The article you requested is
Mental Health Service Utilization by Borderline Personality Disorder Patients and Axis II Comparison Subjects Followed Prospectively for 6 Years.
Objective: The purpose of this study was to
describe the psychiatric treatment received by a well-defined
sample of patients with borderline personality disorder and Axis
subjects over 6 years of prospective follow-up.
Method: 362 inpatients were interviewed about
their treatment histories during their index admission
(1992-1995). 290 patients met both Revised Diagnostic Interview
for Borderlines and DSM-III-R criteria for borderline personality
disorder and 72 met DSM-III-R criteria for at least 1 nonborderline Axis II disorder (and neither criteria set for borderline personality disorder). Over 94% of surviving patients were reinterviewed about their psychiatric treatment histories 2, 4, and 6 years later.
Results: Only 33% of borderline patients were
hospitalized during the final 2 years of the 6-year follow-up, a
substantial decline from the 79% who had prior hospitalizations
at baseline. Much the same pattern emerged for day and/or
residential treatment (from 55% to 22%). In contrast, about three
quarters of borderline patients were still in psychotherapy and
taking psychotropic medications after 6 years of follow-up.
Additionally, over 70% of borderline patients participating in
these outpatient modalities did so for at least 75% of each
follow-up period. While rates of intensive psychotherapy declined
significantly over time (from 36% to 16%), rates of intensive
polypharmacy remained relatively stable over time, with about 40%
of borderline patients taking 3 or more concurrent standing
medications during each follow-up period, about 20% taking
4 or more, and about 10% taking 5 or more.
Conclusions: The results of this study suggest that the majority of borderline patients continue to use outpatient treatment in a sustained manner through 6 years of follow-up, but only a declining minority use more restrictive and costly forms of treatment.