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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 6/2007

01-06-2007 | ORIGINAL PAPER

Personality disorder and pathways to inpatient psychiatric care

Authors: Marianne Hayward, Paul Moran

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 6/2007

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Abstract

Background

The impact of personality disorder on pathways into psychiatric care is unknown.

Aim

To examine associations between personality disorder status, length of pathway into inpatient psychiatric care, and involvement of the criminal justice service in the pathway into care.

Method

The Structured Clinical Interview for DSM-IV personality disorders (SCID-II) and a modified WHO Pathways Encounter Form were administered to a sample of 153 consecutive inpatients admitted to acute wards in one inner London borough over a 4-month period. Diagnosis, socio-demographic variables, social support and substance misuse were also ascertained.

Results

The presence of personality disorder was not associated with significant differences in the number of carers, time spent along the pathway, or probability of criminal justice system involvement. However, all three personality disorder clusters were significantly associated with increased use of Accident and Emergency (A & E) services.

Conclusion

Given the high levels of contact with A & E services, casualty staff should receive improved training in the assessment and management of patients with personality disorders. Improved detection of personality disorder within A & E departments could lead to earlier diversion to mental health services and a consequential improvement in the planning of subsequent treatment.
Literature
1.
Bender DS, Skodol AE, Pagano ME, Dyck ER, Grilo CM, Shea MT, Sanislow CA, Zanarini MC, Yen S, McGlashan TH, Gunderson JG (2006) Utilization of the emergency department after self-inflicted injury. Psychiatr Serv 57:254–257PubMedCrossRef
2.
Bhui K, Stansfeld S, Hull S, Priebe S, Mole F, Feder G (2003) Ethnic variations in pathways to and use of specialist mental health services in the UK. Systematic review. Br J Psychiatry 182:105–116PubMedCrossRef
3.
Broadhead WE, Gehlbach SH, de Gruy FV, Kaplan BH (1988) The Duke-UNC functional social support questionnaire. Measurement of social support in family medicine patients. Med Care 26(7):709–723PubMedCrossRef
4.
Cole E, Leavey G, King M, Johnson-Sabine E, Hoar A (1995) Pathways to care for patients with a first episode of psychosis. A comparison of ethnic groups. Br J Psychiatry 167(6):770–776PubMedCrossRef
5.
Commander MJ, Cochrane R, Sashidharan SP, Akilu F, Wildsmith E (1999) Mental health care for Asian, black and white patients with non-affective psychoses: pathways to the psychiatric hospital, in-patient and after-care. Soc Psychiatry Psychiatr Epidemiol 34(9):484–491PubMedCrossRef
6.
Commander MJ, Odell SO, Williams KJ, Sashidharan SP, Surtees PG (1999) Pathways to care for alcohol use disorders. J Public Health Med 21(1):65–69PubMedCrossRef
7.
8.
First MB, Gibbon M, Spitzer RL (1997) The structured clinical interview for DSM-IV axis II personality disorders (SCID-II). American Psychiatric Press, Washington
9.
Gater R, Goldberg D (1991) Pathways to psychiatric care in South Manchester. Br J Psychiatry 159:90–96PubMed
10.
Goldberg D, Huxley P (1980) Mental illness in the community: the pathway to psychiatric care. Tavistock, London
11.
Goldberg D, Huxley P (1992) Common mental disorders: a bio-social model. Routledge, London
12.
Harrison J, Kisely SR, Jones JA, Blake I, Creed FH (1997) Access to psychiatric care; the results of the pathways to care study in Preston. J Public Health Med 19(1):69–75PubMed
13.
Lincoln CV, McGorry P (1995) Who cares? Pathways to psychiatric care for young people experiencing a first episode of psychosis. Psychiatr Serv 46(11):1166–1171PubMed
14.
McGuffin P, Farmer A, Harvey I (1991) A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Arch Gen Psychiatry 48(8):764–770PubMed
15.
Moodley P, Perkins RE (1991) Routes to psychiatric inpatient care in an Inner London Borough. Soc Psychiatry Psychiatr Epidemiol 26(1):47–51PubMedCrossRef
16.
Morgan C, Mallett R, Hutchinson G, Bagalkote H, Morgan K, Fearon P, Dazzan P, Boydell J, McKenzie K, Harrison G, Murray R, Jones P, Craig T, Leff J, AESOP Study Group (2005) Pathways to care and ethnicity. 1: sample characteristics and compulsory admission. Report from the AESOP study. Br J Psychiatry 186:281–289PubMedCrossRef
17.
Morgan C, Mallett R, Hutchinson G, Bagalkote H, Morgan K, Fearon P, Dazzan P, Boydell J, McKenzie K, Harrison G, Murray R, Jones P, Craig T, Leff J, AESOP Study Group (2005) Pathways to care and ethnicity. 2: source of referral and help-seeking. Report from the AESOP study. Br J Psychiatry 186:290–296PubMedCrossRef
18.
National Institute for Mental Health in England (2003) Personality disorder: no longer a diagnosis of exclusion. Policy implementation guidance for the development of services for people with personality disorder. Department of Health
19.
Saunders JB, Aasland OG, Babor TF, de lF Jr, Grant M (1993) Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol Consumption–II. Addiction 88(6):791–804
20.
Skodol AE, Pagano ME, Bender DS, Shea MT, Gunderson JG, Yen S, Stout RL, Morey LC, Sanislow CA, Grilo CM, Zanarini MC, McGlashan TH (2005) Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder over two years. Psychol Med 35(3):443–451PubMedCrossRef
21.
SPSS (1999) SPSS for Windows (Version 10.0.5.) IL, Chicago
22.
Tyrer P, Johnson T (1996) Establishing the severity of personality disorder. Am J Psychiatry 153(12):1593–1597PubMed
23.
Zimmerman M (1994) Diagnosing personality disorders. A review of issues and research methods. Arch Gen Psychiatry 51(3):225–245PubMed
Metadata
Title
Personality disorder and pathways to inpatient psychiatric care
Authors
Marianne Hayward
Paul Moran
Publication date
01-06-2007
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 6/2007
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-007-0185-0

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