The 10-Year Course of Social Security Disability Income Reported by Patients With Borderline Personality Disorder and Axis II Comparison Subjects

Laboratory for the Study of Adult Development, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, USA.
Journal of personality disorders (Impact Factor: 3.08). 09/2009; 23(4):346-56. DOI: 10.1521/pedi.2009.23.4.346
Source: PubMed


This study had two purposes. The first purpose was to assess the prevalence as well as the stability of reliance on social security disability income (SSDI) among patients with borderline personality disorder (BPD). The second purpose was to detail the prevalence of aspects of adult competence reported by borderline patients who ever received disability payments and those who never received such payments. The disability status and other aspects of psychosocial functioning of 290 borderline inpatients and 72 axis II comparison subjects were assessed using a semi-structured interview at baseline and at each of the five subsequent two-year follow-up periods. Borderline patients were three times more likely to be receiving SSDI benefits than axis II comparison subjects over time, although the prevalence rate for both groups remained relatively stable. Forty percent of borderline patients on such payments at baseline were able to get off disability but 43% of these patients subsequently went back on SSDI. Additionally, 39% of borderline patients who were not on disability at baseline started to receive federal benefits for the first time. However, borderline patients on SSDI were not without psychosocial strengths. By the time of the 10-year follow-up, 55% had worked or gone to school at least 50% of the last two years, about 70% had a supportive relationship with at least one friend, and over 50% a good relationship with a romantic partner. The results of this study suggest that receiving SSDI benefits is both more common and more fluid over time for patients with BPD than previously known.


Available from: Ryan J. Jacoby, Jul 21, 2014
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    • "According to the DSM-IV criteria [4], BPD is characterized by a pervasive pattern of instability in interpersonal relationships, identity, impulsivity, and affect. BPD is associated with high rates of suicide [5], comorbid Axis I and II mental disorders [6-8], severe functional impairment [9], and high costs for psychiatric services [9,10]. BPD diagnosis is generally based on (1) generic Axis II diagnostic interviews that include all DSM-IV Axis II diagnoses such as the SCID-II [11] or (2) BPD-specific structured interviews such as the Diagnostic Interview for Borderlines-Revised (DIB-R) [12,13], which improve the specificity and accuracy of the diagnosis. "
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