Factors Associated with Emergency Department Patients’ Knowledge of Their Borderline Personality Disorder Diagnosis

Background: Research on borderline personality disorder (BDP) has shown that less intensive, easier-to-learn approaches like good psychiatric management (GPM) are especially effective when based on patient knowledge of their diagnosis and the provision of psychoeducation. However, issues with failing to make the diagnosis are also described in the literature. This study therefore aimed to explore the sociodemographic and clinical factors associated with the challenges of detecting BDP and providing a diagnosis to patients. Methods: A retrospective database maintained at Toulouse University Hospital was employed in the study. This contains information on 202 patients with a CIM -10 F60.3 diagnosis admitted to the short-term hospitalization unit of the adult psychiatric emergency department (ED). This data was used to compare the sociodemographic and clinical benchmarks associated with knowledge of the criteria employed for diagnosing BDP. We then performed a multimodal logistic regression analysis. Findings: We found that 63% of the BDP patients in the database were aware of their diagnosis. The regression model identified that the factors associated with this knowledge were: a history of hospitalization on a psychiatric ward (OR=6.1; 95% CI= [2.3-17]); having a major depressive disorder (MDD) diagnosis (OR=0.4; 95% CI= [0.1-0.9]); and the number of admissions to the ED in the previous 12 months (OR=1.25; 95% CI= [1.02-1.5]). Conclusions: The main factor associated with knowledge of a BDP diagnosis was previous hospitalization on a psychiatric ward, suggesting a lack of disclosure in outpatient care. This could mean that incorporating a period of short-term hospitalization (as occurs in the ED) in the healthcare provided could not only improve how physicians detect the disorder, but also their delivery of the diagnosis to patients.