The British Journal of Psychiatry (2008) 193: 471-476. doi: 10.1192/bjp.bp.107.038208
© 2008 The Royal College of Psychiatrists
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Immigrants and borderline personality disorder at a psychiatric emergency service

J. C. Pascual, PhMDD

Department of Psychiatry, Sta. Creu i St. Pau Hospital, Universitat Autònoma de Barcelona, and CIBER-SAM

A. Malagón, MD, D. Córcoles, MD and J. M. Ginés, MD

Department of Psychiatry, IAPS, Hospital del Mar, Universitat Autònoma de Barcelona

J. Soler, PsyD

Department of Psychiatry, Sta. Creu i St. Pau Hospital, Universitat Autònoma de Barcelona, and CIBER-SAM

C. García-Ribera, MD

Department of Psychiatry, IAPS, Hospital del Mar, Universitat Autònoma de Barcelona

V. Pérez, PhD, MD

Department of Psychiatry, Sta. Creu i St. Pau Hospital, Universitat Autònoma de Barcelona, and CIBER-SAM

A. Bulbena, PhD, MD

Department of Psychiatry, IAPS, Hospital del Mar, Universitat Autònoma de Barcelona, Spain

Correspondence: Dr J.C. Pascual, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Avenida Sant Antoni M. Claret, 167. 08025 Barcelona, Spain. Email: jpascual{at}hsp.santpau.es

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Several studies have suggested that immigrants have higher rates of psychiatric emergency service use and a higher risk of mental disorders such as schizophrenia than indigenous populations.

Aims

To compare the likelihood that immigrants (immigrant group) v. indigenous population (indigenous group) will be diagnosed with borderline personality disorder in a psychiatric emergency service and to determine differences according to area of origin.

Method

A total of 11 578 consecutive admissions over a 4-year period at a tertiary psychiatric emergency service were reviewed. The collected data included socio-demographic and clinical variables and the Severity of Psychiatric Illness rating score. Psychiatric diagnosis was limited to information available in the emergency room given that a structured interview is not usually feasible in this setting. The diagnosis of borderline personality disorder was based on DSM–IV criteria. Immigrants were divided into five groups according to region of origin: North Africa, sub-Saharan Africa, South America, Asia and Western countries.

Results

Multivariate statistical logistic regression analysis showed that all subgroups of immigrants had a lower likelihood of being diagnosed with borderline personality disorder than the indigenous population independently of age and gender. Furthermore, the rates of borderline personality disorder diagnosis were considerably lower in Asian and sub-Saharan subgroups than in South American, North African, Western or native subgroups.

Conclusions

Our results showed that in the psychiatric emergency service borderline personality disorder was diagnosed less frequently in the immigrant group v. the indigenous group. Our results do not support the concept of migration as a risk factor for borderline personality disorder.


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