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The following is a summary of “Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study,” published in the May 2025 issue of BMC Psychiatry by Chen et al. 

Outpatient psychotherapies were considered the gold standard for treating borderline personality disorder (BPD), yet individuals with BPD experienced higher rates of psychiatric hospitalization and more severe symptoms, such as suicidality and self-harm, compared to those with other psychiatric disorders in inpatient settings.  

Researchers conducted a retrospective study to differentiate the clinical profile and outcomes of patients screening positive for BPD traits in the inpatient psychiatric setting using the McLean Screening Instrument for BPD (MSI-BPD) from those who did not.  

They enrolled 1,034 adults admitted to the Division of Depression & Anxiety Disorders (DDAD) short-term inpatient unit at McLean Hospital between September 2020 and February 2022. The short-term unit provided generalist care for individuals with mood and anxiety disorders, typically those experiencing first episodes and often undiagnosed, without major psychotic features. Inpatient treatment reflected usual care, not specialized for specific diagnoses. Self-assessments were administered primarily via electronic tablets (Apple iPads) or desktop computers using Research Electronic Database Capture (REDCap) following the development and implementation of standardized patient-reported clinical measurements. 

The results showed that patients screening positive on the MSI-BPD + were younger, more likely to be female, and reported higher rates of health and psychosocial risk factors, including unstable housing, lower educational attainment, physical health issues, past trauma, and problematic drug and alcohol use, compared to those screening negative (MSI-BPD -). The patients with MSI-BPD + also reported significantly higher severity of anxiety, depression, suicidality, self-harm, and global symptoms upon admission. In terms of response to inpatient care, patients with MSI-BPD + self-reported greater improvements and a higher proportion of reliable change on measures of anxiety, depression, and general psychiatric severity. By discharge, suicidality no longer differed significantly, but patients with MSI-BPD + continued to report higher levels of thoughts of self-harm.  

Investigators concluded that patients with self-reported BPD symptoms experienced acute symptom relief, including for suicidality, during short-term inpatient hospitalization, and the MSI-BPD screening tool was feasible for identifying individuals with distinct clinical profiles in a large adult inpatient psychiatric population. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06928-8