DIFFICULTIES IN TREATMENT OF BORDERLINE PERSONALITY DISORDER (BPD) – A REVIEW OF VARIOUS FORMS OF THERAPY AND PHARMACOLOGICAL METHODS

Marta Koneczna; Franciszek Szweda; Tomasz Poczwardowski; Adrianna Kaczmarek; Katarzyna Anna Kowalska; Jakub Tomasz Latos; Marcin Chwalczuk; Oliwia Grygorcewicz; Karolina Alicja Krystyniak; Kinga Augustyniak

doi:10.31435/ijitss.1(49).2026.5260

Authors

Marta Koneczna University of Lodz, Łódź, Poland https://orcid.org/0009-0006-7373-6539
Franciszek Szweda Wojewódzki Szpital Specjalistyczny im. Władysława Biegańskiego w Grudziądzu, Grudziądz, Poland https://orcid.org/0009-0001-1251-1380
Tomasz Poczwardowski Collegium Medicum in Bydgoszcz; University Hospital No. 2 im. Jana Biziela in Bydgoszcz, Bydgoszcz, Poland https://orcid.org/0009-0000-2056-1073
Adrianna Kaczmarek 10th Military Clinical Hospital with Polyclinic SPZOZ in Bydgoszcz, Bydgoszcz, Poland https://orcid.org/0009-0005-6490-0483
Katarzyna Anna Kowalska Szpital Kliniczny Pamięci Norberta Barlickiego No. 1 of the Medical University of Lodz, Łódź, Poland https://orcid.org/0009-0000-8444-1505
Jakub Tomasz Latos Medical University of Lodz, Łódź, Poland https://orcid.org/0009-0001-1262-0173
Marcin Chwalczuk 116th Military Hospital in Opole, Opole, Poland https://orcid.org/0009-0007-1357-6788
Oliwia Grygorcewicz University of Lodz, Łódź, Poland https://orcid.org/0009-0005-0983-7661
Karolina Alicja Krystyniak Szpital Kliniczny Pamięci Norberta Barlickiego No. 1 of the Medical University of Lodz, Łódź, Poland https://orcid.org/0009-0003-1880-7232
Kinga Augustyniak Independent Public Healthcare Institution in Turek, Turek, Poland https://orcid.org/0009-0000-7631-3685

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.5260

Keywords:

Borderline Personality Disorder, Psychotherapy, Pharmacotherapy, MBT, DBT, Gut-Brain Axis

Abstract

Objective: The primary objective of this comprehensive review is to systematically evaluate and synthesize the latest scientific knowledge regarding the pathophysiology, diagnostic complexities, and the clinical effectiveness of various therapeutic interventions for borderline personality disorder (BPD).

Methods: A narrative literature review methodology was employed, involving a rigorous search of leading scientific databases, including PubMed, Scopus, Web of Science, and Google Scholar. The selection process prioritized randomized clinical trials, extensive meta-analyses, and current treatment guidelines, with a particular emphasis on peer-reviewed publications from the last decade to ensure the utmost relevance.

Findings: A review of the literature indicates that integrated evidence-based psychotherapy, particularly dialectical behavior therapy (DBT) and mentalization-based treatment (MBT), remains the gold standard for treating BPD. Furthermore, intensive short-term forms (5–6 months) have been shown to be more clinically effective than traditional long-term programs. Pharmacotherapy plays exclusively a supportive role and is utilized for the temporary relief of acute symptoms. Second-generation antipsychotics (SGAs) are highly effective in mitigating suicidal behavior in severe cases of BPD. New biological interventions, such as intravenous ketamine infusions or the modulation of the newly studied gut-brain axis, represent highly promising areas of future research.

Conclusions: Effective treatment of BPD requires a highly personalized, holistic approach, with psychotherapy serving as its undeniable foundation. Pharmacotherapy must be introduced with extreme caution, placing particular emphasis on the absolute avoidance of polypharmacy.

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