title: Combined treatment of borderline personality disorder with interpersonal psychotherapy and pharmacotherapy: predictors of response.
abstract: Borderline personality disorder (BPD) is characterized by affective instability, impulsive behaviors, and disturbed interpersonal relationships. A previous study of our group found that combined therapy with interpersonal psychotherapy adapted to BPD (IPT-BPD) and fluoxetine was superior to single pharmacotherapy in BPD patients. The aim of the present study was to examine what clinical factors predicted response to combined therapy in patients evaluated in the previous efficacy study. The subgroup of 27 patients allocated to combined therapy was analyzed. Patients were treated for 32 weeks with fluoxetine 20-40 mg/day plus IPT-BPD. Patients were assessed at baseline and week 32 with an interview for demographic and clinical variables, CGI-S, HDRS, HARS, SOFAS, BPDSI, and SAT-P. Statistical analysis was performed with multiple regression. The difference of CGI-S score between baseline and week 32 (∆CGI-S) was the dependent variable. Factors significantly and independently related to ∆CGI-S were the BPDSI total score and the items abandonment, affective instability, and identity. Patients with more severe BPD psychopathology and with a higher degree of core symptoms such as fear of abandonment, affective instability, and identity disturbance have a better chance to improve with combined therapy with fluoxetine and IPT-BPD.
authors: Center for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, University of Turin, Italy. Electronic address: silvio.bellino@unito.it.
authors: Silvio
authors: S
authors: Bellino
authors: Center for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, University of Turin, Italy.
authors: Paola
authors: P
authors: Bozzatello
authors: Center for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, University of Turin, Italy.
authors: Filippo
authors: F
authors: Bogetto
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D007175:Impulsive Behavior; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine
keywords: Borderline personality disorder; Combined therapy; Fluoxetine; Interpersonal psychotherapy; Outcome; Predictors