Primary care and suicidality among psychiatric outpatients: The patient-doctor relationship matters

2020 ◽  
pp. 009121742097799
Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Primary Care Physician ◽  
Population Based ◽  
Borderline Personality ◽  
Care Physician ◽  
Cross Sectional

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.

scholarly journals Primary Care Physician Panel Size and Quality of Care: A Population-Based Study in Ontario, Canada

2016 ◽  
Vol 14 (1) ◽  
pp. 26-33 ◽  
Author(s):  
S. Dahrouge ◽  
W. Hogg ◽  
J. Younger ◽  
E. Muggah ◽  
G. Russell ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Primary Care Physician ◽  
Population Based ◽  
Care Physician ◽  
Population Based Study ◽  
Panel Size

Borderline Personality Programme in a Rural Area: The Value of a Therapy

2017 ◽  
Vol 41 (S1) ◽  
pp. S714-S714
Author(s):  
M. Marin Olalla ◽  
B. Perez Ramirez ◽  
A.M. Vidal Lopez ◽  
B. Martinez Martinez ◽  
R. Maldonado Lozano
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Functional Organization ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Therapeutic Group ◽  
Behaviour Therapy

IntroductionAn increased incidence of personality disorders (TP) in general, and borderline personality (BP) is currently a significant health problem because of the complexity of the clinic, the difficulty for early diagnosis, often unsatisfactory response to available treatments and the lack of clear proposals on multidisciplinary therapeutic interventions. In more serious cases, people with TP generate a high level of self and family suffering, as well as a high care burden that does not have a proportional impact on the quality of life of those affected and their families.AimEstablish a stable functional organization of professional and organizational resources of the Mental Health Unit of the North of Almeria that ensuring comprehensive care for people with borderline personality disorder and their families.MethodsThe program was structured:– elemental: BP census, individual sessions with optional nurse reference;– advanced individual: BP census, individual sessions, Nurse reference;– advanced individual and group: BP census, Individual sessions, Nurse reference and Therapeutic Group Hospital Mental Health Day weekly applying dialectical behaviour therapy.ResultsThe census of patients with borderline personality disorder was established in 30 people, 20 of them participating in two editions of therapeutic group. Fifty weekly sessions were carried out continuously, except holiday periods. A multidisciplinary team (nurse and two psychiatrists) were involved. The results indicate that there was an improvement in the quality of life of patients. It had been reduced hospitalisations, emergency assistance, and more than 60% of them got a job after that.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Mental Health Workers’ Attitudes Toward Individuals With a Diagnosis of Borderline Personality Disorder: A Systematic Literature Review

2021 ◽  
pp. 1-29
Author(s):  
Karen McKenzie ◽  
James Gregory ◽  
Lorna Hogg
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Health Workers ◽  
Borderline Personality ◽  
Mental Health Workers ◽  
Negative Attitudes ◽  
Factors Associated ◽  
Current Review

The attitudes of mental health workers toward individuals with mental health conditions can impact the quality of care they provide. Negative attitudes among mental health workers seem particularly common in response to people diagnosed with borderline personality disorder (BPD). The current review aimed to identify and review the literature regarding mental health workers’ attitudes toward individuals diagnosed with BPD, specifically focusing on studies comparing workers’ attitudes toward BPD with attitudes toward other mental health diagnoses. The findings suggest that mental health workers have more negative attitudes toward individuals labeled as having BPD than toward individuals with other diagnoses, such as depression. This is likely due to factors associated with the label itself, in addition to workers’ perceptions of BPD symptoms and previous experiences of delivering treatment. The implications of these findings are considered, with a particular focus on how mental health services can effectively address negative attitudes toward BPD.

Prevalence of the metabolic syndrome in patients with borderline personality disorders - results of a cross-sectional study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1025-1025
Author(s):  
K. Kahl ◽  
W. Greggersen ◽  
U. Schweiger ◽  
C. Correll ◽  
C. Balijepalli ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Heart Association ◽  
Borderline Personality ◽  
Targeted Prevention ◽  
Cross Sectional ◽  
Control Subjects ◽  
The Metabolic Syndrome

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.

scholarly journals How long does it take patients to find a new primary care physician when theirs retires: a population-based, longitudinal study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lindsay Hedden ◽  
Megan A. Ahuja ◽  
M. Ruth Lavergne ◽  
Kimberlyn M. McGrail ◽  
Michael R. Law ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Rural Areas ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Care Physician ◽  
Potential Threat ◽  
Patient Age ◽  
Patient Âgé

Abstract Background The retirement of a family physician can represent a challenge in accessibility and continuity of care for patients. In this population-based, longitudinal cohort study, we assess whether and how long it takes for patients to find a new majority source of primary care (MSOC) when theirs retires, and we investigate the effect of demographic and clinical characteristics on this process. Methods We used provincial health insurance records to identify the complete cohort of patients whose majority source of care left clinical practice in either 2007/2008 or 2008/2009 and then calculated the number of days between their last visit with their original MSOC and their first visit with their new one. We compared the clinical and sociodemographic characteristics of patients who did and did not find a new MSOC in the three years following their original physician’s retirement using Chi-square and Fisher’s exact test. We also used Cox proportional hazards models to determine the adjusted association between patient age, sex, socioeconomic status, location and morbidity level (measured using Johns Hopkins’ Aggregated Diagnostic Groupings), and time to finding a new primary care physician. We produce survival curves stratified by patient age, sex, income and morbidity. Results Fifty-four percent of patients found a new MSOC within the first 12 months following their physician’s retirement. Six percent of patients still had not found a new physician after 36 months. Patients who were older and had higher levels of morbidity were more likely to find a new MSOC and found one faster than younger, healthier patients. Patients located in more urban regional health authorities also took longer to find a new MSOC compared to those in rural areas. Conclusions Primary care physician retirements represent a potential threat to accessibility; patients followed in this study took more than a year on average to find a new MSOC after their physician retired. Providing programmatic support to retiring physicians and their patients, as well as addressing shortages of longitudinal primary care more broadly could help to ensure smoother retirement transitions.

Effects of a modified DBT Skills Group for military personnel and Veterans with OSIs and borderline personality disorder or traits

2021 ◽  
pp. e20190067
Author(s):  
Pamela L. Holens ◽  
Jeremiah N. Buhler ◽  
Stephanie Yacucha ◽  
Alyssa Romaniuk ◽  
Brent Joyal
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Military Personnel ◽  
Group Treatment ◽  
Stress Disorder ◽  
Borderline Personality ◽  
Behaviour Therapy ◽  
Negative Thoughts ◽  
Skills Group

LAY SUMMARY This study looked at the use of a group treatment known as dialectical behaviour therapy skills group (DBT-SG) to see if it was helpful for military personnel and veterans who had a variety of mental health disorders related to their service. The results of the study showed improvements in symptoms of borderline personality disorder, reductions in negative thoughts and feelings, and reductions in unhelpful behaviours. Results also showed improvements in all examined areas of functioning among participants, with the largest change occurring in the area of social functioning. The presence of posttraumatic stress disorder (PTSD), depression, or chronic pain did not impact results, but the presence of a substance abuse disorder did. Overall, the results provide preliminary support for DBT-SG as an intervention for borderline personality disorder symptoms among military and veterans, and perhaps particularly for persons who also have other mental health challenges, or persons considered inappropriate for other treatment.

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