Characteristics of Patients With Borderline Personality Disorder in a State Psychiatric Hospital

Abstract

Borderline personality disorder is common across mental health settings and associated with substantial suffering, disability, and mortality risk. However, it is often underdiagnosed and no prevalence data are available for state hospital settings. This study aims to provide a preliminary assessment of the prevalence and characteristics of borderline personality disorder (BPD) within an inpatient unit of a state psychiatric hospital. In order to improve the quality of care at a state psychiatric hospital, all patients admitted to a 40-bed unit from April 2008 to June 2009 were routinely administered a structured diagnostic interview for BPD. A total of 65 patients were screened and their charts were reviewed. Twenty patients (31%) met criteria for BPD, but only eight of them (40%) had a chart diagnosis of BPD. Compared to patients without BPD, patients with BPD were significantly more likely to be female (75%), to carry a diagnosis of major depressive disorder, and to have been admitted within the past year. Twenty-four percent of patients with a primary psychotic disorder also met criteria for BPD. BPD patients tended to have shorter lengths of stay, but they had significantly more management problems, including incidents of self-harm, episodes of restraint, and stat administrations of medications. The authors conclude that BPD can be a common but underappreciated co-occurring condition in a state psychiatric hospital. In this setting, BPD is associated with more frequent admissions and numerous management challenges, suggesting the need for comprehensive screening, coordination of care, and specialized treatment programming.

Anxious adult attachment may mediate the relationship between childhood emotional abuse and borderline personality disorder

“…Because subjects with several personality disorders are very representative among psychiatric outpatients, we were aware that this decision could reduce the ecological validity of our results, but we prioritized the internal validity. To control the effects of sex, we also excluded men for the current study because the relative risk of under‐representation (men : women) among BPD patients when compared with other personality disorders (Goodman et al, ; Leontieva & Gregory, )…”

Factors influencing clinical decision making used by mental health nurses to provide provisional diagnosis: A scoping review

“…Accurate diagnosis is imperative to ensure that appropriate referral and treatment are provided (Leontieva & Gregory ). MHNs who are embedded in the ED have a fundamental role in the assessment of consumers who present to the ED seeking treatment.…”

Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

“…Thus, although personality disorder showed shorter LOS, our more complex approach to examine outcomes could relativize the weight of this variable, valuing other clinical aspects. In this line, Leontieva and Gregory found shorter LOS in inpatients with borderline personality disorder compared with other diagnoses, but significantly more management problems, such as incidents of self-harm, episodes of restraint, stat administrations of medications and readmissions 32 . Thus, the chronic disruptive behavior of such patients can make the hospitalization insufficient to improve the functioning and the severity of their symptoms, regardless of LOS.…”