title: Borderline personality disorder and traits in veterans: psychiatric comorbidity, healthcare utilization, and quality of life along a continuum of severity.
abstract: OBJECTIVE
  To examine the presence of borderline personality disorder (BPD) traits in Gulf War veterans, and to assess psychiatric comorbidity, health status, healthcare utilization, and quality of life (QOL) along a continuum of BPD trait severity.
  
  
  METHODS
  BPD and traits were evaluated using the Schedule for Non-Adaptive and Adaptive Personality in 576 veterans who were either deployed to the Persian Gulf (1990-1991) or were on active duty though not deployed to the Gulf. Demographic and military characteristics, personal and family history, psychiatric comorbidity, and QOL were also assessed.
  
  
  RESULTS
  One or more BPD traits were present in 247 subjects (43%), and BPD (>5 traits) was identified in 15 subjects (3%). The number of traits was significantly associated with age and level of education. Lifetime psychiatric comorbidity was significantly associated with the number of BPD traits present, and level of functioning, health status, healthcare utilization, social functioning, self-injurious tendencies, and military/behavioral problems.
  
  
  CONCLUSIONS
  BPD and traits identified in Gulf War veterans were associated with significant psychiatric morbidity, poorer QOL, and increased utilization of healthcare resources. Early recognition and treatment of veterans with BPD symptoms may be warranted to minimize the burden on the healthcare system.
authors.affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA 52242, USA. donald-black@uiowa.edu
authors.forename: Donald W
authors.initials: DW
authors.lastname: Black
authors.forename: Nancee
authors.initials: N
authors.lastname: Blum
authors.forename: Elena
authors.initials: E
authors.lastname: Letuchy
authors.forename: Caroline
authors.initials: C
authors.lastname: Carney Doebbeling
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Forman-Hoffman
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D005260:Female; D047830:Gulf War; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*