Pharmacopsychiatry 2003; 36 - 24
DOI: 10.1055/s-2003-825275

A new concept for crisis management in borderline patients

K Bernhardt 1, L Friege 1, K Gerok-Falke 1, K Röhling 1, JB Aldenhoff 1
  • 1Department of Psychiatry and Psychotherapy, Christian-Albrechts-University School of Medicine, Kiel, Germany

Whereas the longterm treatment in psychotherapy of female patients with borderline personality disorder has been successfully implemented in clinical practice by the well known concept by Marsha Linehan[1,2], the management of recurrent crisis has continued to be a significant challenge to psychiatrists. Therefore, we have established an acute, short-term crisis treatment concept for both gender on a locked unit. The treatment basis is dialectical behavior therapy. The focus is to improve stress-tolerance, especially by skills-training regarding the individual situation and problems at time of admittance. The patients stay at most for 21 days. Outcome variables are: Improvement in 1. suicidal /self destructive behavior, 2. dissociative states/flashbacks, 3. psychotic features, 4. substance/drug abuse, 5. need for medication and 6. neurocognitive functioning. For the longterm survey the duration of treatment as well as the frequency of recurrent hospitalisation will be evaluated. First preliminary results of this innovative crisis management program will be presented.

[1] Linehan et al. Arch Gen Psychiatry 1993, 48:971–74

[2] Linehan et al. Am J Psychiatry 1994, 151:1771–76