Advances in Treatment for Personality Disorders

Treatment for patients with personality disorders, particularly borderline personality disorder, has advanced considerably over the past decade. New models are in development to help diagnose personality disorders, although have not yet demonstrated sufficient superiority over existing models to be widely implemented. Prognosis for patients with personality disorders is better than expected and newly developed treatments, particularly for patients with borderline personality disorder, has instilled more optimism in both treaters and patients. This is almost exclusively due to a number of specialized psychotherapies, such as dialectical behavior therapy, although recent interest in integrating the core therapeutic components from each of these specialized treatments has been increasing. Pharmacotherapeutic options are also being investigated, although replication of small preliminary results are still needed before medications can be routinely suggested with psychotherapy, and should certainly not be used as a replacement for psychoatherapy. The literature regarding treatment for other personality disorders remains sparse, although the importance of treatment of substance use disorders in patients with antisocial personality disorder is increasingly recognized as central to a longterm improvement. Future research should focus on the development of briefer therapies that integrate the best elements of existing specialized treatments and demonstrate that these benefits persist over longer follow-up periods.