Message from the current President

Among the most demanding, but also rewarding, parts of my clinical work is treating suicidal and self-harming adolescents. These kids struggle with a host of problems in their young lives; most of their troubles are intimately related to a heightened sensitivity and reactivity towards the environment and strong problems with regulating emotions and behaviours. Quite a few of the adolescents I treat have a diagnosis of Borderline Personality Disorder (BPD) and even more have subsyndromal levels of BPD traits. Although their frequent self-harming behaviour is often of low lethality, it nevertheless carries with it a substantially increased risk of eventual suicide or accidental death. Only half a decade ago, there was no treatment available that had a documented efficacy in reducing suicidal and self-harming behaviours in adolescents with problems such as these. Fortunately, we have lately made great progress, so that we now do know how to provide effective treatment that can be delivered at a sufficiently high level by clinicians in normal care settings (Mehlum et al., 2014; Rossouw & Fonagy, 2012). Still, we have a long way to go before we will be able to offer these treatments to the majority of teenagers and their families who need them. There are many obstacles on this road, but one of the most important, I think, is the reluctance we find among many of our colleagues to diagnose BPD and to screen for selfharming behaviour in adolescents. This occurs despite our knowledge that BPD usually has its onset in adolescence or early adulthood and that the disorder is common in these age groups. There is a great need to increase awareness and knowledge on the importance of early diagnosis and intervention for BPD and subsyndromal levels of BPD traits in adolescents. Recently the Global Alliance for Prevention and Early Intervention for BPD was established as a joint effort of scientists, clinicians and societies within the PD field to promote action through a set of scientifically based clinical, research and social policy strategies and recommendations. Among them are to promote a recognition of BPD as a severe mental disorder in adolescents at all levels of the health system, to adopt early detection and intervention for BPD and to train clinicians in evidence based interventions (Chanen, Sharp, Hoffman, Global Alliance for, & Early Intervention for Borderline Personality, 2017). I think this is an important initiative well worth fighting for and you can rest assured that I will be among those who speak up for the right of adolescents to have access to treatments that may not only save their lives, but also give them a life worth living.

Lars Mehlum, current President of the ESSPD

ESSPD Research Update

This quarterly newsletter focused upon the theme of Diagnostics and Comorbidity in its selection of the five most innovative contributions to the literature in the recent months.

The corresponding scientific writer is Sophie Liljedahl, Ph. D.,

What works in the treatment of borderline personality disorders

by Choi-Kain, L. W., Finch, E. F., Masland, S. R., Jenkins, J. A. & Unruh, B. T. (Mar 2017)

Current Behavioural Neuroscience Reports, 4, 21-30

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Personality disorder and alcohol treatment outcome: systematic review and meta-analysis

Newton-Howes, G. M., Foulds, J. A., Guy, N. H., Boden, J. M. & Mulder, R. T. (Apr, 2017)

The British Journal of Psychiatry doi: 10.1192/bjp.bp.116.194720

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