ABSTRACT
BACKGROUND: Negative attitudes towards patients with borderline personality disorder (BPD) may affect their treatment. We aimed to identify attitudes toward patients with BPD. METHODS: Clinicians in four psychiatric hospitals in Israel (n = 710; psychiatrists, psychologists, social workers and nurses) were approached and completed questionnaires on attitudes toward these patients. RESULTS: Nurses and psychiatrists reported encountering a higher number of patients with BPD during the last month, and exhibited more negative attitudes and less empathy toward these patients than the other two professions. The whole sample evaluated the decision to hospitalize such a patient as less justified than the decision to hospitalize a patient with Major Depressive Disorder. Negative attitudes were positively correlated with caring for greater numbers of patients with BPD in the past month and in the past 12 months. Nurses expressed the highest interest in studying short-term methods for treating patients with BPD and a lower percentage of psychiatrists expressed an interest in improving their professional skills in treating these patients. CONCLUSIONS: The findings show that nurses and psychiatrists differ from the other professions in their experience and attitudes toward patients with BPD. We conclude that nurses and psychiatrists may be the target of future studies on their attitudes toward provocative behavioral patterns (e.g., suicide attempts) characterizing these patients. We also recommend implementing workshops for improving staff attitudes toward patients with BPD.
Subject(s)
Attitude of Health Personnel , Borderline Personality Disorder/psychology , Hospitalization , Hospitals, Psychiatric , Adult , Female , Humans , Israel , Male , Surveys and QuestionnairesABSTRACT
BACKGROUND: The study of near-fatal suicide attempters may provide insight into the minds of suicidal subjects. Our aim is to test the hypothesis that mental pain is a general risk factor for suicidal behavior and communication difficulties are a particular risk factor for medically serious suicidal behavior. METHODS: Thirty five subjects who made medically serious suicide attempts were compared with 67 medically not serious suicide attempters and 71 healthy controls. All were interviewed with the SCID-I and completed questionnaires covering mental pain, communication difficulties and seriousness of suicide attempt. RESULT: Variables from the mental pain domain (e.g. depression) predicted the presence of suicidal behavior, and variables from the communication difficulties domain (e.g., self-disclosure) predicted the lethality and seriousness of the suicide attempts. LIMITATIONS: Relatively small number of patients with medically serious suicide attempt and the relatively large number of questionnaires which may to some extent have diminished informant reliability. CONCLUSIONS: Problems with sharing of feelings with others are an important risk factor for near-lethal suicide, over and above the contribution of psychiatric illness and mental pain, including depression and hopelessness.
Subject(s)
Affective Symptoms/psychology , Self Disclosure , Suicide, Attempted/psychology , Adult , Affective Symptoms/diagnosis , Affective Symptoms/epidemiology , Aged , Aged, 80 and over , Attitude to Health , Control Groups , Depression/diagnosis , Depression/epidemiology , Depression/psychology , Diagnostic and Statistical Manual of Mental Disorders , Emotions , Female , Humans , Interpersonal Relations , Life Change Events , Male , Middle Aged , Models, Psychological , Psychiatric Status Rating Scales , Risk Factors , Suicide, Attempted/classification , Suicide, Attempted/statistics & numerical data , Surveys and QuestionnairesABSTRACT
The relationships between acute life events and type of depression were evaluated among inpatient adolescents with schizophrenia. Forty-two adolescent inpatients were assessed, 25 with schizophrenia and 17 with personality disorder. Acute life events and other psychosocial situations were identified with the ICD-10 Axis V semistructured interviews. The Depression Equivalent Questionnaire for Adolescents (DEQ-A) and the Positive and Negative Symptom Scale (PANSS) were used to measure quality and severity of depression. In the patients with schizophrenia, psychosocial situations were related to the anaclitic type of depression, whereas in the subjects with personality disorder, they were highly correlated with introjective depression. In the schizophrenic group, the psychosocial situations related to depression were of a more intrapersonal nature and, in the personality-disordered group, they were more interpersonal. Environmental factors play an important role in the course of schizophrenia in adolescents and should remain a focus of study. Object relations theory may be of heuristic value in the investigation of these factors.
