The experience of treatment of persons with concomitant psychotic and borderline personality disorders

Abstract

The present study investigated the treatment experience of nine individuals with concomitant psychotic and borderline personality disorders. Given the paucity of research on the experience of this population, the goal was to explore pathways to care, transitions between services and general perception of treatments using a qualitative methodology. A semi-structured interview schedule was administered to each participant, who was referred by participating psychiatrists in each program. Transcripts were coded using a mixed open and closed coding procedure and QDA Miner 3.2.3 analysis software. Results found that participants did not dichotomise their experience into all-good or all-bad categories, but gave nuanced accounts of their treatment. Each participant described several pathways to care that explained their entry into specific treatments, with only coercion negatively impacting treatment experience. Many transitions were described, though only those who were coerced experienced these negatively. The key factor that participants highlighted in their treatment experience was the clinician/participant relationship. A positive relationship permitted participants to trust and receive help from their clinician. Limits include the possible bias of the recruitment procedure and the limited scope of the study. This understanding of the perspective of these individuals can lead to promoting better treatment experiences in the future. IntroductionThere is a paucity of research on the co-occurrence of psychosis and borderline personality disorder (BPD) (Kingdon et al., 2010). Despite the controversy surrounding the existence of individuals with both a psychotic disorder and BPD, the literature consistently finds a prevalence of 10-20% of individuals with a psychotic disorder also having a BPD diagnosis, and a similar prevalence of individuals with BPD meeting the symptomatic criteria for an Axis I psychotic disorder, (Coid et al.,

Improved mental health among LABILE study participants: A qualitative exploration

“…The key aspects of the trial that were appreciated by participants included the way in which they felt generally well informed about the process of the trial, the frequency of interview sessions, and the approachability and friendliness of the research staff. The latter reflects the conclusions of previous research regarding the importance of positive relationships between patients with BPD and health‐care professionals in eliciting long‐term recovery.…”

Raiders of the Lost Art: A review of published evaluations of inpatient mental health care experiences emanating from the United Kingdom, Portugal, Canada, Switzerland, Germany and Australia

“…Interpersonal relationships with the psychiatric unit staff have been found to directly account for how SUs perceive treatment (Thérrien et al . ; Thibeault ). Marriage et al .…”

“…; Thérrien et al . ) and a lack of trust has led to negative evaluations (Letendre ; Marriage et al . ).…”

Introduction to Special Issue on Psychosis and Personality Disorder

“…To spur discussion and debate about the interface of personality this Special Issue features papers which examine: links between cognitive flexibility and delusional ideation (Oliver et al, 2012), comorbidity with antisocial personality disorder (Mueser et al, 2012), trauma history, stigma and anger (Outcalt & Lysaker, 2012), experiences of abuse, interpersonal functioning and relationships with voices (Connor & Birchwood, 2012), mentalisation in people with psychosis in both community and forensic settings (Mitchell et al, 2012), and experiences of treatment amongst those with psychosis and comorbid personality disorder (Therien, Tranulis, Lecomte, & Berube, 2012). To prepare readers for these pieces we will offer a brief review of literature on the patterns and frequencies of the co-occurrence of psychosis and personality disorders, the correlates of personality features when they cooccur in psychosis, and the impact of personality-related issues on treatment.…”