title: The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder.
abstract: OBJECTIVE
  The syndromal and subsyndromal phenomenology of borderline personality disorder was tracked over 6 years of prospective follow-up.
  
  
  METHODS
  The psychopathology of 362 inpatients with personality disorders was assessed with the Revised Diagnostic Interview for Borderlines (DIB-R) and borderline personality disorder module of the Revised Diagnostic Interview for DSM-III-R Personality Disorders. Of these patients, 290 met DIB-R and DSM-III-R criteria for borderline personality disorder and 72 met DSM-III-R criteria for other axis II disorders (and neither criteria set for borderline personality disorder). Most of the borderline patients received multiple treatments before the index admission and during the study. Over 94% of the total surviving subjects were reassessed at 2, 4, and 6 years by interviewers blind to previously collected information.
  
  
  RESULTS
  Of the subjects with borderline personality disorder, 34.5% met the criteria for remission at 2 years, 49.4% at 4 years, 68.6% at 6 years, and 73.5% over the entire follow-up. Only 5.9% of those with remissions experienced recurrences. None of the comparison subjects with other axis II disorders developed borderline personality disorder during follow-up. The patients with borderline personality disorder had declining rates of 24 symptom patterns but remained symptomatically distinct from the comparison subjects. Impulsive symptoms resolved the most quickly, affective symptoms were the most chronic, and cognitive and interpersonal symptoms were intermediate.
  
  
  CONCLUSIONS
  These results suggest that symptomatic improvement is both common and stable, even among the most disturbed borderline patients, and that the symptomatic prognosis for most, but not all, severely ill borderline patients is better than previously recognized.
authors.affiliation: Laboratory for the Study for Adult Development, McLean Hospital, MA, USA. zanarini@mclean.harvard.edu
authors.forename: Mary C
authors.initials: MC
authors.lastname: Zanarini
authors.forename: Frances R
authors.initials: FR
authors.lastname: Frankenburg
authors.forename: John
authors.initials: J
authors.lastname: Hennen
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Silk
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D017063:Outcome Assessment, Health Care; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012008:Recurrence; D012720:Severity of Illness Index