Crisis and acute mental health care for people who have been given a diagnosis of a 'personality disorder': a systematic review.
Complex emotional needs
Crisis care
Home treatment
Inpatient admission
Personality disorder
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
05 10 2023
05 10 2023
Historique:
received:
09
05
2023
accepted:
18
08
2023
medline:
2
11
2023
pubmed:
6
10
2023
entrez:
5
10
2023
Statut:
epublish
Résumé
People who have been given a diagnosis of a 'personality disorder' need access to good quality mental healthcare when in crisis, but the evidence underpinning crisis services for this group is limited. We synthesised quantitative studies reporting outcomes for people with a 'personality disorder' diagnosis using crisis and acute mental health services. We searched OVID Medline, PsycInfo, PsycExtra, Web of Science, HMIC, CINAHL Plus, Clinical Trials and Cochrane CENTRAL for randomised controlled trials (RCTs) and observational studies that reported at least one clinical or social outcome following use of crisis and acute care for people given a 'personality disorder' diagnosis. We performed a narrative synthesis of evidence for each model of care found. We screened 16,953 records resulting in 35 studies included in the review. Studies were published between 1987-2022 and conducted in 13 countries. Six studies were RCTs, the remainder were non randomised controlled studies or cohort studies reporting change over time. Studies were found reporting outcomes for crisis teams, acute hospital admission, acute day units, brief admission, crisis-focused psychotherapies in a number of settings, Mother and Baby units, an early intervention service and joint crisis planning. The evidence for all models of care except brief admission and outpatient-based psychotherapies was assessed as low or very low certainty. The literature found was sparse and of low quality. There were no high-quality studies that investigated outcomes following use of crisis team or hospital admission for this group. Studies investigating crisis-focused psychological interventions showed potentially promising results.
Sections du résumé
BACKGROUND
People who have been given a diagnosis of a 'personality disorder' need access to good quality mental healthcare when in crisis, but the evidence underpinning crisis services for this group is limited. We synthesised quantitative studies reporting outcomes for people with a 'personality disorder' diagnosis using crisis and acute mental health services.
METHODS
We searched OVID Medline, PsycInfo, PsycExtra, Web of Science, HMIC, CINAHL Plus, Clinical Trials and Cochrane CENTRAL for randomised controlled trials (RCTs) and observational studies that reported at least one clinical or social outcome following use of crisis and acute care for people given a 'personality disorder' diagnosis. We performed a narrative synthesis of evidence for each model of care found.
RESULTS
We screened 16,953 records resulting in 35 studies included in the review. Studies were published between 1987-2022 and conducted in 13 countries. Six studies were RCTs, the remainder were non randomised controlled studies or cohort studies reporting change over time. Studies were found reporting outcomes for crisis teams, acute hospital admission, acute day units, brief admission, crisis-focused psychotherapies in a number of settings, Mother and Baby units, an early intervention service and joint crisis planning. The evidence for all models of care except brief admission and outpatient-based psychotherapies was assessed as low or very low certainty.
CONCLUSION
The literature found was sparse and of low quality. There were no high-quality studies that investigated outcomes following use of crisis team or hospital admission for this group. Studies investigating crisis-focused psychological interventions showed potentially promising results.
Identifiants
pubmed: 37798701
doi: 10.1186/s12888-023-05119-7
pii: 10.1186/s12888-023-05119-7
pmc: PMC10552436
doi:
Types de publication
Systematic Review
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
720Subventions
Organisme : Department of Health
ID : NIHR301772
Pays : United Kingdom
Organisme : Department of Health
ID : NIHR133027
Pays : United Kingdom
Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Int J Ment Health Nurs. 2022 Apr;31(2):313-325
pubmed: 34821012
BJPsych Open. 2022 May 17;8(3):e94
pubmed: 35579039
J Psychiatr Pract. 2019 May;25(3):199-205
pubmed: 31083032
J Ment Health. 2019 Mar 12;:1-21
pubmed: 30862201
PLoS One. 2021 Apr 29;16(4):e0248316
pubmed: 33914750
Cochrane Database Syst Rev. 2015 Dec 03;(12):CD001087
pubmed: 26633650
BMC Psychiatry. 2022 Jan 27;22(1):55
pubmed: 35081929
Rev Psiquiatr Salud Ment (Engl Ed). 2021 Jan-Mar;14(1):40-49
pubmed: 31160228
Perspect Psychiatr Care. 2014 Jan;50(1):65-75
pubmed: 24387616
Ment Illn. 2016 Dec 23;8(2):6868
pubmed: 28217274
Perspect Psychiatr Care. 2010 Apr;46(2):127-34
pubmed: 20377800
Aust N Z J Psychiatry. 1987 Dec;21(4):539-44
pubmed: 3449049
PLoS One. 2018 Nov 6;13(11):e0206472
pubmed: 30399184
J Pers Disord. 2004 Jun;18(3):240-7
pubmed: 15237044
Encephale. 2003 May-Jun;29(3 Pt 1):205-12
pubmed: 12876544
J Pers Disord. 2013 Oct;27(5):636-51
pubmed: 22928855
JAMA Netw Open. 2019 Jun 5;2(6):e195463
pubmed: 31173128
Psychiatry Res. 2011 Apr 30;186(2-3):287-92
pubmed: 20667602
Evid Based Med. 2017 Jun;22(3):85-87
pubmed: 28320705
World Psychiatry. 2022 Jun;21(2):220-236
pubmed: 35524608
Can J Psychiatry. 2005 Nov;50(13):857-62
pubmed: 16483121
Borderline Personal Disord Emot Dysregul. 2019 May 22;6:10
pubmed: 31143449
BJPsych Open. 2022 Feb 24;8(2):e53
pubmed: 35197131
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Ann Gen Psychiatry. 2010 Apr 27;9:19
pubmed: 20420716
Infant Ment Health J. 2020 Nov;41(6):770-782
pubmed: 32573014
J Psychiatr Pract. 2010 Mar;16(2):93-102
pubmed: 20511733
Br J Psychiatry. 2013 May;202(5):357-64
pubmed: 23637110
Psychiatr Serv. 2000 Jul;51(7):893-8
pubmed: 10875954
BJPsych Open. 2019 Jan;5(1):e1
pubmed: 30575497
Can J Psychiatry. 2015 Jul;60(7):301-2
pubmed: 26175387
Behav Cogn Psychother. 2014 Mar;42(2):156-65
pubmed: 23218099
Compr Psychiatry. 2011 Sep-Oct;52(5):548-55
pubmed: 21130423
BMJ. 2016 Oct 12;355:i4919
pubmed: 27733354
Issues Ment Health Nurs. 2022 Jul;43(7):593-602
pubmed: 35026125
Bull Soc Sci Med Grand Duche Luxemb. 2003;(2):87-96
pubmed: 15544003
J Psychiatr Pract. 2015 May;21(3):208-13
pubmed: 25955263
Psychol Med. 1994 Aug;24(3):731-40
pubmed: 7991755
J Psychiatr Pract. 2009 May;15(3):173-82
pubmed: 19461390
Issues Ment Health Nurs. 1994 Jan-Feb;15(1):1-11
pubmed: 8119792
J Psychother Pract Res. 1996 Winter;5(1):57-71
pubmed: 22700265
BMC Psychiatry. 2022 Sep 5;22(1):589
pubmed: 36064337
J Affect Disord. 2020 Jul 1;272:158-165
pubmed: 32379609
J Psychiatr Pract. 2010 May;16(3):145-54
pubmed: 20485102
Nord J Psychiatry. 2011 Sep;65(4):251-8
pubmed: 21062122
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
Psychiatr Serv. 2005 Feb;56(2):193-7
pubmed: 15703347
Syst Rev. 2016 Dec 5;5(1):210
pubmed: 27919275
BMC Psychiatry. 2019 Nov 6;19(1):341
pubmed: 31694681
Qual Life Res. 2021 Dec;30(12):3485-3500
pubmed: 34075531
BJPsych Bull. 2016 Dec;40(6):306-309
pubmed: 28377808
Gen Hosp Psychiatry. 1993 Sep;15(5):307-15
pubmed: 8307344
J Pers Disord. 2016 Apr;30(2):271-87
pubmed: 26111250
Hosp Community Psychiatry. 1990 Sep;41(9):988-92
pubmed: 2210709
Front Psychiatry. 2021 May 10;12:655548
pubmed: 34040555
J Pers Disord. 2022 Jun;36(3):277-295
pubmed: 34747648
Cochrane Database Syst Rev. 2022 Sep 26;9:CD009353
pubmed: 36161394