General psychiatric management (GPM) for borderline personality disorder: a generalist model for Latin America

Authors

  • Marcos Signoretti Croci Ambulatório para o Desenvolvimento dos Relacionamentos e das Emoções. ADRE, Hospital das Clínicas, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, USP, São Paulo, SP, Brasil https://orcid.org/0000-0002-0743-2565
  • Marcelo José Abduch Adas Brañas Ambulatório para o Desenvolvimento dos Relacionamentos e das Emoções. ADRE, Hospital das Clínicas, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, USP, São Paulo, SP, Brasil https://orcid.org/0000-0003-3218-7327
  • Carl Fleisher Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA https://orcid.org/0000-0003-3672-3385
  • Teresa Carreño Department of Psychiatry and Behavioral Sciences. University of Miami Miller School of Medicine, Miami, USA https://orcid.org/0000-0001-8898-8938
  • Maria Dayana Jurado Andia Hospital Antonio Lorena, Cusco, Peru https://orcid.org/0000-0003-1608-3616
  • Eduardo Martinho Júnior Ambulatório para o Desenvolvimento dos Relacionamentos e das Emoções. ADRE, Hospital das Clínicas, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, USP, São Paulo, SP, Brasil https://orcid.org/0000-0002-0092-0881
  • Lois W Choi-Kain Harvard Medical School, Boston, USA. Gunderson Personality Disorders Institute. GPDI. McLean Hospital, Belmont, USA https://orcid.org/0000-0003-4459-0412

DOI:

https://doi.org/10.25118/2763-9037.2022.v12.446

Keywords:

borderline personality disorder, public health, case management, psychotherapy, therapeutics

Abstract

For many years, borderline personality disorder (BPD) has been regarded as an untreatable mental health condition. However, several effective evidence-based treatments developed in the last decades, such as dialectical behavior therapy (DBT), mentalization-based treatment (MBT) and transference focused psychotherapy (TFP), proved otherwise. The problem from a public health perspective is that their availability is limited. In this context of increased need for trained clinicians, general psychiatric management (GPM) and other generalist approaches emerged. This article reviews GPM’s major foundations and framework that guide non-specialized clinicians to structure a treatment based on medicalization of the disorder, case management and supportive psychotherapeutic interventions. We also illustrate the approach with a case vignette and finally present newer developments, such as integration with DBT and GPM for adolescents (GPM-A).

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Author Biographies

Marcos Signoretti Croci, Ambulatório para o Desenvolvimento dos Relacionamentos e das Emoções. ADRE, Hospital das Clínicas, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, USP, São Paulo, SP, Brasil

Medical Doctor at the Faculty of Medicine of the University of São Paulo (FMUSP) in 2011.
Psychiatrist from the Institute of Psychiatry of the Hospital das Clínicas of the Faculty of
Medicine of the University of São Paulo (IPq-HCFMUSP). Research Fellow at Mclean Hospital,
Harvard Medical School, 2015. Preceptor of the Graduation of Psychiatry at FMUSP, 2016.
Preceptor of the Medical Residency in Psychiatry at IPq-HCMFUSP, 2017.
Currently, he works at the Outpatient Clinic for the Development of Relationships and Emotions (ADRE )
of IPq-HCFMUSP, where he supervises and is general co-coordinator.
He is an official Good Psychiatric Management (GPM) trainer at the Mclean Hospital Borderline
Personality Disorder Training Institute.

Marcelo José Abduch Adas Brañas, Ambulatório para o Desenvolvimento dos Relacionamentos e das Emoções. ADRE, Hospital das Clínicas, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, USP, São Paulo, SP, Brasil

http://lattes.cnpq.br/1032185402291440

Carl Fleisher, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA

https://medschool.ucla.edu/

Médico pela Harvard Medical School. Psiquiatra pela UCLA School of Medicine. Fellowship pela UCLA School of Medicine. Psiquatra da Infância e Adolescência pelo American Board of Psychiatry and Neurology. Professor Clínico Assistente, Departamento de Psiquiatria e Ciências Biocomportamentais, Universidade da California, Los Angeles, California. 

 

Teresa Carreño, Department of Psychiatry and Behavioral Sciences. University of Miami Miller School of Medicine, Miami, USA

https://med.miami.edu/

Médica pela University of Miami Miller School of Medicine, Miami, USA. Psiquiatra e psiquiatra da infância e da adolescência pelo American Board of Psychiatry and Neurology. Professora assistente voluntária no Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA.

Maria Dayana Jurado Andia , Hospital Antonio Lorena, Cusco, Peru

http://hospitalantoniolorena.gob.pe/

Médica formada pela Universidad del Valle, Cochabamba, Bolívia. Psiquiatra pelo Instituto de Psiquiatría do Hospital das Clínicas da Faculdade de Medicina da USP – São Paulo, Brasil. Psiquiatra en el Hospital de Salud Mental, San Juan Pablo II, Cusco Perú

Eduardo Martinho Júnior , Ambulatório para o Desenvolvimento dos Relacionamentos e das Emoções. ADRE, Hospital das Clínicas, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, USP, São Paulo, SP, Brasil

http://lattes.cnpq.br/1106658523184853

https://orcid.org/0000-0002-0092-0881

 

 

 

Lois W Choi-Kain, Harvard Medical School, Boston, USA. Gunderson Personality Disorders Institute. GPDI. McLean Hospital, Belmont, USA

https://hms.harvard.edu/

Bacharelado em Artes pelo Harvard-Radcliffe College. Mestrado pelo Harvard Graduate School of Education. Médica pela Thomas Jefferson University. Psiquiatra pelo Massachusetts General Hospital/McLean Hospital. Fellowship Psicossocial, McLean Hospital. Diretora do Gunderson Personality Disorders Institute, Mclean Hospital, Harvard Medical School. 

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2022-12-19

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Croci MS, Brañas MJAA, Fleisher C, Carreño T, Jurado Andia MD, Martinho Júnior E, et al. General psychiatric management (GPM) for borderline personality disorder: a generalist model for Latin America. Debates Psiquiatr. [Internet]. 2022 Dec. 19 [cited 2026 Jun. 3];12:1-26. Available from: https://revistardp.org.br/revista/article/view/446

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Vol. 12 (2022)

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Review Articles

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Copyright (c) 2022 Marcos Signoretti Croci, Marcelo José Abduch Adas Brañas, Carl Fleisher, Teresa Carreño, Maria Dayana Jurado Andia , Eduardo Martinho Júnior , Lois W Choi-Kain

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