今日文獻聚焦於BPD的共病(尤其SUD)、神經生物學機制(白質病變、HPA軸)、功能復原與臨床實踐障礙(診斷猶豫),顯示趨勢向整合治療、生物標誌物研究及早期干預轉移。
Journal of dual diagnosis · Treatment Outcomes for Co-Occurring Borderline Personality Disorder and Substance Use Disorders: A Systematic Review.
證實辯證行為療法(DBT)可改善共病BPD與SUD患者的情緒調節,部份研究顯示可減少物質使用,強調需更大樣本與整合治療研究。
Australian occupational therapy journal · A qualitative description of the daily living functioning of people diagnosed with borderline personality disorder from consumer, carer and clinician perspectives.
揭示BPD患者在結構化routines、情緒能量消耗、價值脫節及他人依賴方面的日常困境,凸顯職能治療在功能復原中的關鍵角色。
Personality and mental health · Vulnerable Narcissism in Borderline Personality Disorder: Impact on Emotion Dysregulation, Identity Disturbance, and Rejection Sensitivity in Psychiatric Inpatients.
發現共病易受傷自戀(VN)的BPD住院患者情緒失調、身份識別問題與拒絕敏感度顯著加劇,並伴隨更高自殺企圖與創傷暴露,提醒早期識別的重要性。
Journal of affective disorders · Mineralocorticoid receptor stimulation effects on stress-induced cortisol and alpha-amylase in female patients with borderline personality disorder and healthy controls: A randomized placebo-controlled experimental study.
證實BPD女性具有壓力誘發皮質醇反應鈍化,但礦物質皮質醇受體激發(fludrocortisone)無法正常化此反應,提示HPA軸異常機制複雜,非單純MR過度反饋所致。
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry · Advances in non-invasive brain stimulation for borderline personality disorder: clinical targets and future directions - an updated narrative review.
初步證據顯示NIBS(如rTMS、tDCS)可針對性改善衝動(右DLPFC)與情緒調節/認知(左DLPFC),結合心理治療可行,但需更大樣本與對照試驗。
Psychiatry research. Neuroimaging
發現BPD患者多腦區白質病變(如胼胝體、 cingulate、 SLF),並與焦慮(胼胝體)及自殺/攻擊行為(三網絡連通性)相關,支持DTI作為生物標誌物的潛力。
Brain, behavior, & immunity - health
概括證實包括BPD在內的各類精神疾病與高血壓、早産、胎兒生長異常等產科不良結果相關,但機制複雜,呼籲超越抑鬱中心模式。
World psychiatry : official journal of the World Psychiatric Association (WPA)
發現BPD遺傳風險與自殺企圖、雙極、內向/外向、進食障礙等具關聯,顯示其在精神病理遺傳網絡中的中心樞紐地位。
Personality and mental health
指出儘管指南推薦早期評估與心理治療,臨床師因污名化或過早診斷顧慮而猶豫診斷青少年BPD,導致護理碎片化,強調需改變臨床師態度。
Early intervention in psychiatry
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