Abstract：
Borderline personality disorder is a common condition characterized by numerous comorbid conditions, frequent use of clinical services, and an elevated lifetime risk for suicide. Good psychiatric management (GPM) was developed for patients with borderline personality disorder with the purpose of supporting wider community adoption and dissemination compared with existing therapies. The authors aimed to review the foundations and development of GPM, in particular the initial Canadian study assessing the therapy. They then reviewed the progress in research arising from the initial study and explored the research and educational opportunities needed to further the development of GPM for patients with borderline personality disorder. Research has indicated that patients with borderline personality disorder with complex comorbid conditions and impulsivity may benefit from GPM. Future research needs include noninferiority and equivalence studies comparing GPM with another evidence-based treatment; studies demonstrating that evidence-based therapies for borderline personality disorder improve functioning; and research on more accessible therapies, mechanisms of action for evidence-based therapies, extending therapies to patients with borderline personality disorder and significant comorbid conditions, and modifying therapies for men with borderline personality disorder. Attention should be directed toward testing stepped care models and integrating therapies such as GPM into psychiatric training programs. GPM is in development but shows promise as a therapy that is effective and accessible and that can be widely disseminated.
摘要：
边缘性人格障碍是一种常见病，其特征是多种合并症，频繁使用临床服务，和自杀的终生风险升高。为边缘性人格障碍患者开发了良好的精神病管理（GPM），目的是与现有疗法相比，支持更广泛的社区采用和传播。作者旨在回顾GPM的基础和发展，特别是最初的加拿大研究评估治疗。然后，他们回顾了最初研究中的研究进展，并探讨了进一步发展边缘性人格障碍患者GPM所需的研究和教育机会。研究表明，患有复杂合并症和冲动性的边缘性人格障碍患者可能会从GPM中受益。未来的研究需求包括将GPM与另一种循证治疗进行比较的非劣效性和等效性研究；研究表明，基于证据的治疗边缘性人格障碍可改善功能；以及对更容易获得的治疗方法的研究。循证治疗的作用机制，将治疗扩展到边缘性人格障碍和显著合并症的患者，以及对患有边缘性人格障碍的男性进行改良治疗。应注意测试阶梯式护理模型，并将诸如GPM之类的疗法整合到精神病学培训计划中。GPM正在开发中，但显示出有望作为一种有效且可获得且可以广泛传播的疗法。
