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Ten-Year Use of Mental Health Services by Patients With Borderline Personality Disorder and With Other Axis II Disorders

Susanne Hörz‐Sagstetter · Mary C. Zanarini · Frances Rachel Frankenburg · Donald Bradford Reich · Garrett M. Fitzmaurice

118 citations0/0 files storedPsychiatric Services

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Personality Disorders and Psychopathology Psychiatric care and mental health services Bipolar Disorder and Treatment

Abstract

OBJECTIVE: The study determined the prevalence of use of three treatment modalities (individual therapy, medication, and hospitalization) reported over a ten-year period by patients with borderline personality disorder and by those in a comparison group with other axis II disorders. Time to cessation and time to resumption for each modality among patients with borderline personality disorder were also determined. METHODS: Treatment history of inpatients with a reliable diagnosis of borderline personality disorder (N=290) and of other axis II disorders (N=72) was assessed with an interview of proven reliability during the index admission. Treatment history was reassessed at two-year intervals for ten years. RESULTS: For all three treatment modalities, prevalence of use declined significantly among patients with borderline personality disorder and among those in the comparison group. Among patients with borderline personality disorder, 52% reported having stopped individual therapy and 44% reported having stopped medication at one or more of the follow-up interviews over ten years. However, 85% of those who had stopped psychotherapy and 67% of those who stopped taking medication resumed these treatments during a subsequent two-year period. In contrast, 88% had experienced at least one two-year period without a psychiatric hospitalization by the time of the ten-year follow-up; however, almost half of these patients were subsequently rehospitalized. CONCLUSIONS: The results suggest that patients with borderline personality disorder tend to use outpatient treatments without interruption over prolonged periods. They also suggest that inpatient treatment is used far more intermittently by patients with borderline personality disorder.

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References

1992The Structured Clinical Interview for DSM-III-R (SCID)1957Two Factor Index of Social Position 1991Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients 1999Effectiveness of Partial Hospitalization in the Treatment of Borderline Personality Disorder: A Randomized Controlled Trial 2006Outpatient Psychotherapy for Borderline Personality Disorder 2007Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study 2003The Longitudinal Course of Borderline Psychopathology: 6-Year Prospective Follow-Up of the Phenomenology of Borderline Personality Disorder 1989The Revised Diagnostic Interview for Borderlines: Discriminating BPD from other Axis II Disorders

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2014Pharmacotherapy for Borderline Personality Disorder—Current Evidence and Recent Trends 2022Pharmacological interventions for people with borderline personality disorder 2013The relationship of chronic medical illnesses, poor health-related lifestyle choices, and health care utilization to recovery status in borderline patients over a decade of prospective follow-up 2012Use of Dialectical Behavior Therapy in Inpatient Treatment of Borderline Personality Disorder: A Systematic Review

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