European guidelines for personality disorders: past, present and future

Sebastian Simonsen, Anthony Bateman, Martin Bohus, Henk Jan Dalewijk, Stephan Doering, Andres Kaera, Paul A Moran, Babette Renneberg, Joaquim Soler Ribaudi, Svenja Taubner, Theresa Wilberg, Lars Mehlum

Research output: Contribution to journalArticle (Academic Journal)peer-review

66 Citations (Scopus)
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Personality disorders (PD) are common and burdensome mental disorders. The treatment of individuals with PD represents one of the more challenging areas in the field of mental health and health care providers need evidence-based recommendations to best support patients with PDs. Clinical guidelines serve this purpose and are formulated by expert consensus and/or systematic reviews of the current evidence. In this review, European guidelines for the treatment of PDs are summarized and evaluated. To date, eight countries in Europe have developed and published guidelines that differ in quality with regard to recency and completeness, transparency of methods, combination of expert knowledge with empirical data, and patient/service user involvement. Five of the guidelines are about Borderline personality disorder (BPD), one is about antisocial personality disorder and three concern PD in general. After evaluating the methodological quality of the nine European guidelines from eight countries, results in the domains of diagnosis, psychotherapy and pharmacological treatment of PD are discussed. Our comparison of guidelines reveals important contradictions between recommendations in relation to diagnosis, length and setting of treatment, as well as the use of pharmacological treatment. All the guidelines recommend psychotherapy as the treatment of first choice. Future guidelines should rigorously follow internationally accepted methodology and should more systematically include the views of patients and users.
Original languageEnglish
Article number9
Number of pages10
JournalBorderline Personality Disorder and Emotion Dysregulation
Publication statusPublished - 21 May 2019


  • Guidelines
  • Personality disorders
  • Recommendations


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