Patients with Borderline Personality Disorder (BPD) show a pervasive pattern of instability in their affects, impulsivity, self-image as well as in their interpersonal relationships. Co-morbid mental disorders, particularly disorders like depression, anxiety and substance-related disorders are common. The high amount of health care utilization of borderlinepatients makes care systems encounter considerable challenges. Although disorder-specific psychotherapeutic concepts of treatment have proven efficacious, it needs to be emphasized that the current range of outpatient care available for borderline-patients in Germany and in Austria is absolutely insufficient. The major part of the high costs of inpatient care could certainly be reduced by establishing an integrated care system. In the current follow-up survey 73 patients were contacted who -being diagnosed with Borderline Personality Disorder according to DSM-IV -had at least one inpatient stay in department 5B, the department of cognitive behavioural treatment, in the Vienna General Hospital (AKH) in the years from 2000 to 2004. Questionnaires provided information on sociodemographic data, on the extent of medical and psychotherapeutic treatment, the severity of symptoms (BSL) and on the quality of life (WHOQOL-BREF). 29 patients were reached after an average period of 2.2 (SD+/-1.3) years following the inpatient stay in the department of cognitive behavioural treatment (Response rate 39.7%). At the time of the survey 22 persons (75.9 %) received psychotherapy, 18 persons (62.1 %) regularly consulted a psychiatrist, 13 persons were in regular contact with a general practitioner (45 %). The subjective severity of symptoms according to the Borderline Symptom List (BSL) turns out below average with a percentage value of 19. This means 81% of the norm sample of 308 female patients with BPD shows a higher severity of symptoms than the patient population surveyed. However, the quality of life in WHOQOL-BREF turns out to be significantly (p < 0.01) reduced. Apart from the evaluation of the severity of total symptomatology, there was a 5-step Likert scale (BSL-SUPPLEMENTARY SCALE) administered to assess the borderline specific dysfunctional behaviour; the period selected for evaluation was the past week regarding to follow up. Results of the BSL-SUPPLEMENTARY SCALE demonstrate a high range and various aspects of borderline typical complaints, concerning self injury, like attempted suicide, addiction to certain substances, drug or alcohol abuse, eating disorder and uncritical sexual contacts, followed by regret. This outcome reflects the main problem dealing with the transfer of the therapeutically induced change of behaviour during the inpatient stay into the outpatient daily life experience. The low response rate of 39.7 % in this follow-up survey also reflects the compliance problems of these patients with regard to psychiatric treatment.
Zusammenfassung: Patienten mit einer Borderline-Störung (BPS) zeigen ein tiefgreifendes Muster von Instabilität in derAffektregul...