Time to Attainment of Recovery From Borderline Personality Disorder and Stability of Recovery: A 10-year Prospective Follow-Up Study

Abstract

Objective The first purpose of this study was to determine time-to attainment of recovery from borderline personality disorder and the second was to determine the stability of this important outcome. Method 290 inpatients meeting both Revised Diagnostic Interview for Borderlines and DSM-III-R criteria for the disorder were assessed during their index admission using a series of semistructured interviews and self-report measures. The same instruments were readministered at five contiguous two-year time periods. Results All told, 50% of the borderline patients studied achieved a recovery from borderline personality disorder—an outcome that required being symptomatically remitted and having good social and vocational functioning during the past two years. In contrast, 93% of borderline patients attained a symptomatic remission lasting two years and 86% attained a sustained symptomatic remission that lasted four years. In terms of stability of these outcomes, 34% of borderline patients lost their recovery from borderline personality disorder. A similar 30% had a symptomatic recurrence after a two-year long remission but only 15% experienced a symptomatic recurrence after a sustained remission. Conclusions Taken together, the results of this study suggest that recovery from borderline personality disorder combining both symptomatic remission and good psychosocial functioning seems difficult for many borderline patients to attain. These results also suggest that such a recovery once attained is relatively stable over time.

Factor Structure of Borderline Personality Disorder Symptomatology in Adolescents

“…[9][10][11][12] However, this is not unique to adolescents, as demonstrated in a recent 10-year prospective follow-up study that showed that up to 50% of adults with a BPD will eventually recover. 13 In contrast with the categorical diagnoses, it appears that a greater stability can be observed using a dimensional approach with selected symptom criteria, such as mood lability and anger dyscontrol, which emerge as significant predictors of BPD diagnosis in both adolescent and adult samples. 11,12,14,15 Thus conceptualizing BPD from a dimensional, rather than a categorical, approach could be particularly pertinent in adolescents, as a dimensional approach may better account for the developmental variability and heterogeneity observed during this age period.…”

Diagnosing borderline personality disorder

“…8,9 One large, well-conducted 10-year prospective study found that 93% of those with borderline personality disorder had at least a 2-year period of remission, but only 50% also attained good psychosocial functioning. 10 In this article, we focus on the current diagnostic criteria for borderline personality disorder, as presented in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), 11 and how these criteria can be used to differentiate it from other disorders that may share symptoms. A summary of the evidence used in this review is found in Box 1.…”

Stability and change in personality and personality disorders

“…For instance, Grilo et al (2004) reported that more than half of the patients in CLPS had remitted from their index diagnosis within two years, and Zanarini, Frankenburg, Reich, & Fitzmaurice (2010) found that 93% of the patients in the Mclean Study of Adult Development (MSAD) had remitted from borderline personality disorder in ten years. This research challenges longstanding assumptions that personaliy symptoms are highly stable, and provides hope for people with personality diagnoses But it also stands in marked contrast to research on basic traits, which show relative absolute stability at brief intervals despite agenormative changes across longer intervals (Roberts, Walton, & Viechtbauer, 2006).…”