title: Why are women diagnosed borderline more than men?
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.
authors.affiliation: Department of Personality Studies, New York State Psychiatric Institute, Box 121, 1051 Riverside Drive, New York, NY 10032, USA. aes4@columbia.edu
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Skodol
authors.forename: Donna S
authors.initials: DS
authors.lastname: Bender
mesh_terms: D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D015994:Incidence; D011287:Prejudice; D012737:Sex Factors; D014481:United States