Profile of egyptian patients with borderline personality disorder with and without comorbidity

Abstract

Background Borderline personality disorder (BPD) is a complex psychiatric disorder associated with a wide range of psychopathology, including unstable mood, impulsive behavior, and suicidality, which is a defining feature of borderline, as well as high rates of axis I comorbidity. Aim To identify the profile of psychiatric comorbidity among patients with BPD and to compare them with a group of patients with BPD without comorbidity regarding some demographic variables, suicidal behavior, impulsivity, and functioning. Methods Structural Clinical Interviewing was done for DSM-IV axis I and axis II diagnoses. We recruited 30 patients with BPD, without axis I comorbidity (group I) and other 31 patients with BPD with comorbidity (group II). We compared both groups regarding different demographic variables, family circumstances impulsivity, suicidality, and functioning using suicide behavior questionnaire − revised, Barratt impulsiveness scale II, and global assessment of function. Results Patients with BPD in group II had one additional diagnosis, mainly major depression (35.5%), substance-related disorder (35.5%), anxiety disorder (16.1%), whereas bipolar disorder and eating disorders were equally rated (6.5% each). Group II patients scored significantly higher in the total suicidality scores using suicide behavior questionnaire − revised than group I, yet the two groups did not differ significantly in impulsivity scores. Meanwhile, the former group was significantly younger (P=0.05), and they started their illness and seeked treatment at a younger age with more history of previous hospitalization than did group I. In addition, their global assessment of function is significantly impaired (P=0.002). Conclusion Comorbidities in patients with BPD are high, mainly major depression and substance-related disorders, which are associated with increased suicidality behavior, hospital admission, and impaired functioning. Data obtained conveys the need to give high priority to recognize the comorbidities that pose risk on the lives of patients with BPD.