PSYCHOTHERAPEUTIC AND PHARMACOLOGICAL INTERVENTIONS IN THE TREATMENT OF BORDERLINE PERSONALITY DISORDER

Abstract

Borderline Personality Disorder (BPD) is a debilitating psychiatric condition characterized by a persistent pattern of instability in interpersonal relationships, self-image, and affects, as well as marked impulsivity, imposing a significant burden on healthcare systems due to high rates of self-harming behaviors and suicide attempts. The clinical management of BPD establishes psychotherapy as the gold standard of treatment, while pharmacological interventions remain strictly adjunctive tools, often used to manage the high rate of associated comorbidities. This study is a narrative literature review, developed through data collection from the PubMed and Cochrane Library databases, with the objective of compiling and analyzing current scientific evidence on therapeutic interventions for BPD. The findings indicate that structured psychotherapies, such as Dialectical Behavior Therapy (DBT) and Mentalization-Based Treatment (MBT), are established as first-line interventions, demonstrating robust results in reducing emotional dysregulation and impulsive behaviors. In contrast, the evidence for the efficacy of pharmacotherapy alone on the core symptoms of BPD is limited and of low certainty, with no medication specifically approved for the disorder. The use of medications, such as anticonvulsants and second-generation antipsychotics, is predominantly off-label, focused on mitigating specific target symptoms (such as anger and affective instability) or managing comorbidities. A favorable prognosis depends on the integration of evidence-based approaches, prioritizing functional recovery and overcoming institutional and social stigma.