[Digital applications in the treatment of adolescent patients with borderline personality disorder].

Abstract

Background: Borderline personality disorder (BPD) is often manifested during adolescence and is associated with substantial morbidity and mortality. Early disorder-specific treatment is considered state of the art but is hampered by discontinuities at the transition to adult services and limited resources. Digital technologies play an increasing key role in adolescents' daily lives.

Objective: Presentation of key characteristics of adolescent BPD and psychiatric transition-focused care concepts, an overview of digital applications in BPD treatment and the possibilities and challenges in the clinical practice.

Methods: Narrative review article based on selected literature on the prevalence, treatment and digital interventions in adolescent BPD, complemented by two clinical examples: a secure emergency chat for suicidal youths in Bern and digital routine outcome monitoring (ROM) in the Adolescent Center for Emotion Regulation in Mannheim.

Results: Meta-analyses show heterogeneous, predominantly small effects of digital interventions on mental health outcomes in children and adolescents; health economic data are limited. For BPD the findings suggest effectiveness for specific symptoms (e.g., suicidal ideation, paranoia) and high acceptance although adherence is variable. Telemedicine and ROM can improve the continuity of care and crisis management when embedded in structured services.

Conclusion: Digital applications are promising components of blended care and transition-focused programs. They should complement face-to-face therapy and require careful attention to data protection, financing and technical reliability. Stepped-care approaches tailoring digital and personal contact to individual needs appear useful.