Psychopharmakotherapie verbessert das psychosoziale Funktionsniveau bei adoleszenten Patienten mit Borderline-Persönlichkeitsstörung

Abstract

Treatment of patients with borderline personality disorder (BPD) has undergone significant changes within the last decades. Although there is no specific pharmacological treatment approach for BPD per se, there is evidence for a beneficial effect of psychopharmacological treatment in adults. As there is a significant lack of data regarding such treatment in adolescents we aim to investigate the effects of psychopharmacological treatment retrospectively focusing on the first period of treatment. The study sample comprised 2,778 subjects (inpatients and outpatients) from a population on demand of psychiatric services referred to our department, with 39 patients (aged 16,2 +/- 1,7 yrs.) having a diagnosis of BPD. Psychosocial functioning as indexed on axis VI was assessed within the BADO documentation algorithm before and after treatment. Effects of treatment in terms of improved psychosocial functioning under different medications as well as different risk variables were assessed. Moreover, medicated and un-medicated patients were compared as regards effects of treatment. Upon admission inpatients showed a significantly higher impairment in their psychosocial functioning compared with outpatients. There was no significant difference between medicated and un-medicated patients with respect to the different risk variables assessed. Psychosocial functioning improved under pharmacological treatment, with this effect being unrelated to in- or outpatient status. About 80% of the prescribed medications were antidepressants and neuroleptics, with a combination of two drugs being the most frequent treatment approach to be observed. The data of the present study indicate that psychopharmacological treatment of adolescents with BPD can improve psychosocial functioning.