[Diagnosis and treatment of borderline disorders within the scope of inpatient psychiatric care].

Borderline-patients compose a group of severe problem-patients on psychiatric inpatient units. Among other topics this concerns the difficult differential diagnosis, attitudes of demandingness and entitlement, feelings of depressive despair, acting out and impulsive behavior. Using a process oriented diagnostical approach which includes the behavior of the patient on the unit and the analysis of the therapeutic interaction, the borderline disorder is differentiated from the psychoses on the one side and the neuroses on the other. The specific treatment problems of borderline-patients are dealt with under the headings of regression, splitting, projective identification and acting out. The counter-transference problems of treatment teams are taken under special consideration. The last part of the article deals with treatment goals and therapeutic strategies in the psychiatric inpatient treatment of borderline patients and discusses possible modalities of adjunctive treatment.