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Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis. NEW IDEAS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.newideapsych.2023.101010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Lester R, Prescott L, McCormack M, Sampson M. Service users' experiences of receiving a diagnosis of borderline personality disorder: A systematic review. Personal Ment Health 2020; 14:263-283. [PMID: 32073223 DOI: 10.1002/pmh.1478] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/22/2020] [Accepted: 01/30/2020] [Indexed: 11/11/2022]
Abstract
There is ongoing controversy regarding the borderline personality disorder (BPD) diagnosis. Whilst the experiences of people living with BPD have been widely acknowledged, the process of receiving the diagnosis is poorly described. This systematic review aimed to synthesize the existing research exploring people's experiences of receiving a diagnosis of BPD, as well as examining what is considered best practice in the diagnostic delivery process. The findings from 12 qualitative studies were synthesized using thematic analysis, generating two overarching themes: negative and positive experiences of receiving a diagnosis of BPD. These themes were described using the following sub-themes: the communication of diagnosis and meaning made of it, validity around diagnosis and attitudes of others. Results indicate that there is a substantial difference between a well-delivered and poorly delivered diagnosis. The diagnostic delivery process is fundamental to how people understand and interpret the BPD diagnosis. The way in which the BPD diagnosis is shared with people can ultimately shape their views about hope for recovery and their subsequent engagement with services. © 2020 John Wiley & Sons, Ltd.
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Affiliation(s)
- R Lester
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
| | - L Prescott
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - M McCormack
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
| | - M Sampson
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
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di Giacomo E, Arntz A, Fotiadou M, Aguglia E, Barone L, Bellino S, Carpiniello B, Colmegna F, Lazzari M, Lorettu L, Pinna F, Sicaro A, Signorelli MS, Clerici M. The Italian Version of the Borderline Personality Disorder Severity Index IV: Psychometric Properties, Clinical Usefulness, and Possible Diagnostic Implications. J Pers Disord 2018; 32:207-219. [PMID: 28604275 DOI: 10.1521/pedi_2017_31_294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Borderline personality disorder (BPD) has a core embodied in affective and behavioral dysregulations, impulsivity, and relational disturbance. Clinical presentation might be heterogeneous due to a combination of different symptoms listed in the DSM-5. Clinical diagnosis and assessment of the severity of manifestations might be improved through the administration of structured interviews such as the Borderline Personality Disorder Severity Index, 4th edition (BPDSI-IV). The psychometric properties of the Italian version of the BPDSI-IV were examined for the first time in 248 patients affected by BPD and 113 patients affected by bipolar disorder, proving to be a valid and accurate instrument with good internal consistency and high accuracy. The Italian version also demonstrates significant validity in the discrimination between these clinical groups (p < 5001).
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Affiliation(s)
- Ester di Giacomo
- School of Medicine and Surgery, University of Milan, Bicocca, Italy.,Psychiatric, Department, S. Gerardo Health Care Trust, Monza, Italy.,PhD Program, in Neuroscience, Doctorate School, University of Milan, Bicocca
| | - Arnoud Arntz
- Department of Clinical, Psychology, University of Amsterdam, the Netherlands
| | - Maria Fotiadou
- Female Medium Secure Forensic Service, South London, and the Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, University of Catania, Italy
| | - Lavinia Barone
- Psychology, Section, Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
| | - Silvio Bellino
- Center for, Personality Disorders, Psychiatric Clinic, Department of Neuroscience, University of Turin, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Clinical and Molecular Medicine, Psychiatric Unit, University of Cagliari, Italy
| | | | - Marina Lazzari
- Psychiatric, Department, S. Gerardo Health Care Trust, Monza, Italy
| | - Liliana Lorettu
- Psychiatric Clinic, Department of Biomedical Science, University of Sassari, Italy
| | - Federica Pinna
- Department of Public Health, Clinical and Molecular Medicine, Psychiatric Unit, University of Cagliari, Italy
| | - Aldo Sicaro
- Psychiatric, Department, S. Gerardo Health Care Trust, Monza, Italy
| | | | | | - Massimo Clerici
- School of Medicine and Surgery, University of Milan, Bicocca, Italy.,Psychiatric, Department, S. Gerardo Health Care Trust, Monza, Italy
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Abstract
Borderline personality disorder (BPD) has been demonstrated to be a reliable and valid construct in young people (adolescents and young adults). Both borderline- and mood-related psychopathology become clinically apparent from puberty through to young adulthood, frequently co-occur, can reinforce one another, and can be difficult to differentiate clinically. This Gordian knot of overlapping clinical features, common risk factors, and precursors to both BPD and mood disorders complicates clinical assessment, prevention, and treatment. Regardless of whether an individual crosses an arbitrary diagnostic threshold, a considerable proportion of young people with borderline- and mood-related psychopathology will develop significant and persistent functional, vocational, and interpersonal impairment and disability during this critical risk and developmental period. There is a clear need for early intervention, but spurious diagnostic certainty risks stigma, misapplication of diagnostic labels, inappropriate treatment, and unfavorable outcomes. This article aims to integrate early intervention for BPD and mood disorders in the clinical context of developmental and phenomenological change and evolution. "Clinical staging," similar to disease staging in general medicine, is presented as a pragmatic, heuristic, and trans-diagnostic framework to guide prevention and intervention. It acknowledges that the early stages of these disorders cannot be disentangled sufficiently to allow for disorder-specific preventive measures and early interventions. Clinical staging defines an individual's location along the continuum of the evolving temporal course of a disorder. Such staging aids differentiation of early or milder clinical phenomena from those that accompany illness progression and chronicity, and suggests the application of appropriate and proportionate intervention strategies.
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