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Impulsivity and its Therapeutic Management in Borderline Personality Disorder: a Systematic Review

Abstract

No treatment has been approved and recognized as effective in borderline personality disorder (BPD). Impulsivity is a key dimension because it is a predictor of remission but also suicide. The purpose of this review is to establish an inventory on the management of impulsivity in BPD and determine the effective treatments. A systematic review on the PubMed and Ovid databases was conducted up to September 2019 to December 2019 using the PRISMA guidelines. The inclusion criteria were: studies with patients with borderline personality disorder, were published between 1989 and 2019, used English-language and evaluated impulsivity before and after treatment. 41 articles selected were included for pharmacological treatment. 24 articles were found for psychotherapeutic management and one randomized study of transcranial magnetic stimulation. Based on this review, we must focus on psychotherapy in BPD, particularly the schema therapy, dialectical behavioral therapy, psychoeducation, system training of emotional predictability and problem solving and psychotherapy using mentalisation. The use of neuroleptics and mood stabilizers appears to be more effective than antidepressants. Another approach, such as transcranial magnetic stimulation, may prove useful in the near future if this technique is studied further.

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Acknowledgments

I want to thank Marushka Dehaye (MD) for their support.

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Anaïs Mungo: principal investigator, conceived the study and drafted the protocol, performed the database searches, reviewed the titles and abstracts, performed the data extraction and.

Matthieur Hein: performed the data extraction, made substantial contributions to the revision of the manuscript.

Philippe Hubain: made substantial contributions to the revision of the manuscript.

Gwenole Loas: made substantial contributions to the revision of the manuscript.

Philippe Fontaine: conceived the study and drafted the protocol, made substantial contributions to the revision of the manuscript.

All authors have given final approval of the version to be published.

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Correspondence to Anaïs Mungo.

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Mungo, A., Hein, M., Hubain, P. et al. Impulsivity and its Therapeutic Management in Borderline Personality Disorder: a Systematic Review. Psychiatr Q 91, 1333–1362 (2020). https://doi.org/10.1007/s11126-020-09845-z

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Keywords

  • Borderline personality disorder
  • Impulsivity
  • Psychotherapy
  • Pharmacotherapy
  • Systematic review