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Long-Term Data Document Course of BPD Symptoms

There is an interesting article in the June 1, 2007 issue of The Psychiatric News about a study in the June, 2007 issue of the American Journal of Psychiatry which found that over 10 years 12 of the 24 symptoms of Borderline Personality disorder which deal with impulsivity and suicidality seemed to improve while the remaining 12 symptoms which deal with affect and interpersonal relationships seemed to be more stable.

Twelve of the 24 symptoms studied showed patterns of sharp decline over time and were reported at 10-year follow-up by less than 15 percent of the patients who reported them at baseline. The other 12 symptoms showed patterns of substantial but less dramatic decline over the follow-up period.

Symptoms reflecting core areas of impulsivity (such as self-mutilation and suicide efforts), and active attempts to manage interpersonal difficulties (such as problems with demandingness/entitlement and serious treatment regressions) seemed to resolve the most quickly.

In contrast, affective symptoms reflecting areas of chronic dysphoria (such as anger, loneliness, or emptiness) and interpersonal symptoms reflecting abandonment and dependency issues (such as intolerance of aloneness and problems with dependency) seemed to be the most enduring.

It seems to be somewhat seredipity for me to find this study because I just raised this question with my psychotherapy supervisor last week about whether people with Borderline Personality Disorder, "mellow" as they get older and the symptoms subside or whether the symptoms persist and functioning slowly deteriorates. Neither one of us seemed to know the answer, but in my professional and practical experience it seemed to me that without treatment, the symptoms seem to get worse and functioning deteriorates.

I tend to tend to think of the symptoms of Borderline Personality Disorder on a continuum from mild to severe. People with mild to moderate symptoms often either do not seek treatment, or do not stick with it if they seek treatment briefly for immediate symptomatic relief or to manage a crisis. Once the immediate problems subside, treatment is rejected and the underlying difficulties are never adequately addressed. Over time the symptoms seem to take their toll and functioning deteriorates as time goes on.

Link: Long-Term Data Document Course of BPD Symptoms -- Moran 42 (11): 13 -- Psychiatr News.


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