Pharmacotherapy of personality disorders: what we know and what we have to search for

IF 0.6 Q4 CLINICAL NEUROLOGY

Future Neurology Pub Date : 2017-12-01 DOI:10.2217/FNL-2017-0010

P. Bozzatello, Camilla Ghirardini, Maria Uscinska, P. Rocca, S. Bellino

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引用次数: 6

Abstract

Pharmacotherapy for personality disorders is in the early stage of development because the evidence base for effective drug treatment is insufficient, biased toward borderline personality disorder and rampant with methodological issues. In this paper, we reviewed randomized, placebo-controlled trials of drugs efficacy in patients with personality disorders published between 1990 and 2016. Overwhelming majority of studies focused on borderline personality disorder (BPD), and the accumulation of evidence resulted in 7 meta-analyses, which are interpreted into better strategies for evidence-based practice. Little research attention was given to schizotypal (SPTD) and antisocial (ASPD) personality disorders, with only indirect treatment efficacy evidence for the obsessive-compulsive (OCPD) and avoidant (AvPD) personality disorders. Some avenues for future efficacy research are indicated. respectively on a fair (level B) and minimal (level C) research-based evidence level. The main symptomatic targets of pharmacotherapy in personality disorders, according to WFSBP guidelines, are affective dysregulation, cognitive-perceptual symptoms, impulsivity and anger. The effects of pharmacotherapy in these patients can also be useful to increase response to combined psychosocial interventions.

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人格障碍的药物治疗：我们所知道的和我们必须寻找的

人格障碍的药物治疗处于发展的早期阶段，因为有效药物治疗的证据基础不足，偏向于边缘型人格障碍，并且方法论问题猖獗。在这篇论文中，我们回顾了1990年至2016年间发表的关于人格障碍患者药物疗效的随机安慰剂对照试验。绝大多数研究都集中在边缘型人格障碍（BPD）上，证据的积累导致了7项荟萃分析，这些分析被解释为循证实践的更好策略。很少有研究关注分裂型（SPTD）和反社会型（ASPD）人格障碍，只有强迫症（OCPD）和回避型（AvPD）人格障碍的间接治疗疗效证据。指出了未来疗效研究的一些途径。分别在基于公平（B级）和最低（C级）研究的证据水平上。根据WFSBP指南，人格障碍药物治疗的主要症状靶点是情感失调、认知感知症状、冲动和愤怒。药物治疗对这些患者的影响也有助于提高对联合心理社会干预的反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Future Neurology CLINICAL NEUROLOGY-

CiteScore

2.10

自引率

0.00%

发文量

期刊介绍： The neurological landscape is changing rapidly. From the technological perspective, advanced molecular approaches and imaging modalities have greatly increased our understanding of neurological disease, with enhanced prospects for effective treatments in common but very serious disorders such as stroke, epilepsy, multiple sclerosis and Parkinson’s disease. Nevertheless, at the same time, the healthcare community is increasingly challenged by the rise in neurodegenerative diseases consequent upon demographic changes in developed countries.