Gender differences in borderline personality disorder: a narrative review

Area of Science:

• Psychiatry and Psychology
• Neuroscience
• Gender Studies

Background:

• Borderline personality disorder (BPD) is a complex mental disorder with historically reported higher prevalence in females.
• Recent epidemiological data present conflicting prevalence rates between genders in community samples, prompting investigation into diagnostic and sampling biases.
• Understanding gender-specific manifestations of BPD is crucial for accurate diagnosis and effective treatment.

Purpose of the Study:

• To provide an updated overview of gender differences in borderline personality disorder.
• To examine variations in diagnosis, temperamental and clinical characteristics, comorbidities, neuroimaging findings, and treatment attitudes between genders.
• To synthesize current literature addressing the heterogeneity of BPD presentation across genders.

Main Methods:

• This narrative review synthesized findings from studies investigating gender differences in BPD.
• Searched a single database for relevant publications, with limitations on publication time and language.
• Focused on studies that specifically considered gender as a variable or had significant gender representation.

Main Results:

• Men with BPD were more likely to meet criteria for intense anger and impulsivity.
• Women with BPD more frequently endorsed criteria related to chronic emptiness, affective instability, and suicidality/self-harm behaviors.
• Significant gender differences were also observed in patterns of comorbidity, neurobiological mechanisms, and treatment attitudes.

Conclusions:

• Gender influences the expression of borderline personality disorder symptoms, temperament, and clinical characteristics.
• These findings highlight the need for gender-sensitive approaches in the diagnosis and management of BPD.
• Further research with balanced gender representation and comprehensive methodology is warranted.