Impulsivity and emotional dysregulation are common characteristics of patients presenting with co-occurring borderline personality disorder (BPD) and substance use disorder (SUD). This article aims to provide an overview of the clinical approaches psychiatrists should consider when treating patients with these conditions.
Conclusions:
Co-occurring BPD and SUD can be effectively treated within a staged, transdiagnostic approach with an emphasis on the therapeutic alliance.
PennayACameronJReichertT, et al. A systematic review of interventions for co-occurring substance use disorder and borderline personality disorder. J Subst Abuse Treat2011; 41: 363–373.
2.
TrullTJSherKJMinks-BrownC, et al. Borderline personality disorder and substance use disorders: a review and integration. Clin Psychol Rev2000; 20: 235–253.
3.
HeathLMParisJLaporteL, et al. High prevalence of physical pain among treatment-seeking individuals with borderline personality disorder. J Pers Disord2018; 32: 414–420.
4.
HeathLMLaporteLParisJ, et al. Substance misuse associated with increased psychiatric severity among treatment-seeking individuals with borderline personatliy disorderJ Pers Disord2018; 32: 694–708.
5.
LubmanDIHallKPennayA, et al. Managing borderline personality disorder and substance use an integrated approach. Aust Fam Physician2011; 40: 376–381.
6.
ZanariniMCYongLFrankenburgFR, et al. Severity of reported childhood sexual abuse and its relationship to severity of borderline psychopathology and psychosocial impairment among borderline inpatients. J Nerv Ment Dis2002; 190: 381–387.
7.
MillsKLTeessonMRossJ, et al. PTSD, and substance use disorders: findings from the Australian national survey of mental health and well-being. Am J Psychiatry2006; 163: 652–658.
8.
CheethamAAllenNBYucelM, et al. The role of affective dysregulation in drug addiction. Clin Psychol Rev2010; 30: 621–634.
9.
NHMRC. Clinical practice guideline for the management of borderline personality disorder. Melbourne: National Health & Medical Research Council, 2012.
10.
HallKGibbieTLubmanDI. Motivational interviewing techniques facilitating behaviour change in the general practice setting. Aust Fam Physician2012; 41: 660–667.
RalevskiEBallSNichC, et al. The impact of personality disorders on alcohol-use outcomes in a pharmacotherapy trial for alcohol dependence and comorbid Axis I disorders. Am J Addict2007; 16: 443–449.
14.
LiebKVollmBRuckerG, et al. Pharmacotherapy for borderline personality disorder: cochrane systematic review of randomised trials. Br J Psychiatry2010; 196: 4–12.
15.
FinebergSKGuptaSLeavittJ. Collaborative deprescribing in borderline personality disorder: a narrative review. Harv Rev Psychiatry2019; 27: 75–86.
16.
VolkertJHauschildSTaubnerS. Mentalization-based treatment for personality disorders: efficacy, effectiveness, and new developments. Curr Psychiatry Rep2019; 21: 25–25.
17.
OudMArntzAHermensMLM, et al. Specialized psychotherapies for adults with borderline personality disorder: a systematic review and meta-analysis. Aust N Z J Psychiatry2018; 52: 949–961.
18.
LivesleyWJ. Integrated modular treatment for borderline personality disorder: a practical guide to combining effective treatemnt methods. Cambridge, UK: Cambridge University Press, 2017.
19.
BourkeMEGrenyerBFS. Therapists’ accounts of psychotherapy process associated with treating patients with borderline personality disorder. J Pers Disord2013; 27: 735–745.
