BPD recovery study

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Following is the abstract of a research study published in the Feb 2003

issue of the AJP. It indicates recovery time of BPDs in treatment, with

declining rates in 24 symptom patterns:

34.5% at 2 years

49.4% at 4 years

68.6% at 6 years

And, in a comparison of four traits, control over impulsivity occurred

the quickest; improvement in cognitive (ie, thinking/understanding) and

interpersonal traits were intermediate; and changes in affect (mood)

took the longest.

- Edith

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MEDLINE, Abstract

" The longitudinal course of borderline psychopathology: 6-year

prospective follow-up of the phenomenology of borderline personality

disorder. "

Zanarini MC, enburg FR, Hennen J, Silk KR

Am J Psychiatry 2003 Feb 160:274-83

Volume 160 • Issue 2

OBJECTIVE: The syndromal and subsyndromal phenomenology of borderline

personality disorder was tracked over 6 years of prospective follow-up.

METHOD: The psychopathology of 362 inpatients with personality disorders

was assessed with the Revised Diagnostic Interview for Borderlines

(DIB-R) and borderline personality disorder module of the Revised

Diagnostic Interview for DSM-III-R Personality Disorders. Of these

patients, 290 met DIB-R and DSM-III-R criteria for borderline

personality disorder and 72 met DSM-III-R criteria for other axis II

disorders (and neither criteria set for borderline personality

disorder). Most of the borderline patients received multiple treatments

before the index admission and during the study. Over 94% of the total

surviving subjects were reassessed at 2, 4, and 6 years by interviewers

blind to previously collected information.

RESULTS: Of the subjects with borderline personality disorder, 34.5% met

the criteria for remission at 2 years, 49.4% at 4 years, 68.6% at 6

years, and 73.5% over the entire follow-up. Only 5.9% of those with

remissions experienced recurrences. None of the comparison subjects with

other axis II disorders developed borderline personality disorder during

follow-up. The patients with borderline personality disorder had

declining rates of 24 symptom patterns but remained symptomatically

distinct from the comparison subjects. Impulsive symptoms resolved the

most quickly, affective symptoms were the most chronic, and cognitive

and interpersonal symptoms were intermediate.

CONCLUSIONS: These results suggest that symptomatic improvement is both

common and stable, even among the most disturbed borderline patients,

and that the symptomatic prognosis for most, but not all, severely ill

borderline patients is better than previously recognized.

Author Address

Laboratory for the Study for Adult Development, McLean Hospital, MA,

USA. zanarini@...

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