Long-Term Course of Borderline Personality Disorder: A Prospective 10-Year Follow-Up Study

Alvarez-Tomás, Irene; Soler, Joaquim; Bados, Arturo; Martín-Blanco, Ana; Elices, Matilde; Reyes-Carmona, Cristina; Bauza, J A; Pascual, Juan Carlos

doi:10.1521/pedi_2016_30_269

Cited by 57 publications

(51 citation statements)

References 40 publications

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“…However, like prior studies, Alvarez-Tomás et al also observed a reduction in general activity (functioning) and social life despite a marked improvement in psychiatric symptoms of BDP such as emotional dysregulation, affective instability, and impulsivity (10).…”

Section: Introductionsupporting

confidence: 62%

An Update on Borderline Personality Disorder

Çetin¹,

Köse²

2017

JMOOD

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Several studies have been conducted for a long time to identify the borderline personality and to elucidate its distinctive characteristics from other psychopathologies. However, the different findings obtained in these studies carried out provided findings that this disorder is not yet understood sufficiently. Therefore, studies about the prevalence, the comorbidity, causative factors and treatment approaches of borderline personality disorder are of vital importance. Moreover, studies about suicidality among BPD patients also have a separate importance because repetitive suicidal behaviors complicate the medical care significantly. In this review, we aimed to reevaluate the recent studies conducted on the diagnosis, the prevalence, the comorbidity, causative factors, and treatment of borderline personality disorder.

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Section: Introductionsupporting

confidence: 62%

An Update on Borderline Personality Disorder

Çetin¹,

Köse²

2017

JMOOD

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“…The course of BPD from adolescence to adulthood is characterized by a symptomatic switch from predominantly symptoms of affective dysregulation, impulsivity, and suicidality to maladaptive interpersonal functioning and enduring functional impairments, with subsequent periods of remission and relapse of the full categorical BPD diagnosis, i.e., meeting the threshold of at least five out of nine DSM-criteria for BPD [ 16 •, 32 , 33 ]. Longitudinal studies show a general decrease of full BPD diagnoses from young to middle adulthood [ 34 , 35 ]. However, remission of the categorical BPD diagnosis is commonly followed by relapse, and almost half of BPD patients never recover fully, both socially and vocationally [ 35 , 36 ].…”

Section: Waxing and Waning Course Of Bpd From Childhood To Old Agementioning

confidence: 99%

“…BPD in young adulthood predicts a host of negative outcomes across the life span, including mood, anxiety, eating and substance use disorders, increased risk for physical illnesses and medical care, reduced quality of life, and reduced life expectancy [ 39 , 42 – 45 ]. As a consequence, many BPD patients never manage to fully participate in society [ 34 , 46 ].…”

Section: Waxing and Waning Course Of Bpd From Childhood To Old Agementioning

confidence: 99%

A Life Span Perspective on Borderline Personality Disorder

Videler

Hutsebaut

Schulkens

et al. 2019

Curr Psychiatry Rep

140

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Purpose of Review To provide an update of a life span perspective on borderline personality disorder (BPD). We address the life span course of BPD, and discuss possible implications for assessment, treatment, and research. Recent Findings BPD first manifests itself in adolescence and can be distinguished reliably from normal adolescent development. The course of BPD from adolescence to late life is characterized by a symptomatic switch from affective dysregulation, impulsivity, and suicidality to maladaptive interpersonal functioning and enduring functional impairments, with subsequent remission and relapse. Dimensional models of BPD appear more age neutral and more useful across the entire life span. There is a need for age-specific interventions across the life span. Summary BPD symptoms and impairments tend to wax and wane from adolescence up to old age, and presentation depends on contextual factors. Our understanding of the onset and early course of BPD is growing, but knowledge of BPD in late life is limited. Although the categorical criteria of DSM allow for reliable diagnosis of BPD in adolescence, dimensional models appear both more age neutral, and useful up to late life. To account for the fluctuating expression of BPD, and to guide development and selection of treatment across the life span, a clinical staging model for BPD holds promise.

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“…The hours of formal therapy fluctuated between 60 and over 600 h, the latter reported by the MBT trial [20]. Among naturalistic studies, two studies followed up samples who initially participated in a clinical trial, although treatment subgroups were not individually studied at follow-up [10,13]. Besides, three naturalistic studies informed of treatment use during follow-up in general terms.…”

Section: Treatment Interventionsmentioning

confidence: 99%

Long-term clinical and functional course of borderline personality disorder: A meta-analysis of prospective studies

et al. 2018

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Background:This meta-analytic review is the first to synthesise findings from prospective research on the long-term course of borderline personality disorder in adult clinical populations.Methods:Systematic searches were conducted in Medline, PsycINFO, PsycArticles, PubMed and Scopus within the period 1990-2017. Inclusion criteria were: (1) adult BPD sample diagnosed by a validated, semi-structured interview; (2) at least two prospective assessments of outcomes; and (3) follow-up period ≥ 5 years. Quality of evidence was rated with the Systematic Assessment of Quality in Observational Research (SAQOR). Four outcomes were meta-analysed using mixed-effect methods: remission from BPD diagnosis, completed suicide, depressive symptoms, and functioning. Potential moderators regarding the natural course and the initial treatment received were studied.Results:Eleven studies met the inclusion criteria, with 837 participants from nine countries being followed. Between 50% and 70% of the BPD patients achieved remission in the long-term. Significant reductions in depression and functional impairment were also found. Mean suicide rate ranged from 2% to 5%. Younger age was associated with higher likelihood for remission. Being female was correlated with lower functional improvement. Despite some positive trends, there were no significant associations between treatment moderators and the long-term outcome.Conclusions:Findings suggest that the course of BPD is characterised by symptomatic amelioration and a slight functional improvement in the long-term. Age and gender modulate the long-term prognosis and should be considered to adapt treatment resources. Further research is required to draw robust conclusions on the long-term effects of psychotherapeutic interventions.

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Long-Term Course of Borderline Personality Disorder: A Prospective 10-Year Follow-Up Study

Cited by 57 publications

References 40 publications

An Update on Borderline Personality Disorder

An Update on Borderline Personality Disorder

A Life Span Perspective on Borderline Personality Disorder

Long-term clinical and functional course of borderline personality disorder: A meta-analysis of prospective studies

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