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Updated: Mar 11, 2026

Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder
Published on: March 8, 2018
Multiple cluster axis II comorbidity and functional outcome in severe patients with borderline personality disorder
Nerea Palomares1, Antonia McMaster2, Marina Díaz-Marsá3
1Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC). Madrid, Spain Centro de Investigación en Red de Salud Mental (CIBERSAM). Hospital Gregorio Marañón. Madrid, Spain.
Background:
Current literature suggests that personality disorder comorbidity negatively contributes to both the severity and prognosis of other disorders; however, little literature has been devoted to its influence on borderline personality disorder (BPD). The objective of the present work is to study comorbidity with other personality disorders in a severe clinical sample of patients with BPD, and its relationship with global functionality.
Methods:
A sample of 65 patients with severe borderline personality disorder was included in the study. Clinical and functionality measures were applied in order to study comorbidity of BPD with other disorders and its relationship with functionality. Associations with other comorbid PDs were analyzed with t-tests and linear correlations.
Results:
Most patients (87%) presented comorbidity with other PDs. Almost half of the sample (42%) presented more than two PDs, and cluster A (paranoid) and C (obsessive and avoidant) PD were more frequent than cluster B (histrionic and antisocial). Only the presence of avoidant PD predicted a worse functional outcome in the long term (U Mann Withney p<0.01).
Conclusions:
Severely impaired BPD patients present greater comorbidity with cluster A and C PDs. Comorbid avoidant personality disorder might negatively predict for prognosis.
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