MHGCJ – 2020

Mental Health: Global Challenges Journal

https://mhgcj.org

ISSN 2612-2138

Borderline personality disorder and nursing

approach

Marindela Pergjini

, Evangelos C. Fradelos

, Ioanna V. Papathanasiou

1,3

Nursing Department, University of Thessaly, Larissa, Greece

General Department, University of Thessaly, Larissa, Greece

Community Nursing Lab, Nursing Department, University of Thessaly, Greece

Abstract

Introduction: Borderline Personality Disorder, is one of the ten Personality Disorders. These

Disorders are split into three categories, with the Borderline being part of the second one where

elements of dramatization and emotional instability are frequently evident.
Purpose: The purpose of the present study is to investigate and highlight the characteristics, the

treatment and nursing approach for people with this disorder.
Methodology: The study material consisted of articles on the topic found in Greek and

international databases such as: PubMed, Cochrane, Hellenic Academic Libraries Association

(HEAL-Link), Scopus and PsycINFO, using keywords as: “Borderline Personality Disorder”,

“Diagnosis”, “Therapy”, “Treatment”, “Holistic Care”, “Nursing Care”.
Results: Bordeline Personality Disorder is characterized as a condition in which a person differs

significantly from the average of people, about how he thinks, perceives, feels or relates to

others. Treatment for this Disorder does not exist, however medication is used to remission the

symptoms. Nurses are part of the treatment team. They’re going to help the patient learn to live

with the symptoms of his disorder. As these people are special patients, nurses must learn from

their training not to focus on the patient's problem, but on the patient himself.
Conclusions: The key characteristics of Borderline are impulsivity and instability in interpersonal

relationships, self-image and emotions. As there is no treatment, nurses as members of the

treatment team must develop a relationship of trust with the patient in order to be able to help

him in his recovery. It is important for nurses to be able to properly approach the person with

Borderline Personality Disorder to learn to adapt according to his personality

Keywords

Borderline Personality Disorder, Diagnosis, Medication, Holistic Care, Nursing Care.

Address for correspondence:

Marindela Pergjini, RN, Nursing Department, University of Thessaly, Larissa, Greece. e-mail:

marindela96@gmail.com

This work is licensed under a Creative Commons Attribution-
NonCommercial 4.0 International License (CC BY-NC 4.0).

©Copyright: Pergjini, Fradelos, Papathanasiou, 2020

Licensee NDSAN (MFC- Coordinator of the NDSAN), Italy
DOI:

http://doi.org/10.32437/mhgcj.v3i1.81

Submitted for publication:

June 2020

Received:

18 June 2020

Accepted for publication:

September 2020

MHGCJ – 2020

Mental Health: Global Challenges Journal

https://mhgcj.org

ISSN 2612-2138

Introduction

Borderline Personality Disorder, according to

the American Psychiatric Association and the

DSM is one of the ten Personality Disorders. These

Disorders are split into three categories, with the

Borderline being part of the second one where

elements of dramatization and emotional

instability are frequently evident. (APA, 2013). The

key characteristics of BPD are impulsivity and

instability in interpersonal relationships, self-image

and emotions. These symptoms tend to start in

the early years of adulthood and affect various

circumstances of the patient’s life. This Disorder is

usually found in the 1% - 3% of the general

population

while

clinical

patients

cover

approximately 10% of the cases. Individuals with

Borderline Personality Disorder can also have an

intense tendency of suicidal ideation and self-

harm. The suicide rate is 8%-10% (Stroud &

Parsons, 2012) but there are few epidemiological

data for BPD patients in Greece. In order for the

diagnosis of the Personality Disorder to be

accurate, the individual needs to be over the

age of 18 because its personality is still being

shaped under this age. What is more, the

patient’s behavior should be persistent over time

and not transient.

Purpose

The purpose of the present study is to

investigate and highlight the characteristics of

Bordeline Disorder as defined by the World Health

Organization and the American Psychiatric

Association, the treatment consisting, and the

nursing approach for people with this disorder.

Methodology

The study material consisted of articles on the

topic found in Greek and international databases

such as: PubMed, Cochrane, Hellenic Academic

Libraries Association (HEAL-Link), Scopus and

PsycINFO, using keywords as: “Borderline

Personality Disorder”, “Diagnosis”, “Therapy”,

“Treatment”, “Holistic Care”, “Nursing Care”.

Results

Historical background

In older times, scientists of the psychodynamic

direction used the terms

"Ambulatory schizophrenia" and "Pseudo-

neurotic schizophrenia" in order to describe a

group of people that is in-between neurosis and

psychosis, with the main characteristics of

instability (emotional, interpersonal relationships

and self-image) and impulsivity. In 1938 the term

“Borderline” was suggested for the first time by the

psychoanalyst Stern, in an effort to describe a

patient who was in-between neurosis and

psychosis and was mentally unstable and difficult

to manage (Eby & Brown 2010). The Borderline

Personality Disorder as an official term, was finally

institutionalized in the early 1980’s at DSM-III and

constitutes one of the ten Personality Disorders

since then (Lenzenweger & Clarkin, 2005).

Clinical Characteristics

Individuals that have been diagnosed with

Borderline Personality Disorder are usually

impulsive and unstable in their interpersonal

relationships, self-image and emotions. These

symptoms appear in the early adult life of the

individual. They may appear as responses to

personal and social situations and they differ,

fundamentally, from the way the average person

understands, thinks, feels and relates with others
(Χριστοδούλουκαισυν., 2000).

The intense and unstable relationships are

these people’s main characteristic. They tend to

be extremely sensitive to the idea of rejection

and the fear of abandonment. When it comes to

their interpersonal relationships, they usually have

non-realistic expectations and show increased

emotional instability in the case of unexpected

disappointment and obvious rejection (Dubovsky

& Kiefer, 2014; Andrew et al., 2011). Borderline

Personality Disorder is, also, characterized by an

unstable self-image and self-worth. The life goals,

plans, values, sexual identity and friends of the

BPD patient may change in an abrupt way and

that is why these people respond better to a

predictable and structured environment (Eby &

Brown, 2010).

Moreover, impulsivity is one more key element

of the BPD. The diagnosis requires impulsivity in at

least two sections that could be proven self-

destructive, such as gambling, irresponsible

waste of money, reckless driving, bulimic eating,

unprotected sex, substance abuse or self-

harming behavior (Giannouli et al., 2009; Nehls,

2000). This type of impulsivity differs from the

impulsive behavior that appears during the

manic episodes where it is prolonged and

accompanied by other symptoms of mania such

as grandeur, stressful speech and lack of need

for sleep.

Self-harming is, also, frequent in this Disorder.

More specifically, 75% of the individuals that

have been diagnosed with Personality Disorder

and an even higher percentage of the clinical

patients have attempted self-harm (Geoffrey et

al., 2016). An 8 – 10% of the patients have

successfully attempted suicide (Tomko et al.,

2014) but there are numerous cases of self-harm

without suicide, such as self-cutting, scratches or

MHGCJ – 2020

Mental Health: Global Challenges Journal

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ISSN 2612-2138

burns on themselves which are much more

common.

The aforementioned behavior, often, occurs

when the person is worried about possible

abandonment or rejection. It can also be seen

during

episodes

de-realization

depersonalization (Bach & Sellbom, 2016).

Depersonalization consists of a detachment

within the self, in which the individual feels like he

is placed outside of his body and looks at himself

from a distance. He doesn’t feel pain if he is

injured. Some patients claim that the pain from

cutting and burning reminds them that they’re

alive (Eby & Brown, 2010).

Diagnosis

The immense need for a “common

language” in clinical psychiatry, not only on an

international level but also on a national, brought

to the foreground the formation of the two

taxonomic systems:

1) the Diagnostic and Statistical Manual of

Mental Disorders (DSM), the American Psychiatric

Association and

2) the International Classification of Diseases

(ICD) of the World Health Organization.

These two systems are the tools for the

classification and the diagnosis of mental

illnesses and use specific diagnostic criteria in

order for those illnesses to be diagnosed,

including the Borderline Personality Disorder.

The fifth edition of the Diagnostic and

Statistical Manual of Mental Disorders (DSM-5)

includes nine diagnostic criteria. The individuals

with Borderline Personality Disorder should have at

least five of these criteria which should be evident

in various circumstances of the person’s life (APA,

2013).

Borderline Disorder patients make excessive

efforts to prevent either an existing or an

imaginary rejection. When they get the feeling of

abandonment, they may intentionally change

their self-image and behavior. They, also,

experience intense anger even when separation

inevitable.

They,

often,

associate

abandonment with the belief that they are “bad”

themselves. The intense efforts to avoid

abandonment may lead to impulsive actions, like

this of self-harm (Bach & Sellbom, 2016).

Furthermore, the unstable and intense

interpersonal relationships are a behavioral

characteristic of Borderline Disorder patients

(Sellbom et al., 2014). They tend to idealize a

friend, partner or mental assistant from their very

first contact, to spend time together and share

details of their personal life. However, they can

easily change this sympathy into devaluation. The

feel that this person does not give them time or

listen to them, and mainly does not show his

support.

The main feature of this Disorder, is impulsive

behavior in at least two sections that could be

proven catastrophic, such as excessive food or

alcohol

consumption,

substance

abuse,

dangerous sexual intercourse and reckless driving

(APA, 2013).

There may be an identity crisis with an intense

and unstable self-image (Trull et al., 2011). The

individual feels the need to drastically and

dramatically change its self-image which is

characterized by a shift in goals, values and

professional aspirations. There may be a sudden

change in his views and plans about his career,

sexual identity and values (Tomko et al., 2014).

Such behaviors, occur in situations in which the

individual feels the lack of a meaningful

relationship, progress and support.

Borderline

Disorder

patients

adopt

continuous suicidal behavior or the habit of self-

harm (APA, 2013). The repeated suicide attempts

are often the reason why these people seek for

help. These acts are overshadowed by threats of

separation or rejection. Self-harm can occur

during fun experiences and often brings relief to

the individual.

Another criterion is the emotional instability

which is caused by intense episodic discomfort or

anxiety and lasts for a couple of hours or, very

rarely, for a few days (Trull et al., 2011).The

discomfort of people with Borderline Disorder is

often disturbed during periods of anger, panic or

despair and rarely by periods of calmness or

satisfaction.

These patients are, also, characterized by a

chronic feeling of emptiness (APA, 2013). They

can easily get bored of anything and are

constantly looking for something to do. They have

a difficulty in controlling their anger which is

usually inappropriate. This anger takes place

when they feel neglected, embarrassed or

abandoned.

In periods of intense stress, individuals with

Borderline Disorder experience transient paranoid

ideationor severe detachment symptoms [APA,

2013]. These episodes tend to be transient and

they usually last a few minutes, hours and, very

rarely, days. They occur during periods of realistic

or imaginary abandonment and usually go away

when another person’s stay is perceived (Trull et

al., 2011).

On the other hand, the World Health

Organization,

through

the

International

Classification of Diseases (ICD-10), suggests that

there should be a separate description of five

areas – characteristics for the recognition of

Personality Disorder. According to ICD-10, the

individual should exhibit three of the general

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characteristics of Personality Disorders and at

least two of the characteristics of Borderline
Disorder (Στεφανήςκαισυν., 1997).

According to the basic criteria of the ICD-10,

at first, there should be an indication of the

patient’s characteristics and the permanent

patterns of the mental experience and behavior,

as a whole, should be significantly deviant from

the culturally expected and accepted rules. Such

a deviation must be manifested in more than

one area, like cognitive function, emotionality,

control over impulses and satisfaction of needs,

and how the individual relates to others and

handles interpersonal situations. This deviation

should be present extensively as a behavior that

is inelastic, maladaptive or dysfunctional across a

wide range of personal and social situations.

What is more, there should be mental stress or an

unpleasant impact on the social environment, or

both. There must be an indication that the

deviation is stable and long-lasting and has

begun in late childhood or adolescence.

Deviation cannot be interpreted as a

manifestation or consequence of other mental

disorders, and at the same time an organic brain

disease, trauma or dysfunction must be excluded
as possible causes of the deviation (Μαδιανός,
2006).

Provided that there will be a recognition of at

least three criteria of the general diagnostic

criteria, the ICD-10 suggests the following

diagnostic criteria for Borderline Disorder. It is

mainly characterized by disturbances and

uncertainty about oneself, goals and inner

preferences.

Patients

usually

have

predisposition to engage in intense and unstable

relationships that often lead to emotional crises

(Whewell et al., 2000). They are filled with a sense

of grandeur and become very manipulative with

people around them. As soon as they realize that

those around them do not embrace their

grandeur, they will become quite hostile. These

people go to great lengths to avoid

abandonment. In this endeavor, they display

repeated threats or acts of self-harm. Chronic

feelings of emptiness, as well as negative

emotions  and  bad  mood  are  distinctive
characteristics  of  theirs  (Στεφανήςκαισυν.,  1997).
Individuals  with  Borderline  Disorder  show  severe

emotional instability, and they are also very

anxious and usually depressed. They are, also,

detached andcarry a pattern of indifference.

Apart from that, they do not feel the need to

develop intimacy with others and are mostly
indifferent to their feelings (Μαδιανός, 2006).

The symptoms should be intense to make the

diagnosis and associated with weakened

psychosocial function. Once the diagnosis of

Borderline Personality Disorder is made, the

proposed ICD-10 model includes the assessment

of the condition of individuals with BPD as mild,
moderate or severe (Στεφανήςκαισυν., 1997).

Looking at the two taxonomic systems DSM-5

and ICD-10, there do not seem to be major

differences in the recognition of Borderline

Disorder, however some differences are

noticeable. One of them is the way of diagnosing

Borderline Disorder, in DSM-5 there are nine

diagnostic criteria for the recognition of Borderline

Disorder, while in ICD-10 the diagnosis of

Personality Disorder comes first and then the

recognition of Borderline Disorder. Also, the

absence of psychosis is observed as a diagnostic

criterion in ICD-10. The element of psychosis,

according to ICD-10, seems to be a diagnostic

criterion of schizophrenia and schizotypal

personality disorder and not of Borderline

Disorder.

Despite the already existing diagnostic criteria,

further research seems to be needed to

determine whether some criteria should be more

important than others. For instance, self-harm

and suicide attempts along with unstable

interpersonal relationships may be more

important signs in the diagnosis of Borderline

Personality Disorder.

Therapy/Treatment

Ensuring the right treatment for people with

Borderline Personality Disorder is especially

important. The initial priority in the psychosocial

treatment of Borderline Disorder is to avoid self-

harm. Other issues that need attention are mood

problems and the impulsive behavior. The

treatment of this Disorder is long lasting. It requires

the individual to work with a team of health

professionals.

Dialectical Behavioral Therapy is a cognitive

and behavioral psychotherapy used specifically

for Borderline Personality Disorder. Dialectical

Behavioral Therapy has been shown to reduce

suicidal

behavior

and

the

need

for

hospitalization, while increasing interpersonal

functionality and anger control (Beck et al.,

2015).

Equally important is psychopharmacology,

which should be taken as complementary

therapy and not as the main. Polypharmacy is a

common problem faced by people with

Borderline Disorder. Research shows that 80% of

people diagnosed with Borderline Disorder are on

medication, while 40% of them seem to be

receiving more than 3 medications (Gunderson &

Berkowitz, 2003). Serotonin reuptake inhibitors are

the most widely used class of drugs in people

with Borderline Disorder that help with the

symptoms of depression (Zanarini et al., 2001).

Another class of drugs used is that of

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ISSN 2612-2138

benzodiazepines. Although there is no research

data to support their use in people with Borderline

Disorder, they are used to treat anxiety and

emotional instability. However, they should be

prescribed, if necessary, very carefully and in

small doses (Stoffers & Lieb, 2015; Zanarini et al.,

2001). Anticonvulsants seem to have positive

effects on reducing depression and interpersonal

problems.Another widely used class of drugs are

antipsychotics, which are used both for psychotic

symptoms and to manage mood instability (Lieb

et al., 2010).

All classes of drugs should be prescribed with

great caution as there are individuals with

Borderline Disorder who are prone to suicide

attempts, with the result that the medication can

be fatal in case of overdose. Due to the different

classes of medications available, medication

should be adjusted according to the symptoms

of the person with Borderline Disorder and

unnecessary medication should be avoided.

Nursing Approach

The nurse is an integral part of the team of

health professionals in which he comes in

contact with people with Borderline Disorder.

Peplau is the one who stressed the importance of

the relationship that is being developed between

the nurse and the patient. She, also, pointed out

how important it is for the patient (as a human) to

be the focal point of nursing care and not his

problem.

Peplau's model, which is based on

psychodynamic and psychodramatic theories,

seems to be the most appropriate for the nurses'

proper treatment of people with Borderline

Disorder. Peplau described 4 interrelated and

overlapping phases in the nurse-patient

relationship [Peplau, 1997]. The orientation phase

in which the nurse understands and evaluates

why the person is at the point of receiving help.

Then, follow the phases of identification and

exploitation, which are phases of work, patient

support in recognizing internal dissonance as well

as developing and testing strategies that reduce

internal dissonance. Finally, there is the analysis

phase, where the patient uses these strategies to

reduce and resolve internal dissonance and

psychological pain [Peplau, 1992].

The role of the nurse in the treatment of

people with Borderline Disorder is mainly

supportive. The nurse, is the one who will help

these people learn to cope with the demands of

daily life and to meet their basic needs

[O’Connell & Dowling, 2013]. This procedure

should be done in collaboration with the patient,

so it is especially important to develop a trust

relationship. The nurse should encourage the

person to make small gradual decisions about his

daily life, so the person takes on a role in the

treatment team by helping in his smoother and

faster recovery and well-being.

People with Borderline Disorder are people

who have difficulty in developing interpersonal

relationships so they need to be given more time

to develop a proper therapeutic relationship. This

proper relationship, allows the nurse to determine

the roles he will adopt as well as the nursing

interventions he will follow and the roles the

person must adopt in order to proceed with the

recovery

(Papathanasiou

al.,

2013;

Stockmann, 2005).

The nurse is responsible for a big part of the

patient’s care. In order to be able to provide

proper nursing care and for his patients to have

the right healing process it would be right to try to

see the person and not the problem.

Unfortunately, the nurse during his training is

detuned in his attempt to learn the practical part

correctly, forgetting that he must also understand

the psychosynthesis of his patient (Henderson,

2002).

Conclusions

People with Borderline Personality Disorder are

characterized by a rather peculiar behavior, with

impulsivity, tendencies of self-injury and unstable

interpersonal relationships being key features. The

diagnosis of the Disorder cannot be made before

the age of 18, as until then the personality is still

being formed. However, it is important to

diagnose Borderline Disorder early so that people

can learn how to control their impulsivity and

reduce the tendency for self-harm. Nurses have

an important role in this process, as they are next

to these people teaching them how to cope with

meeting their basic needs. In order to do this, a

therapeutic relationship must be developed

between nurses and patients, but individuals with

Borderline Disorder find it difficult to develop and

maintain a relationship. Knowledge of the salient

features is essential to create a favorable

therapeutic alliance, to increase the patient's self-

awareness, to plan realistic therapeutic goals and

to match the treatment with the individual's

personality. Nursing has a human-centered

character so nurses should not forget that behind

the problem they face, there is a person who is

the center of attention.

Conflict of interest

Authors declare that they have no conflict of

interests.

References

MHGCJ – 2020

Mental Health: Global Challenges Journal

https://mhgcj.org

ISSN 2612-2138

American

Psychiatric

Association.

(2013).

Diagnostic and Statistical Manual Of Mental

Disorders. 5th ed. Washington: American

Psychiatric Association.

Andrew, E. et al. (2011). Personality Disorder Types

Proposed for DSM-5. Journal of Personality

Disorders, 25(2), 136-169. Accessed From

April,

2011,

Available

From:

https://doi.org/10.1521/pedi.2011.25.2.136 .

Bach, B. & Sellbom, M. (2016). Continuity

between DSM-5 Categorical Criteria and Traits

Criteria for Borderline Personality Disorder. SAGE

Journals, 61(8), 489-494. Accessed From 18th

March,

2016,

Available

From:

https://doi.org/10.1177/0706743716640756.

Beck, A., Davis, D. & Freeman, A. (2015).

Cognitive Therapy of Personality Disorders. 3rd

ed. New York: The Guilford Press.

Brieger, P. et al. (2000). The Relationship Between

Five-Factor Personality Measurements and

ICD-10 Personality Disorder Dimensions: Results

from a Sample of 229 Subjects. Journal of

Personality Disorders, 14(3), 282-290. Available

From:

https://doi.org/10.1521/pedi.2000.14.3.282.

Dubovsky, A. & Kiefer, M. (2014). Borderline

Personality Disorder in the Primary Care Setting.

Medical Clinics of North America, 98(5),1049-

1064. Accessed From September, 2014,

Available

From:

https://doi.org/10.1016/j.mcna.2014.06.005.

Eby, L. &Brown, N. (2010). Η Νοσηλευτική στην

Ψυχική Υγεία. 2η έκδ. Αθήνα: Ιατρικές Εκδόσεις
Λαγός Δημήτριος.

Geoffrey, L. et al. (2016). Mental health nurses'

attitudes,

behaviour,

experience

and

knowledge regarding adults with a diagnosis

of borderline personality disorder: systematic,

integrative literature review. Journal of Clinical

Nursing, 25(13-14), 1848-1845. Accessed

From 3th May, 2016, Available From:

https://doi.org/10.1111/jocn.13202.

Giannouli, H. et al. (2009). Attitudes, knowledge

and experience of nurses working in

psychiatric hospitals in Greece, regarding

borderline personality disorder: a comparative

study. Journal of Psychiatric and Mental

Health Nursing, 16(5), 481-487. Accessed

From 7th May, 2009, Available From:

https://doi.org/10.1111/j.1365-

2850.2009.01406.x.

Gunderson, J. & Berkowitz, C. (2003). An

Introduction To Borderline Personality Disorder.

Diagnosis, Origins, Course, and Treatment.

New York: NEPDA.

Henderson, S. (2002). Factors impacting on

nurses' transference of theoretical knowledge

of holistic care into clinical practice. Nurse

Education in Practice, 2(4), 244-250.

Accessed 22th April, 2002, Available From:

DOI: 10.1016/s14715953(02)00020-3.

Lenzenweger, F. & Clarkin, J. (2005). Major

Theories of Personality Disorder. 2nd ed. New

York: The Guilford Press.

Lieb, K. et al. (2010). Pharmacotherapy for

borderline personality disorder: Cochrane

systematic review of randomised trials.

Cambridge University Press, 196(1), 4-12.

Accessed From 2 January, 2018, Available

From: doi: 10.1192/bjp.bp.108.062984.

Μαδιανός, Μ. (2006). Κλινική Ψυχιατρική. 2η έκδ.

Αθήνα: Εκδόσεις Καστανιώτη.

Nehls, N. (2000). Being a case manager for

persons with borderline personality disorder:

perspectives of community mental health

center clinicians. Archives of Psychiatric

Nursing, 14(1), 12-18. Accessed From

February,

2000,

Available

From:

DOI:10.1016/s0883-9417(00)80004-7.

O’Connell, & Dowling, M. (2013). Community

psychiatric nurses’ experiences of caring for

clients with borderline personality disorder.

Mental

Health

Practice,

17(4):27-33.

Accessed From 1st March, 1013, Available

From:

https://dx.doi.org/10.7748/mhp2013.12.17.4.2

7.e845.

Papathanasiou, I., Slavou, M. & Kourkouta, L.

(2013). Holistic Nursing Care: Theories and

Perspectives. American Journal of Nursing

Science, 2(1), 1-5. Accessed From 20th

February, 2013, Available From: doi:

10.11648/j.ajns.20130201.11.

Peplau, HE. (1997). Peplau’s theory of

interpersonal relations. SAGE Journals, 10(4),

162-167. Accessed From 1 October, 1997,

Available

From:

DOI:10.1177/089431849701000407.

Peplau, HE. (1992). Interpersonal relations: a

theoretical framework for application in

MHGCJ – 2020

Mental Health: Global Challenges Journal

https://mhgcj.org

ISSN 2612-2138

nursing practice. SAGE Journals, 5(1), 13-18.

Accessed From 1 January, 1992, Available

From: DOI:10.1177/089431849200500106.

Sellbom, M. et al. (2014). Convergence between

DSM-5 Section II and Section III diagnostic

criteria for borderline personality disorder.

SAGE Journals, 48(4), 325-332. Accessed From

19th November, 2014, Available From:

https://doi.org/10.1177/0004867413511997.

Στεφανής, Κ., Σολδάτος, Κ. & Μαυρέας, Β. (1997).

Ταξινόμηση ICD-10 Ψυχικών Διαταραχών και
Διαταραχών

Συμπεριφοράς.

Αθήνα:

ΒήταΙατρικέςΕκδόσεις.

Stockmann, C. (2005). A literature review of the

progress of the psychiatric nurse-patient

relationship as described by Peplau. Issues in

Mental Health Nursing, 25(9), 911-919.

Accessed 9th July, 2005, Available From:

https://doi.org/10.1080/01612840500248197.

Stoffers, J. & Lieb, K. (2015). Pharmacotherapy for

Borderline

Personality

Disorder—Current

Evidence and Recent Trends. Current

Psychiatry Reports. 17(534). Accessed From 21

November,

2015,

Available

From:

https://doi.org/10.1007/s11920-014-0534-0.

Stroud, J. & Parsons, R. (2012). Working with

borderline personality disorder: A small-scale

qualitative investigation into community

psychiatric nurses' constructs of borderline

personality disorder. Personality and Mental

Health, 7(3),242-253. Accessed From 23th

August,

2012,

Available

From:

https://doi.org/10.1002/pmh.1214.

Tomko, R. et al. (2014). Characteristics of

borderline personality disorder in a community

sample: comorbidity, treatment utilization,

and general functioning. Journal of Personality

Disorders, 28(5), 734-750. Accessed From

October, 2014, Available From: doi:

10.1521/pedi_2012_26_093.

Trull, T. et al. (2011). DSM-5 Borderline Personality

Disorder: At the Border Between a Dimensional

and a Categorical View. Curr Psychiatric, 13,

43-49. Accessed From 24th November, 2011,

Available

From:

https://doi.org/10.1007/s11920-010-0170-2.

Whewell, P. et al. (2000). Does the ICD 10

classification accurately describe subtypes of

borderline personality disorder?. British Journal

Of Medical Psycology, 73(4), 483-494.

Accessed From 14th February, 2000, Available

From:

https://doi.org/10.1348/000711200160679.

Χριστοδούλου, Γ. και συν. (2000). Ψυχιατρική. 1η

εκδ. Αθήνα: Βήτα Ιατρικές Εκδόσεις.

Zanarini, M. et al. (2001). Treatment histories of

borderline

inpatients.

Comprehensive

Psychiatry, 42(2), 144-150. Accessed From

March,

2001,

Available

From:

https://doi.org/10.1053/comp.2001.19749