BORDERLINE PERSONALITY-DISORDER - A CHALLENGE FOR MENTAL-HEALTH-SERVICES

Objective: This study had two main aims: to determine the stability ov er time of the diagnosis borderline personality disorder (BPD) in a ps ychiatric hospital population; and to assess the quality and effective ness of treatment offerred within a state mental health service. Metho d: The case notes of 47 psychiatric hospital patients followed up for 3 years after the index admission were analysed. Results: The mean num ber of previous psychiatric hospital admissions was 9.0, and at least 74% of the sample had further admissions (mean 3.7) during the 3 year follow-up. Comorbidity with schizophrenia and schizoaffective disorder was rare, and was only 13% with major depression, Longitudinal stabil ity of diagnosis was very high. Conclusions: The study firmly supporte d BPD as a valid diagnosis, Its treatment within the state mental heal th system was generally haphazard and ineffective, Post-discharge plan s were implemented for only 3 subjects. Current moves toward community psychiatric treatment represent a unique opportunity for improving tr eatment of BPD by using existing resources more effectively.