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Borderline Personality Disorder: What do psychiatrists really think?

Borderline Personality Disorder: What do psychiatrists really think?. Everett Julyan Rajeev Krishnadas Michael Götz. Personality disorders. Importance Predispose to mental illness Pathoplasticity Response to treatment Substance misuse Risks. Personality disorder. Historically

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Borderline Personality Disorder: What do psychiatrists really think?

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  1. BorderlinePersonalityDisorder:What do psychiatristsreally think? Everett Julyan Rajeev Krishnadas Michael Götz

  2. Personality disorders Importance • Predispose to mental illness • Pathoplasticity • Response to treatment • Substance misuse • Risks

  3. Personality disorder • Historically • Prognostic pessimism • Therapeutic nihilism • Recently • Evidence-based optimism • Scottish Personality Disorder Network • ICPs • NICE

  4. Borderline Personality Disorder

  5. Methods • Postal survey • All psychiatrists in Scotland (on RCPsych list) • Grades, specialities, years of experience • 12 statements about BPD • Diagnosis & prognosis • Management • Ethico-legal

  6. Results • 300 responses (28%) • 4432 years experience • Diverse views

  7. Results

  8. Results

  9. Results Diagnosis & prognosis • BPD is a mental illness • BPD is a valid diagnosis • BPD has a good prognosis • Patients with BPD should have their diagnosis explained to them

  10. Results Diagnosis & prognosis • BPD is a mental illness • BPD is a valid diagnosis • BPD has a good prognosis • Patients with BPD should have their diagnosis explained to them

  11. Results Diagnosis & prognosis • BPD is a mental illness • BPD is a valid diagnosis • BPD has a good prognosis • Patients with BPD should have their diagnosis explained to them

  12. Results Diagnosis & prognosis • BPD is a mental illness • BPD is a valid diagnosis • BPD has a good prognosis • Patients with BPD should have their diagnosis explained to them

  13. Results Diagnosis & prognosis • BPD is a mental illness • BPD is a valid diagnosis • BPD has a good prognosis • Patients with BPD should have their diagnosis explained to them

  14. Results Management • Patients with BPD benefit from hospital admission • Patients with BPD benefit from medication • Patients with BPD benefit from psychotherapy • ICPs are helpful in managing patients with BPD

  15. Results Management • Patients with BPD benefit from hospital admission • Patients with BPD benefit from medication • Patients with BPD benefit from psychotherapy • ICPs are helpful in managing patients with BPD

  16. Results Management • Patients with BPD benefit from hospital admission • Patients with BPD benefit from medication • Patients with BPD benefit from psychotherapy • ICPs are helpful in managing patients with BPD

  17. Results Management • Patients with BPD benefit from hospital admission • Patients with BPD benefit from medication • Patients with BPD benefit from psychotherapy • ICPs are helpful in managing patients with BPD

  18. Results Management • Patients with BPD benefit from hospital admission • Patients with BPD benefit from medication • Patients with BPD benefit from psychotherapy • ICPs are helpful in managing patients with BPD

  19. Results Ethico-legal • Patients with BPD are responsible for their behaviour • Patients with BPD are in control of their behaviour • Patients with BPD should have the same healthcare rights as those with schizophrenia • The Mental Health Act should recognise BPD as a mental disorder (as it currently does)

  20. Results Ethico-legal • Patients with BPD are responsible for their behaviour • Patients with BPD are in control of their behaviour • Patients with BPD should have the same healthcare rights as those with schizophrenia • The Mental Health Act should recognise BPD as a mental disorder (as it currently does)

  21. Results Ethico-legal • Patients with BPD are responsible for their behaviour • Patients with BPD are in control of their behaviour • Patients with BPD should have the same healthcare rights as those with schizophrenia • The Mental Health Act should recognise BPD as a mental disorder (as it currently does)

  22. Results Ethico-legal • Patients with BPD are responsible for their behaviour • Patients with BPD are in control of their behaviour • Patients with BPD should have the same healthcare rights as those with schizophrenia • The Mental Health Act should recognise BPD as a mental disorder (as it currently does)

  23. Results Ethico-legal • Patients with BPD are responsible for their behaviour • Patients with BPD are in control of their behaviour • Patients with BPD should have the same healthcare rights as those with schizophrenia • The Mental Health Act should recognise BPD as a mental disorder (as it currently does)

  24. Results

  25. Results Years • Less experience • Trend towards “optimism” • Illness • Responsibility • Admission

  26. Results

  27. Results

  28. Results

  29. Results Grade • Juniors • Agree re: illness • Neutral re: admission • Strongly agree re: psychotherapy • Agree re: ICPs

  30. Results Speciality • Psychotherapy • Strongly agree re: psychotherapy • Strongly agree re: rights

  31. Discussion • Illness vs disorder? • Prognosis? • Responsibility vs control? • Admission, medication, & psychotherapy? • Rights? • Experience? • Speciality?

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