A naturalistic longitudinal study of extended inpatient treatment for adults with borderline personality disorder: An examination of treatment response, remission and deterioration

Abstract

Twenty-five years ago it was assumed that adults with BPD could not benefit from psychiatric treatment. Today there are a number of effective evidence-based outpatient treatments for BPD, but beliefs about extended inpatient treatment have changed little. Current results indicate that extended inpatient treatment can result in significant and clinically meaningful symptomatic and functional improvement in BPD patients without iatrogenic effects.

Short-term and 1-year outcome of patients’ with borderline personality admitted to a short-term recovery-oriented residential service

“…We conclude that the PARC service can promote clinical and psychosocial recovery in patients with BPD. Further studies (prospective cohort and/or a comparative study with extended inpatient treatment 15 ) can help to confirm our findings.…”

Mental health presentations to acute psychiatric services: 3-year study of prevalence and readmission risk for personality disorders compared with psychotic, affective, substance or other disorders

“…Although the health service at the time was unremarkable from others in the state in terms of hospital and out-patient services, the generalisability of these findings to other services in Australia and internationally, should be considered in light of local policies around admissions to hospital, availability of hospital beds and quality of out-patient services. Also worth noting is that although in general hospital admissions for people with personality disorders are not recommended, both the National Health and Medical Research Council and National Health and Care Excellence guidelines suggest that in some cases it is necessary, 21 , 34 and some individuals with borderline personality disorder show positive long-term results from in-patient treatment, particularly for people with complex comorbidity 35 . Future studies would benefit from further investigation about treatment received within their in-patient stay, and further determination of whether the hospital stay was helpful or not or whether it could have been prevented particularly in the case of short-term readmissions.…”

Suicidality in Borderline Personality Disorder

“…Hospitalization has not been supported by evidence, and when suicidality is chronic, admission to hospital provides only temporary relief; most patients continue to have suicidal ideas after discharge. While some research describes intensive treatment in hospital [49], similar programs could be offered on an out-patient basis. To avoid the harm of repetitive admissions, one might prefer day treatment, which offers the advantages of admission (intensive treatment by an experienced team) without its disadvantages, and has some supporting evidence for its efficacy [31].…”