Pharmacological treatment of borderline personality disorder: a retrospective observational study at inpatient unit in Italy.
OBJECTIVE
Borderline personality disorder (BPD) is a high prevalence personality disorder. Pharmacotherapy is commonly used, however, a minority of studies investigated patterns of prescription for BPD, particularly in inpatients unit. We aimed to describe the clinical features and the prescribing practice for BPD patients, and to investigate the possible advantages of a single class of medications or of combined drug treatments in terms of length of stay in hospital.


METHODS
This is a retrospective observational study evaluating 109 BPD inpatients from June 2011 to June 2013.


RESULTS
There was evidence of an extensive use of drugs: benzodiazepines/hypnotics (85.2%), antipsychotics (78.7%), mood stabilizers (70.4%) and antidepressants (31.5%). Polypharmacy was common (83.5%). A longer length of stay in hospital was associated with the prescription of antipsychotic and/or antidepressant medication, while a shorter hospitalization was associated with the use of a mood stabilizer.


CONCLUSIONS
The rates of prescription of different classes of drugs reported in our sample and in similar 'naturalistic' studies highlight a heterogeneous pattern of prescriptions for BPD. Mood stabilizers showed a more favourable profile in terms in length of stay in hospital than antipsychotic and/or antidepressant. Our results reiterate the discrepancy between international recommendations and everyday clinical practice.
a School of Psychiatry , University of Perugia , Perugia , Italy.
Enrico
E
Paolini
a School of Psychiatry , University of Perugia , Perugia , Italy.
Francesca Alice Fiore
FA
Mezzetti
b Department of Economics, Statistical Section , University of Perugia , Perugia , Italy.
Francesca
F
Pierri
c Department of Medicine, Division of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation , University of Perugia , Perugia , Italy.
Patrizia
P
Moretti
D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007297:Inpatients; D007558:Italy; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D055815:Young Adult
D011619:Psychotropic Drugs
Borderline personality disorder; drug therapy; inpatient; length hospital stay; mood stabilizers