Effects of inpatient psychiatric care for individuals with borderline personality disorder, self-harm or risk of suicide

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SBU Enquiry Service

Responds to queries received from Swedish healthcare and social service providers, or governmental organisations. Queries have a limited scope and the process is designed to enable a more rapid response, typically within two to three months. Reports are based on systematic reviews, that are identified through structured searches and critically appraised for risk of bias.

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Published: Report no: ut202605 Registration no: SBU 2025/1397

Question

What systematic reviews have been published regarding the effects of inpatient psychiatric care for individuals with borderline personality disorder, self-harm or risk of suicide?

PECO

  • Population: Individuals with borderline personality disorder, self-harm or risk of suicide?
  • Exposure: Inpatient psychiatric care, with or without involuntary admission
  • Control: No intervention, treatment as usual or psychatric outpatient care
  • Outcome: Mortality (suicide), suicidal ideation, self-harm, ratings of symptoms

Method

A systematic literature search was performed using the following databases: Medline via OvidSP, Scopus and PsycInfo via EBSCO.
Two authors independently assessed the abstracts of all identified studies.
Risk of bias in relevant systematic reviews was assessed using an assessment tool based on AMSTAR.

Identified literature

One relevant systematic reviews was identified [1]. Due to high risk of bias the results and conclusions are not reported.

References

  1. Lak M, Shakiba S, Dolatshahi B, Saatchi M, Shahrbaf M, Jafarpour A. The prevalence of suicide ideation, suicide attempt and suicide in borderline personality disorder patients: A systematic review and meta-analysis. Gen Hosp Psychiatry. 2025;95:52-61. Available from: https://doi.org/10.1016/j.genhosppsych.2025.04.005

 

Search strategies

Medline via OvidSP 16 Jan 2026

Title: Inpatient care of patients with borderline personality disorder
/ = Term from the MeSH controlled vocabulary; .sh = Term from the MeSH controlled vocabulary; exp = Term from MeSH including terms found below this term in the MeSH hierarchy; .ti,ab = Title or abstract; .tw = Title or abstract; .kf = Keywords; .kw = Keywords, exact; .bt = Book title. NLM Bookshelf; .pt = Publication type; .ja = Journal abbreviation; .af = All fields; adjn = Adjacent. Proximity operator retrieving adjacent words, adj3 retrieves records with search terms within two terms from each other; * or $ = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population: borderline personality disorder
1. Borderline Personality Disorder/ 8790
2. ((borderline or border-line) adj3 (personalit* or state*)).ti,ab,kf,bt. 10 662
Population: self-injurious behavior / risk of suicide
3. Suicide/ or Suicidal Ideation/ or Suicide, Attempted/ or Drug Overdose/ or Self-Injurious Behavior/ or Self-Mutilation/ 93 236
4. (suicide* or parasuicid* or "auto mutilat*" or automutilat* or "self destruct*" or selfdestruct* or self-harm* or selfharm* or "self immolat*" or selfimmolat* or "self inflict*" or selfinflict* or "self injur*" or selfinjur* or selfmutilat* or "self mutilat*" or "self poison*" or selfpoison* or (self adj2 (cut or cuts or cutting or cutter? or burn or burns or burning or bite or bites or biting or hit or hits or hitting)) or "head bang*" or headbang* or nssi? or ((nonsuicid* or non-suicid*) adj2 (self* or injur*)) or ((nonfatal or non-fatal) adj2 (overdose? or over dose?))).ti,ab,kf,bt. 111 109
Intervention: voluntary or involuntary psychiatric inpatient care
5. Inpatients/ or Emergency Services, Psychiatric/ or Involuntary Treatment, Psychiatric/ 36 065
6. (Inpatient* OR ((involuntary OR coercive OR compulsory) adj3 (care OR treatment* OR admission* OR hospital* OR detention OR commitment))).ti,ab,kf,bt. 169 161
Study types: systematic reviews and meta-analysis / randomized controlled trials*
7. ((Systematic Review/ or Meta-Analysis/ or Cochrane Database Syst Rev.ja. or (((systematic or realist or integrative or mixed method* or umbrella) adj4 (review)) or "meta analys*" or metaanalys*).ti,bt,ab.) not (editorial/ or letter/ or case reports/)) 592 920
Combined sets:
8. 1 or 2 12 489
9. 3 or 4 145 639
10. 8 or 9 155 511
11. 5 or 6 181 952
12. 10 and 11 6514
Final result
13. 12 and 7 134

* Cochrane Highly Sensitive Search Strategy for identifying randomized trials in MEDLINE: sensitivity- and precision-maximizing version (2008 revision); Ovid format. The Cochrane Collaboration; 2008. Available from: https://training.cochrane.org/handbook/current/chapter-04-technical-supplement-searching-and-selecting-studies#section-3-6-1. with modifications: the following terms are added: clinical trial, phase iii.pt. ; randomised.ab. ; ("Phase 3" or "phase3" or "phase III" or P3 or "PIII").ti,ab,kw.

Scopus via scopus.com 19 January 2026

Title: Inpatient care of patients with borderline personality disorder
TITLE-ABS-KEY = Title, abstract or keywords (including indexed keywords and author keywords); ALL = All fields; W/n = Within. Proximity operator retrieving terms within n words from each other; PRE/n = Precedes by. Proximity operator, the first term in the search must precede the second by n words; LIMIT-TO (X) = Includes only results of specified type, e.g., publication type or time range; DOCTYPE = Publication type; “re” = review; “le” = letter; “ed” = editorial; “ch” = book chapter; “cp” = conference proceedings; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population: borderline personality disorder
1. TITLE-ABS-KEY ( ( borderline or border-line ) w/3 ( personalit* or state* ) ) 22 074
Population: self-injurious behavior / risk of suicide  
2. TITLE-ABS-KEY (suicid* OR parasuicid* OR "auto mutilat*" OR automutilat* OR "self destruct*" OR selfdestruct* OR self-harm* OR selfharm* OR "self immolat*" OR selfimmolat* OR "self inflict*" OR selfinflict* OR "self injur*" OR selfinjur* OR selfmutilat* OR "self mutilat*" OR "self poison*" OR selfpoison* OR ( self W/2 ( cut OR cuts OR cutting OR cutter? OR burn OR burns OR burning OR bite OR bites OR biting OR hit OR hits OR hitting ) ) OR "head bang*" OR headbang* OR nssi? OR ( ( nonsuicid* OR non-suicid* ) W/2 ( self* OR injur* ) ) OR ( ( nonfatal OR non-fatal ) w/2 ( overdose? OR "over dose?" ) ) ) 241 775
Intervention: voluntary or involuntary psychiatric inpatient care
3. TITLE-ABS-KEY ( Inpatient* OR ( ( involuntary OR coercive OR compulsory ) w/3 ( care OR treatment* OR admission* OR hospital* OR detention OR commitment ) ) ) 211 157
Study types: systematic reviews and meta-analysis / randomized controlled trials
4. TITLE-ABS-KEY ( ( (systematic OR realist OR integrative OR “mixed method*” or umbrella) W/3 review ) OR "meta analy*" OR metaanaly* ) AND (EXCLUDE (DOCTYPE, “le”) OR EXCLUDE (DOCTYPE, “ed”) OR EXCLUDE (DOCTYPE, “ch”) OR EXCLUDE (DOCTYPE, “cp”)) 891 599
Combined sets:
5. 1 OR 2 258 562
6. 5 AND 3 8485
Final result
7. 6 AND 4 236

PSYCINFO via EBSCO 20 January 2026

Title: Inpatient care of patients with borderline personality disorder
TI = Title; AB = Abstract; SU = Keyword, exact or part (including all other fields for indexed and author keywords); DE = Exact keyword; TX = All text; MR = Methodology; Nn = Near. Proximity operator retrieving terms within n words from each other; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population: borderline personality disorder
1. TI (( borderline or border-line ) n3 ( personalit* or state* )) OR AB (( borderline or border-line ) n3 ( personalit* or state* )) OR SU (( borderline or border-line ) n3 ( personalit* or state* )) 18 003
2. TI (suicid* or parasuicid* or "auto mutilat*" or automutilat* or "self destruct*" or selfdestruct* or self-harm* or selfharm* or "self immolat*" or selfimmolat* or "self inflict*" or selfinflict* or "self injur*" or selfinjur* or selfmutilat* or "self mutilat*" or "self poison*" or selfpoison* or (self N2 (cut or cuts or cutting or cutter? or burn or burns or burning or bite or bites or biting or hit or hits or hitting)) or "head bang*" or headbang* or nssi? or ((nonsuicid* or non-suicid*) N2 (self* or injur*)) or (nonfatal or non-fatal) w/2 (overdose? or "over dose?"))AB (suicid* or parasuicid* or "auto mutilat*" or automutilat* or "self destruct*" or selfdestruct* or self-harm* or selfharm* or "self immolat*" or selfimmolat* or "self inflict*" or selfinflict* or "self injur*" or selfinjur* or selfmutilat* or "self mutilat*" or "self poison*" or selfpoison* or (self N2 (cut or cuts or cutting or cutter? or burn or burns or burning or bite or bites or biting or hit or hits or hitting)) or "head bang*" or headbang* or nssi? or ((nonsuicid* or non-suicid*) N2 (self* or injur*)) or (nonfatal or non-fatal) w/2 (overdose? or "over dose?"))SU (suicid* or parasuicid* or "auto mutilat*" or automutilat* or "self destruct*" or selfdestruct* or self-harm* or selfharm* or "self immolat*" or selfimmolat* or "self inflict*" or selfinflict* or "self injur*" or selfinjur* or selfmutilat* or "self mutilat*" or "self poison*" or selfpoison* or (self N2 (cut or cuts or cutting or cutter? or burn or burns or burning or bite or bites or biting or hit or hits or hitting)) or "head bang*" or headbang* or nssi? or ((nonsuicid* or non-suicid*) N2 (self* or injur*)) or (nonfatal or non-fatal) w/2 (overdose? or "over dose?")) 104 368
Intervention: voluntary or involuntary psychiatric inpatient care
3. Inpatient* OR ( ( involuntary OR coercive OR compulsory ) N3 ( care OR treatment* OR admission* OR hospital* OR detention OR commitment ) ) 66 689
Study types: systematic reviews and meta-analysis / randomized controlled trials
4. (TI(((systematic OR realist OR integrative OR “mixed method*” OR umbrella) N3 review) OR "meta analys*" OR metaanalys*) OR AB(((systematic OR realist OR integrative OR “mixed method*” OR umbrella) N3 review) OR "meta analys*" OR metaanalys*) OR SU(((systematic OR realist OR integrative OR “mixed method*” OR umbrella) N3 review) OR "meta analys*" OR metaanalys*)) OR (MR "Systematic Review" OR MR "meta analysis") 860 889
Combined sets:
5. 1 OR 2 118 782
6. 5 AND 3 6969
Final result
7. 6 AND 4 124
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