Emotionally unstable adolescents – a current challenge of child psychiatry and pediatrics
Authors:
Kocourková Jana; Koutek Jiří; Kolouch David
Authors‘ workplace:
Dětská psychiatrická klinika, 2. lékařská fakulta, Univerzita Karlova a FN Motol, Praha
Published in:
Čes-slov Pediat 2023; 78 (6): 298-302.
Category:
Chapters for Specialization in Pediatrics
doi:
https://doi.org/10.55095/CSPediatrie2023/050
Overview
Emotionally unstable adolescents, mainly girls, represent the largest group of patients currently hospitalized in children’s inpatient pedopsychiatric departments. At the same time, these patients require the cooperation of pediatricians, especially in cases of self-harm, intoxication, including suicide attempts. An important aspect is the assessment of suicidal risk. Emotional instability in adolescence represents a spectrum of severity, starting with emotional lability common in adolescence, up to disturbance in personality development, which in the most serious case can result in emotionally unstable - borderline personality disorder. Typical features of this personality disorder are, for example, abandonment anxiety, unstable interpersonal relationships, self-destructive behavior, affective instability. Therapeutic interventions include crisis intervention, supportive psychotherapy, systematic psychotherapy, work with the family, and pharmacotherapy. The goal of therapy during hospitalization is mainly to alleviate emotional fluctuations and self-destructive behavior (self-harm, suicidal behavior), stabilize the family environment and motivate for further outpatient pedopsychiatric and psychotherapeutic care.
Sources
1. Greenfield B, Henry M, Lis E, et al. Correlates, stability and predictors of bordeline personality disorder among previously suicidal youth. Eur Child Adolesc Psychiatry 2015; 24(4): 397–406.
2. Bach B, First MB. Application of the ICD-11 classification of personality disorders. BMC Psychiatry 2018; 18: 351.
3. Guilé JM, Boissel L, Alaux-Cantin S, Garny de la Riviere S. Bordeline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies. Adolesc Health Med Ther 2018; (9): 199–210.
4. Chanen AM, McCutcheon LK, Jovev M, et al. Prevention and early intervention for borderline personality disorder. Med J Australia 2007; 187(7): S18–21.
5. Greenfield B, Henry M, Weiss M et al. Previously suicidal adolescents: predictors of six-monthoutcome. J Can Acad Adolesc Psychiatry 2008; 17(4): 197–201.
6. Gorton G, Akhtar S. The literature on personality disorders 1985 – 1988: trends, issues and controversis. Hosp Community Psychiatry 1990; (41): 39–51.
7. Kocourková J, Koutek J. Emočně nestabilní adolescenti a možnosti jejich ovlivnění. Čes Slov Psychiat 2022; 118(2): 81–84.
8. Kaltiala-Heino R, Bergman T, Työläjärvi M, Frisén L. Gender dysphoria in adolescence: current perspectives. Adolesc Health Med Ther 2018; 9: 31–41.
9. Cavelti M, Thompson K, Chanen AM, Kaess M. Psychotic symptoms in bordeline personality disorder: developmental aspects. Curr Opin Psychol 2021; 37: 26–31.
10. Thompson KN, Cavelti M, Chanen AM. Psychotic symptoms in adolescents with bordeline personality disorder features. Eur Child Adolesc Psychiatry 2019; 28(7): 985–992.
11. Belohradova Minarikova K, Prasko J, Holubova M, et al. Hallucinations and other psychotic symptoms in patients with bordeline personality disorder. Neuropsychiatr Dis Treat 2022; 18: 787–799.
12. Niemantsverdriet MBA, Slotema CW, Blom JD, et al. Hallucinations in bordeline personalitz disorder: prevalence, characteristics and associations with comorbid szmptoms and disorders. Sci Rep 2017; 7: 13920.
13. Quek J, Melvin GA, Bennett C, et al. Mentalization in adolescents with bordeline personality disorder: a comparison with healthy controls. J Pers Disord 2018; 22: 1–19.
14. Fonagy P, Rossouw T, Sharp C, et al. Mentalization-based treatment for adolescents with bordeline traits. In: Sharp C, Tackett JL (eds.). Handbook of bordeline personality disorder in children and adolescents. New York: Springer 2014.
15. Linehan MM. Cognitive-behavioral treatment of bordeline personality disorder. New York: Guilford Press 1993.
16. Klein DA, Miller AL. Dialectical behavior therapy for suicidal adolescents with bordeline personality disorder. Child Adol Psychiatric Clin Am 2011; 20: 205–216.
17. Schlüter-Müller S, Goth K, et al. Assessment and treatment of identity pathology during adolescence. Scand J Child Adol Psychiatry Psychol 2015; 3(1): 63–70.
18. Kasal M. Současný pohled na doporučení ohledně farmakoterapie hraniční poruchy osobnosti. Čes Slov Psychiat 2021; 117(3): 144–149.
19. Herman E. Farmakoterapie pacientů trpících emočně nestabilní poruchou osobnosti. Psychiatrie Praxi 2004; 4: 206–207.
Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
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