Does diagnosing a patient with borderline personality disorder negatively impact patient satisfaction with the initial diagnostic evaluation?

BACKGROUND

Research has found that clinicians have less sympathetic attitudes and behave less empathically toward patients with borderline personality disorder (BPD). Anecdotal conversations with clinicians and trainees reveal that some have a reluctance to tell their patients that they have BPD due to a concern that these patients will react badly. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined whether diagnosing BPD resulted in lower satisfaction with the initial evaluation.

METHODS

One thousand ninety-three patients presenting to the Rhode Island Hospital partial hospital program completed the Clinically Useful Patient Satisfaction Scale (CUPSS), a reliable and valid measure of satisfaction with the initial evaluation. The usual clinical practice in our program is to discuss with the patients their diagnoses.

RESULTS

Approximately one-sixth of the patients were diagnosed with BPD (15.6%, n = 171). There were no significant differences in satisfaction ratings on the 16 items of the CUPSS between patients with and without BPD.

CONCLUSIONS

There was no evidence that diagnosing BPD was associated with reduced satisfaction with the initial diagnostic evaluation. Approaches toward making the diagnosis of BPD also are discussed.