Goorden et al reported a decision tool for referring a patient with a personality disorder to highly specialized care. The authors are from multiple institutions in The Netherlands.
Patient selection: personality disorder
Outcome: referral to highly specialized care
Parameters:
(1) severe negative affect with disadaptive coping
(2) severe destructive behavior to oneself or others
(3) multiple comorbid disorders on axis I and/or axis II due to severe psychiatric problems
(4) severe social and societal dysfunction (Global Assessment of Functioning, GAF<=50)
(5) severe chronic traumatization in childhood
(6) difficulties in developing a therapeutic relationship
(7) treatment in specialized care was not successful
Response
Points
no
0
yes
1
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
Score
Possibility and Motivation to Conform to Minimum Treatment Conditions
Referral to Highly Specialized Care
0 to 3
NA
no
4 to 7
yes
yes
4 to 7
no
no
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