Is hospitalization useful for suicidal patients with borderline personality disorder?

@article{Paris2004IsHU,
  title={Is hospitalization useful for suicidal patients with borderline personality disorder?},
  author={Joel Paris},
  journal={Journal of personality disorders},
  year={2004},
  volume={18 3},
  pages={
          240-7
        },
  url={https://api.semanticscholar.org/CorpusID:28921269}
}
The value of hospitalization for chronically suicidal patients with borderline personality disorder (BPD) is examined, finding that chronic suicidality can best be managed in an outpatient setting.
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Borderline personality disorder

    Joel Paris
    Psychology, Medicine
    Canadian Medical Association Journal
  • 2005
Although the cause of borderline personality disorder is uncertain, most patients improve with time, and the clinical challenge centres on managing chronic suicidality.

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Suggestions for enhanced in-hospital treatment are offered, including increased collaborative decision-making, clear and realistic short- and long-term goals for patient and family, and increased supervision and ongoing education of staff.

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Current state of knowledge offers only partial clues to help identify the BPD patients most at risk of death by suicide, and offers a limited armamentarium of treatment targeted to suicide prevention, creating discomfort in clinicians and fears regarding litigation in the event of a successful suicide.

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Patients with borderline personality disorder (BPD) are likely to attend the ED while experiencing crises and associated self‐injury and suicidality. Our study describes the prevalence, features, and…

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The authors identified self-harming behavior as a predictor of readmission frequency, whereas depression and hallucinations and delusions predicted time elapsed between the index admission and the first readmission.

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There is strong support for well-structured forms of psychotherapy, but evidence for pharmacotherapy in BPD is mixed.

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Preliminary results indicate that preventive admissions may be easy to use and cost effective with severe BPD patients in mainstream psychiatric services, but more research into the intervention is needed.

[Should hospitalization be required after the emergency discharge of patients with borderline personality disorder who have attempted suicide (FRENCH CRISIS cohort)?].

RUNNING TITLE: ACUTE PSYCHIATRIC READMISSIONS IN BPD Chronic Suicidality in Borderline Personality Disorder: What Predicts Acute Psychiatric Readmissions? Authors:

It is recommended that predictors of readmissions should be carefully monitored and treated following index admission, and self-harming behavior as predictor of readmission frequency was identified, whilst depression and hallucinations and delusions predicted time between the index admission and the first readmission.
...

44 References

Half in Love with Easeful Death: The Meaning of Chronic Suicidality in Borderline Personality Disorder

Since there is no evidence that hospitalization prevents completion, an ambulatory approach to the management of chronically suicidal patients may be most useful.

Predictors of Suicide in Borderline Personality Disorder

The most significant predictors of completed suicide were previous attempts and higher education, and borderline personality disorder patients followed for a mean of 15 years were compared with patients who committed suicide.

Chronic suicidality among patients with borderline personality disorder.

No evidence that full hospitalization prevents suicide completion by patients with borderline personality, suicidal risk is not a contraindication for day hospital treatment and Clinicians' fear of potential litigation resulting from a completed suicide should not be the basis for admission.

Suicide and clinical practice

An empirically based model of suicide risk assessment for patients with affective disorder and the implications of patient suicide for the surviving psychotherapist are described.

Implications of long-term outcome research for the management of patients with borderline personality disorder.

Fifteen- and 27-year follow-up studies of patients with borderline personality disorder show that most of them no longer meet full criteria for the disorder by age 40, and that even more show…

Psychopharmacology of borderline personality disorder.

Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction, and prevention.

Clinicians must avoid the mistake of thinking that a pattern of repeated attempts indicates little desire to die, because BPD is frequently complicated by suicidal behavior.

Dilemmas in the management of suicidal behavior in individuals with borderline personality disorder.

It is argued in this paper that clinicians treating borderline individuals need to carefully discriminate "acute" from "chronic" suicidal states, and recommendations are made for clinicians to effectively manage chronic suicidal behaviors within present ethical and legal guidelines.

Personality disorders over time: implications for psychotherapy.

The chronicity of personality disorders is both a challenge and a frame for treatment planning for patients with Antisocial and borderline personality disorders, which can focus on rehabilitation and the development of social niches that match their personality profiles.

Introduction to the Special Feature On Suicide and Borderline Personality Disorder

Suicide attempts and threats are a defining feature of borderline personality disorder (BPD). The chronic suicidality that characterizes BPD can arouse strong reactions in clinicians. Many clinicians…