Comorbidity of borderline personality disorder with other personality disorders in psychiatric outpatients: How does it look at 2-year follow-up?

Abstract

Background: The rates of remission of comorbid personality disorders for patients with a primary borderline personality disorder (BPD) have previously only been addressed in samples of inpatients or former inpatients with BPD receiving treatment-as-usual. Aims: The aim of the current study was to assess the rates of remission of comorbid axis II personality disorders in a sample of 32 outpatients with a primary BPD receiving open-ended non-manualized psychotherapy. Methods: Structured psychiatric interviews for DSM-IV were conducted by independent assessors at intake, discharge and 2-year follow-up. Independent t-test, chi-square and McNemar analyses based on intent-to-treat were used. Results: The overall rate of comorbid axis II disorders was significantly reduced from intake to 2-year follow-up. Patients with non-remitted BPD had significantly more PD diagnoses and symptomatic distress on all outcome measures at follow-up. Conclusion: Comorbid personality disorders among outpatients with BPD can be expected to remit with time and with remission of BPD. In the current sample of outpatients, comorbid paranoid, avoidant and obsessive–compulsive personality disorders at 2-year follow-up were associated with non-remitted BPD. The clinical implication of the results is that especially comorbid avoidant and obsessive–compulsive personality disorders may require specific attention in treatment of patients with BPD.

• Borderline personality disorder
• Comorbid
• Outcome

Acknowledgements

This study has used data from the Norwegian Multisite Study of Process and Outcome in Psychotherapy (NMSPOP) that was supported by grants from Medicine and Health, the Norwegian Research Council, Health and Rehabilitation through the Norwegian Council of Mental Health, Department of Psychology, University of Oslo and the Faculty of Psychology, University of Bergen.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.