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Objective: The aim of this study was to investigate the well-being of people with severe borderline personality disorder (BPD) during the first wave of COVID-19 social restrictions. Method: Clients of an outpatient specialist personality disorder clinic (n = 77) were invited to the study. An online survey was conducted including a range of open-ended questions exploring well-being and the Coronavirus Anxiety Scale (CAS) which assesses 'coronaphobia'. Qualitative data were analysed using inductive content analysis with NVivo software. CAS data were analysed descriptively using SPSS version 25. Results: Thirty-six surveys were completed (48% response rate). Many participants experienced significant challenges to their overall well-being during lockdown although some reported improvements in psychosocial functioning. Three participants (8.3%) experienced clinically significant 'coronaphobia'. Conclusion: The self-reported physical and mental health of participants with BPD demonstrated resilience, suggesting that the capacity to maintain treatment via telehealth helped to mitigate many of the adverse aspects of social restrictions. This study was conducted during the first wave of social restrictions; subsequent studies will reveal longer-term effects of extended community lockdowns. [ABSTRACT FROM AUTHOR]

To investigate the well-being of mental healthcare providers working in a specialist clinic for personality disorder during the first wave of COVID-19 social restrictions. Clinical (n = 31) and nonclinical (n = 11) staff in a public outpatient specialist personality disorder clinic were invited to participate. Data were collected via an online survey which incorporated the Coronavirus Anxiety Scale (CAS) together with a range of open-ended questions exploring mental health, physical health, sleep quality, management of relationships, alcohol consumption, eating patterns, and use of media. Inductive content analysis was used to review the responses to the open-ended questions. Data from CAS was reported descriptively. In total, 39 surveys were completed (92.8% response rate). According to the CAS, two participants (5.1%) experienced coronaphobia during the initial pandemic restrictions. Participants reported a diversity of experiences affecting their health status during this time. While loss of social interactions with family and friends was reported as the most challenging aspect of lockdown, participants reported that conducting their work using telehealth and the absence of the work commute provided opportunities for more time with family and for self-reflection. The self-reported physical and mental health of participants demonstrated resilience. This suggests that the capacity to conduct therapeutic work via telehealth, and having the option of working from home helped to mitigate many of the adverse aspects of social restrictions due to the global pandemic. This study was conducted during the first wave of social restrictions; subsequent studies will reveal longer-term effects of this policy. Key Points What is already known about this topic: Australian adults reported a slight increase in psychological distress in the general community during the COVID-19 pandemic. Coronavirus Anxiety Scale (CAS) is a validated and reliable mental health questionnaire assessing COVID-19 related fear and anxiety (coronaphobia). CAS measures sleep disturbance, appetite loss, dizziness, tonic immobility, and abdominal distress. Living under lockdown conditions is an unnatural experience. Experience of mental health workers who provide care for people with personality disorder is not yet studied during this condition. What this paper adds: Only two participants (5.1%) experienced coronaphobia during the initial pandemic restrictions. While challenges were endorsed, the self-reported physical and mental health of participants demonstrated resilience. A range of well-being challenges were reported in this study that informs health policy makers for future interventions. [ABSTRACT FROM AUTHOR]

The somatosensory cortex remodels in response to sensory deprivation, with regions deprived of input invaded by neighboring representations. The degree of cortical reorganization is correlated with ongoing pain intensity, which has led to the assumption that chronic pain conditions are invariably associated with somatosensory cortex reorganization. Because the presentation and etiology of chronic pain vary, we determined whether cortical changes in human subjects are similar for differing pain types. Using functional and anatomical magnetic resonance imaging, we found that, while human patients with neuropathic pain displayed cortical reorganization and changes in somatosensory cortex activity, patients with non-neuropathic chronic pain did not. Furthermore, cortical reorganization in neuropathic pain patients was associated with changes in regional anatomy. These data, by showing that pain per se is not associated with cortical plasticity, suggest that treatments aimed at reversing cortical reorganization should only be considered for use in patients with certain types of chronic pain. [ABSTRACT FROM AUTHOR]

Borderline personality disorder has been estimated to occur among about 4% of those with autism spectrum disorder. This co-occurrence can escalate the challenges of treating either condition separately, and patients often face severe challenges in psychosocial and occupational functioning. Clinicians need guidance to manage a high degree of complexity, using standards of care and a synthesis of what is known so far, to navigate the currently limited armamentarium of clinical tools. This article reviews the available scientific research and clinical experience with respect to diagnosis, psychoeducation, treatment framework, safety management, other co-occurring disorders, and multimodal treatments. It also discusses future directions for generating new knowledge to improve the care of patients with this important co-occurrence. Although the discussion explores the unique complexity and relative lack of clinical guidelines at present, good psychiatric management serves as a clinical framework that anchors treatment approaches as the evidence base develops., Competing Interests: The authors report no financial relationships with commercial interests.