|LETTER TO THE EDITOR
|Year : 2021 | Volume
| Issue : 3 | Page : 156
Chen's reply on “A comment on risk of teenage pregnancy among adolescents with borderline personality disorder”
Mu- Hong Chen M.D., Ph.D
Department of Psychiatry, Taipei Veterans General Hospital; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
|Date of Submission||17-May-2021|
|Date of Decision||25-May-2021|
|Date of Acceptance||26-May-2012|
|Date of Web Publication||24-Sep-2021|
Mu- Hong Chen
No. 201, Shih-Pai Road, Section 2, Taipei 112
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chen MH. Chen's reply on “A comment on risk of teenage pregnancy among adolescents with borderline personality disorder”. Taiwan J Psychiatry 2021;35:156
|How to cite this URL:|
Chen MH. Chen's reply on “A comment on risk of teenage pregnancy among adolescents with borderline personality disorder”. Taiwan J Psychiatry [serial online] 2021 [cited 2022 Jun 27];35:156. Available from: http://www.e-tjp.org/text.asp?2021/35/3/156/326582
Thanks for Kao and Jang's comment  on “Risk of teenage pregnancy among adolescents with borderline personality disorder (BPD): a nationwide longitudinal study,” written by Shih-Jen Tsai and me . Recognizing the good points made in their comment, I am offering the following clarification:
Evidence indicated that the estimated point prevalence of BPD is about 1% in the adolescent population despite nonsuicidal self-injury or deliberate self-harm, and one of the clinical indicators in BPD reaches a prevalence of over 20%, even up to 40%, in adolescents ,,,. Johnson et al. further suggested that cumulative prevalences of BPD in youths are 1.4% and 3.2% at 16 years and at 22 years of age, respectively . Increasing evidence has supported the validity, reliability, and stability of BPD diagnosis in adolescents ,, which may be indirectly reflected by such a prevalence gap between BPD diagnosis and BPD symptoms in previous epidemiological studies ,,,.
Kao and Jang also expressed their concern whether clinicians may code BPD in a “difficult” adolescent patient who actually did not meet the BPD criteria . This concern is not only a clinical issue but also a philosophical debate because some clinicians may be reluctant to diagnose BPD in younger individuals . But, an exact diagnosis may indicate the comprehensive understanding in the psychopathology and further facilitates the prompt and optimal treatment ,. In a recent review, Chanen et al. have reported the importance of early identification of BPD symptoms and the prompt intervention programs for those young patients, which may reduce the subsequent adversities, such as early pregnancy in the current study . Finally, when diagnosing and treating BPD in adolescents, I would like to remind that a clinical art of “too much water drowned the miller” should be carefully considered.
| Financial Support and Sponsorship|| |
The study was supported by grant from Taipei Veterans General Hospital (V106B-020, V107B-010, V107C-181, and V108B-012), Yen Tjing Ling Medical Foundation (CI-109-21 and CI-109-22), and Ministry of Science and Technology, Taiwan (107-2314-B-075-063-MY3 and 108-2314-B-075-037).
| Conflicts of Interest|| |
The author declares that he has no conflicts of interest in writing this reply.
| References|| |
Kao PH, Jang FL: A comment on “Risk of teenage pregnancy among adolescents with borderline personality disorder: a nationwide longitudinal study.” Taiwan J Psychiatry
2021; 35. [In this issue]
Chen MH, Tsai SJ: Risk of teenage pregnancy among adolescents with borderline personality disorder: a nationwide longitudinal study. Taiwan J Psychiatry
2021; 35: 26-31.
Johnson JG, Cohen P, Kasen S, et al.: Cumulative prevalence of personality disorders between adolescence and adulthood. Acta Psychiatr Scand
2008; 118: 410-3.
Brunner R, Kaess M, Parzer P, et al.: Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries. J Child Psychol Psychiatry
2014; 55: 337-48.
Lewinsohn PM, Rohde P, Seeley JR, et al.: Axis II psychopathology as a function of Axis I disorders in childhood and adolescence. J Am Acad Child Adolesc Psychiatry
1997; 36: 1752-9.
Reichl C, Kaess M: Self-harm in the context of borderline personality disorder. Curr Opin Psychol
2021; 37: 139-44.
Bondurant H, Greenfield B, Tse SM: Construct validity of the adolescent borderline personality disorder: a review. Can Child Adolesc Psychiatr Rev
2004; 13: 53-7.
Bozzatello P, Bellino S, Bosia M, et al.: Early detection and outcome in borderline personality disorder. Front Psychiatry
2019; 10: 710.
Chanen AM, Nicol K, Betts JK, et al.: Diagnosis and treatment of borderline personality disorder in young people. Curr Psychiatry Rep
2020; 22: 25.