A prospective three-year follow-up study of borderline personality disorder inpatients

Prospective long-term follow-up studies on patients with borderline personality disorder (BPD) have been uncommon. Clinical data suggest that their treatment is highly demanding and that short-term results are sometimes limited. In this study, changes in symptoms and social management were monitored during a hospitalization period of 91 days (mean, range 21-296 days) and during a 3-year follow-up period in 62 patients admitted during 1989 to an open ward specializing in the psychotherapeutic treatment of BPD. The patients were thoroughly evaluated, using various rating scales, at the beginning and at the end of the index admission and after the follow-up period. Forty-two patients (70%) participated in the follow-up evaluation. Most patients suffered from overt anxiety and depressive symptoms at the beginning of hospitalization, and these declined significantly during hospital treatment. At the end of the follow-up period, depressive and anxiety symptoms were at the same level as on discharge, as assessed by the Beck Depression Inventory and Hamilton Depression Rating Scale. Although treatment response was otherwise maintained, the patients often showed suicidal behavior. During the follow-up period the sample clearly differentiated in two groups: those continually fit for work (33%) and those chronically incapable of working (46%).