Factors predicting outcome of psychiatric hospital treatment in patients with borderline personality organization

Abstract

The aim of the present study was to identify factors predicting the outcome of psychiatric hospital treatment carried out on a ward specializing in psychotherapeutic treatment of borderline personality disorders. The sample included patients admitted during 1989 to an open psychiatric ward at the Department of Psychiatry of Kuopio University Hospital in Finland (n=66). The success of treatment was assessed by means of the Beck and Hamilton depression scales, on the basis of which the sample was divided into two groups: those who benefited from treatment and those who did not. Fifty independent variables reflecting the patients' background, previous treatment and expectations were evaluated. A statistically significant association was found between 14 variables and the outcome of the treatment. A good outcome was predicted by subjective symptoms such as tension and suicidal tendencies at the beginning of treatment and a poor outcome by fear of delusions. Active and positive expectations of symptom decline and treatment benefit also predicted a good outcome. The background variables, previous treatment and medical diagnosis did not differentiate between those who benefited from treatment and those who did not. Medication during treatment, use of benzodiazepines in particular, was usually associated with a good outcome. The best results were obtained in patients with mild disorders. We conclude that in crisis situations, non-psychotic patients also benefit from inpatient treatment lasting longer than the immediate alleviation of symptoms would require. The nature of the symptoms and expectations of the treatment outcome have predictive value.