All-Cause Mortality of Hospital-Treated Borderline Personality Disorder: A Nationwide Cohort Study

2020 ◽  
Vol 34 (6) ◽  
pp. 723-735 ◽  
Author(s):  
Jesper N⊘rgaard Kjær ◽  
Robert Biskin ◽  
Claus Vestergaard ◽  
Povl Munk-J⊘rgensen
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mortality Rate ◽  
Borderline Personality ◽  
High Rate ◽  
Standardized Mortality Ratio ◽  
Central Research ◽  
Emergency Rooms ◽  
Icd 10 ◽  
Mortality Ratio

Patients with borderline personality disorder (BPD) are known to present frequently in emergency rooms, and they have a high rate of suicide. The mortality rate of patients with BPD is still unclear. The Danish Psychiatric Central Research Register and The Danish Register for Causes of Death were used to identify patients with a first-ever diagnosis of BPD (ICD-10: F60.31) from 1995 through 2011 together with time and cause of death. A total of 10,545 patients with a BPD diagnosis were followed for a mean time of 7.98 years. A total of 547 deaths were registered. The standardized mortality ratio of patients with BPD compared to the general population was 8.3 (95% CI [7.6, 9.1]). More than three inpatient admissions per year or a comorbid diagnosis of substance use disorder correlated with a higher mortality rate. The increased mortality rate in patients with BPD treated in secondary care emphasizes that it is a severe mental disorder.

A retrospective chart review: adolescents with borderline personality disorder, borderline personality traits, and controls

2016 ◽  
Vol 30 (2) ◽  
Author(s):  
Ellen N. Jopling ◽  
Sarosh Khalid-Khan ◽  
Shivani F. Chandrakumar ◽  
Shira C. Segal
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mortality Rate ◽  
Chart Review ◽  
Adult Population ◽  
Retrospective Chart Review ◽  
Borderline Personality ◽  
Control Group ◽  
Disruptive Disorders

Abstract With an estimated lifetime prevalence as high as 5.9% in the general population, borderline personality disorder (BPD) is a psychiatric disorder characterized by marked impulsivity as well as difficulties in interpersonal relationships, self-image, and affects. The burden on the health care system is immense with BPD patients accounting for 10%–20% of the patients in mental health outpatient facilities and 15%–40% in mental health inpatient facilities. Further, while 75%–80% of BPD patients attempt to commit suicide, 10% succeed; this mortality rate exceeds even that of anorexia nervosa which, with a weighted mortality rate of 5.1%, has often been considered to have the highest mortality rate of any mental disorder. In order to provide treatment and to implement preventative measures, a risk profile as well as clinical features must be identified within the adolescent population. This is presently crucial, as the current criteria for BPD are not developmentally focused, and as a result, criteria initially developed for the adult population are being applied in diagnoses of adolescents. A population of adolescents (n=80) between 16 and 19 years of age meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria either for BPD traits (n=46) or for BPD (n=36) were included in a retrospective chart review; a control group consisting of n=30 mood and anxiety control subjects were included to allow for further comparisons. Complex significant differences were discovered between the three groups in the following areas: history of sexual abuse, suicidal ideation, internalizing/externalizing symptoms, interpersonal difficulties, impulsivity, pre-perinatal stress, bullying, substance abuse, anxiety disorders, disruptive disorders, and finally, learning disorders.

Personality problems and disorders

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Mental Illness ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Team Work ◽  
Dimensional Approach ◽  
Outreach Workers ◽  
Dsm V ◽  
Icd 10

This chapter deals with the controversial issue of personality disorder, whether these are meaningful diagnoses and, if so, how they affect management. The classification is entirely pragmatic: the definitions and classification in both ICD-10 and DSM-V are outlined along with proposals to abandon categories in favour of a dimensional approach. The issue of treatability is explored, but we conclude that ignoring personality and personality disorders is not a viable alternative for outreach workers. Most of the chapter deals with the management of dissocial personality disorder (usually in men) and borderline personality disorder (usually in women). Specific psychotherapies are not dealt with here; the focus is on how to use team work to manage individuals with severe mental illness and disorders of personality.

Reasons for Acute Psychiatric Admissions and Psychological Interventions for Patients with Borderline Personality Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S71-S71
Author(s):  
N.P. Lekka ◽  
G. Carr ◽  
T. Gilpin ◽  
B. Eyo
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Significant Risk ◽  
Borderline Personality ◽  
Psychological Interventions ◽  
Nice Guidance ◽  
Icd 10 ◽  
Psychosocial Difficulties ◽  
Relationship Breakdown ◽  
Competing Interest

IntroductionNICE guidelines advise to consider admission for patients with borderline personality disorder (BPD) for the management of crises involving significant risk to self or others. Furthermore, to consider structured psychological interventions of greater than three months’ duration and twice-weekly sessions according to patients’ needs and wishes.ObjectivesWe aimed to assess reasons for admission and access to psychological interventions in an acute inpatient BPD population.MethodsCase notes of patients with a diagnosis of BPD (ICD-10 F60.3 and F60.31), discharged from four acute general adult wards in Sheffield during a period of twelve months were studied retrospectively, using a structured questionnaire based on BPD NICE guidance.ResultsOf the 83 identified BPD patients, seventy-eight percent were female and 82% between 16–45 years old. Eleven patients had four or more admissions. Eighty percent reported suicidal ideation at admission, with 50% having acted on it (70% by overdose, 50% cutting, 10% hanging). Of this cohort, 58% reported they intended to die. Psychosocial factors at admission were identified in 59 cases, including relationship breakdown (47.5%), alcohol/drug use (30.5%) and accommodation issues (17%). Disturbed/aggressive behaviour was documented in 27.1% of these cases. Sixty-eight percent of patients had psychology input in the 5 years preadmission: 38% (21 patients) received structured therapy, whilst 62% received only one assessment or advise to teams.ConclusionsPatients were mainly admitted for risk management. A high proportion received unstructured psychological interventions. Services offering structured psychological interventions should be supported, as hospitalisations only temporarily address BPD patients’ suicidality and psychosocial difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Substance Use in Youth With Borderline Personality Disorder

2018 ◽  
Vol 32 (5) ◽  
pp. 603-617
Author(s):  
Franco Scalzo ◽  
Carol A. Hulbert ◽  
Jennifer K. Betts ◽  
Sue M. Cotton ◽  
Andrew M. Chanen
Keyword(s):  
Substance Use ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
General Population ◽  
Help Seeking ◽  
Population Sample ◽  
Borderline Personality ◽  
High Rate ◽  
The Past ◽  
And Gender

Co-occurring substance misuse and borderline personality disorder (BPD) in adults is associated with more severe dysfunction and poorer prognosis than BPD alone. However, it is unknown to what extent substance use in youth with BPD is normative for this age group or pathological. This study compared substance use in 117 help-seeking youth (aged 15–25 years) with their first presentation for treatment of BPD, with an epidemiological general population sample and with healthy, age- and gender-matched controls. Established instruments were used to diagnose BPD and assess substance use. Alcohol dependence, daily tobacco use, and use of illicit substances in the past month were between four and nine times more prevalent in the BPD group than in the general population. Similarly, the prevalence of substance use was disproportionately higher in youth with BPD than in matched controls. The findings indicate a non-normative, alarmingly high rate of substance use among youth with BPD.

scholarly journals Targeting the Endocannabinoid System in Borderline Personality Disorder

2020 ◽  
Vol 18 ◽  
Author(s):  
Sari Goldstein Ferber ◽  
Reut Hazani ◽  
Gal Shoval ◽  
Aron Weller
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Endocannabinoid System ◽  
Brain Regions ◽  
Borderline Personality ◽  
High Rate ◽  
Potential Contribution ◽  
Emotional Instability ◽  
Functional Changes ◽  
Corticolimbic System

: Borderline Personality Disorder (BPD) is a chronic debilitating psychiatric disorder characterized mainly by emotional instability, chaotic interpersonal relationships, cognitive disturbance (e.g. dissociation and suicidal thoughts) and maladaptive behaviors. BPD has a high rate of comorbidity with other mental disorders and high burden on society. In this review, we focus on two compromised brain regions in BPD – the hypothalamus and the corticolimbic system, emphasizing the involvement and potential contribution of the endocannabinoid system (ECS) to improvement in symptoms and coping. The hypothalamus-regulated endocrine axes (hypothalamic pituitary – gonadal, thyroid & adrenal) have been found to be dysregulated in BPD. There is also substantial evidence for limbic system structural and functional changes in BPD, especially in amygdala and hippocampus, including cortical regions within the corticolimbic system. Extensive expression of CB1 and CB2 receptors of the ECS has been found in limbic regions and the hypothalamus. This opens new windows of opportunity for treatment with cannabinoids such as cannabidiol (CBD) as no other pharmacological treatment has shown long-lasting improvement in the BPD population to date. This review aims to show the potential role of the ECS in BPD patients through their most affected brain regions, the hypothalamus and the corticolimbic system. The literature reviewed does not allow for general indications of treatment with CBD in BPD. However, there is enough knowledge to indicate a treatment ratio of high level of CBD to low level of THC. A randomized controlled trial investigating the efficacy of cannabinoid based treatments in BPD is warranted.

scholarly journals Recent developments in borderline personality disorder

2000 ◽  
Vol 6 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Anthony P. Winston
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
World Health ◽  
Recent Developments ◽  
Icd 10 ◽  
Negative Effect ◽  
Health Organization ◽  
Personality Disturbance ◽  
Emotionally Unstable Personality Disorder

Patients with borderline personality disorder (BPD; known in ICD–10 (World Health Organization, 1992) as emotionally unstable personality disorder) pose some of the most difficult management problems facing the clinical psychiatrist. They frequently present in crisis, but are often difficult to engage in any form of treatment. Their behaviour causes considerable anxiety but their ambivalence about treatment often leaves professionals feeling frustrated and resentful. These feelings can all too easily be transformed into therapeutic nihilism. As well as being a significant problem in its own right, comorbid personality disturbance complicates the management of other psychiatric disorders and has a negative effect on their prognosis (Reich & Vasile, 1993).

Factitious bereavement with psychotic features in a patient with borderline personality disorder and opium dependence

2011 ◽  
Vol 26 (S2) ◽  
pp. 1020-1020
Author(s):  
A. Ghaffarinejad ◽  
V. Shahriari
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Final Diagnosis ◽  
Borderline Personality ◽  
High Rate ◽  
Psychotic Symptoms ◽  
Factitious Disorder ◽  
Bam Earthquake ◽  
Diagnostic Difficulties ◽  
Psychotic Features

Factitious disorder, whilst uncommon, is not rare in patients referring to clinics and psychiatric hospital.Concerning high rate of grief reactions in this province after the Bam earthquake in the year 2004, we believe that this condition is Under diagnosed, mainly because of diagnostic difficulties. In current article an unusual case who came with psychotic symptoms accompanied by symptoms of complicated grief is reported. The final diagnosis is supposed to be factitious bereavement.Reported case is a 27 years old man with approved diagnosis of borderline personality disorder and opium dependence. At the last session of hospitalizing in 2010, his symptoms include : irritability, aggression and emphasis on visiting his relatives and some strange people who died in the Bam earthquake about six years ago, in which the patient took part in finding their corpses in collaboration with safety guards.From onset of disturbance, patient claimed that those deceased people are continuously present around him, talk to him and blame him because of his insufficient effort to save them. He also believes that the experiences are real and those people are alive at present. Relationship between factitious disorder with bereavement symptoms is not well-described in literatures, so this patient and influences of personality structure and opium dependence on forming patient's symptoms are discussed in this article.

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