Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study
Abstract Background Outpatient 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 thos...
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2025-05-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-06928-8 |
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| author | Joann J. Chen Sam A. Mermin Lucie A. Duffy Samantha A. Wong Savannah D. Layfield Fernando Rodriguez-Villa Steven E. Gelda Eliot M. Gelwan Jane Eisen Kerry J. Ressler Lois W. Choi-Kain Agustin G. Yip |
| author_facet | Joann J. Chen Sam A. Mermin Lucie A. Duffy Samantha A. Wong Savannah D. Layfield Fernando Rodriguez-Villa Steven E. Gelda Eliot M. Gelwan Jane Eisen Kerry J. Ressler Lois W. Choi-Kain Agustin G. Yip |
| author_sort | Joann J. Chen |
| collection | DOAJ |
| description | Abstract Background Outpatient 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. Methods This 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. Results Compared 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. Conclusions These 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. |
| format | Article |
| id | doaj-art-a562bc44a0164a2181c96c1a2b1fa20b |
| institution | OA Journals |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Psychiatry |
| spelling | doaj-art-a562bc44a0164a2181c96c1a2b1fa20b2025-08-20T01:49:35ZengBMCBMC Psychiatry1471-244X2025-05-0125111410.1186/s12888-025-06928-8Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional studyJoann J. Chen0Sam A. Mermin1Lucie A. Duffy2Samantha A. Wong3Savannah D. Layfield4Fernando Rodriguez-Villa5Steven E. Gelda6Eliot M. Gelwan7Jane Eisen8Kerry J. Ressler9Lois W. Choi-Kain10Agustin G. Yip11University of Texas Southwestern Medical CenterGunderson Personality Disorders Institute, McLean HospitalEmory University School of MedicineNew York University School of MedicineHarvard Medical SchoolDivision of Depression and Anxiety Disorders, McLean HospitalDivision of Depression and Anxiety Disorders, McLean HospitalDivision of Depression and Anxiety Disorders, McLean HospitalDivision of Depression and Anxiety Disorders, McLean HospitalDivision of Depression and Anxiety Disorders, McLean HospitalGunderson Personality Disorders Institute, McLean HospitalDivision of Depression and Anxiety Disorders, McLean HospitalAbstract Background Outpatient 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. Methods This 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. Results Compared 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. Conclusions These 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.https://doi.org/10.1186/s12888-025-06928-8Patient-reported measuresObservational studyBorderline personality disorderSuicidalityInpatient hospitalization |
| spellingShingle | Joann J. Chen Sam A. Mermin Lucie A. Duffy Samantha A. Wong Savannah D. Layfield Fernando Rodriguez-Villa Steven E. Gelda Eliot M. Gelwan Jane Eisen Kerry J. Ressler Lois W. Choi-Kain Agustin G. Yip Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study BMC Psychiatry Patient-reported measures Observational study Borderline personality disorder Suicidality Inpatient hospitalization |
| title | Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study |
| title_full | Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study |
| title_fullStr | Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study |
| title_full_unstemmed | Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study |
| title_short | Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study |
| title_sort | characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit a cross sectional study |
| topic | Patient-reported measures Observational study Borderline personality disorder Suicidality Inpatient hospitalization |
| url | https://doi.org/10.1186/s12888-025-06928-8 |
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