Personality functioning and borderline personality disorder in patients referred for psychiatric consultation in an emergency service

Abstract

Background: In the last decade, personality disorders suffered a transformation regarding their classification and diagnosis. The personality disorder (PD) dimensional diagnosis proposed by DSM-V´s Alternative Model (AMPD) and CIE-11 defines personality pathology as an impairment in self and interpersonal functioning. In this context, epidemiological data is still scarce, and no studies to date inquire the prevalence of this diagnosis in patients referred for psychiatric consultation in emergency services. Thus, the main objective of this study is to describe the proportion of consultants referred to psychiatric consultation with the AMPD PD diagnosis and the severity of borderline features in this sample. Methods: Participants were adults (+18) consulting an adult general emergency service from a Chilean public hospital in a deprived urban area. We used two self-report screening scales (LPFS-BF 2.0 and ZAN BPD) to measure personality functioning and borderline symptoms. Results: From our total 182 participants sample, 27.5% presented personality functioning impairment. The group with a probable AMPD PD diagnosis consistently scored higher in mean borderline symptomatology. Additionally, the group with personality functioning difficulties presented more psychosocial impairment. Conclusions: Our findings suggest that dimensional PD diagnosis is a highly prevalent condition among patients referred for psychiatric consultation in emergency services. These results underscore the need to gather quality epidemiological data to promote the design and implementation of appropriate emergency care interventions for this condition and to advance PD inclusion in national mental healthcare policies.