Personality disorder can develop early on in life and doesn’t just stop at 18, it can be a life-long disorder. Thus, if its emerging early we should be able to target and treat early too. However, recognising the signs, diagnosing early using the correct criteria and breaking the barriers of the stigmas surrounding the disorder are all issues that child and adolescent psychiatrists face. Professor Michael Kaess of the University of Bern, Switzerland, is no stranger to these issues and here addresses some of the approaches he and his colleagues are employing. He will present as a State of the Art speaker in Vienna.
It is the basic traits of personality disorder that need to be identified as early warning signs; instable patterns of interpersonal relationships of identity development and emotional regulation. Some adolescents will have experienced these long before the emerging borderline personality disorder starts to manifest, eventually developing symptoms such as suicidal and self-harm behaviour, severe risk-taking behaviour and/or substance abuse.
The hope comes in the form of the correct criteria to diagnose children at various ages. “The new ICD-11 approach reduces the criteria to a two-dimension approach containing interpersonal functioning and identity that will allow us to define these constructs for different age groups and then with time we should be able to define a developmentally adapted criteria of maladaptive personality functioning for each age group” describes Michael Kaess in his interview.
Kaess strongly advocates an early intervention protocol for borderline personality disorder in adolescents to improve the prognosis for the individual, but there is a need for developmentally adapted treatment for all ages. Ideally, these treatment options would not include pharmaceutical intervention if possible. Kaess explains “The main objective in treatment is to increase self-efficacy and responsibility in these individuals….medication may interfere these goals”.
Listen to his interview to find out more.