But that is all psychiatry talk. Does not exist in ICD-9 and have not
checked ICD-10.

Fasciniating to meet a pure private practitioner psychiatrist in KL and sees
lots of high profile patients. He sees 30 to 40 patients per day. Very few
GP referrals.Totally chemically focused but quite proprietary about his
'cures'. Says that psychotherapy is pure bunkum. I don’t think there are any
talking cures unless you have heaps of money and then that is probably the
problem in itself. 

He also does his own EHRs but it is on a local server with no security.
Interesting.

David de Bhál
www.v-practice.com


-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Ian Cheong
Sent: Friday, April 28, 2006 6:19 AM
To: General Practice Computing Group Talk
Subject: Bordeline personality disorder was Re: [GPCG_TALK] Clinicalsoftware
recommendations

At 5:24 pm +1000 27/4/06, ash wrote:
>Oliver wrote:
>>>-----Original Message-----
>>>From: [EMAIL PROTECTED]
>>>[mailto:[EMAIL PROTECTED] Behalf Of David de Bhál
>>>Sent: Thursday, 27 April 2006 4:34 PM
>>
>>>And WTF is "borderline personality disorder"? 
>>>Is it akin to borderline pregnancy or 
>>>borderline senility or borderline?
>>
>>I think that it may have been invented since 
>>you and I graduated.  I wonder what the label 
>>used to be for people who behaved in these ways.
>
>sociopath i believe (or psychopath was the less demure expression)
>

Label first introduced officially in 1980 DSMIII.

Definitely not sociopath. Perhaps "suicidal", 
"non-coper", "pain in the ...". I recall when I 
was a student they had the label of "too hard to 
deal with" from psych registrars.

If you want to help these people, you could read:

Marsha Linehan on "dialectic behaviour therapy" 
(a newish term not on the cover!)
http://tinyurl.com/l6kle

Russel Meares on "self psychology"
http://tinyurl.com/jj9cn

And remember that a large number of "borderline" 
patients have suffered significant childhood 
trauma (sexual/physical/emotional).

Also search for "borderline" on this page, which 
is a fabulous site for complete exploration of 
trauma, including full text of all major research 
papers:
http://www.trauma-pages.com/pg4.htm

Major issues include:
* boundaries
* trust
* control

So attaching a label and not telling them about 
it is a serious problem, which helps perpetuate 
their aberrant behaviour.

"Borderline" patients are a long-term project 
that can be helped towards cure. I have a couple 
of them who have eventually been relabelled 
correctly as "dissociative" rather than 
"borderline" and are moving towards cure after a 
long trail of different psychiatrists over 
decades who didn't manage to help them. It seems 
they often fall over at "...that was a long time 
ago...get over it...."



Ian.

-- 
Dr Ian R Cheong, BMedSc, FRACGP, GradDipCompSc, MBA(Exec)
Health Informatics Consultant, Brisbane, Australia
Internet: [EMAIL PROTECTED]
(for urgent matters, please send a copy to my 
practice email as well: 
[EMAIL PROTECTED])

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