Borderline personality disorder: a challenge for mental health services.
OBJECTIVE
This study had two main aims: to determine the stability over time of the diagnosis borderline personality disorder (BPD) in a psychiatric hospital population; and to assess the quality and effectiveness of treatment offered within state mental health service.


METHODS
The case notes of 47 psychiatric hospital patients followed up for 3 years after the index admission were analysed.


RESULTS
The mean number of previous psychiatric hospital admissions was 9.0, and at least 74% of the sample had further admissions (mean 3.7) during the 3 year follow-up. Comorbidity with schizophrenia and schizoaffective disorder was rare, and was only 13% with major depression. Longitudinal stability of diagnosis was very high.


CONCLUSIONS
The study firmly supported BPD as a valid diagnosis. Its treatment within the state mental health system was generally haphazard and ineffective. Post-discharge plans were implemented for only 3 subjects. Current moves toward community psychiatric treatment represent a unique opportunity for improving treatment of BPD by using existing resources more effectively.
Clarke
M
M
Glenside Hospital, Eastwood, South Australia.
Hafner
R J
RJ
Holme
G
G
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D003156:Community Mental Health Services; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010348:Patient Care Team; D010359:Patient Readmission; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012559:Schizophrenia / Q000175:diagnosis / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D013021:South Australia; D016896:Treatment Outcome
D011619:Psychotropic Drugs