Levels of Depersonalization and Derealization Reported by Recovered and Non-recovered Borderline Patients Over 20 Years of Prospective Follow-up

ABSTRACT

Borderline personality disorder (BPD) is a serious psychiatric illness, and it is often associated with dissociative symptoms. The purpose of this study was to assess the course of depersonalization and derealization symptoms in recovered and non-recovered borderline patients over 20 years of prospective follow-up. The Dysphoric Affect Scale (DAS) – a 50-item self-report measure was administered to 290 borderline inpatients at baseline, and the remaining participants (85%) at 10 follow-up interviews conducted over 20 years. The level of depersonalization and derealization experienced by borderline patients was assessed using three items (feeling unreal, feeling completely numb, and feeling like people and things aren’t real) from the DAS. The patients who recovered from BPD reported significantly lower scores in all three inner states (62 - 63%) at baseline compared to those patients who did not recover. Furthermore, scores of recovered and non-recovered groups decreased significantly in all three inner states studied over 20 years of prospective follow-up. Overall, these results suggest that the severity of depersonalization and derealization symptoms decreased significantly over 20 years of prospective follow-up and had a strong association with BPD recovery status.

KEYWORDS:

• Borderline personality disorder
• dissociation
• depersonalization
• derealization
• longitudinal

Conflict of interest

The authors report no relevant conflicts of interest.

Additional information

Funding

This study was supported by NIMH grants MH47588 and MH62169.