Borderline Personality Disorder: The NICE Guideline on Treatment and Management
National Collaborating Centre for Mental Health (NCCMH)
Personality disorder now accounts for a
substantial portion of the workload of most community mental health
teams in the UK and borderline personality disorder is associated
with significant functional impairments for the individual. The
NICE guideline takes the first comprehensive view of the disorder
and is an important resource for healthcare professionals to
improve people’s long-term outcomes.
Recent years have seen an exponential rise in available treatments
for personality disorder and the guideline on borderline
personality disorder covers the available evidence on all of those
interventions. It also includes management of crises, configuration
and organisation of services and experience of care. The primary
focus is on adults, but the guideline looks at emerging
characteristics of borderline personality disorder in younger
people. The guideline also considers the needs of those with
learning disabilities and contains a useful overview of borderline
personality disorder.
Also see the 'sister' NICE guideline: Antisocial Personality Disorder
List of the other NICE mental health
guidelines
NICE Mental Health Guidelines
These guidelines from NICE set out clear
recommendations, based on the best available evidence, for health
care professionals on how to work with and implement physical,
psychological and service-level interventions for people with
various mental health conditions.
The book contains the full guidelines that cannot be obtained
in print anywhere else. It brings together all of the evidence that
led to the recommendations made, detailed explanations of the
methodology behind their preparation, plus an overview of the
condition covering detection, diagnosis and assessment, and the
full range of treatment and care approaches.
The accompanying free CD-ROM contains all the data used as
evidence, including:
- Included and excluded studies.
- Profile tables that summarise both the quality of the evidence
and the results of the evidence synthesis.
- All meta-analytical data, presented as forest plots.
- Detailed information about how to use and interpret forest
plots.
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