STRUCTURED ADMISSION TO PREVENT CRISIS ADMISSION IN BORDERLINE PERSONALITY DIOSRDER - PowerPoint PPT Presentation

Loading...

PPT – STRUCTURED ADMISSION TO PREVENT CRISIS ADMISSION IN BORDERLINE PERSONALITY DIOSRDER PowerPoint presentation | free to download - id: 4e0a3e-N2Q0M



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

STRUCTURED ADMISSION TO PREVENT CRISIS ADMISSION IN BORDERLINE PERSONALITY DIOSRDER

Description:

... revolving door Prearranged structured admissions Eclectic therapy Team effort Psychosocial management No medical review Behavioural contract Positive ... – PowerPoint PPT presentation

Number of Views:85
Avg rating:3.0/5.0

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: STRUCTURED ADMISSION TO PREVENT CRISIS ADMISSION IN BORDERLINE PERSONALITY DIOSRDER


1
STRUCTURED ADMISSIONTO PREVENTCRISIS ADMISSION
IN BORDERLINE PERSONALITY DIOSRDER
  • VALSA MANNALI
  • JOHN PRENTICE
  • EMMA MACRAE
  • CAROL SPRATT
  • NEW CRAIGS HOSPITAL
  • NHS HIGHLAND

2
BORDERLINE PERSONALITY DISORDER
  • Known for excessive use of psychiatric services
  • Crisis, chaotic, lengthy repeated admissions
  • Benefit of admission doubtful

3
INVERNESS EXPERIENCE
  • Crisis admission pattern
  • Suicidal/ parasuicidal
  • Crisis A E, police, Day centre
  • Const. obs.- trying to leave
  • MHA assessment - detention
  • Copy cat agitation
  • Chaotic - closed wards
  • Discharge problem - revolving door

4
Prearranged structured admissions
  • Eclectic therapy
  • Team effort
  • Psychosocial management
  • No medical review
  • Behavioural contract
  • Positive reinforcement
  • Further admission on the merit of previous
    admission

5
AIMS
  • To explore the possibility of undertaking and
    implementing planned, structured admissions to
    prevent chaotic, crisis and repeated admissions
    in BPD.
  • To demarcate possible prognostic indicators.

6
HYPOTHESES
  • Planned, structured admission can prevent crisis
    admission in BPD
  • Study outcome will help in identifying prognostic
    indicators.

7
COHORT
  • Subjects of the study will be recruited from
    OP/IP at New Craigs Hospital over a span of 12-
    18 months.
  • Consecutive BPD patients who present in crisis
    will be assessed for suitability for the study.

8
INCLUSION CRITERIA
  • Both genders
  • Age between 18-60
  • DSM-IV diagnosis of BPD
  • At least one crisis presentation at New Craigs
    Hospital.

9
EXCLUSION CRTITERIA
  • Axis I diagnosis
  • Organic brain syndrome
  • Psychotic dis
  • Factitious dis.
  • Primary diagnosis of alcohol/drug use
  • Axis II diagnosis
  • Learning disability
  • Antisocial personality dis.
  • Axis III diagnosis
  • Epilepsy
  • Inability to understand English

10
CONTROL GROUP
  • Age-matched controls with DSM IV diagnosis of BPD
  • Exclusion criteria
  • Organic brain syndrome
  • Epilepsy
  • Psychotic disorder
  • Factitious disorder
  • Learning disability
  • Antisocial personality disorder
  • Primary diagnosis of alcohol/drug abuse
  • Inability to understand English

11
CLINICAL ASSESSMENT
  • Detailed history
  • Physical examination
  • Investigations, drug screen
  • DSM IV criteria for BPD
  • Rating scales for BPD Sx at the start, and at the
    end of 1 yr
  • Depression rating scale at recruitment.

12
STRUCTURED ADMISSIONS
  • MDT assessment of needs agenda
  • Behavioural contract- defining borders
  • Depending on needs, 2-4 admissions/year
  • Admission for 5 days
  • No medication review
  • Psychosocial management with CBT overlay
  • General strategies
  • Tailor made for the patient
  • Other interventions
  • Occupational therapy
  • Physiotherapy
  • Dietetics

13
OTHERS
  • Informed consent
  • Ethics
  • Appropriate statistical analysis

14
EXPECTATIONS FROM OUTCOME
  • Benefit in planning services for BPD population
  • Off shoot questions to be addressed in future
    research
  • Eg Childhood precursors
  • Cluster of personality traits
  • gender difference

15
THANK YOU
About PowerShow.com