LETTER TO THE EDITOR
Year : 2021 | Volume
: 35 | Issue : 3 | Page : 156-
Chen's reply on “A comment on risk of teenage pregnancy among adolescents with borderline personality disorder”
Mu- Hong Chen
Department of Psychiatry, Taipei Veterans General Hospital; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Mu- Hong Chen
No. 201, Shih-Pai Road, Section 2, Taipei 112
|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;35:156-156
|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 2021 Dec 8 ];35:156-156
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.
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