Demographic and clinical characteristics of patients with borderline personality disorder: Real-world insights from a retrospective observational study.

Abstract

Background: Current treatment modalities demonstrate variable effectiveness across patients with borderline personality disorder (BPD). Here, we describe the presenting clinical characteristics of patients with BPD based on approximately 20 years of real-world data.

Methods: This retrospective, observational study was based on de-identified MindLinc electronic health records of individuals (aged ≥12 years with ≥1 diagnosis of BPD) receiving mental healthcare between 1999 and 2020 across 15 US states using the NeuroBlu database (vRel21R2). Demographic and clinical characteristics at first recorded BPD diagnosis (index date), baseline (index date ±14 days), and in the 12 months prior to diagnosis were described. BPD symptoms were derived by natural language processing (NLP) of unstructured clinician-documented mental state examination (MSE) data.

Results: Across the 13,444 patients analysed at baseline (mean [SD] age 33 [12.8] years; 83.6 % female; 97.5 % with psychiatric comorbidities), the most frequent comorbid psychiatric conditions were major depressive disorder (45.7 %), substance use disorder (34.6 %) and post-traumatic stress disorder (29.2 %). Emotional dysregulation (35.8 %) and suicidal intent/ideation (31.3 %) were the most frequent NLP-derived BPD symptoms. Emotional dysregulation was more common in older patients, whereas suicidal intent/ideation/attempt/self-injury were more prevalent in younger patients. Mean (SD) length of hospitalisation was 2.9 (4.2) days, with 46.5 % of patients requiring ≥1 psychiatric hospitalisation. At diagnosis, 67.7 % of patients were prescribed pharmacological treatment, including antidepressants (51.1 %), second-generation antipsychotics (34.0 %) and anticonvulsants (33.7 %).

Conclusion: BPD symptoms varied according to patient characteristics, including age and gender. These insights may enable patient-specific treatment planning in the future and improve therapeutic outcomes.