Treatment of Severe Emotionally Unstable Personality Disorder with Comorbid Ehlers-Danlos Syndrome and Functional Neurological Disorder in an Inpatient Setting: A Case for Specialist Units without Restrictive Interventions
Open accessAbstract
We present the case of a young woman with an Emotionally Unstable Personality Disorder (EUPD) diagnosis suffering from high-risk self-injurious behaviour. She was also diagnosed with Ehlers-Danlos Syndrome and Functional Neurological Disorder, manifesting as nonepileptic seizures and immobility. Our patient, “A,” endured traumatic childhood abuse and became highly dependent on services in her late teens. Recurrent suicide attempts resulted in twenty to thirty acute psychiatric admissions, Intensive Care Unit stays, and multiple failed trials of psychological therapy. Nonepileptic seizures and wheelchair dependency made her “too complex” for many specialist services. She was eventually admitted to Springbank ward in Fulbourn Hospital, Cambridge. The EUPD specialist unit prides itself on evidence-based treatments, shared values, and a least restrictive approach. At discharge, our patient was self-harm free and able to walk unaided and no longer met EUPD diagnostic criteria. We include “A’s” personal views on her illness and how Springbank ward facilitated her recovery, together with results from structured clinical outcome measures.
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Henry et al.'s case report found improvements in all nine outcome measures assessing symptomology, quality of life, mindfulness, and recovery at discharge, which persisted at 6-month follow-up.
“The participant saw improvements in all nine outcome measures assessing symptomology, quality of life, mindfulness, and recovery at discharge which persisted at 6-month follow-up.”
From Psychological interventions for individuals with Ehlers-Danlos syndrome and hypermobility spectrum disorder: a scoping review (2023) · cites this paper as [46]
One case report included in this study focused heavily on the patient's other comorbidity (EUPD) rather than their EDS, which may confound its findings.
“Lastly, one case report [46] included in our study focused heavily on the patient’s other comorbidity (EUPD) rather than their EDS, which may confound its findings (i.e., Henry et al.’s [46] intervention may be better suited for individuals with EUPD rather than EDS).”
From Psychological interventions for individuals with Ehlers-Danlos syndrome and hypermobility spectrum disorder: a scoping review (2023) · cites this paper as [46]
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Diagnostic and Statistical Manual of Mental Disorders, 5th Edition
(2013) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9780890425596.893619 · Cited by 4,390 · see citing works
Axis I Comorbidity of Borderline Personality Disorder
Zanarini, M. C., Frankenburg, F. R., Dubo, E., Sickel, A. E., Trikha, A., Levin, A., & Reynolds, V. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.12.1733 · Cited by 978 · see citing works
Adverse childhood experiences and mental health in young adults: a longitudinal survey
Schilling, E. A., Aseltine, R. H., & Gore, S. L. (2007) · BMC Public Health · doi:10.1186/1471-2458-7-30 · Cited by 930 · see citing works
Bateman, A., & Fonagy, P. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.07040636 · Cited by 894 · see citing works
Ludwig, L., Pasman, J. A., Nicholson, T., Aybek, S., David, A. S., Tuck, S., Kanaan, R. A., Roelofs, K., Carson, A., & Stone, J. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30051-8 · Cited by 495 · see citing works
Golier, J. A., Yehuda, R., Bierer, L. M., Mitropoulou, V., New, A. S., Schmeidler, J., Silverman, J. M., & Siever, L. J. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.11.2018 · Cited by 266 · see citing works
Neurological and spinal manifestations of the Ehlers–Danlos syndromes
Henderson, F. C., Austin, C., Benzel, E., Bolognese, P., Ellenbogen, R., Francomano, C. A., Ireton, C., Klinge, P., Koby, M., Long, D., et al. (2017) · American Journal of Medical Genetics Part C: Seminars in Medical Genetics · doi:10.1002/ajmg.c.31549 · Cited by 238 · see citing works
Fobian, A. D., & Elliott, L. (2019) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.170190 · Cited by 134 · see citing works
Venter, M. D., Demyttenaere, K., & Bruffaerts, R. (2013) · PubMed · Cited by 124 · see citing works
MacIntosh, H. B., Godbout, N., & Dubash, N. (2015) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cap0000028 · Cited by 100 · see citing works
Perceived coercion in voluntary hospital admission
O'Donoghue, B., Roche, E., Shannon, S., Lyne, J., Madigan, K., & Feeney, L. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2013.10.016 · Cited by 89 · see citing works
Responses of mental health clinicians to patients with borderline personality disorder.
Sansone, R. A., & Sansone, L. A. (2013) · Europe PMC (PubMed Central) · Cited by 88 · see citing works
Hershenfeld, S. A., Wasim, S., McNiven, V., Parikh, M., Majewski, P., Faghfoury, H., & So, J. (2016) · Rheumatology International · doi:10.1007/s00296-015-3375-1 · Cited by 81 · see citing works
Testa, S. M., Krauss, G. L., Lesser, R. P., & Brandt, J. (2012) · Seizure · doi:10.1016/j.seizure.2012.02.002 · Cited by 77 · see citing works
Jungfer, H. A., Schneeberger, A. R., Borgwardt, S., Walter, M., Vogel, M., Gairing, S. K., Lang, U. E., & Huber, C. G. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.03.020 · Cited by 70 · see citing works
Baeza-Velasco, C., Pailhez, G., Bulbena, A., & Baghdadli, A. (2015) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2014.10.002 · Cited by 67 · see citing works
Björkenstam, E., Björkenstam, C., Holm, H., Gerdin, B., & Ekselius, L. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.149583 · Cited by 53 · see citing works
Steinert, T., Eisele, F., Goeser, U., Tschoeke, S., Uhlmann, C., & Schmid, P. (2008) · Clinical Practice and Epidemiology in Mental Health · doi:10.1186/1745-0179-4-27 · Cited by 34 · see citing works
Liljedahl, S., Helleman, M., Daukantaité, D., Westrin, Å., & Westling, S. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1371-6 · Cited by 27 · see citing works
van den Bosch, L. M. C., Sinnaeve, R., Roijen, L. H., & van Furth, E. F. (2014) · Trials · doi:10.1186/1745-6215-15-152 · Cited by 24 · see citing works
Recurrent Depression and Borderline Personality Disorder in a Patient with Ehlers-Danlos Syndrome
Espiridion, E. D., Daniel, A., & Allen, J. R. V. (2018) · Cureus · doi:10.7759/cureus.3760 · Cited by 9 · see citing works
Jakovljević, M. (2019) · Psychiatria Danubina · doi:10.24869/psyd.2019.282 · Cited by 8 · see citing works
Lana, F., Sánchez-Gil, C., Ferrer, L., López-Patón, N., Litvan, L., Marcos, S., Sierra, A., Soldevilla, J. M., Feixas, G., & Pérez, V. (2015) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2015.03.005 · Cited by 7 · see citing works
Lana, F., Sánchez-Gil, C., Ferrer, L., López-Patón, N., Litvan, L., Marcos, S., Sierra, A. C., Soldevilla, J. M., Feixas, G., & Pérez, V. (2015) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2014.09.002 · Cited by 3 · see citing works
Flagged first, then by citations
1 of the 25 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- [1]Gamlin C. Varney A. Agius M. Emotionally unstable personality disorder in primary care: a thematic review and novel toolkit Psychiatria Danubina 2019 31 Supplement 3 282 289 31488741
- [11]National Collaborating Centre for Mental Health Borderline Personality Disorder: Recognition and Management 2009 National Institute for Health and Care Excellence Clinical Guidelines website NICE guidelines 39480982
Cited by
Sorted by citations
Ehlers-Danlos Syndrome in the Field of Psychiatry: A Review
Ishiguro, H., Yagasaki, H., & Horiuchi, Y. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.803898 · Cited by 31 · see citing works
Stigma in functional seizures: A scoping review
Annandale, M., Vilyte, G., & Pretorius, C. (2022) · Seizure · doi:10.1016/j.seizure.2022.05.016 · Cited by 23 · see citing works
Lazzari, C. G., Nikolou‐Walker, E., Liu, L. Q., & Rabottini, M. (2024) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s491376 · Cited by 16 · see citing works
Ellouze, M., Mechti, S., & Belguith, L. H. (2021) · Lecture notes in computer science · doi:10.1007/978-3-030-82153-1_54 · Cited by 10 · see citing works
Song, J. Z., Luong, D., Feldman, E. C. H., Tran, S., Perrier, L., Eubanks, K., Bayley, M., Kastner, M., Slepian, M., & Munce, S. E. P. (2023) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-023-02799-y · Cited by 9 · see citing works
“The ten studies included participants with EDS (hypermobile [32, 44, 48, 51, 52], classic [45], vascular [47], or unspecified [46, 50, 52] subtype) and/or JHS [32, 44, 49, 51].”
BackgroundMethodResultInfluential
- Authors
- Henry, J., Collins, E., Griffin, A., & Zimbron, J.
- Affiliations
- University of Cambridge (GB)
- Somerset Partnership NHS Foundation Trust (GB)
- Fulbourn Hospital (GB)
- Corresponding author
- Zimbron, Jorge
- Venue
- Case Reports in Psychiatry
- Publisher
- Wiley
- Published
- 2021-02-25
- Volume
- 2021
- Pages
- 1-6
- ISSN
- 2090-682X (ISSN-L)
- 2090-6838
- PMC
- PMC7939736
- OpenAlex
- W3132024764
- Cited by
- 5
- References
- 25
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1
- FWCI
- 0.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Case Reports in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Apollo
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- borderline personality disorder, Ehlers-Danlos syndrome, conversion disorder, non-epileptic seizures, self-harm, suicide attempts, childhood abuse, psychiatric inpatient care, immobility
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