讨论了与特殊关注人群相关的BPD治疗，包括面临社会歧视的个体和青少年。通过这篇综述，我们旨在突出当前初级保健中管理BPD的知识差距，并为未来研究提供方向。
