scholarly journals Borderline Personality Disorder, Exposure to Interpersonal Trauma, and Psychiatric Comorbidity in Urban Primary Care Patients

Psychiatry ◽  
2013 ◽  
Vol 76 (4) ◽  
pp. 365-380 ◽  
Author(s):  
Maren Westphal ◽  
Mark Olfson ◽  
Margarita Bravova ◽  
Marc J. Gameroff ◽  
Raz Gross ◽  
...  
Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy

Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. Results The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. Conclusions The degree to which patients’ perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.


Author(s):  
Julian Wlodarczyk ◽  
Sharon Lawn ◽  
Kathryn Powell ◽  
Gregory Crawford ◽  
Janne McMahon ◽  
...  

The prevalence of people seeking care for Borderline Personality Disorder (BPD) in primary care is four to five times higher than in the general population. Therefore, general practitioners (GPs) are important sources of assessment, diagnosis, treatment, and care for these patients, as well as important providers of early intervention and long-term management for mental health and associated comorbidities. A thematic analysis of two focus groups with 12 GPs in South Australia (in discussion with 10 academic, clinical, and lived experience stakeholders) highlighted many challenges faced by GPs providing care to patients with BPD. Major themes were: (1) Challenges Surrounding Diagnosis of BPD; (2) Comorbidities and Clinical Complexity; (3) Difficulties with Patient Behaviour and the GP–Patient Relationship; and (4) Finding and Navigating Systems for Support. Health service pathways for this high-risk/high-need patient group are dependent on the quality of care that GPs provide, which is dependent on GPs’ capacity to identify and understand BPD. GPs also need to be supported sufficiently in order to develop the skills that are necessary to provide effective care for BPD patients. Systemic barriers and healthcare policy, to the extent that they dictate the organisation of primary care, are prominent structural factors obstructing GPs’ attempts to address multiple comorbidities for patients with BPD. Several strategies are suggested to support GPs supporting patients with BPD.


2002 ◽  
Vol 162 (1) ◽  
pp. 53 ◽  
Author(s):  
Raz Gross ◽  
Mark Olfson ◽  
Marc Gameroff ◽  
Steven Shea ◽  
Adriana Feder ◽  
...  

2013 ◽  
Vol 27 (2) ◽  
pp. 171-174 ◽  
Author(s):  
Enric Aragonès ◽  
Luis Salvador-Carulla ◽  
Judit López-Muntaner ◽  
Marc Ferrer ◽  
Josep Lluís Piñol

Sign in / Sign up

Export Citation Format

Share Document