Handbook of Good Psychiatric Management for Borderline Personality Disorder and Alcohol Use Disorder

Book excerpt: Six percent of people in North America will develop borderline personality disorder (BPD) in their lifetime, and about 46% of them will have alcohol use disorder (AUD) at the same time. Alcohol use exacerbates the symptoms of both diseases, rendering treatment more challenging and increasing the risk of suicide. Integrated treatments have been lacking. Good Psychiatric Management for Borderline Personality Disorder and Alcohol Use Disorder meets the urgent need for such an integrated approach. It provides clearly articulated descriptions of both BPD and AUD, outlining clinical patterns and how to diagnose them with confidence. Relying on general psychiatric principles with which most clinicians are already familiar, as well as up-to-date standards of care for both BPD and AUD, the handbook pays particular attention to areas of potential synergy, providing clinical logic for addressing complex, real-world cases. Topics include the following: • Progress assessment, psychoeducation, and goal setting;• Managing suicidality and nonsuicidal self-harm;• Pharmacotherapy;• Multimodal treatments, including mutual-help groups and family intervention; and• Level-of-care considerations. The authors stress that, in the absence of evidence-based manualized therapy for treating BPD and AUD simultaneously, clinicians already have the tools to increase treatment retention, reduce the risk of suicide and death, and provide a sensible road map in the face of interpersonal, behavioral, and emotional challenges inherent to recovery for both conditions.