Psychiatric Annals

Feature 

Integrated Treatment for Borderline Personality Disorder

John M. Oldham, MD

Abstract

Perhaps in no other area of clinical psychiatry is the importance of careful and sophisticated integration of psychotherapy and pharmacotherapy as central as in the treatment of personality disorders (PDs). The only American Psychiatric Association (APA) evidence-based practice guideline that recommends psychotherapy as the primary, or core, treatment is the practice guideline for the treatment of patients with borderline personality disorder (BPD). This practice guideline also recommends symptom-targeted adjunctive pharmacotherapy. Although the combination of psychotherapy and pharmacotherapy is reported anecdotally in the clinical literature for a number of other personality disorders (eg, schizotypal, histrionic, narcissistic, avoidant), the most extensively studied and the most prevalent PD in treatment populations is BPD, which will be the focus of this article.

ABOUT THE AUTHOR

Dr. Oldham is professor and chairman, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.

Address reprint requests to: John M. Oldham, MD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, 5 South Charleston, SC 29425; or e-mail oldhamj@musc.edu.

Abstract

Perhaps in no other area of clinical psychiatry is the importance of careful and sophisticated integration of psychotherapy and pharmacotherapy as central as in the treatment of personality disorders (PDs). The only American Psychiatric Association (APA) evidence-based practice guideline that recommends psychotherapy as the primary, or core, treatment is the practice guideline for the treatment of patients with borderline personality disorder (BPD). This practice guideline also recommends symptom-targeted adjunctive pharmacotherapy. Although the combination of psychotherapy and pharmacotherapy is reported anecdotally in the clinical literature for a number of other personality disorders (eg, schizotypal, histrionic, narcissistic, avoidant), the most extensively studied and the most prevalent PD in treatment populations is BPD, which will be the focus of this article.

ABOUT THE AUTHOR

Dr. Oldham is professor and chairman, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.

Address reprint requests to: John M. Oldham, MD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, 5 South Charleston, SC 29425; or e-mail oldhamj@musc.edu.

Perhaps in no other area of clinical psychiatry is the importance of careful and sophisticated integration of psychotherapy and pharmacotherapy as central as in the treatment of personality disorders (PDs). The only American Psychiatric Association (APA) evidence-based practice guideline that recommends psychotherapy as the primary, or core, treatment is the practice guideline for the treatment of patients with borderline personality disorder (BPD). This practice guideline also recommends symptom-targeted adjunctive pharmacotherapy. Although the combination of psychotherapy and pharmacotherapy is reported anecdotally in the clinical literature for a number of other personality disorders (eg, schizotypal, histrionic, narcissistic, avoidant), the most extensively studied and the most prevalent PD in treatment populations is BPD, which will be the focus of this article.

ABOUT THE AUTHOR

Dr. Oldham is professor and chairman, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.

Address reprint requests to: John M. Oldham, MD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, 5 South Charleston, SC 29425; or e-mail oldhamj@musc.edu.

10.3928/00485713-20060501-06

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