Screening of psychiatric outpatients for borderline personality disorder with the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD).
BACKGROUND
Detecting patients with borderline personality disorder (BPD) is important, and feasible screening instruments are needed.


OBJECTIVE
To investigate our Finnish translation of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) as a screen for BPD among psychiatric outpatients, its psychometric and screening properties, and feasibility in improving the recognition of BPD.


METHODS
We screened 302 consecutive psychiatric outpatients at the Department of Psychiatry at the Helsinki University Central Hospital in Finland for BPD using the Finnish MSI-BPD. Of the patients, 69 (23%) were assigned to a random sample that was stratified according to the number of screens returned to the outpatient clinics, and further stratified into the three strata, high scores deliberately enriched, according to the MSI-BPD scores. Finally, a stratified random sample of 45 patients was interviewed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) by the interviewers blind to the patients' MSI-BPD scores.


RESULTS
One third (29%) of 302 screened patients had a positive MSI-BPD. The internal consistency of the MSI-BPD was good (Cronbach's alpha = 0.77). Of the 45 patients interviewed with the SCID-II, 11 (24%) were found to have BPD, five (46%) of whom a previously clinical diagnosis. In a ROC analysis, the optimal cut-off score was 7.


CONCLUSIONS
The translated MSI-BPD was found to be a feasible screen for BPD in Finnish psychiatric outpatient care. Further studies investigating the clinical utility of MSI-BPD in larger clinical samples are warranted.
Melartin
Tarja
T
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Häkkinen
Miikka
M
Koivisto
Maaria
M
Suominen
Kirsi
K
Isometsä
Erkki T
ET
D000328:Adult; D000553:Ambulatory Care; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003156:Community Mental Health Services; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006785:Hospitals, University; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011567:Psychiatric Department, Hospital; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D014175:Translating