Borderline Personality Disorder in Adolescence

Borderline personality disorder (BPD) is a severe mental illness characterized by high morbidity and mortality and associated with low psychosocial functioning. BPD often presents at the onset of early adolescence (from age 12). In addition to repetitive self-harm and suicidality, there are often symptoms of both internalizing (depression and anxiety) and externalizing disorders (hyperactivity and substance use). Therefore, differential diagnostic clarification and diagnosis, with the aim of early intervention, play a special role in clinical practice. Psychotherapy is a hugely effective treatment method for BPD, while evidence for the effectiveness of pharmacological interventions is lacking. The key to improving care in adolescents with BPD lies in generating knowledge about precursor symptoms and evidence-based, stage-specific treatment (early treatment even of subclinical BPD, with treatment intensity graded by severity). This review article highlights the current state of research and provides recommendations for therapeutic work in clinical practice.