181349 - 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.
Borderline personality disorder (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 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.
General practitioners (GPs) are well placed to identify individuals with BPD and to provide education, management, and access to appropriate care as needed.
D1. Communication skills and the patient-doctor relationship
Effective communication is used in challenging situations
D2. Applied professional knowledge and skills
Diagnosis and management is evidence-based and relevant to the needs of the patient
D3. Population health and the context of general practice
D4. Professional and ethical role
Patient–doctor boundaries are identified and maintained
D5. Organisational and legal dimensionsCurriculum Contextual Units
- Adult health
- Children and young people health
- Psychological health
Australian BPD Foundation Limited, Orygen, Spectrum and Project Air