A comparison of women who continue and discontinue treatment for borderline personality disorder

Abstract

AbstractBackground Treatment non‐completion is a significant problem for personality disorder treatment services.Aims We investigated differences between treatment continuers and treatment discontinuers of a tertiary specialist service for people with borderline personality disorder. The two groups were compared on: (1) personality disorder severity; (2) motivation for therapy; (3) mood; and (4) social problem solving.Method Patients' personality disorders were examined using the International Personality Disorder Examination. Three self‐report questionnaires were administered at the start of treatment: the Treatment Motivation Questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Social Problem Solving Inventory‐Revised.Results Of 14 outpatients recruited to the service during 2005 to 2007, seven continued and seven discontinued treatment. Those who did not continue with therapy had more complex personality disorder profiles, were more externally motivated for treatment and were less internally motivated for treatment. All patients scored high on the HADS. Problem‐solving abilities were apparently intact, but adversely affected by a negative problem orientation. Treatment discontinuers spent, on average, three times longer in hospital than continuers.Conclusion Engaging people with complex personality disorders, low internal motivation for therapy and negative problem orientation is a challenge for services. Non‐completion of treatment is associated with more days in hospital and higher service costs. Copyright © 2009 John Wiley & Sons, Ltd.