ArticleBMC psychiatry2025
Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study.
Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
backgroundOutpatient psychotherapies are gold standard interventions for borderline personality disorder (BPD); however, in clinical reality, higher rates of psychiatric hospitalization and more severe symptoms, including suicidality and self-harm, occur for those with BPD compared to those with other psychiatric disorders in inpatient units.
methodsThis study aims to distinguish the clinical profile and outcomes of patients screening positive for a threshold of BPD traits in the inpatient psychiatric setting using the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), from those who do not.
resultsCompared to those screening negative on the MSI-BPD (MSI-BPD-), those who screen positive (MSI-BPD +) are younger, more likely to be female, and more likely to report a range of health and psychosocial risk factors such as unstable housing, reduced educational attainment, physical health problems, past trauma, and problematic drug and alcohol use. MSI-BPD + patients report significantly higher severity of anxiety, depression, suicidality, self-harm, and global symptoms on admission than MSI-BPD- patients. In terms of response to inpatient care, they also self-report significantly greater improvements and higher proportions of reliable change on measures of anxiety, depression, and general psychiatric severity. At discharge, MSI-BPD + patients no longer report significantly higher suicidality but do report greater levels of thoughts of self-harm.
conclusionsThese findings suggest that patients with self-reported BPD symptoms experience acute symptom relief during short-term inpatient hospitalization, including for suicidality-related symptoms. Our study also demonstrates the feasibility of utilizing the MSI-BPD screening tool within a large adult inpatient psychiatric population to identify individuals likely to have BPD with distinct clinical profiles.
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