Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN.
McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA.
J Acad Consult Liaison Psychiatry. 2023 Jan-Feb;64(1):83-91. doi: 10.1016/j.jaclp.2022.08.003. Epub 2022 Aug 19.
We present a case illustrating common challenges in the hospital management and treatment of comorbid borderline personality disorder and substance use disorders. Experts in the field of personality disorders and substance use disorders discuss various topics and strategies for patient-centered management. Key learning points include evaluation and diagnosis of borderline personality disorder, good psychiatric management, withdrawal and pharmacologic management, harm reduction, team dynamics, and behavior planning all in the hospital setting. This paper provides actionable considerations with elements common to many clinical encounters that present challenges to the consultation-liaison psychiatrist in the general hospital setting.
我们呈现了一个案例,说明了合并边缘型人格障碍和物质使用障碍的医院管理和治疗中的常见挑战。人格障碍和物质使用障碍领域的专家讨论了患者为中心的管理的各种主题和策略。关键学习要点包括边缘型人格障碍的评估和诊断、良好的精神科管理、戒断和药物管理、减少伤害、团队动态以及行为计划,所有这些都在医院环境中进行。本文提供了可操作的考虑因素,其中包括许多临床情况下共同存在的元素,这些元素给综合医院会诊联络精神科医生带来了挑战。