A Martín-Blanco1,2,3,4, A Ancochea1,2,3,4, J Soler1,2,3,4, M Elices1,2,3,4, C Carmona1,2,3,4, J C Pascual1,2,3,4. 1. Department of Psychiatry, Santa Creu and Sant Pau Hospital, Barcelona, Spain. 2. Autonomous University of Barcelona, Barcelona, Spain. 3. Research Institute of the Santa Creu and Sant Pau Hospital (IIB Sant Pau), Barcelona, Spain. 4. CIBER of Mental Health (CIBERSAM), CIBERSAM, Barcelona, Spain.
Abstract
OBJECTIVE: To describe the pharmacological management of borderline personality disorder (BPD) in Spain from 2001 through 2016, the factors associated with prescriptions, and changes in pharmacotherapy over this time period. METHODS: Retrospective, cross-sectional, observational study conducted in a sample of 457 patients with BPD consecutively admitted to a specialist BPD Program between January 2001 and November 2016. Data on sociodemographic and clinical variables, as well as pharmacological treatment upon the admission to the programme, were used to describe pharmacological prescriptions, the factors associated with these medications, and changes in prescription over the last 15 years. RESULTS: Most (88.4%) patients were on pharmacological treatment, with 53.8% of persons taking ≥3 medications. No significant changes in these percentages were observed over the study period. The use of tricyclic antidepressants and benzodiazepines decreased, while the use of atypical antipsychotics increased. Axis I comorbidity was the main factor associated with pharmacological treatment and polypharmacy. CONCLUSIONS: This study provides further evidence confirming the worldwide overuse of prescription medications for BPD and shows that there has been a shift in the prescription pattern in the last 15 years. These results suggest that real clinical practice only partially adheres to clinical treatment guidelines.
OBJECTIVE: To describe the pharmacological management of borderline personality disorder (BPD) in Spain from 2001 through 2016, the factors associated with prescriptions, and changes in pharmacotherapy over this time period. METHODS: Retrospective, cross-sectional, observational study conducted in a sample of 457 patients with BPD consecutively admitted to a specialist BPD Program between January 2001 and November 2016. Data on sociodemographic and clinical variables, as well as pharmacological treatment upon the admission to the programme, were used to describe pharmacological prescriptions, the factors associated with these medications, and changes in prescription over the last 15 years. RESULTS: Most (88.4%) patients were on pharmacological treatment, with 53.8% of persons taking ≥3 medications. No significant changes in these percentages were observed over the study period. The use of tricyclic antidepressants and benzodiazepines decreased, while the use of atypical antipsychotics increased. Axis I comorbidity was the main factor associated with pharmacological treatment and polypharmacy. CONCLUSIONS: This study provides further evidence confirming the worldwide overuse of prescription medications for BPD and shows that there has been a shift in the prescription pattern in the last 15 years. These results suggest that real clinical practice only partially adheres to clinical treatment guidelines.
Authors: Joaquim Soler; Elisabet Casellas-Pujol; Isabel Fernández-Felipe; Ana Martín-Blanco; David Almenta; Juan C Pascual Journal: Acta Psychiatr Scand Date: 2022-02-04 Impact factor: 7.734