European guidelines for personality disorders: past, present and future

Borderline Personality Disorder and Emotion Dysregulation

Babette Renneberg¹  Stephan Doering²  Martin Bohus³  Svenja Taubner⁴  Andres Kaera⁵  Joaquim Soler Ribaudi⁶  Paul Moran⁷  Lars Mehlum⁸  Theresa Wilberg⁹  Henk Jan Dalewijk^1,10  Sebastian Simonsen^1,11  Anthony Bateman^1,12 

[1] 0000 0000 9116 4836, grid.14095.39, Freie Universität, Berlin, Germany;0000 0000 9259 8492, grid.22937.3d, Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria;0000 0001 2190 4373, grid.7700.0, Institute of Psychiatric and Psychosomatic Psychotherapy; Central Institute of Mental Health, Heidelberg University, Mannheim, Germany;0000 0001 2190 4373, grid.7700.0, Universitätsklinikum Heidelberg

[2]  Universität Heidelberg, Heidelberg, Germany;0000 0004 0628 3152, grid.413739.b, Kanta-Häme Central Hospital, Hämeenlinna, Finland;0000 0004 1768 8905, grid.413396.a, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;grid.469673.9, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain;0000 0004 1936 7603, grid.5337.2, Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK;0000 0004 1936 8921, grid.5510.1, National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Private practice, Weesp, The Netherlands;Stolpegaard Psychotherapy Centre, Copenhagen, Denmark;University College, London and Anna Freud National Centre for Children and Families, University of Copenhagen, London, UK;

关键词: Guidelines;    Personality disorders;    Recommendations;   

DOI  :  10.1186/s40479-019-0106-3

来源: publisher

【 摘 要 】

Personality disorders (PD) are common and burdensome mental disorders. The treatment of individuals with PD represents one of the more challenging areas in the field of mental health and health care providers need evidence-based recommendations to best support patients with PDs. Clinical guidelines serve this purpose and are formulated by expert consensus and/or systematic reviews of the current evidence. In this review, European guidelines for the treatment of PDs are summarized and evaluated. To date, eight countries in Europe have developed and published guidelines that differ in quality with regard to recency and completeness, transparency of methods, combination of expert knowledge with empirical data, and patient/service user involvement. Five of the guidelines are about Borderline personality disorder (BPD), one is about antisocial personality disorder and three concern PD in general. After evaluating the methodological quality of the nine European guidelines from eight countries, results in the domains of diagnosis, psychotherapy and pharmacological treatment of PD are discussed. Our comparison of guidelines reveals important contradictions between recommendations in relation to diagnosis, length and setting of treatment, as well as the use of pharmacological treatment. All the guidelines recommend psychotherapy as the treatment of first choice. Future guidelines should rigorously follow internationally accepted methodology and should more systematically include the views of patients and users.

【 授权许可】

CC BY