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The outcomes of home treatment for borderline personality disorder

  • Sibel Turhan (a1) and Mark Taylor (a1)
Abstract
Aims and method

There is currently no trial or other scientific evidence informing the efficacy of any crisis intervention for people with borderline personality disorder (BPD). We aimed to assess the patterns of service use by patients with BPD taken on for crisis resolution and home treatment between 2010 and 2013. Patients with a diagnosis of BPD were identified and demographic and clinical data were collected.

Results

All patients were female, and a high proportion had recurrent presentations to crisis and home treatment services in Edinburgh. Many appeared to benefit from intensive home treatment, as measured by the Clinical Global Impression scale. A small number of patients (n = 5) were responsible for more than half of all referrals. Polypharmacy, or regular use of multiple medications, was common, with 62% of all patients receiving three or more regular medications.

Clinical implications

Crisis and home treatment services can be beneficial to most people with BPD in crisis. The high rate of polypharmacy seen in this study is of concern.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Mark Taylor (marktaylor2@nhs.net)
Footnotes
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Declaration of interests

M.T. works in a home treatment/crisis team.

Footnotes
References
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1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). APA, 2010.
2 Busner, J, Targum, SD. The Clinical Global Impression Scale: applying a research tool in clinical practice. Psychiatry (Edgmont) 2007; 4: 2837.
3 Johnson, S. Crisis resolution and home treatment teams: an evolving model. BJPsych Adv 2013; 19: 115–23.
4 Barker, V, Taylor, M, Kader, I, Stewart, K, Le Fevre, P. Impact of crisis resolution and home treatment services on user experience and admission to psychiatric hospital. Psychiatrist 2011; 35: 106–10.
5 Borschmann, R, Henderson, C, Hogg, J, Phillips, R, Moran, P. Crisis interventions for people with borderline personality disorder. Cochrane Database Syst Rev 2012; 6: CD009353.
6 Oldham, JM. Guideline Watch: Practice Guideline for the Treatment of Patients with Borderline Personality Disorder. American Psychiatric Association, 2005.
7 Abraham, PF, Calabrese, JR. Evidence-based pharmacologic treatment of borderline personality disorder: a shift from SSRIs to anticonvulsants and atypical antipsychotics? J Affect Disord 2008; 111: 2130.
8 Lieb, K, Vollm, B, Rucker, G, Timmer, A, Stoffers, JM. Pharmacotherapy for borderline personality disorder: Cochrane systematic review of randomised trials. Br J Psychiatry 2010; 196: 412.
9 National Institute for Health and Care Excellence. Recommendation 1.3.5 The role of drug treatment. In: Borderline Personality Disorder: Recognition and Management (CG78). NICE, 2009.
10 Kendall, T, Burbeck, R, Bateman, A. Pharmacotherapy for borderline personality disorder: NICE guideline. Br J Psych 2010; 196: 158–9.
11 Bateman, A, Fonagy, P. Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomised controlled trial. Am J Psychiatry 1999; 156: 1563–9.
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
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The outcomes of home treatment for borderline personality disorder

  • Sibel Turhan (a1) and Mark Taylor (a1)
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