Outcomes in women diagnosed with borderline personality disorder in adolescence

This study examined the outcomes of patients diagnosed with borderline personality disorder (BPD) prior to age 18. In a group of 47 adolescent girls assessed over a 10 year period, 31 had a past diagnosis of BPD while 16 had not met criteria. Subjects were assessed with the SCID-I, the Diagnostic Interview for Borderlines (DIB), the SCL-90-R, the Social Adjustment Scale (SAS-SR), the Affective Lability Scale (ALS), the Barratt Impulsivity Scale (BIS), the Continuous Performance Test (CPT), the Wisconsin Card Sorting Test (WCST), and the Attention Network Task (ANT). 4.3 years after initial presentation (mean age=19.6), only 11 index patients still met criteria for BPD and no new cases developed. Those who did not remit were significantly more likely to have a current episode of major depressive disorder, lifetime substance use disorder, and self-reported childhood sexual abuse. Those who still met BPD criteria also scored higher on the ALS and the total severity scale as well as several subscales of the SCL-90, but not on other measures. These findings support the validity of an adolescent diagnosis of BPD and show that the majority of cases that develop in early adolescence can be expected to remit within 4 years.