PMID- 33790813
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231111
IS  - 1664-0640 (Print)
IS  - 1664-0640 (Electronic)
IS  - 1664-0640 (Linking)
VI  - 12
DP  - 2021
TI  - Borderline Personality Features in Patients With Persistent Depressive Disorder 
      and Their Effect on CBASP Outcome.
PG  - 608271
LID - 10.3389/fpsyt.2021.608271 [doi]
LID - 608271
AB  - Introduction: The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) 
      was developed for the treatment of persistent depressive disorder (PDD), where 
      comorbid personality disorders (PD) are common. In contrast to other PD, comorbid 
      borderline personality disorder (BPD) is often regarded as an exclusion criterion 
      for CBASP. In clinical settings, however, subthreshold BPD symptoms are prevalent 
      in PDD and may not be obvious at an initial assessment prior to therapy. As data 
      on their impact on CBASP outcome are very limited, this naturalistic study 
      investigates BPD features in PDD and their relevance for the therapeutic outcome 
      of a multimodal CBASP inpatient program. Method: Sixty patients (37 female, mean 
      age 38.3, SD 11.9 years) meeting DSM-5 criteria for PDD underwent a 10 weeks 
      CBASP inpatient program. BPD features (i.e., number of fulfilled DSM-5 criteria) 
      together with childhood maltreatment and rejection sensitivity were assessed on 
      admission. Before and after treatment, severity of depressive symptoms was 
      measured using the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck 
      Depression Inventory (BDI-II). BPD symptoms were assessed using the Borderline 
      Personality Disorder Severity Index (BPDSI-IV) and the Borderline Symptom List 
      (BSL-23). Intercorrelations of baseline characteristics and symptom change during 
      treatment were analyzed. Results: Patients with PDD met a mean of 1.5 (SD 1.6) 
      BPD criteria with 4 patients fulfilling >/=5 criteria. BPD symptoms and depressive 
      symptoms showed a strong correlation, and BPD symptoms were additionally 
      correlated with emotional abuse and rejection sensitivity. There was no 
      association between BPD features at baseline and improvement on the MADRS, 
      however, BPD features tended to be associated with a lower response according to 
      the BDI-II score after 10 weeks of treatment. Furthermore, BPD symptoms (i.e., 
      abandonment, impulsivity and affective instability) were reduced after 10 weeks 
      of CBASP treatment. Discussion: BPD symptoms are prevalent in patients with PDD 
      and highly intertwined with the experience of depressive symptoms. In this 
      naturalistic study in PDD, BPD features at baseline did not limit the clinical 
      response to CBASP. Future studies may extend the spectrum of PDD to comorbid 
      subsyndromal or even syndromal BPD in order to develop tailored psychotherapeutic 
      treatment for these complex affective disorders.
CI  - Copyright (c) 2021 Konvalin, Grosse-Wentrup, Nenov-Matt, Fischer, Barton, Goerigk, 
      Brakemeier, Musil, Jobst, Padberg and Reinhard.
FAU - Konvalin, Franziska
AU  - Konvalin F
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Grosse-Wentrup, Fabienne
AU  - Grosse-Wentrup F
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Nenov-Matt, Tabea
AU  - Nenov-Matt T
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Fischer, Kai
AU  - Fischer K
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Barton, Barbara B
AU  - Barton BB
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Goerigk, Stephan
AU  - Goerigk S
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Brakemeier, Eva-Lotta
AU  - Brakemeier EL
AD  - Department of Clinical Psychology and Psychotherapy, University of Greifswald, 
      Greifswald, Germany.
FAU - Musil, Richard
AU  - Musil R
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Jobst, Andrea
AU  - Jobst A
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Padberg, Frank
AU  - Padberg F
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
FAU - Reinhard, Matthias A
AU  - Reinhard MA
AD  - Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 
      Munich, Germany.
LA  - eng
PT  - Journal Article
DEP - 20210312
PL  - Switzerland
TA  - Front Psychiatry
JT  - Frontiers in psychiatry
JID - 101545006
PMC - PMC8006327
OTO - NOTNLM
OT  - CBASP
OT  - borderline personality disorder
OT  - childhood maltreatment
OT  - comorbidity
OT  - persistent depressive disorder
OT  - rejection sensitivity
COIS- FP is a member of the European Scientific Advisory Board of Brainsway Inc., 
      Jerusalem, Israel, and has received speaker's honoraria from Mag&More GmbH and 
      the neuroCare Group. His lab has received support with equipment from neuroConn 
      GmbH, Ilmenau, Germany, and Mag&More GmbH and Brainsway Inc., Jerusalem, Israel. 
      The remaining authors declare that the research was conducted in the absence of 
      any commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/04/02 06:00
MHDA- 2021/04/02 06:01
PMCR- 2021/03/12
CRDT- 2021/04/01 06:26
PHST- 2020/09/19 00:00 [received]
PHST- 2021/02/15 00:00 [accepted]
PHST- 2021/04/01 06:26 [entrez]
PHST- 2021/04/02 06:00 [pubmed]
PHST- 2021/04/02 06:01 [medline]
PHST- 2021/03/12 00:00 [pmc-release]
AID - 10.3389/fpsyt.2021.608271 [doi]
PST - epublish
SO  - Front Psychiatry. 2021 Mar 12;12:608271. doi: 10.3389/fpsyt.2021.608271. 
      eCollection 2021.