Article

Prediction of the 10-Year Course of Borderline Personality Disorder

Harvard University, Cambridge, Massachusetts, United States
American Journal of Psychiatry (Impact Factor: 12.3). 06/2006; 163(5):827-32. DOI: 10.1176/appi.ajp.163.5.827
Source: PubMed

ABSTRACT

The purpose of this study was to determine the most clinically relevant baseline predictors of time to remission for patients with borderline personality disorder.
A total of 290 inpatients meeting criteria for both the Revised Diagnostic Interview for Borderlines and DSM-III-R for borderline personality disorder were assessed during their index admission with a series of semistructured interviews and self-report measures. Diagnostic status was reassessed at five contiguous 2-year time periods. Discrete survival analytic methods, which controlled for baseline severity of borderline psychopathology and time, were used to estimate hazard ratios.
Eighty-eight percent of the patients with borderline personality disorder studied achieved remission. In terms of time to remission, 39.3% of the 242 patients who experienced a remission of their disorder first remitted by their 2-year follow-up, an additional 22.3% first remitted by their 4-year follow-up, an additional 21.9% by their 6-year follow-up, an additional 12.8% by their 8-year follow-up, and another 3.7% by their 10-year follow-up. Sixteen variables were found to be significant bivariate predictors of earlier time to remission. Seven of these remained significant in multivariate analyses: younger age, absence of childhood sexual abuse, no family history of substance use disorder, good vocational record, absence of an anxious cluster personality disorder, low neuroticism, and high agreeableness.
The results of this study suggest that prediction of time to remission from borderline personality disorder is multifactorial in nature, involving factors that are routinely assessed in clinical practice and factors, particularly aspects of temperament, that are not.

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    • "Mejorías modestas en funcionamiento social. Zanarini y colaboradores (2006) Seguimiento de 10 años a pacientes (n= 290) con TPL. 88% lograron remisión total del trastorno. "
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    • "In conclusion, despite reports of low temporal stability of BPD in adolescents (Zanarini, Frankenburg, Hennen, Reich, et al., 2006) it has been evidenced that dysfunctional areas of borderline personality disorder (like identity disturbance, affective instability, relational difficulties, impulsivity) could represent a clinical core which is relevant for an accurate diagnosis (Miller et al., 2008). In this realm, the IPOP-A seems to be a promising tool in the assessment of those personality dimensions during adolescence. "
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    • "The main characteristic of BPD, is a comprehensive model of instability in the interpersonal relations, self-concept, emotions and impulsiveness which has been commenced from the early adultness and appeared in the different context (DSM IV-TR, 2000). Among all the personality disorder, BPD has lower stability during the time and in many studies of short-term and long-term a high rate of improvement has been reported (Zanarini et al, 2006). It doesn't seem that this improvement rate is affected by major depression disorder, whilst depression improvement rate when has pathologic concomitant to BPD, is reduced extremely (Gunderson et al, 2004). "
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