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Borderline personality disorder: health service use and social functioning among a national household population

Published online by Cambridge University Press:  02 March 2009

J. Coid ,
M. Yang ,
P. Bebbington ,
P. Moran ,
T. Brugha ,
R. Jenkins ,
M. Farrell ,
N. Singleton  and
S. Ullrich
J. Coid*
Affiliation:
Forensic Psychiatry Research Unit, Queen Mary College, University of London, UK
M. Yang
Affiliation:
Forensic Psychiatry Research Unit, Queen Mary College, University of London, UK
P. Bebbington
Affiliation:
Department of Mental Sciences, University College London, London, UK
P. Moran
Affiliation:
Institute of Psychiatry, King's College London, London, UK
T. Brugha
Affiliation:
Department of Health Sciences, University of Leicester, Leicester, UK
R. Jenkins
Affiliation:
Institute of Psychiatry, London, UK
M. Farrell
Affiliation:
Institute of Psychiatry, London, UK
N. Singleton
Affiliation:
UK Drug Policy Commission, London, UK
S. Ullrich
Affiliation:
Forensic Psychiatry Research Unit, Queen Mary College, University of London, UK
*
*Address for correspondence: Professor J. Coid, Forensic Psychiatry Research Unit, St Bartholomew's Hospital, William Harvey House, 61 Bartholomew Close, London EC1A 7BE, UK. (Email: [email protected])
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Abstract

Background

It is unclear whether Axis II psychopathology or co-morbid clinical syndromes result in the treatment-seeking behaviour and social impairment of patients with borderline personality disorder (BPD). This study examined the independent associations between social functioning and service use and Axis I and Axis II disorders in persons with BPD in the national household population of Britain.

Method

The study was a cross-sectional survey of adults aged 16–74 years in households (n=8397). Data included self-reported consultations with health-care professionals and behavioural problems. Diagnosis was determined by computer-assisted interviews. Analyses included logistic regression adjusting for demography, co-morbid Axis I clinical syndromes and other Axis II disorders.

Results

Consultation in the past year was reported by 57.5% of persons with BPD but only 13.4% reported lifetime psychiatric admission. BPD was not independently associated with impaired functioning but was associated with co-morbid psychotic, depressive and anxiety disorders. Only general practitioners (GPs) were consulted for problems independently due to BPD.

Conclusions

Functional effects of BPD are mediated through co-morbid clinical syndromes, not Axis II psychopathology. A subgroup do not have co-morbid disorders or seek treatment, and are high functioning.

Keywords

Co-morbiditydemographyepidemiologypersonality disorder (Axis I)social functioningservice use
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 10 , October 2009 , pp. 1721 - 1731
Copyright
Copyright © 2009 Cambridge University Press

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