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A retrospective survey of care provided to patients with borderline personality disorder admitted to a female psychiatric intensive care unit

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Aims: To survey the characteristics and care pathway of patients with a diagnosis of borderline personality disorder (BPD) admitted to Elizabeth Casson House female PICU over a four year period. To describe the nature of admissions, survey the treatment given, review discharge planning and explore the financial implications of this care. Method: A retrospective descriptive survey of patient records with reference to the standards of care set out by NICE (The National Institute for Health and Care Excellence). Results: Almost a quarter (n = 34, 24%) of patients admitted had a diagnosis of BPD and all had previous contact with mental health services and a complex range of needs. The most common reason for admission in this study was risk of self-harm (n = 34, 74%) and self-harm occurred during the majority of admissions (n = 26, 57%). Intramuscular rapid tranquilisation was used in over a third of admissions (n = 17, 37%). Around a quarter of patients accessed psychological therapies during their admission (n = 8, 28%). The estimated costs associated with these admissions was in excess of a million pounds. Conclusion: This survey suggests striking differences between male and female PICU patients and highlights the challenges of providing evidence based treatment for patients with BPD in a PICU. NICE guidelines recommend the formation of specialist multidisciplinary personality disorder teams which can contribute to reducing episodes of crisis and periods of hospitalisation. The findings of this survey make both a financial and clinical case for this approach to care.
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Document Type: Conference Report

Publication date: April 1, 2020

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  • Published twice a year, the Journal of Psychiatric Intensive Care is devoted to issues affecting the care and treatment of people with mental disorders who manifest severely disturbed functioning. The journal is international and multidisciplinary. It provides stimulating papers and articles of interest to those who work in or study psychiatric intensive care, low secure services, acute inpatient wards, challenging behaviour environments, emergency psychiatry, or intensive treatments settings in other parts of the wider mental health system. The Journal of Psychiatric Intensive Care encourages informed debate and exchange of opinion. Its content includes editorials, original research, brief reports, reviews, conference reports, news and notices, but preference is given to original research of a high scientific quality.
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