Comorbidity of Borderline Personality Disorder and Lifetime Substance Use Disorders in a Nationally Representative...

Borderline personality disorder (BPD) is comorbid with substance use disorders (SUDs). However, most epidemiological work on BPD and SUDs has collapsed nonalcohol substances into a drug use disorder indicator, potentially obscuring patterns of association between BPD and individal SUDs. Using a nationally representative sample (National Epidemiologic Survey on Alcohol and Related Conditions; N = 34,481), the authors examined the association between lifetime BPD and nine lifetime SUDs. First, the authors examined the bivariate association of BPD and each SUD. BPD was associated with all nine SUDs. Second, they added relevant covariates (demographic variables, additional psychopathology) to each model. Seven SUDs remained significant. Finally, to account for shared variance across SUDs, the authors conducted a multivariate logistic regression with the nine SUDs and covariates as predictors. Alcohol, cocaine, and opiate use disorder were the only significant SUD predictors, indicating a unique association between BPD and these three SUDs. Future research should explore factors involved in the association of BPD with these specific SUDs.