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 5.6 Data 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 10. Summary of recommendations 11. Appendices 12. References 13. Abbreviations

About the Author

The National Collaborating Centre for Mental Health (NCCMH) was established in 2001 by the UK-based National Institute for Health and Clinical Excellence (NICE) to develop guidance on the appropriate treatment and care of people with mental health problems and then write the clinical guidelines. The NCCMH is a partnership between the Royal College of Psychiatrists and the British Psychological Society.