Polypharmacy in borderline personality disorder: Associations with subjective illness severity, self stigma, and childhood trauma : Polypharmacy and Illness severity in borderline personality disorder

Strany: 16 - 25

Jazyk: eng

BACKGROUND: Despite limited evidence for pharmacological efficacy in core BPD symptoms, pharmacotherapy is frequently used and may become the dominant treatment modality, often resulting in clinically significant polypharmacy. We examined whether psychotropic pharmacological burden at hospital admission is associated with perceived illness severity, internalized stigma, and childhood trauma. METHODS: In this cross-sectional study, 220 inpatients with ICD-10 BPD (mean age 30.8 years) were assessed during the first week of hospitalization. The total number of concurrently prescribed psychotropic medications at admission was extracted from medical records. Participants completed the patient-rated Clinical Global Impression Severity Scale (CGI-S-PV), the Internalized Stigma of Mental Illness scale (ISMI), and the Childhood Trauma Questionnaire–Short Form (CTQ-SF). Analyses included correlations, group comparisons, and multivariable linear and logistic regression. RESULTS: The mean number of medications was 1.76 (SD = 1.37); 57% of patients received ≥2 psychotropic medications at admission. Medication count correlated with perceived illness severity (r = 0.21, p = 0.002) and increased with age (B = 0.05, p = 0.002). Patients prescribed ≥2 psychotropic medications reported significantly higher levels of emotional and sexual abuse (CTQ-SF) and higher scores in selected ISMI subscales: alienation, discrimination experience, and social withdrawal. In multivariable models, age (B = 0.05, p = 0.002) and CGI-S-PV (B = 0.19, p = 0.017) independently predicted medication count, whereas ISMI and CTQ-SF total scores did not. In subscale-level models adjusted for age and CGI-S-PV, ISMI Alienation (β = 0.21, p = 0.031) and Stereotype Endorsement (β = 0.19, p = 0.042) independently predicted medication count, and Stereotype Endorsement (OR = 1.59) and Discrimination Experience (OR = 1.52) predicted polypharmacy in logistic regression. CONCLUSION: While childhood trauma and self-stigma contribute to between-group differences, they do not independently predict pharmacological burden after adjustment. These findings indicate that at admission, pharmacological burden is independently predicted by perceived illness severity and age, while trauma expo- sure and global internalized stigma do not contribute independently after adjustment.

ISO 690:

Kasal, M., Praško, J., Ociskova, M., Belohradová, K., Visnovsky, J., Nesnidal, V., Vanek, J., Mate, Z., Pazstor, J., Vevera, J. 2026. Polypharmacy in borderline personality disorder: Associations with subjective illness severity, self stigma, and childhood trauma : Polypharmacy and Illness severity in borderline personality disorder. In Activitas Nervosa Superior Rediviva, vol. 68, no.1, pp. 16-25. 1337-933X. DOI: https://doi.org/10.31577/ansr.2026.68.1.2

APA:

Kasal, M., Praško, J., Ociskova, M., Belohradová, K., Visnovsky, J., Nesnidal, V., Vanek, J., Mate, Z., Pazstor, J., Vevera, J. (2026). Polypharmacy in borderline personality disorder: Associations with subjective illness severity, self stigma, and childhood trauma : Polypharmacy and Illness severity in borderline personality disorder. Activitas Nervosa Superior Rediviva, 68(1), 16-25. 1337-933X. DOI: https://doi.org/10.31577/ansr.2026.68.1.2

Vydavateľ: Slovak Academy of Sciences