P-943 - Management of people with borderline personality disorder (BPD) in the secondary care mental health service

Abstract

Aims To identify clinical and sociodemographic characteristics of people with BPD in secondary care mental health service. Method 29 individuals (27 women and 2 men, average age 32.8 years) with a diagnosis of BPD treated within secondary care services from 1 st January to 31 st December 2010. Results 96.5% of the clients were on a combination of psychotropics; 93% on antidepressants; 82% on anxiolytics; 72.4% on antipsychotics; 55% on hypnotics; 38% on mood stabilisers; and 24% taking other medication. All had a co-morbid axis-I disorder; moreover 55% of subjects had two, and 14% three co-morbidities. Substance misuse (44.8%), “neurotic” disorders (41.4%), depression (27.6%); and eating disorders (13.8%) were the most common co-morbidities. 55% disclosed a history of a sexual abuse. 60% had been assessed, and 40% detained under the MHA 1983. 96.5% were admitted to hospital, with the average length of admission of 41 days. 68% admitted ≥2 times; and on average, each client had a history of 3 admissions within a year. 90% had basic education and were unemployed. All patients had a history of a suicide attempt; 90% requiring an assessment at the AE 80% attending the AE and on average clients attended the A&E 5 times a year. One patient died as a result of hanging. Conclusion People with BPD represent one of the most challenging groups of patients, with multiple needs. Polypharmacy and co-morbidity is very widespread. They are one of the most frequent consumers of emergency services, requiring immediate medical and psychiatric input.