Borderline Personality Disorder: The NICE Guideline on Treatment and Management

by National Collaborating Centre for Mental Health (section of the Collegeee/

Overview

Personality disorder now accounts for a substantial portion of the workload of most community mental health teams in the UK and borderline personality disorder is associated with significant functional impairments for the individual. The NICE guideline takes the first comprehensive view of the disorder and is an important resource for healthcare professionals to improve people’s long-term outcomes.

Recent years have seen an exponential rise in available treatments for personality disorder and the guideline on borderline personality disorder covers the available evidence on all of those interventions. It also includes management of crises, configuration and organisation of services and experience of care. The primary focus is on adults, but the guideline looks at emerging characteristics of borderline personality disorder in younger people. The guideline also considers the needs of those with learning disabilities and contains a useful overview of borderline personality disorder.

NICE Mental Health Guidelines

These guidelines fromNICEset out clear recommendations, based on the best available evidence, for health care professionals on how to work with and implement physical, psychological and service-level interventions for people with various mental health conditions.

The book containsthe full guidelines that cannot be obtained in print anywhere else. It brings together all of the evidence that led to the recommendations made, detailed explanations of the methodology behind their preparation, plus an overview of the condition covering detection, diagnosis and assessment, and the full range of treatment and care approaches.

The accompanying free CD-ROM contains all the data used as evidence, including:

• Included and excluded studies.
• Profile tables that summarise both the quality of the evidence and the results of the evidence synthesis.
• All meta-analytical data, presented as forest plots.
• Detailed information about how to use and interpret forest plots.

Product Details

ISBN-13:	9781854334770
Publisher:	Royal College of Psychiatrists
Publication date:	09/01/2009
Series:	NICE Guidelines Series
Pages:	556
Product dimensions:	6.60(w) x 9.40(h) x 1.30(d)

Table of Contents

Full Contents

1.Preface
1.1 National guideline
1.2 The national borderline personality disorder guideline

2.Borderline personality disorder
2.1 The disorder
2.2 Diagnosis
2.3 Epidemiology
2.4 Aetiology
2.5 Treatment and management
2.6 Multi-agency perspective
2.7 Young people
2.8 The experience of service users and families/carers
2.9 Economic impact

3.Methods used to develop this guideline
3.1 Overview
3.2 The Scope
3.3 The Guideline Development Group
3.4 Clinical questions
3.5 Systematic clinical literature review
3.6 Health economics review strategies
3.7 Stakeholder contributions
3.8 Validation of the guideline

4.Experience of care
4.1 Introduction
4.2 Personal accounts
4.3 Review of the qualitative literature
4.4 Family/Carer experience
4.5 Summary of themes
4.6 Clinical practice recommendations

5.Psychological therapies, therapeutic communities, arts therapies, and complementary therapies in the management of borderline personality disorder
5.1 Introduction
5.2 Psychological therapies
5.3 Complex interventions
5.4 Individual psychological therapies
5.5 Brief psychological interventions
5.6Data by outcome
5.7 Combination therapy
5.8 Overall clinical summary
5.9 Therapeutic Communities
5.10 Studies considered
5.11 Complementary therapies
5.12 Arts therapies
5.13 Clinical practice recommendations
5.14 Research recommendations

6.Pharmacological and other physical treatments in the management of borderline personality disorder
6.1 Introduction
6.2 Anticonvulsants and lithium
6.3 Antipsychotics
6.4 Antidepressants
6.5 Omega-3 fatty acids
6.6 Naloxone
6.7 Effect of treatment on symptoms
6.8 Effect of treatment on general functioning and other outcomes
6.9 Effect of treatment on acceptability/tolerability outcomes
6.10 Summary of clinical evidence review
6.11 Clinical practice recommendations
6.12 Research recommendation

7.Management of crises
7.1 Introduction
7.2 Current practice
7.3 Reviewing the evidence base
7.4 General management of crises
7.5 Pharmacological management of crises
7.6 Follow-up after a crisis
7.7 Management of insomnia

8.The configuration and organisation of services
8.1 Introduction
8.2 The role of specialist services
8.3 Risk factors for sucide in people with borderline personality disorder
8.4 The role of inpatient services
8.5 Care pathway
8.6 Research recommendation
8.7 Special considerations for people with learning disabilities
8.8 Special considerations for people from black and ethnic minority groups

9.Young people with borderline personality disorder
9.1 Introduction
9.2 Diagnosis
9.3 Stability of the diagnosis of borderline personality disorder in young people
9.4 Suicide risk in young people with borderline personality disorder
9.5 Assessment
9.6 Treatment
9.7 Service configuration
9.8 Suggested care pathway for young people with borderline personality disorder
9.9 Overall clinical summary
9.10 Clinical practice recommendations