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BPD
is a severe and chronic mental illness affecting 2-3%
of the population, 11% of the outpatients and 20% of
inpatients. One in ten people with the disorder commits
suicide, usually due to impulsivity rather than chronic
depression. BPD worsens the outcome and complicates
the treatment of any co-occurring disorder such as Bipolar
Disorder, Substance Abuse or Eating Disorders. BPD,
a major public health burden, is a key factor in substance
abuse recidivism (67% of SA meet criteria for BPD),
domestic violence, (22-35% of DV perpetrators meet criteria
for BPD), gambling, eating disorders (40%), shop lifting,
sex addiction, AIDS, homelessness and child abuse. Impulsive
aggression, a core symptom of BPD, leads a significant
number of sufferers, particularly men, into fights,
perpetration of domestic violence or road rage and ultimately
into forensic rather than mental health settings. Relationships
with people with BPD can be extremely chaotic due to
their "emotional storms." They are highly sensitive
to rejection and, not surprisingly, account for one
out of three stalkers. Many are recipients of SSI and/or
SSD. Availability of evidence based treatment nationwide
remains minimal or non-existent, as are help, support
or psycho-education for family members of people with
BPD.
Latest
research documents that patients with BPD are the most
extensive users of Mental Health Services including
virtually every mode of psychosocial treatment, more
often and in greater amounts than any other diagnostic
group. BPD patients have more complicated and impairing
symptoms, more enduring distress and disability, more
extensive treatment histories, a relatively higher incidence
of psychiatric hospitalization and an extensive, if
erratic, use of outpatient mental health services than
do patients with major depression. They continue to
function at lower levels despite receiving greater amounts
of treatment than depressed patients. Evidence that
these patients receive adequate or appropriate treatment
in the community is unavailable. Functional impairment
of people with BPD exceeds that of patients with major
depressive disorder yet the costs to patients, families
and society from BPD are persistently overlooked.
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