[Psychopharmacotherapy in adolescents with borderline personality disorder in inpatient and outpatient psychiatric treatment].
OBJECTIVE
The majority of adult patients with borderline personality disorder (BPD) are treated with psychotropic drugs. However, there are no data on psychotropic therapy in adolescents. This study examines the prevalence of BPD in an adolescent population undergoing either inpatient or outpatient psychiatric treatment and assesses psychotropic prescription patterns in adolescent in- and outpatients with BPD.


METHODS
Out of a population of adolescents undergoing psychiatric treatment over a seven-year observation period, 58 adolescent patients with BPD (16.7 +/- 2.5 years) were investigated retrospectively with regard to their first episode of treatment, type of medication, and different risk variables.


RESULTS
Out of the investigated population, 37 inpatients and 21 outpatients received treatment. Inpatients were shown to have higher rates of risk variables (approx. 68% with co-morbid disorders and approx. 49% with self-harmful behaviour, significantly (p < .001) more attempted suicides in their patient history) and higher rates of psychotropic treatment (p < .001). Antidepressants (SSRI and NaSSA) were most commonly prescribed, followed by neuroleptics. More than 50% of the medicated patients were treated with multiple psychotropic drugs administered simultaneously.


CONCLUSIONS
Pharmacotherapy in BPD has a high and increasing therapeutic value, with the prescription of psychotropic drugs being primarily symptom-orientated. Pharmacotherapy of co-morbid disorders should be accorded equal treatment priority. In line with this, psychotropic treatment of BPD in adolescents is increasingly important. Inpatient adolescents are more burdened in terms of psychiatric risk variables, and also receive medication more often.
Wöckel
Lars
L
Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universitätsklinik Frankfurt am Main. lwoeckel@ukaachen.de
Goth
Kirstin
K
Matic
Nina
N
Zepf
Florian Daniel
FD
Holtmann
Martin
M
Poustka
Fritz
F
D000293:Adolescent; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D005858:Germany; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs