Therapeutic community treatment of personality disorder: service use and mortality over 3 years' follow-up

Abstract

BackgroundA number of studies have demonstrated reductions in the utilisation of psychiatric services, especially acute inpatient admissions, following therapeutic community treatment of personality disorder. These studies have, however, been of limited duration (1 year) and follow-up has not always been complete.AimsTo identify hospital admissions before and after therapeutic community treatment of personality disorder.MethodA naturalistic clinical cohort of patients admitted between January 1993 and December 1995 was followed up for 3 years. All subjects were traced to their current consultant psychiatrist, general practitioner or death.ResultsAll patients were traced at 3-year follow-up. The significant reduction in in-patient admissions seen in the first year was maintained over 3 years. Those with the poorest outcomes, suicide, accidental death or prolonged admission were all in the quartile with the shortest admissions (under 42 days) to the therapeutic community.ConclusionsPreviously reported reductions in psychiatric admissions following therapeutic community treatment of personality disorder are maintained over 3 years.