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Substance use in borderline personality disorder.

R A Dulit1, M R Fyer, G L Haas

  • 1Department of Psychiatry, New York Hospital-Cornell University Medical Center, NY 10021.

The American Journal of Psychiatry
|August 1, 1990
PubMed
Summary
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A study found 67% of inpatients with borderline personality disorder also had substance use disorders, primarily alcohol and sedatives. Removing substance abuse criteria identified a subgroup of borderline patients where substance use may be central to their condition.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Addiction Medicine

Background:

  • Borderline personality disorder (BPD) is a complex mental health condition.
  • Substance use disorders (SUDs) are frequently comorbid with BPD.
  • The specific relationship and diagnostic overlap require further investigation.

Purpose of the Study:

  • To determine the prevalence of substance use disorders in inpatients diagnosed with DSM-III borderline personality disorder.
  • To explore the impact of substance use on the diagnosis and characteristics of borderline personality disorder.

Main Methods:

  • Retrospective analysis of 137 inpatients diagnosed with DSM-III borderline personality disorder.
  • Assessment of DSM-III substance use disorder diagnoses.
  • Comparison of patient characteristics when substance abuse was included versus excluded as a diagnostic criterion for BPD.

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Main Results:

  • A high prevalence of substance use disorders (67%) was observed in the BPD patient cohort.
  • Alcohol and sedative-hypnotics were the most commonly abused substances.
  • Excluding substance abuse as a diagnostic criterion resulted in 23% of patients no longer meeting BPD criteria, with distinct illness severity and course.

Conclusions:

  • Substance use disorders are highly prevalent among individuals with borderline personality disorder.
  • A distinct subgroup of borderline personality disorder patients may exist where substance use is a primary driver of psychopathology.
  • These findings highlight the importance of considering substance use in the diagnosis and treatment of BPD.