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Course and Prevalence of Borderline Personality Disorder

Borderline Personality Disorder probably affects anywhere from 0.7% to 1.8% of all people in the general population [ref, ref], though some studies have found that as much as 5.9% of the population may be diagnosed with this condition at some point in their life [ref]. Some studies have suggested that Borderline Personality Disorder is as much as three times more common in women than in men [ref], though other studies have found that both genders are affected more or less equally by this condition [ref].

By definition, the disorder begins - or at least becomes apparent - in early adulthood. Thereafter, the symptoms tend to remain a stable feature of an individual's personality. On the one hand, follow-up studies have shown that among individuals with this disorder who are in treatment programs, after 10 years close to 90% no longer meet full criteria for the disorder [ref]. While these findings are encouraging, it does not mean that all these people are then totally symptom free [ref, ref]. The impulsivity symptoms are the ones that tend to subside most quickly over time, giving the impression that Borderline Personality Disorder "burns-out" with age; however, the interpersonal difficulties, emotional instability and cognitive disturbances tend to be more stable over time and to continue into older age [ref, ref].

People with Borderline Personality Disorder tend to have considerable persistent difficulties in various areas of life [ref]. The quality of their interpersonal relationships will be greatly affected and marriages will be problematic. Difficulties in work settings and even in their ability to enjoy leisure activities are also common.

Conditions Associated with Borderline Personality Disorder (Comorbidity)

Furthermore, these individuals nearly always suffer from other concurrent psychiatric disorders [ref]. Virtually all people with Borderline Personality Disorder will also have a Mood Disorder, with over 80% having Major Depression, 45% having Dysthymia, and 5% suffering from Bipolar Disorder. Close to two-thirds will have a Substance Use Disorder. Over 80% will have an Anxiety Disorder, with Panic Disorder and Social Phobia both reaching close to 50%, and PTSD reaching close to 60%. Half of all individuals with this condition will have an Eating Disorder.

Borderline Personality Disorder, Self-Harm and Suicide

The biggest concern regarding these individuals is suicide [ref]. At least three-quarters of people with Borderline Personality Disorder will attempt suicide, and up to 10% will die by suicide. It can be difficult at times to distinguish suicidal acts from self-mutilation.

Self-mutilation involves inflicting pain on oneself, such as by cutting or burning oneself, with the goal of punishing oneself, relieving tension, or drawing others' attention to the fact that one is upset. These self-injurious acts are often done impulsively and in moments of intense anger. However, suicide attempts can also be made impulsively and for the same reasons.

It is common for people with Borderline Personality Disorder to have suicidal thoughts and to make threats of suicide. It is very difficult for mental health professionals to know for sure when these threats are serious and to predict if or when a person with Borderline Personality Disorder will actually make a suicide attempt [ref]. Those at higher risk of suicide are ones with [ref]:

Prognosis

Individuals with Borderline Personality Disorder who tend to fare better or those who are diagnosed and treated at a younger age, who are not victims of childhood sexual abuse, who have been able to maintain a good vocational record, and who do not have a family history of Substance Use Disorder [ref].

 

Causes

Overview of Treatment