scholarly journals Borderline Personality Disorder in Primary Care

2002 ◽  
Vol 162 (1) ◽  
pp. 53 ◽  
Author(s):  
Raz Gross ◽  
Mark Olfson ◽  
Marc Gameroff ◽  
Steven Shea ◽  
Adriana Feder ◽  
...  
Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy

Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. Results The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. Conclusions The degree to which patients’ perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.


Author(s):  
Julian Wlodarczyk ◽  
Sharon Lawn ◽  
Kathryn Powell ◽  
Gregory Crawford ◽  
Janne McMahon ◽  
...  

The prevalence of people seeking care for Borderline Personality Disorder (BPD) in primary care is four to five times higher than in the general population. Therefore, general practitioners (GPs) are important sources of assessment, diagnosis, treatment, and care for these patients, as well as important providers of early intervention and long-term management for mental health and associated comorbidities. A thematic analysis of two focus groups with 12 GPs in South Australia (in discussion with 10 academic, clinical, and lived experience stakeholders) highlighted many challenges faced by GPs providing care to patients with BPD. Major themes were: (1) Challenges Surrounding Diagnosis of BPD; (2) Comorbidities and Clinical Complexity; (3) Difficulties with Patient Behaviour and the GP–Patient Relationship; and (4) Finding and Navigating Systems for Support. Health service pathways for this high-risk/high-need patient group are dependent on the quality of care that GPs provide, which is dependent on GPs’ capacity to identify and understand BPD. GPs also need to be supported sufficiently in order to develop the skills that are necessary to provide effective care for BPD patients. Systemic barriers and healthcare policy, to the extent that they dictate the organisation of primary care, are prominent structural factors obstructing GPs’ attempts to address multiple comorbidities for patients with BPD. Several strategies are suggested to support GPs supporting patients with BPD.


2013 ◽  
Vol 27 (2) ◽  
pp. 171-174 ◽  
Author(s):  
Enric Aragonès ◽  
Luis Salvador-Carulla ◽  
Judit López-Muntaner ◽  
Marc Ferrer ◽  
Josep Lluís Piñol

Psychiatry ◽  
2013 ◽  
Vol 76 (4) ◽  
pp. 365-380 ◽  
Author(s):  
Maren Westphal ◽  
Mark Olfson ◽  
Margarita Bravova ◽  
Marc J. Gameroff ◽  
Raz Gross ◽  
...  

2011 ◽  
Vol 26 (S2) ◽  
pp. 1025-1025
Author(s):  
K. Kahl ◽  
W. Greggersen ◽  
U. Schweiger ◽  
C. Correll ◽  
C. Balijepalli ◽  
...  

IntroductionThe metabolic syndrome (MetS) is an important risk factor for the development of type-2 diabetes and coronary artery disease. However, little is known about the prevalence of the MetS in patients with borderline personality disorder (BPD).Objectives, aimsWe aimed to compare the MetS prevalence in patients with borderline personality disorder (BPD) with control subjects followed in primary care from a similar region.MethodsOne-hundred thirty five BPD patients according to DSM-IV diagnostic criteria were compared to 1009 subjects from primary care. We used the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHBLI) criteria to determine the rate of MetS and of each individual MetS criterion. For comparison purposes we calculated age-standardized rates of the MetS and their 95%-confidence intervals (CI).ResultsThe age-standardized prevalence of MetS was more than double in patients with BPD compared to control subjects (23.3% vs. 10.6%, p < 0.05).Within BPD patients, an increased rate of MetS was associated with higher BMI (Wald = 10.2; p = 0.004), age (Wald = 4.7; p = 0.03), treatment with second generation antipsychotics (quetiapine, olanzapine and clozapine) (Wald = 4.6; p = 0.032), dysthymia (Wald = 4.6; p = 0.031), panic disorder (Wald = 4.6; p = 0.032), benzodiazepine dependency (Wald = 5.9; p = 0.015), and binge-eating disorder (Wald = 5.4; p = 0.02).ConclusionsOur results demonstrate an increased MetS rate, dysregulated glucose and lipid metabolism in patients with BPD. Independent predictors of MetS in BPD patients require further study to inform targeted prevention efforts in this population. Cardiometabolic monitoring and careful screening for physical health conditions among people with BPD is warranted.


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