The 24-year course of substance use disorders in patients with borderline personality disorder and personality-disordered comparison subjects.

IF 2.5 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions Pub Date : 2025-02-25 DOI:10.1111/ajad.70012

Mary C Zanarini, Christina M Temes, Isabel V Glass, Frances R Frankenburg, Garrett M Fitzmaurice, Brandon T Unruh, Roger D Weiss

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引用次数: 0

Abstract

Background and objectives: The purpose of this study is to detail the long-term course of substance use disorders (SUDs) among patients with borderline personality disorder (BPD) and subjects with other personality disorders (OPD).

Methods: Two hundred and ninety patients with BPD and 72 subjects with OPD were assessed at baseline and 12 contiguous waves of follow-up as part of the McLean Study of Adult Development (MSAD). The SCID-I for DSM-III-R Axis I disorders was administered 13 times (at baseline admission and at 12 follow-up periods). Kaplan-Meier analyses were used to assess time-to-remission (2-12 years in length), time-to-recurrence (2-12 years after first remission), and cumulative time-to-new onsets of alcohol and drug use disorders.

Results: Both study groups achieved high rates of remission (ranging from 12-year long to 2-year long) from alcohol use disorder (AUD) (BPD: 64%-91%; OPD: 80%-100%) and drug use disorder (DUD) (BPD: 71%-100%; OPD: 75%-100%). Recurrences (following 12-year long and 2-year long remissions) of AUD (BPD: 24%-63%; OPD: 46%-70%) and DUD (BPD: 28%-67%; OPD: 0%-38%) were not uncommon. Cumulative rates of new onsets during the 24 years of prospective follow-up of AUD (BPD: 5%-27%; OPD: 2%-10%) and DUD (BPD: 5%-21%; OPD: 7%-18%) were less common.

Discussion and conclusions: Remissions of alcohol and drug use disorders among borderline patients are very common but recurrences are not uncommon. Results also suggest that new onsets of these disorders are relatively rare.

Scientific significance: The course of SUDs in those with BPD is more complex than found in prior shorter-term studies.

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边缘型人格障碍患者24年物质使用障碍病程与人格障碍对照研究。

背景与目的：本研究的目的是详细描述边缘型人格障碍（BPD）和其他人格障碍（OPD）患者的物质使用障碍（SUDs）的长期病程。方法：作为McLean成人发展研究（MSAD）的一部分，对290名BPD患者和72名OPD患者进行基线和12波连续随访评估。DSM-III-R轴I障碍的SCID-I治疗13次（基线入院和12个随访期）。Kaplan-Meier分析用于评估酒精和药物使用障碍的缓解时间（2-12年）、复发时间（首次缓解后2-12年）和新发病的累积时间。结果：两个研究组酒精使用障碍（AUD）的缓解率都很高（从12年到2年不等）(BPD: 64%-91%；OPD: 80%-100%)和药物使用障碍（DUD） (BPD: 71%-100%；门诊部当:75% - -100%)。复发（经过12年和2年的缓解）AUD (BPD: 24%-63%；OPD: 46%-70%)和DUD (BPD: 28%-67%；OPD: 0%-38%)并不少见。在24年的预期随访期间，AUD的累计新发病率（BPD）： 5%-27%；OPD: 2%-10%)和DUD (BPD: 5%-21%；OPD: 7%-18%)较少见。讨论和结论：酒精和药物使用障碍在边缘患者中得到缓解是非常常见的，但复发并不罕见。结果还表明，这些疾病的新发病相对罕见。科学意义：与之前的短期研究相比，BPD患者的sud病程更为复杂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal on Addictions SUBSTANCE ABUSE-

CiteScore

5.00

自引率

0.00%

发文量

118

期刊介绍： The American Journal on Addictions is the official journal of the American Academy of Addiction Psychiatry. The Academy encourages research on the etiology, prevention, identification, and treatment of substance abuse; thus, the journal provides a forum for the dissemination of information in the extensive field of addiction. Each issue of this publication covers a wide variety of topics ranging from codependence to genetics, epidemiology to dual diagnostics, etiology to neuroscience, and much more. Features of the journal, all written by experts in the field, include special overview articles, clinical or basic research papers, clinical updates, and book reviews within the area of addictions.