Association Between Social Determinants of Health and Borderline Personality Disorder: A Systematic Review.

Abstract

Borderline personality disorder (BPD) is a common and serious mental health condition characterized by emotional instability, impulsive behavior, and difficulties in interpersonal relationships. This review aimed to comprehensively summarize the current stage of knowledge on the association between social determinants of health (SDoH) and BPD. MEDLINE (PubMed), Embase, and PsycINFO databases were searched from inception to May 2025. We included peer-reviewed studies written in English that assess the association between SDoH and BPD. Each article was screened by two reviewers, and disagreements were resolved by a third reviewer. A narrative synthesis was used to summarize the studies, grouped by the domain of SDoH. Of the 3983 articles screened, 29 were included in this review. The majority of the studies (59.3%) were conducted in the United States, with the social and community context emerging as the most frequently represented domain. A bidirectional relationship was observed between SDoH and BPD, where unfavorable SDoH triggers or worsen BPD symptoms, and BPD can limit access to favorable SDoH. There is a significant and bidirectional relationship between SDoH and BPD. Addressing SDoH is essential for prevention, recovery, and long-term well-being among individuals with borderline personality disorder.