Borderline personality disorder. When medical care is complicated by mental illness

Management of patients with borderline personality disorder on a medical ward requires the cooperation of all caregivers involved. First, it is necessary to recognize the disorder in patients who exhibit maladaptive behavior. Next, a comprehensive plan of behavioral management should be implemented that includes (1) clear communication among staff members, (2) education of staff members, (3) a consistent approach to the patient, (4) firm limits on the patient's behavior, and (5) an empathic rather than confrontational response to the patient's demands. Use of psychoactive medications may be a valuable adjunct to these approaches. A consulting psychiatrist can confirm the diagnosis and help to develop and implement the management plan.