Cited by 55Personality Disorders and PsychopathologyBipolar Disorder and TreatmentPsychosomatic Disorders and Their Treatments

Borderline Personality Disorder in Patients With Medical Illness: A Review of Assessment, Prevalence, and Treatment Options

Doering, Stephan·2019·Psychosomatic Medicine

Abstract

Objective: Borderline personality disorder (BPD) occurs in 0.7% to 3.5% of the general population. Patients with BPD experience excessive comorbidity of psychiatric and somatic diseases and are known to be high users of health care services. Because of a range of challenges related to adverse health behaviors and their interpersonal style, patients with BPD are often regarded as “difficult” to interact with and treat optimally. Methods: This narrative review focuses on epidemiological studies on BPD and its comorbidity with a specific focus on somatic illness. Empirically validated treatments are summarized, and implementation of specific treatment models is discussed. Results: The prevalence of BPD among psychiatric inpatients (9%–14%) and outpatients (12%–18%) is high; medical service use is very frequent, annual societal costs vary between €11,000 and €28,000. BPD is associated with cardiovascular diseases and stroke, metabolic disease including diabetes and obesity, gastrointestinal disease, arthritis and chronic pain, venereal diseases, and HIV infection as well as sleep disorders. Psychotherapy is the treatment of choice for BPD. Several manualized treatments for BPD have been empirically validated, including dialectical behavior therapy, transference-focused psychotherapy, mentalization-based therapy, and schema-focused therapy. Conclusions: Health care could be substantially improved if all medical specialties would be familiar with BPD, its pathology, medical and psychiatric comorbidities, complications, and treatment. In mental health care, several empirically validated treatments that are applicable in a wide range of clinical settings are available.

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Crossref · 10.1097/psy.0000000000000724

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Authors
Doering, S.
Affiliations
Medical University of Vienna (AT)
Corresponding author
Doering, Stephan
Venue
Psychosomatic Medicine
Published
2019-06-20
Volume
81
Issue
7
Pages
584-594
ISSN
  • 0033-3174 (ISSN-L)
  • 1534-7796
OpenAlex
W2952894461
Cited by
55
References
127
Citations by year
2026: 7 · 2025: 9 · 2024: 8 · 2023: 8 · 2022: 9 · 2021: 7 · 2020: 6 · 2019: 1
FWCI
6.71
Type
journal article
Language
en
Open access
closed
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
borderline personality disorder, comorbidities, somatic diseases, prevalence, health care utilization, cardiovascular disease, diabetes mellitus, chronic pain, psychotherapy, dialectical behavior therapy, transference-focused psychotherapy, mentalization-based treatment, schema therapy, treatment implementation
MeSH terms
Adult, Borderline Personality Disorder, Female, Humans, Mental Health Services, Psychotherapy, Comorbidity

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