Psychiatrist.comThe 24-Year Course of Symptomatic Disorders in Patients with Borderline Personality Disorder and Personality-Disordered Comparison Subjects: Description and Prediction of Recovery From BPD

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This 24-year prospective study, conducted from 1992 to 2018, examines the prevalence and course of symptomatic disorders in patients with borderline personality disorder (BPD) compared to other personality-disordered individuals. The research provides insights into the long-term progression of comorbid disorders in BPD and factors associated with recovery.

Study Design:

• Naturalistic prospective follow-up study (McLean Study of Adult Development)
• 362 inpatients assessed at 12 contiguous 2-year follow-up waves over 24 years
• Symptomatic disorders assessed using Structured Clinical Interview for DSM-III-R Axis I Disorders
• Generalized estimating equations used for outcome analysis

Key Findings:

• BPD patients had significantly higher rates of all 5 types of disorders studied compared to comparison subjects
• Prevalence of symptomatic disorders declined significantly over time at similar rates for both BPD and comparison groups
• Similar decline observed in both recovered and non-recovered BPD patients
• Absence of substance use disorders was the strongest predictor of BPD recovery (relative risk ratio: 2.53, P < .001)

HCN Medical Memo
This longitudinal study highlights the importance of comprehensive, long-term care for BPD patients, with a particular emphasis on addressing substance use disorders. Clinicians should consider integrating substance use treatment into BPD management strategies to potentially improve recovery outcomes.

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