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

East Midlands Centre for Forensic Mental Health, Leciester

PENELOPE CAMPLING, MRCPsych

Francis Dixon Lodge Therapeutic Community, Leicester, UK

Correspondence: Dr Steffan Davies, Academic Unit, Arnold Lodge, East Midlands Centre for Forensic Mental Health, Cordelia Close, Leicester LE5 0LE, UK. Tel: 01162 256124; fax: 01162 256065; e-mail: drsteffand{at}aol.com

Declaration of interest None.

^* Paper presented at the second conference of the British and Irish Group for the Study of Personality Disorders (BIGSPD), University of Leicester, UK, 31 January to 3 February 2001.

Background A number of studies have demonstrated reductions in the utilisation of psychiatric services, especially acute in-patient 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.

Aims To identify hospital admissions before and after therapeutic community treatment of personality disorder.

Method A 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.

Results All 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.

Conclusions Previously reported reductions in psychiatric admissions following therapeutic community treatment of personality disorder are maintained over 3 years.

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