Early education intervention in schools and immediate environment
Early education intervention would help the parents bond and attach to a child, limit the frustrations with children who are needy, and should address the children's needs in a way that is comprehensible to parents. Primary care teams can be effective in applying primary prevention programs in schools, or working with parents individually and enhancing attitudes and skills of good parenting, identifying risk factors in the immediate environment of the children (socio-economic adversity and deprivation, single mothering, parents' mental-ill health, postnatal depression of the mother, alcoholism and drug abuse etc.) in order to eliminate possible negative influences in the child's development. Apart of the general practitioner and the pediatrician, the role of the health visitor, regularly visiting the child and the family from a very early stage, is crucial in applying such preventive interventions.
Adult personality disorders should be carefully diagnosed and decompensation and complications such as self-destructive behavior, including multiple attempts (caused by a frequent regression to borderline level of functioning) prevented by adequate treatment strategies, including both pharmacotherapy and psychotherapy. The competence of individuals with personality disorders should be increased by effective services for patients with personality disorders (delivering acute care, such as crisis and emergency services and acute psychiatric hospitalization; continuing care at the outpatients services; day hospital treatment; assertive community treatment programs; integrated treatment for comorbid substance abuse and psychoeducational interventions for families of patients with personality disorders). Programs for reducing PDs and their deleterious effects on the immediate (micro) and wider (macro) surroundings may contribute to the alleviation or prevention of the expansion of aggression and violence as well as of the transgenerational transmission of these disorders.
D. Lecic-Tosevski, MD, PhD
Institute for Mental Health, School of Medecine, Belgrade
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