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Is Borderline Personality Disorder Madness? a Qualitative Study of the Perceptions of Medical Students in Somaliland

Published online by Cambridge University Press:  07 July 2023

Hanny Arisna ,
Jibril Handuleh ,
Kamaldeep Bhui ,
Victor Pereira-Sanchez  and
Tennyson Lee
Hanny Arisna*
Affiliation:
The Centre for Understanding of Personality (CUSP), London, United Kingdom East London NHS Foundation Trust, London, United Kingdom
Jibril Handuleh
Affiliation:
The Centre for Understanding of Personality (CUSP), London, United Kingdom Department of Psychiatry St Paul Hospital Millenium Medical College, Adis Ababa, Ethiopia
Kamaldeep Bhui
Affiliation:
The Centre for Understanding of Personality (CUSP), London, United Kingdom East London NHS Foundation Trust, London, United Kingdom Department of Psychiatry & Nuffield Department of Primary Care Health Sciences Medical Sciences Division, University of Oxford, Oxford, United Kingdom
Victor Pereira-Sanchez
Affiliation:
The Centre for Understanding of Personality (CUSP), London, United Kingdom Department of Child and Adolescent Psychiatry, New York University (NYU) Grossman School of Medicine, New York, United States of America
Tennyson Lee
Affiliation:
The Centre for Understanding of Personality (CUSP), London, United Kingdom East London NHS Foundation Trust, London, United Kingdom
*
*Corresponding author.
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Abstract

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Aims

As the next generation of doctors, medical students' perception of patients with personality disorder (PD) is critical. Yet a systematic review of the literature shows this has not been studied. The study aims to identify 1) the understanding and perception of medical students about PD and 2) factors that may relate to this knowledge and perception.

Methods

A focus group discussion (FGD) was conducted with eight medical students in their sixth year at Amoud University, Somaliland. We presented a case vignette of a patient with typical Borderline PD symptoms (which would meet DSM5 criteria for Borderline PD) and used Barts Explanatory Model Inventory (BEMI) to explore the issue. The FGD was recorded, transcribed, translated and thematically analysed.

Results

The Medical students showed accurate knowledge regarding Borderline PD, recognising features of unstable mood, impulsiveness, and emptiness. Medical students showed binary perception, whether this patient was ‘crazy’ (waali) or not crazy. They perceived their community as a strong African Muslim population. Half the participants believed religious intervention would be helpful “I believe in Islam. So, to some degree it could be managed in certain religious centrs”. Importantly, medical students, when asked to divest of their professional identity, and to describe their personal views as members of the local population, then associated PD with craziness or madness.

Conclusion

The views of PD as craziness or ‘madness’ and the role of religious intervention have important implications for training and service development. The importance of a culturally sensitive training to medical students regarding PD in order to match cultural and religious views, and consideration of development of health services which are sensitive to religious practice is highlighted. We recommend including social and cultural implications in the training of medical students to better prepare them for the complexity of managing PD.

Type
Education and Training
Information
BJPsych Open , Volume 9 , Supplement S1: Abstracts from the RCPsych International Congress 2023, 10–13 July , July 2023 , pp. S14
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NC
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This does not need to be placed under each abstract, just each page is fine.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Footnotes

Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.

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