A retrospective survey of care provided to patients with borderline personality disorder admitted to a female psychiatric intensive care unit
Bibliographic record
Abstract
Aims: To survey the characteristics and care pathway of patients with a diagnosis of borderline personality disorder (BPD) admitted to Elizabeth Casson House female PICU over a four year period. To describe the nature of admissions, survey the treatment given, review discharge planning and explore the financial implications of this care. Method: A retrospective descriptive survey of patient records with reference to the standards of care set out by NICE (The National Institute for Health and Care Excellence). Results: Almost a quarter (n = 34, 24%) of patients admitted had a diagnosis of BPD and all had previous contact with mental health services and a complex range of needs. The most common reason for admission in this study was risk of self-harm (n = 34, 74%) and self-harm occurred during the majority of admissions (n = 26, 57%). Intramuscular rapid tranquilisation was used in over a third of admissions (n = 17, 37%). Around a quarter of patients accessed psychological therapies during their admission (n = 8, 28%). The estimated costs associated with these admissions was in excess of a million pounds. Conclusion: This survey suggests striking differences between male and female PICU patients and highlights the challenges of providing evidence based treatment for patients with BPD in a PICU. NICE guidelines recommend the formation of specialist multidisciplinary personality disorder teams which can contribute to reducing episodes of crisis and periods of hospitalisation. The findings of this survey make both a financial and clinical case for this approach to care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".