Management of personality disorders in acute in-patient settings. Part 1: Borderline personality disorders

Leonard Fagin is a consultant psychiatrist and the Clinical Director of the North East London Mental Health NHS Trust. He also holds the post of honorary senior lecturer at University College London (South Forest Centre, 21 Thorne Close, Leytonstone, London E11 4HU, UK). Among his research interests he has studied the psychological effects of unemployment, occupational stress, standards of care in in-patient units and the effects of deinstitutionalisation.

General principles of management of patients with personality disorders admitted in crises to the in-patient unit are discussed. The role of the acute ward in the overall plan of care, the clinical thresholds to consider in deciding whether admission is appropriate and the main elements of the in-patient care plan are outlined. The management of patients with borderline personality disorder, who constitute the majority of such admissions, is discussed in detail.