Borderline personality disorder among chronic pain patients?

This “study” is so garbled it would be comical if it weren’t insinuating that chronic pain patients are mentally ill.  Notice the uncorrected misspelling of the very first word, which is supposed to be “AAPM”

FAAPM [?] 36th Annual Meeting Scientific Poster Abstracts annualmeeting.painmed.org | #AAPM2020 505 | Psychosocial Borderline personality features among patients with chronic non-cancer pain, barrier versus unexploited targets for effective pain management: a systemic review

Because two pain-oriented medical websites both had fairly demeaning (to pain patients) articles about the implications of this “abstract”, and it was deemed significant enough to be presented at this renowned pain association’s annual meeting, I decided to take a closer look.

It’s a total mess.

It lamely rehashes the “literature” found in multiple medical databases, uses odd criteria to select (fish for) studies, and looks for an association which (surprise!) was then found.

And, to top it all, it’s written with such horribly bad grammar that it’s almost incomprehensible.

Why wouldn’t these “scientists” use the grammar and spell-check tools so readily available when their English is so poor? Do they perhaps not even know how bad their writing is?

Could this “study” really be as awful, illogical, and pointless as it seems?

Objective: 

Borderline personality disorder (BPD) is common in patients with chronic non-cancer pain (CNCP).

BPD patients with CNCP often report worse severity and are more likely to abuse opioids, which further complicates their pain assessment and management. 

This study would systemically check association between BPD and CNCP, to provide some unexploited targets for effectively managing CNCP.

Method: a comprehensive literature search was performed through multiple databases, including Pubmed, PsychINFO and Google Scholar. 

Combination of following search terms were used:

  • borderline personality disorder,
  • chronic pain,
  • chronic non-cancer pain,
  • headache,
  • fibromyalgia, and
  • arthritis.

Why were headache, fibromyalgia, and arthritis singled out? It makes no logical sense – shouldn’t they already be included in the search for “chronic pain”?

This is a very strange list and certainly can’t be generalized to apply to chronic pain patients as a group.

The reference lists of relevant articles were also searched for appropriate studies. 

If they already ran a literature search through every known medical database of at least some repute, why would they not already have found the articles referenced? Where else would such articles reside?

Results:

Our results showed the pool prevalence of BPD among CNCP was 23.3% (including 11.3% in chronic headache, 27.5% in arthritis, and 24.3% in chronic spinal pain), which suggested there was a significant portion of CNCP patients had co-occurring BPD. 

Conclusions:

Our results emphasize approximately one fourth of individuals with CNCP could have co-occurring BPD, which necessitates paying extra attention to manage BPD in patient with CNCP. 

A growing literature showed that in patients with BPD and co-occurring mood and/or anxiety disorders, treatment should focus principally on BPD, because effective treating BPD, rather than co-occurring disorders, is more likely to lead to remission of both mood and anxiety disorders.

This is only about anxiety and doesn’t even mention pain of any kind.

Similarly, for CNCP co-occurring BPD, CNCP should be treated through multiple approaches, but not to the exclusion of BPD treatments if patients exhibit some BPD features.

Similarly? To what? This last “sentence” is incomprehensible.

It seems they’re trying to say that if a CNCP patient has BPD, BPD treatment should not be excluded. While this is completely obvious, nothing they “found” in their review supports this “conclusion”. 

The one and only “finding” of this “review” was that chronic pain patients suffer mentally too.

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