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

Published online by Cambridge University Press:  23 March 2020

N.P. Lekka ,
G. Carr ,
T. Gilpin  and
B. Eyo
G. Carr
Affiliation:
Sheffield Health and Social Care Foundation Trust, Acute Inpatient Service, Sheffield, United Kingdom
T. Gilpin
Affiliation:
Sheffield Health and Social Care Foundation Trust, Acute Inpatient Service, Sheffield, United Kingdom
B. Eyo
Affiliation:
Sheffield Health and Social Care Foundation Trust, Acute Inpatient Service, Sheffield, United Kingdom

Abstract

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Introduction

NICE 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.

Objectives

We aimed to assess reasons for admission and access to psychological interventions in an acute inpatient BPD population.

Methods

Case 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.

Results

Of 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.

Conclusions

Patients 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 interest

The authors have not supplied their declaration of competing interest.

Type
Oral communications: Anxiety disorders and somatoform disorders; depression; obsessive-compulsive disorder and personality and personality disorders
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S71
Copyright
Copyright © European Psychiatric Association 2017
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