Patients with Borderline Personality Disorder in Emergency Departments

Borderline personality disorder (BPD) patients, when in crisis, are frequent visitors of emergency departments (EDs). When these patients exhibit symptoms such as aggressiveness, impulsivity, intense anxiety, severe depression, self-harm, and suicidal attempts or gestures, diagnosis, and treatment o...

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Bibliographic Details
Published in:Frontiers in psychiatry 2017-08, Vol.8, p.136-136
Main Authors: Shaikh, Untara, Qamar, Iqra, Jafry, Farhana, Hassan, Mudasar, Shagufta, Shanila, Odhejo, Yassar Islamail, Ahmed, Saeed
Format: Article
Language:English
Subjects:
borderline personality disorder
cluster B personality disorders
emergency psychiatry
impulsivity
Psychiatry
psychosocial issues
psychotherapy
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Summary:Borderline personality disorder (BPD) patients, when in crisis, are frequent visitors of emergency departments (EDs). When these patients exhibit symptoms such as aggressiveness, impulsivity, intense anxiety, severe depression, self-harm, and suicidal attempts or gestures, diagnosis, and treatment of the BPD becomes challenging for ED doctors. This review will, therefore, outline advice to physicians and health-care providers who face this challenging patient population in the EDs. Crisis intervention should be the first objective of clinicians when dealing with BPD in the emergency. For the patients with agitation, symptom-specific pharmacotherapy is usually recommended, while for non-agitated patients, short but intensive psychotherapy especially dialectical behavior therapy (DBT) has a positive effect. Although various psychotherapies, either alone or integrated, are preferred modes of treatment for this group of patients, the effects of psychotherapies on BPD outcomes are small to medium. Proper risk management along with developing a positive attitude and empathy toward these patients will help them in normalizing in an emergency setting after which treatment course can be decided.
ISSN:1664-0640
1664-0640
DOI:10.3389/fpsyt.2017.00136