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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO126

Non-suicidal self-injury as a distinct clinical entity in borderline personality disorder: diagnostic and treatment implications

NON-SUICIDAL SELF-INJURY AS A DISTINCT CLINICAL ENTITY IN BORDERLINE PERSONALITY DISORDER: DIAGNOSTIC AND THERAPEUTIC IMPLICATIONS

Non-suicidal self-injury is a clinically distinct phenomenon that requires assessment beyond the criteria for borderline personality disorder, and dialectical behavior therapy is the best-supported intervention for reducing it.

Non-suicidal self-injury (NSSI), defined as deliberate tissue damage without suicidal intent, affects 17% to 80% of patients with borderline personality disorder (BPD). While retaining NSSI as a diagnostic criterion for BPD, DSM-5 also introduced NSSI Disorder as a separate condition requiring further study, sustaining the debate over its nosological status; this narrative review examined the clinical distinctiveness of NSSI and the evidence base for targeted treatments in adults with BPD. PubMed and PsycINFO were searched for peer-reviewed studies examining the diagnostic overlap between NSSI and BPD, the clinical differentiation of NSSI presentations, and evidence-based treatments in adult clinical samples; studies restricted to child and adolescent populations or lacking standardized diagnostic assessment were excluded. The evidence supports a clinically meaningful distinction between NSSI and BPD: adults with co-occurring NSSI and BPD exhibit more frequent, more recent, and more severe self-injury than those with NSSI alone, as well as higher rates of psychiatric comorbidity, particularly anxiety disorders. Emotion dysregulation was consistently identified as a transdiagnostic mechanism. A systematic review of eighteen randomized controlled trials (n = 1,755) showed that dialectical behavior therapy (DBT) produced small to moderate reductions in self-injurious behaviors, with improvements maintained for up to 24 months after treatment. Although heterogeneity in the definition of NSSI across studies limits comparability, the findings indicate that NSSI should be assessed beyond the criteria for BPD and that DBT is the best-supported intervention in this population.

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