The American Psychiatric Association (APA) is releasing updated Practice Guidelines for Borderline Personality Disorder (BPD) in January. While the core diagnostic criteria remain largely unchanged, the new guidelines reflect advancements in understanding the illness course, treatment options, and potential for remission.
The APA 's Practice Guidelines synthesize current scientific knowledge and rational clinical practice. New Guidelines will soon be released for borderline personality disorder (BPD), updating those from 24 years ago. A new version of these will be formally released in January—though preview summaries, on which this analysis is based, have already been released.What can we expect to be different? A lot... and not very much.
The Diagnostic and Statistical Manual of Mental Disorders (DSM)-III was markedly different from the two previous DSM publications, as its description of each disorder was defined by specific criteria. DSM-III was also the first edition to formally recognize and categorize BPD. In the ensuing 45 years, DSM-IV and DSM-5 (and accompanying text revisions) have had only minor adjustments to the defining criteria. Thus, the introductory descriptions of BPD characteristics in the new Practice Guidelines will not differ substantially from the 2001 notation. However, there will undoubtedly be recognition of likely changes to a more dimensional definition of BPD (citing the degree of illness, the severity of impairment, etc.) that will surely influence the future DSM-6 edition. Since the 2001 publication, some pharmaceutical institutions have attempted but failed to achieve an FDA-approved indication for specific medications approved specifically for its treatment. Research is continuing with some companies.Probably the most notable difference in our understanding of BPD over the past 24 years is in the course of the illness. Long-term follow-up studies were limited. The 2001 Guideline stated that “cure is not a realistic goal,” going on to note that “in the largest follow-up study to date , about one-third of patients with borderline disorder had recovered by the follow-up evaluation.” More recent studies now demonstrate that prognosis is much better, with remission and recovery rates significantly improving over time., were not mentioned in the 2001 publication
BORDERLINE PERSONALITY DISORDER APA PRACTICE GUIDELINES TREATMENT DIAGNOSIS
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