143719 - Borderline personality disorder: diagnosis and management in general practice

This activity has been developed by the Royal Australian College of General Practitioners (RACGP) with expert input obtained through Australian BPD Foundation Limited, Orygen, Spectrum and Project Air. Its focus is to assist GPs in identifying the risk factors for, and clinical features of, BPD; discussing effective management options including appropriate prescribing and involvement of families/carers; and describing strategies to manage the doctor-patient relationship, including crisis management. 

Tempo activities are designed as quick activities (when both the Overview and Interactive activity are completed) but recognise the additional effort GPs undertake when utilising the supplemental resources provided. Hence, this activity has been approved by the RACGP Quality Improvement and Continuing Professional Development (QI&CPD) Program for 2 Category 2 point in the 2017-2019 triennium. 

BPD is often under-recognised due to presentation with other psychiatric comorbidities. If left undiagnosed and untreated, BPD is associated with significant morbidity and mortality: 
• mortality rate (8-10%) 
• comorbidity rate (94%) including substance use, PTSD, depression, eating disorders and metabolic syndrome and 
• substantial impacts on quality of life (disability weight 0.54 equivalent to autism 0.55 and HIV-AIDS 0.57). 

With a limited number of publicly funded therapeutic services delivering care to adolescents and adults in Australia with BPD, it is estimated that less than 10% of affected individuals are able to access services to reduce their risk of suicide, self-harm, significant social dysfunction and other comorbidities outlined above. 

GPs are well placed to identify individuals with BPD and to provide education, management, and access to appropriate care as needed. Structured psychological interventions have been demonstrated to improve outcomes for BPD.