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Factors Associated with High Use of Public Mental Health Services by Persons with Borderline Personality Disorder
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Objective: The research presented here was a pilot study to identify clinical factors associated with high use (as opposed to lower use) of inpatient psychiatric services by persons with borderline personality disorder.
Methods: The initial sample was a random sample of English- and Spanish-speaking persons aged 18 to 60 years who had received at least one outpatient mental health service in the previous 90-day period and were enrolled in one of the participating mental health centers in King County, Washington. A random sample of persons who met selection criteria was randomly drawn; persons with high levels of use were oversampled to ensure adequate representation. Twenty-nine participants met full criteria for borderline personality disorder on the Personality
Disorders Examination structured interview and completed all measures. Fifteen (52 percent) of these had a high level of use of inpatient
services, and 14 did not. Results: High use of inpatient psychiatric services was predicted by a history of parasuicide in the previous two years but not by the number or severity of parasuicides; by the presence and number of anxiety disorders but not by depression or psychotic or substance use disorders; and by poorer cognitive functioning. Life stressors,
global functioning, and health service variables did not differentiate patients with high levels of service use from other patients with borderline personality disorder. Conclusions: Further research should explore
these predictors of service use to determine whether they are replicated in larger samples, and treatments that target these variables
should be evaluated. (Authors)
Psychiatric Services
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A program of the U.S. Department of Health and Human Services Substance Abuse & Mental Health Services Administration, Center for Mental Health Services