Comorbidities in Borderline Personality Disorder

Borderline personality disorder (BPD) is frequently seen in clinical practice. Over the past 2 decades, research on BPD has increased substantially, with concomitant specialized psychotherapies that have been proved to be effective. A number of pharmacological agents have also been investigated, but results have been mixed.¹

One of the enduring challenges in treating patients with BPD is that only a minority have straightforward clinical presentations with no comorbidity. BPD typically coexists with depression, anxiety, and substance abuse. Symptoms of these conditions may lead the clinician to miss the diagnosis of personality disorder entirely.

Comorbidities in BPD reflect a connection with both internalizing and externalizing disorders and symptoms. This indicates that unlike many other disorders that are more strongly associated with either internalizing or externalizing symptoms, BPD is associated with domains of symptoms and categories of disorders. Studies have found a mean of 4.1 lifetime Axis I comorbidities and 1.9 lifetime Axis II comorbidities for patients with BPD.²

TABLE 1

Lifetime comorbidities in patients with BPD

Diagnosis

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