Prediction of time-to-attainment of recovery for borderline patients followed prospectively for 16 years

Acta Psychiatr Scand. 2014 Sep;130(3):205-13. doi: 10.1111/acps.12255. Epub 2014 Mar 4.

Abstract

Objective: The purpose of this study was to determine the most clinically relevant baseline predictors of time-to-recovery from borderline personality disorder.

Method: Two hundred and ninety in-patients meeting rigorous criteria for borderline personality disorder were assessed during their index admission using a series of semistructured interviews and self-report measures. Recovery status, which was defined as concurrent symptomatic remission and good social and full-time vocational functioning, was reassessed at eight contiguous 2-year time periods. Survival analytic methods (Cox regression), which controlled for overall baseline severity, were used to estimate hazard ratios and their confidence intervals.

Results: All told, 60% of the borderline patients studied achieved a 2-year recovery. In bivariate analyses, seventeen variables were found to be significant predictors of earlier time-to-recovery. Six of these predictors remained significant in multivariate analyses: no prior psychiatric hospitalizations, higher IQ, good full-time vocational record in 2 years prior to index admission, absence of an anxious cluster personality disorder, high extraversion, and high agreeableness.

Conclusion: Taken together, the results of this study suggest that prediction of time-to-recovery for borderline patients is multifactorial in nature, involving factors related to lack of chronicity, competence, and more adaptive aspects of temperament.

Keywords: outcome; personality disorder; temperament.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Borderline Personality Disorder / diagnosis
  • Borderline Personality Disorder / therapy*
  • Employment / statistics & numerical data
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Intelligence / physiology
  • Longitudinal Studies
  • Male
  • Prognosis*
  • Remission Induction
  • Temperament / physiology
  • Time Factors
  • Young Adult