Patients with Borderline Personality Disorder in Emergency Departments

Shaikh, Untara; Qamar, Iqra; Jafry, Farhana; Hassan, Mudasar; Shagufta, Shanila; Odhejo, Yassar Islamail; Ahmed, Saeed

doi:10.3389/fpsyt.2017.00136

Cited by 56 publications

(71 citation statements)

References 117 publications

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“…Finally, only ED patients with personality disorders were more likely to have recurrent ED visits. This can be explained by the longstanding course of the disease and its multiple and recurrent exacerbations that lead patients with personality disorders to recurrent ED visits (25,34). The ED is indeed the accurate place to treat acute consequences of personality disorders by treating cuts and wounds or removing foreign bodies from any body site, for example, but the ED is not the right locus for treatment of the chronic underlying psychiatric disease.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Recurrent Emergency Department Visits in Patients With Mental Disorders

2020

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Background: Patients with mental disorders are more likely to be frequent emergency department (ED) users than patients with somatic illnesses. There is little information about recurrent ED visitors (≥four ED visits/year) due to mental health problems in Switzerland. Therefore, our aim was to investigate the prevalence of recurrent ED visits due to mental disorders and to determine which mental disorders and risk factors were associated with recurrent ED visits. Methods: In a retrospective analysis, we investigated patients suffering from mental health problems between January and December 2015 who presented more than once in the ED of a tertiary care hospital. ED patients who sought out the ED due to mental disorders were grouped in a recurrent group with at least four ED visits per year or in a control group visiting the ED twice or three times within a year. The primary endpoint was to assess the prevalence of recurrent ED patients due to acute symptoms of mental disorders. As secondary endpoints, we investigated which mental disorders and risk factors were associated with recurrent ED visits. Result: Of 33,335 primary ED visits, 642 ED visits (1.9%) were by 177 visitors suffering from acute mental health problems. Forty-five (25.4%) of these 177 patients were recurrent ED visitors; 132 (74.6%) visited the ED twice or three times (control). Patients with personality disorders had a four-times higher risk (p = 0.011) of being a recurrent ED visitor. Recurrent ED visitors with mental disorders had significantly more in-house admissions (p < 0.001), self-mutilations (p < 0.001), acute drug toxicity (p = 0.007) and were more often persons of single status (p = 0.045). Although recurrent ED visitors more often had an outpatient general physician or psychiatrist, they visited the ED more frequently within office hours (p < 0.001). Conclusion: A quarter of frequent ED users with mental disorders are recurrent ED visitors and were more likely to suffer from personality disorders. Recurrent ED visits are associated with higher rates of self-mutilation, acute drug toxicity, and a greater number of in-house admissions.

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Section: Discussionmentioning

confidence: 99%

Prediction of Recurrent Emergency Department Visits in Patients With Mental Disorders

2020

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“…For individuals with this disorder, people are considered completely good or completely bad. A nursing professional can be idealized by patients with borderline personality disorder, but if something happens that they do not accept, this same professional, who was considered affectionate, can be seen as persecuting or cruel, in his conceptions (5)(6)(7) . Rev Gaúcha Enferm.…”

Section: Discussionmentioning

confidence: 99%

“…It is important that patients are constantly observed for their own safety. This can be done through activities, thus avoiding that the professional seems suspicious and vigilant (5)(6)(7) .…”

Section: Discussionmentioning

confidence: 99%

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Cuidado de enfermagem às pessoas com transtorno de personalidade borderline na perspectiva freireana

Agnol

Meazza

Guimarães

et al. 2019

Rev. Gaúcha Enferm.

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Resumo OBJETIVO Compreender, sob a perspectiva ética de Freire, o cuidado de enfermagem às pessoas com transtorno de personalidade borderline. MÉTODOS Pesquisa qualitativa cuja produção das informações foi realizada de maio a junho de 2016, em duas unidades de internação psiquiátrica. Foram entrevistados sete enfermeiros e oito técnicos de enfermagem. As informações foram analisadas à luz do referencial de Paulo Freire. RESULTADOS Emergiram as categorias: 1) Acolhimento e relacionamento terapêutico como instrumentos para fortalecimento de vínculo; e 2) Terapia medicamentosa e contenção: interface entre proteção, estabelecimento de limites e outros desafios para o cuidado. CONCLUSÕES Os cuidados de enfermagem envolveram tecnologias relacionais, administração de medicamentos e contenção mecânica. Foram referidas dificuldades para lidar com pessoas com esse transtorno. A maneira de cuidar da enfermagem, embora ainda permeada por alguns preconceitos, passa por ideários contidos nos pressupostos éticos que operam à luz da obra de Freire.

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“…Help-seeking, including frequent presentations to emergency departments in response to suicidality, is common among consumers with BPD [13]. Although help-seeking has been identi ed as a healthy coping strategy for assisting consumers with BPD to cope with overwhelming distress [14], current treatment and care responses are often inadequate in meeting the speci c needs of this population [13,15]. Findings from a national survey of consumers with BPD and their carers/ families revealed a lack of BPD-related health services and support during times of crisis [16,17].…”

Section: Introductionmentioning

confidence: 99%

Structural stigma and its impact on healthcare for consumers diagnosed with Borderline Personality Disorder: protocol for a scoping review

Klein

Fairweather‐Schmidt

Lawn

et al. 2020

Preprint

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BackgroundStructural stigma in health systems experienced by consumers diagnosed with Borderline Personality Disorder (BPD), is a widespread phenomenon that causes health inequities and harm for this population. Structural stigma in this context relates to organisational practices, cultural norms, and institutional policies that limits consumers’ access to health services, quality of care, and health and well-being. BPD is a mental illness with high morbidity and mortality, characterised by instability in interpersonal relationships, self-image, and emotional and behavioral deregulation, which stem from significant traumatic childhood/life events, and/or biological etiologies. This scoping review aims to explore the literature on structural stigma in health systems specific to BPD, and to provide an overview of the impact of stigma on healthcare services for BPD consumers, and their carers/families.MethodsThis scoping review will follow the Joanna Briggs Institute (JBI) guidelines. The search strategy was developed and tested using PsycINFO. A comprehensive search will be conducted across PsycINFO, MEDLINE, CINAHL, Scopus, ProQuest, Cochrane library and JBI Evidence-Based databases; as well as a grey literature search using Google search engine. Studies will be screened by title, abstract and full text articles, by separate reviewers against the eligibility criteria. Selected full text articles will be accessed against the inclusion criteria. Quantitative and qualitative data will be extracted from the selected full text articles. A narrative summary of findings will then be conducted and presented in accordance with the JBI guidelines for scoping reviews, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 checklist. Quality appraisal of the included articles will be assessed using the Mixed Methods Appraisal Tool (MMAT) 2018 version.DiscussionThis review is anticipated to enhance both identification and understanding of those structures in health systems (i.e., policies, cultural norms, and practices), that manifest and perpetuate stigma experienced by consumers with BPD, and their carers/families. The findings can be used to inform future research, policy and practice relating to stigma reduction strategies that can be adopted to improve the provision of BPD-responsive services and care for this population.Scoping review registrationThis scoping review was submitted for registration in Open for Science Framework on 11th June 2020.

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Patients with Borderline Personality Disorder in Emergency Departments

Cited by 56 publications

References 117 publications

Prediction of Recurrent Emergency Department Visits in Patients With Mental Disorders

Prediction of Recurrent Emergency Department Visits in Patients With Mental Disorders

Cuidado de enfermagem às pessoas com transtorno de personalidade borderline na perspectiva freireana

Structural stigma and its impact on healthcare for consumers diagnosed with Borderline Personality Disorder: protocol for a scoping review

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