Ten-Year Use of Mental Health Services by Patients With Borderline Personality Disorder and With Other Axis II Disorders
Open accessAbstract
OBJECTIVE: The study determined the prevalence of use of three treatment modalities (individual therapy, medication, and hospitalization) reported over a ten-year period by patients with borderline personality disorder and by those in a comparison group with other axis II disorders. Time to cessation and time to resumption for each modality among patients with borderline personality disorder were also determined. METHODS: Treatment history of inpatients with a reliable diagnosis of borderline personality disorder (N=290) and of other axis II disorders (N=72) was assessed with an interview of proven reliability during the index admission. Treatment history was reassessed at two-year intervals for ten years. RESULTS: For all three treatment modalities, prevalence of use declined significantly among patients with borderline personality disorder and among those in the comparison group. Among patients with borderline personality disorder, 52% reported having stopped individual therapy and 44% reported having stopped medication at one or more of the follow-up interviews over ten years. However, 85% of those who had stopped psychotherapy and 67% of those who stopped taking medication resumed these treatments during a subsequent two-year period. In contrast, 88% had experienced at least one two-year period without a psychiatric hospitalization by the time of the ten-year follow-up; however, almost half of these patients were subsequently rehospitalized. CONCLUSIONS: The results suggest that patients with borderline personality disorder tend to use outpatient treatments without interruption over prolonged periods. They also suggest that inpatient treatment is used far more intermittently by patients with borderline personality disorder.
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Findings might not apply to untreated individuals, since most participants received non-intensive outpatient care.
“The second is that the majority of those in both study groups were in non-intensive outpatient treatment over time (28) and thus, the results may not generalize to untreated subjects.”
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- Authors
- Hörz, S., Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G.
- Venue
- Psychiatric Services
- Published
- 2010-06
- Volume
- 61
- Issue
- 6
- Pages
- 612-616
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- PMC
- PMC3889171
- OpenAlex
- W2098112488
- Cited by
- 118
- References
- 11
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 7 · 2020: 25 · 2019: 6 · 2018: 5 · 2017: 2 · 2016: 9 · 2015: 4 · 2014: 16 · 2013: 15 · 2012: 10
- FWCI
- 10.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- McLean Hospital
- National Institutes of Health
- National Institute of Mental Health (MH-62169, R29MH047588, R01MH062169, MH-47588)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- borderline personality disorder, Axis II personality disorders, mental health service utilization, treatment discontinuation, individual psychotherapy, psychotropic drugs, psychiatric hospitalization, hospital readmission, treatment history, long-term follow-up
- MeSH terms
- Adult, Borderline Personality Disorder, Female, Humans, Interviews as Topic, Male, Mental Health Services, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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