[Olanzapine and cognitive-behavioural group therapy in borderline personality disorder].
BACKGROUND
Borderline Personality Disorder (BPD) is considered one of the most difficult psychiatric conditions to treat, neither psychological nor pharmacological treatments have been shown to be particularly effective. We present a proposal for the treatment of patients diagnosed with BPD which uses an atypical neuroleptic, olanzapine, and cognitive-behavioural group therapy aimed at dealing with the following problems: Interpersonal Conflict, Affective Instability, Impulsiveness, and Confused Identity.


METHODS
Six patients diagnosed with BPD using the International Personality Disorder Evaluation (IPDE) were treated during 6 months with olanzapine (at dosages of 5-20mg/day) and dialectical behaviour therapy, with weekly 2-hour sessions.


RESULTS
All of these patients followed the programme during the first 2 months, and 3 of the 6 completed it, showing an improvement in their behavioural disorder, as indicated by a decrease in parasuicidal episodes (i.e. suicide attempts and self-mutilative acts) and fewer visits to the emergency department. One of the patients dropped out due to side effects.


CONCLUSIONS
The possibility of using a combined therapeutic approach enables us to project controlled clinical trials over a longer period of time, thus making it possible to assess behavioural changes which are difficult to observe in conventional clinical trials.
Soler
J
J
Servicio de Psiquiatría. Hospital de Sant Pau. Barcelona.
Campins
M J
MJ
Pérez
V
V
Puigdemont
D
D
Pérez-Blanco
E
E
Alvarez
E
E
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines; D001883:Borderline Personality Disorder / Q000188:drug therapy / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010349:Patient Compliance; D010865:Pilot Projects; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011615:Psychotherapy, Group
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine