Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Borderline Personality Disorder: Results From the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions
J Clin Psychiatry 2008;69(4):533-545
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objectives: To present nationally representative findings on
prevalence, sociodemographic correlates, disability, and comorbidity of
borderline personality disorder (BPD) among men and women.
Method: Face-to-face interviews were conducted with 34,653
adults participating in the 2004-2005 Wave 2 National Epidemiologic Survey on
Alcohol and Related Conditions. Personality disorder diagnoses were made using
the Wave 2 Alcohol Use Disorder and Associated Disabilities Interview
Results: Prevalence of lifetime BPD was 5.9% (99% CI = 5.4 to
6.4). There were no differences in the rates of BPD among men (5.6%, 99% CI =
5.0 to 6.2) and women (6.2%, 99% CI = 5.6 to 6.9). BPD was more prevalent among
Native American men, younger and separated/divorced/widowed adults, and those
with lower incomes and education and was less prevalent among Hispanic men and
women and Asian women. BPD was associated with substantial mental and physical
disability, especially among women. High co-occurrence rates of mood and
anxiety disorders with BPD were similar. With additional comorbidity controlled
for, associations with bipolar disorder and schizotypal and narcissistic
personality disorders remained strong and significant (odds ratios >= 4.3).
Associations of BPD with other specific disorders were no longer significant or
were considerably weakened.
Conclusions: BPD is much more prevalent in the general
population than previously recognized, is equally prevalent among men and
women, and is associated with considerable mental and physical disability,
especially among women. Unique and common factors may differentially contribute
to disorder-specific comorbidity with BPD, and some of these associations
appear to be sex-specific. There is a need for future epidemiologic, clinical,
and genetically informed studies to identify unique and common factors that
underlie disorder-specific comorbidity with BPD. Important sex differences
observed in rates of BPD and associations with BPD can inform more focused,
hypothesis-driven investigations of these factors.