Prevalence, Characteristics, and Outcomes of Borderline Personality Disorder Among Suicidal Adolescent Outpatients

Few studies have examined the prevalence, characteristics, and outcomes of treatment-seeking-suicidal adolescents with borderline personality disorder (BPD). To address this, we evaluated 108 suicidal adolescents seen in a specialized outpatient program and treated with Dynamic Deconstructive Psychotherapy (DDP) and examined changes in the severity of their BPD symptoms and suicide ideation over 6 months. Of these 108 adolescents, 81% (n = 87) met criteria for BPD on structured interviews. Adolescents with BPD had more frequent suicide attempts and recreational drug use, greater functional impairment and childhood adversity, and worse therapeutic alliance. However, they showed large improvements in BPD severity and suicide ideation on intent-to-treat analyses (d = 1.59 and .96, respectively), with 38% (n = 33) dropping out of treatment. These findings underscore the need for better identification of BPD among suicidal adolescents and additional research to evaluate the efficacy of DDP as a promising treatment for this population.