Borderline personality and psychotropic medication prescription in an outpatient psychiatry clinic

Abstract 

Borderline personality is a complex disorder and pharmacological intervention is typically focused on target symptoms. Previous studies indicate that patients with borderline personality disorder (BPD) are prescribed a greater number of psychotropic medications than those without BPD. However, these studies were self-report in design and/or preceded the use of newer psychotropic medications such as selective serotonin reuptake inhibitors (SSRIs). In this study, we explored among 280 psychiatric outpatients the relationships between an axis II diagnosis of BPD and the number of axis I diagnoses, psychotropic medications, and psychotherapy sessions. Compared to those with other types of personality disorders (n = 128) or no personality disorder at all (n = 91), those with BPD (n = 61) were diagnosed with significantly more axis I disorders, prescribed significantly more psychotropic medications, and attended significantly more psychotherapy sessions. These findings suggest that: (1) BPD patients will probably be prescribed more psychotropic medications than other psychiatric outpatients, and (2) in addition to psychotropic medication prescription, there may be additional variables (e.g., psychotherapy sessions) that make a meaningful contribution to the overall healthcare utilization among those with BPD.