Borderline Personality Disorder and Treatment Resistance: Rediscovering the biopsychosocial model

[Speaker] Plakun, Eric M:1,2
1:Austen Riggs Center (United States of America), 2:Group for the Advancement of Psychiatry Psychotherapy Committee (United States of America)

Borderline Personality Disorder (BPD) has a psychosocial burden comparable to Bipolar Disorder, including a significant risk of suicide. BPD is also the only psychiatric disorder for which an American Psychiatric Association Practice Guideline names psychotherapy as the principal form of treatment. In a field focused on biology and psychopharmacology, BPD is often underdiagnosed, though there is evidence that it--along with other comorbidity and early adversity--contributes to the increasingly recognized problem of treatment resistance in mood and other disorders. This presentation [1] suggests that the currently dominant biomedical clinical paradigm is based on 3 false assumptions despite emerging evidence to the contrary, [2] that undiagnosed and untreated comorbid BPD contributes to treatment resistance, and [3] then describes common factors for therapy of suicidal patients with BPD developed by an expert consensus panel review of evidence based behavioral and psychodynamic psychotherapeutic approaches to suicidal patients with BPD.
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