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Conclusion

The approaches described previously will allow the patient and the clinician to create a therapeutic relationship, decrease risk events in the ED, and foster healthier outcomes to ensure the patient is appropriately diagnosed, treated, and safely discharged.

References

Huang, Y, Kotov, R, de Girolamo, G, Preti, A, Angermeyer, M, Benjet, C, Demyttenaere, K et al. 2009. DSM-IV personality disorders in the WHO World Mental Health surveys. British Journal of Psychiatry 195 (1): 46-53. doi:10.1192/bjp.bp.108.058552.

Williamson, A M, Feyer, A M. 2000. Moderate sleep deprivation produces impairments in cognition and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occupational and Environmental Medicine 57 (10): 649-655.

Resources

American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Arlington, VA: American Psychiatric Association.

Blashfield, R K, Intoccia V. 2000. Growth of the literature on the topic of personality disorders. American Journal Psychiatry. 157(3): 472-473. doi:10.1176/appi.ajp.157.3.472.

Boggild, A K, Heisel M H, Links, P S. 2004. Social, demographic, and clinical factors related to disruptive behaviour in hospital. Canadian Journal Psychiatry 49 (2): 114-118.

Gonzalez, R A, Igoumenou, A, Kallis, C, Coid, J W. 2016. Borderline personality disorder and violence in the UK population: Categorical and dimensional trait assessment. BMC Psychiatry 3(16): 180. doi:10.1186/s12888-016-0885-7.

Hong, V. 2016. Borderline personality disorder in the emergency department: Good psychiatric management. Harvard Review of Psychiatry 24(5):357—366. doi:10.1097/HRP.0000000000000112.

McMain, S F, Boritz, T Z, Leybman, M J. 2015. Common strategies for cultivating a positive therapy relationship in the treatment of borderline personality disorder. Journal of Psychotherapy Integration 25 (1): 20-29.

Silk, K R. 2011. The process of managing medications in patients with borderline personality disorder. Journal of Psychiatric Practice 17(5). 311-319. doi:10.1097/01.pra.0000405361.88257.4a.

Vaillant, G E. 1992. The beginning of wisdom is never calling a patient a borderline; or, the clinical management of immature defenses in the treatment of individuals with personality disorders. Journal of Psychotherapy Practice and Research 1 (2): 117-134.

Wilson, M P, Pepper, D, Currier, G W, Holloman, G H, Feifel, D. 2012. The psychopharmacology of agitation: Consensus statement of the American Association for Emergency Psychiatry project BETA psy- chopharmocology workgroup. Western Journal of Emergency Medicine 13 (1): 26-34. doi:10.5811/ westjem.2011.9.6866.

 
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