Onset, Course, and Prognosis for Borderline Personality Disorder

Borderline personality disorder (BPD) is a common psychiatric disorder; the best epidemiological evidence estimating that about 2% of American adults meet DSM-IV criteria for BPD and an estimated 19% of psychiatric inpatients and approximately 11% of psychiatric outpatients meet criteria for BPD. Cross-sectional studies have found that BPD is associated with high levels of mental health service utilization and a serious degree of psychosocial impairment These facts suggest that BPD is a serious public health problem and yet, the course of BPD has received relatively little attention. Most studies have used adult samples (people age 18 or older), and clinicians have been reluctant until very recently to diagnose adolescents or latency-aged children as meeting full-blown criteria for BPD, choosing instead to diagnose disruptive mood dysregulation disorder (DMDD)—a disorder of childhood marked by frequent temper outbursts and chronic anger or irritability.