Borderline conditions in childhood. A register-based follow-up study over a 22-year period

Area of Science:

• Child and Adolescent Psychiatry
• Psychiatric Epidemiology
• Developmental Psychology

Background:

• Borderline psychosis in children, diagnosed as psychosis limitaris infantilis (ICD-8 299.02), represents a significant diagnostic category.
• Understanding the long-term outcomes for children diagnosed with borderline psychosis is crucial for effective clinical management and public health planning.

Purpose of the Study:

• To present results from a register-based study on Danish children diagnosed with borderline psychosis between 1970 and 1992.
• To investigate the long-term psychiatric outcomes, including re-admission rates and subsequent diagnoses of schizophrenia and personality disorders.

Main Methods:

• Utilized a register-based study design encompassing all Danish children admitted with a diagnosis of psychosis limitaris infantilis (299.02) between 1970 and 1992.
• Data sourced from the Psychiatric Case Register for follow-up examinations.
• Analyzed re-admission rates, and diagnoses of schizophrenia and personality disorders at 5 and 15-year intervals.

Main Results:

• A total of 415 children (332 boys, 83 girls) were diagnosed with psychosis limitaris infantilis.
• Seventy percent of these children were re-admitted to a psychiatric hospital at least once.
• After 15 years, 24% of boys and a smaller proportion of girls received a schizophrenia diagnosis. One-third of boys and 17% of girls were diagnosed with personality disorders.

Conclusions:

• Children diagnosed with borderline psychosis exhibit a high rate of psychiatric re-admission.
• A substantial proportion of these children, particularly boys, develop schizophrenia or personality disorders over the long term, highlighting the chronic nature of the condition.
• These findings underscore the need for sustained psychiatric care and monitoring for children diagnosed with psychosis limitaris infantilis.