Towards the end of 1998 we decided to introduce a facility to lock the doors of the acute psychiatric wards at Bootham Park Hospital, York. At first sight this would appear to be a retrograde step for modern psychiatric care in the UK. But this was a reasoned and planned move which has resulted in improved care for patients overall.

It is suggested that the diagnostic category of BPD requires revision to include psychotic symptoms. Terminology such as pseudo- and quasi-psychotic symptoms are confusing and use of these terms should be revised.

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