Citation

Zanarini MC, Frankenburg FR, Reich DB, Silk KR, Hudson JI, McSweeney LB. Am. J. Psychiatry 2007; 164(6): 929-935.

Affiliation

Laboratory for the Study of Adult Development and the Psychiatric Epidemiology Research Program, McLean Hospital, 115 Mill St., Belmont 02478, and the Department of Psychiatry, Harvard Medical School, Boston, MA, USA. zanarini@mclean.harvard.edu

Copyright

(Copyright © 2007, American Psychiatric Association)

DOI

10.1176/appi.ajp.164.6.929

PMID

17541053

Abstract

OBJECTIVE: The purpose of this study was to characterize the course of 24 symptoms of borderline personality disorder in terms of time to remission. METHOD: The borderline psychopathology of 362 patients with personality disorders, all recruited during inpatient stays, was assessed using two semistructured interviews of proven reliability. Of these, 290 patients met DSM-III-R criteria as well as Revised Diagnostic Interview for Borderlines criteria for borderline personality disorder, and 72 met DSM-III-R criteria for another axis II disorder. Over 85% of the patients were reinterviewed at five distinct 2-year follow-up waves by interviewers blind to all previously collected information. RESULTS: Among borderline patients, 12 of the 24 symptoms studied showed patterns of sharp decline over time and were reported at 10-year follow-up by less than 15% of the patients who reported them at baseline. The other 12 symptoms showed patterns of substantial but less dramatic decline over the follow-up period. Symptoms reflecting core areas of impulsivity (e.g., self-mutilation and suicide efforts) and active attempts to manage interpersonal difficulties (e.g., problems with demandingness/entitlement and serious treatment regressions) seemed to resolve the most quickly. In contrast, affective symptoms reflecting areas of chronic dysphoria (e.g., anger and loneliness/emptiness) and interpersonal symptoms reflecting abandonment and dependency issues (e.g., intolerance of aloneness and counterdependency problems) seemed to be the most stable. CONCLUSIONS: The results suggest that borderline personality disorder may consist of both symptoms that are manifestations of acute illness and symptoms that represent more enduring aspects of the disorder.

Language: en