Psychotherapie der Borderline-Persönlichkeitsstörung: Gemeinsamkeiten und Differenzen evidenzbasierter störungsspezifischer Behandlungen

D. Sollberger; M. Walter

doi:10.1055/s-0029-1245626

Fortschritte der Neurologie · Psychiatrie, Table of Contents

Fortschr Neurol Psychiatr 2010; 78(12): 698-708
DOI: 10.1055/s-0029-1245626

Übersicht

Psychotherapie der Borderline-Persönlichkeitsstörung: Gemeinsamkeiten und Differenzen evidenzbasierter störungsspezifischer Behandlungen

Psychotherapy of Borderline Personality Disorder: Similarities and Differences in Evidence-Based Disorder-Specific Treatment ApproachesD. Sollberger¹ , M. Walter²

¹Spezielle Psychotherapie, Universitäre Psychiatrische Kliniken Basel, Schweiz
²Abhängigkeitserkrankungen, Universitäre Psychiatrische Kliniken Basel, Schweiz

Abstract

Zusammenfassung

Die Borderline-Persönlichkeitsstörung (BPS) ist eine schwere psychische Störung, mit einer hohen Prävalenz in psychiatrischen Kliniken. Häufig ist sie schwer zu behandeln und mit großen Schwierigkeiten und Konflikten bei Therapeuten und Behandlungsteams verbunden. In den letzten Jahrzehnten haben insbesondere neurobiologische Befunde und psychotherapeutische Studien zu einem besseren Verständnis der Störung und ihrer Behandlung geführt. Therapie der Wahl bei der BPS ist die Psychotherapie. In dieser Übersicht werden die 4 wichtigsten störungsspezifischen Psychotherapien der BPS ausführlich vorgestellt. Diese sind jeweils 2 verhaltenstherapeutisch orientierte Verfahren (Dialektisch-behaviorale Therapie, DBT; Schema-fokussierte Psychotherapie, SFT), und 2 psychodynamisch orientierte Ansätze (Übertragungs-fokussierte Psychotherapie, Transference-Focused Psychotherapy, TFP; Mentalisierungs-basierte Therapie, MBT). Gemeinsamkeiten und Unterschiede in der psychotherapeutischen Arbeit dieser störungsspezifischen psychotherapeutischen Verfahren werden in dieser Übersichtsarbeit herausgearbeitet und diskutiert. Nach großen Fortschritten in der störungsspezifischen psychotherapeutischen Behandlung der BPS könnte in Zukunft insbesondere die Entwicklung differenzieller Indikationskriterien für die jeweiligen störungsspezifischen Psychotherapien zu einer weiteren Verbesserung der BPS-Behandlung führen.

Abstract

Borderline personality disorder (BPD) is known as a serious psychiatric disorder with high prevalence rates in clinical psychiatric populations. BPD is often very difficult to treat and is linked with conflicts among therapists and treatment teams. Over the last decades, in particular, neurobiological findings and psychotherapeutic research have led to a better understanding and treatment outcomes in BPD. The therapy of choice is psychotherapy. In the following review four efficient disorder-specific treatments for BPS are presented, two of which are cognitive-behaviourally oriented (dialectical behavioural therapy, DBT; scheme-focused therapy, SFT), and the other two are psychodynamically oriented (transference focused psychotherapy, TFP; mentalisation-based treatment, MBT). In this review, the similarities and differences of the methods are elaborated and discussed. After the current considerable progress in disorder-specific treatments for BPS, the development of differential indication criteria for the various treatments could lead to an additional improvement of BPD therapy in the future.

Schlüsselwörter

Borderline-Persönlichkeitsstörung - Psychotherapie - störungsspezifische Therapie - Übersicht

Keywords

borderline personality disorder - psychotherapy - disorder-specific treatment - review

Full Text

References

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Dr. med. Dr. phil. Daniel Sollberger

Leitender Arzt

Zentrum Spezielle Psychotherapie ZSP

Universitäre Psychiatrische Kliniken Basel

Wilhelm Klein-Strasse 27

4012 Basel

Schweiz

Email: daniel.sollberger@upkbs.ch