Borderline personality disorder and early psychosis: a narrative review.

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2023-11-02 DOI:10.1186/s12991-023-00475-w
Arianna Biancalani, Lorenzo Pelizza, Marco Menchetti
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Abstract

Background: The purpose of the present review was to summarize the main literature contribution on the relationship between borderline personality disorder (BPD) and early psychosis. While retracing the historical path of the term "borderline", specific attention was paid to psychotic and psychotic-like symptoms in BPD. Its relationship with At Risk Mental State was evaluated, as well.

Methods: This search was conducted on PUBMED/MEDLINE and PsycInfo, looking for "Borderline personality disorder, First Episode Psychosis, Early Psychosis, Ultra-High Risk AND/OR Clinical High Risk" for psychosis.

Results: Eight pertinent papers were identified on this topic. Their main findings were then discussed. The term "borderline" has undergone different changes in meaning and use, despite always referring to states considered on the fence between neurosis and psychosis. However, considering the history of psychopathology and its relationship with diagnostic manuals, little attention has been given to its psychotic features. Being those symptoms highly burdensome, this neglect has often led to misdiagnosis and under-treatment.

Conclusions: Psychotic symptoms in BPD can be severe and distressing. Nonetheless they can be easily neglected, and when found they challenge clinicians in defining a differential diagnosis to distinguish between BPD and Psychosis Spectrum Disorders. Given specific needs and interventions for these different conditions, a dimensional, rather than categorical, approach should be considered, as well as specific care pathways and monitoring should be advised.

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边缘型人格障碍与早期精神病:叙述性综述。
背景:本综述的目的是总结关于边缘型人格障碍(BPD)与早期精神病之间关系的主要文献贡献。在追溯“边界”一词的历史路径时,特别关注BPD中的精神病和精神病样症状。它与危险心理状态的关系也进行了评估。方法:在PUBMED/MEDLINE和PsycInfo上搜索精神病的“边缘型人格障碍、首发精神病、早期精神病、超高危和/或临床高危”。结果:就这一主题发表了八篇相关论文。然后讨论了他们的主要发现。“临界”一词在含义和用法上发生了不同的变化,尽管它总是指被认为处于神经症和精神病之间的状态。然而,考虑到精神病理学的历史及其与诊断手册的关系,很少关注其精神病特征。由于这些症状非常繁重,这种忽视往往导致误诊和治疗不足。结论:BPD的精神症状可能严重且令人痛苦。尽管如此,它们很容易被忽视,当被发现时,它们对临床医生定义鉴别诊断以区分BPD和精神病谱系障碍提出了挑战。鉴于这些不同情况的具体需求和干预措施,应考虑一种维度而非分类的方法,并建议具体的护理途径和监测。
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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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