Clinical staging models in the early detection and treatment of borderline personality disorder

Abstract

Background: Borderline personality disorder (BPD) is a severe mental disorder that typically first emerges during adolescence and is associated with great suffering and severe psychosocial deficits for the individual as well as high costs for society. Early detection and intervention of BPD aim to reduce or prevent the negative outcomes of the disorder, and thereby have a positive impact on the life course of affected adolescents. Clinical staging models provide orientation in the choice of a suitable interventions according to the current stage of the disease. Objective: In this article the rationale of clinical staging models is explained. Existing staging models of BPD are presented and discussed. Material and methods: Critical reflection on the available research literature. Results: Previously, two clinical staging models of BPD have been proposed, the first staging model in 2016 as a joint model for both BPD and affective disorders, and the newer model in 2019 that was built on the original model and is characterized by higher specificity and a focus on the development of personality disorders including the emerging difficulties involved. Conclusion: The presented clinical staging models are helpful in describing the typical progression of BPD, and guide the choice of a suitable intervention, especially in the early stages as they can help to recognize early unspecific precursors of a developing disorder and an appropriate treatment. With increasing knowledge about the development of BPD and effective interventions, the clinical staging models can be improved in the future.