Why are women diagnosed borderline more than men?

Psychiatr Q. Winter 2003;74(4):349-60. doi: 10.1023/a:1026087410516.

Abstract

DSM-IV-TR states that borderline personality disorder (BPD) is "diagnosed predominantly (about 75%) in females." A 3:1 female to male gender ratio is quite pronounced for a mental disorder and, consequently, has led to speculation about its cause and to some empirical research. The essential question is whether the higher rate of BPD observed in women is a result of a sampling or diagnostic bias, or is it a reflection of biological or sociocultural differences between women and men? Data to address these issues are reviewed. The differential gender prevalence of BPD in clinical settings appears to be largely a function of sampling bias. True prevalence by gender is unknown. The modest empirical support for diagnostic biases of various kinds would not account for a wide difference in prevalence between the genders. Biological and sociocultural factors provide potentially illuminating hypotheses, should the true prevalence of BPD differ by gender.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Antisocial Personality Disorder / diagnosis
  • Antisocial Personality Disorder / epidemiology
  • Borderline Personality Disorder / diagnosis*
  • Borderline Personality Disorder / epidemiology
  • Cross-Sectional Studies
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Humans
  • Incidence
  • Prejudice
  • Sex Factors
  • United States