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Published Online: 12 February 2016

Fluidity of the Subsyndromal Phenomenology of Borderline Personality Disorder Over 16 Years of Prospective Follow-Up

Mary C. Zanarini, Ed.D., Frances R. Frankenburg, M.D., D. Bradford Reich, M.D., and Garrett M. Fitzmaurice, Sc.D.Authors Info & Affiliations
Publication: American Journal of Psychiatry
Volume 173, Number 7
https://doi.org/10.1176/appi.ajp.2015.15081045
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Abstract

Objective:

The purpose of this study was to determine the cumulative rates of 2- and 4-year remission, and the recurrences that follow them, of 24 symptoms of borderline personality disorder over 16 years of prospective follow-up.

Method:

A total of 290 inpatients meeting rigorous criteria for borderline personality disorder and 72 axis II comparison subjects were assessed during their index admission using a series of semistructured diagnostic interviews. The same instruments were readministered at eight contiguous 2-year time periods.

Results:

The 12 acute symptoms (e.g., self-mutilation, help-seeking suicide attempts) of borderline personality disorder were more likely to remit for a period of 2 years and for a period of 4 years than the 12 temperamental symptoms (e.g., chronic anger/frequent angry acts, intolerance of aloneness) of this disorder. They were also less likely to recur after a remission lasting 2 years or a remission lasting 4 years.

Conclusions:

Taken together, the symptoms of borderline personality disorder are quite fluid, with remissions and recurrences being common. However, the more clinically urgent acute symptoms of borderline personality disorder seem to have a better prognosis than the less turbulent temperamental symptoms of the disorder.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Volume 173 • Number 7 • July 01, 2016
Pages: 688 - 694
PubMed: 26869248

History

Received: 11 August 2015
Revision received: 29 October 2015
Accepted: 16 November 2015
Published online: 12 February 2016
Published in print: July 01, 2016

Authors

Affiliations

Mary C. Zanarini, Ed.D.
From the Department of Psychiatry, Harvard Medical School, Belmont, Mass.; and the Department of Psychiatry, McLean Hospital, Belmont, Mass.
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Frances R. Frankenburg, M.D.
From the Department of Psychiatry, Harvard Medical School, Belmont, Mass.; and the Department of Psychiatry, McLean Hospital, Belmont, Mass.
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D. Bradford Reich, M.D.
From the Department of Psychiatry, Harvard Medical School, Belmont, Mass.; and the Department of Psychiatry, McLean Hospital, Belmont, Mass.
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Garrett M. Fitzmaurice, Sc.D.
From the Department of Psychiatry, Harvard Medical School, Belmont, Mass.; and the Department of Psychiatry, McLean Hospital, Belmont, Mass.
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Notes

Address correspondence to Dr. Zanarini ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

National Institute of Mental Health10.13039/100000025: MH47588, MH62169
Supported by NIMH grants MH47588 and MH62169.

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