What is it about?
Adolescence is a time of profound changes in people’s behavior. It's a period of building a sense of who we are, learning how to manage our emotions, and navigating the social world. For some, this journey is more complicated than for others. Borderline personality disorder indicates a disruption of normal personality development, where teens with a tendency to experience extremes of emotions and act impulsively have greater difficulty in constructing their identity and dealing with close relationships. Eating disorders, on the other hand, indicate an excessive determination of self-worth based on weight and physical appearance, causing individuals to rely on restrictive eating or compensatory behaviors such as inducing vomiting and exercising, which can eventually become a entrenched patterns. Treatments should aim to address both conditions for those affected by both sets of problems. Although specialized therapies have been developed for this population, such as dialectical behavioral therapy (DBT), they are rarely accessible to most. We present General Psychiatric Management for Adolescents with Borderline Personality and Eating Disorders (GPM-AED), an approach using essential care practices for teens with both conditions, which involves educating patients and families, openly discussing the diagnosis, and managing safety and medications. We also highlight the benefits and limitations of this approach.
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Why is it important?
Most people with borderline personality disorder and eating disorders will not have access to adequate treatment. The availability of specialists is limited in most healthcare systems, which is even truer for patients with both disorders. GPM-AED aims to address this gap by describing a treatment that can address both sets of conditions, which would be crucial from a public health perspective. Moreover, this can allow earlier therapy for both disorders, increasing the likelihood of successful treatment and recovery.
Perspectives
These two disorders often emerge in youth and can influence each other, impacting normal development and potentially having disastrous effects on mental health. While specialized treatments for both can help, they are rarely available. Also, when teens reach those treatments, they usually already have more severe illness. Therefore, having a generalist treatment that teaches the main elements of effective treatments to primary care and general mental health providers can not only increase access to treatment but also increase the likelihood of early intervention (i.e., intervention even before the complete disorder emerges), preventing these disorders from becoming more complex to treat.
Dr. Marcos Signoretti Croci
Read the Original
This page is a summary of: General Psychiatric Management for Adolescents With Borderline Personality Disorder and Eating Disorders, American Journal of Psychotherapy, July 2024, American Psychiatric Association,
DOI: 10.1176/appi.psychotherapy.20230045.
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