Does diagnosing a patient with borderline personality disorder negatively impact patient satisfaction with the initial diagnostic evaluation?

BACKGROUND: Research has found that clinicians have less sympathetic attitudes and behave less empathically toward patients with borderline personality disorder (BPD). Anecdotal conversations with clinicians and trainees reveal that some have a reluctance to tell their patients that they have BPD due to a concern that these patients will react badly. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined whether diag­nosing BPD resulted in lower satisfaction with the initial evaluation.

METHODS: One thousand ninety-three patients presenting to the Rhode Island Hospital partial hospital program completed the Clinically Useful Patient Satisfaction Scale (CUPSS), a reliable and valid measure of satis­faction with the initial evaluation. The usual clinical practice in our pro­gram is to discuss with the patients their diagnoses.

RESULTS: Approximately one-sixth of the patients were diagnosed with BPD (15.6%, n = 171). There were no significant differences in satisfaction rat­ings on the 16 items of the CUPSS between patients with and without BPD.

CONCLUSIONS: There was no evidence that diagnosing BPD was asso­ciated with reduced satisfaction with the initial diagnostic evaluation. Approaches toward making the diagnosis of BPD also are discussed.

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