Long term hospitalizations for BPD

It has long been the conventional wisdom that persons with borderline personality disorder should be treated primarily through outpatient psychotherapy with medication as needed. Hospitalization is considered a last resort, only used if necessary. For example, if the patient is acutely suicidial, or battling another condition such as drug addiction or an eating disorder. In general hospitalization is about keeping a patient safe and alive. There are also concerns about iatrogenic effects. This refers to a deterioration that occurs when a person in placed in a hospital.

However, a recent study found large improvements in BPD symptoms in an inpatient sample. With an average stay of about 40 days, patients improved on measures of depression, anxiety, suicidal ideation, and functional disability.

As the authors note, these findings run counter to the prevailing view that clients should be kept out of the hospital unless completely necessary. One reason? Other studies have found that, after long term hospitalization, an increase in suicide attempts and other forms of deterioration after leaving the hospital. It is thought persons become dependent on the strucuture of the hosptial, which does not exist when they return home,