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Borderline personality disorder: part 2 – psychiatric management

Published online by Cambridge University Press:  30 July 2024

Ashutosh Ratnam Open the ORCID record for Ashutosh Ratnam [Opens in a new window] ,
Jacqueline Garland  and
Stephen Miller
Ashutosh Ratnam*
Affiliation:
Specialist registrar at the Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
Jacqueline Garland
Affiliation:
Consultant psychiatrist with Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
Stephen Miller
Affiliation:
Consultant psychiatrist and former clinical lead for personality disorders for South London and Maudsley NHS Foundation Trust, London, UK
*
Correspondence Ashutosh Ratnam. Email: ashratnam@yahoo.com
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Summary

The large volume of seemingly conflicting guidance on the management of borderline personality disorder (BPD), combined with the ongoing shortage of specialised resources, can make the task feel like an exclusive undertaking that the general psychiatrist is underprepared for. In this article, we distil current evidence to submit that sound psychiatric management principles used to treat all serious and enduring mental disorders (diagnostics, comorbidity management, rational pharmacotherapy and dynamic risk management) are readily applicable and particularly therapeutic for BPD. We offer actionable practice guidance that we hope will render the clinical management experience a more lucid and rewarding one for both practitioner and patient.

Keywords

Personality disordersgeneral psychiatrycase managementpharmacotherapyrisk management
Type
Article
Information
BJPsych Advances , First View , pp. 1 - 14
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Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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