Patient-reported outcomes in borderline personality disorder

Area of Science:

• Psychiatry and Behavioral Sciences
• Clinical Psychology
• Health Outcomes Research

Background:

• Patient-reported outcomes (PROs) capture subjective health experiences, typically via questionnaires or interviews.
• Defining PROs for borderline personality disorder (BPD) presents unique challenges due to symptom heterogeneity, high comorbidity, fluctuating symptoms, and weak outcome correlations.
• Existing BPD outcome measures often lack sufficient clinical, psychometric, and experimental validation.

Observation:

• Current PROs for BPD are limited by symptomatic heterogeneity and high comorbidity.
• There is a lack of valid experimental measures to complement self-report data in BPD assessment.
• Existing measures show weak correlations between BPD symptoms and functional outcomes.

Findings:

• A review of current BPD outcome measures highlights limitations from clinical, psychometric, and patient perspectives.
• Promising avenues for improving BPD PROs include DSM-5 Section III, the Recovery Approach, and Ecological Momentary Assessments.
• Novel experimental measures of social functioning show potential for better association with functional and social outcomes.

Implications:

• Improved PROs are crucial for advancing BPD research and clinical practice.
• Integrating diverse assessment methods may enhance the validity and reliability of BPD outcome measurement.
• Future research should focus on developing and validating novel experimental and ecological measures for BPD.