title: The subsyndromal phenomenology of borderline personality disorder: a 10-year follow-up study.
abstract: OBJECTIVE
  The purpose of this study was to characterize the course of 24 symptoms of borderline personality disorder in terms of time to remission.
  
  
  METHODS
  The borderline psychopathology of 362 patients with personality disorders, all recruited during inpatient stays, was assessed using two semistructured interviews of proven reliability. Of these, 290 patients met DSM-III-R criteria as well as Revised Diagnostic Interview for Borderlines criteria for borderline personality disorder, and 72 met DSM-III-R criteria for another axis II disorder. Over 85% of the patients were reinterviewed at five distinct 2-year follow-up waves by interviewers blind to all previously collected information.
  
  
  RESULTS
  Among borderline patients, 12 of the 24 symptoms studied showed patterns of sharp decline over time and were reported at 10-year follow-up by less than 15% of the patients who reported them at baseline. The other 12 symptoms showed patterns of substantial but less dramatic decline over the follow-up period. Symptoms reflecting core areas of impulsivity (e.g., self-mutilation and suicide efforts) and active attempts to manage interpersonal difficulties (e.g., problems with demandingness/entitlement and serious treatment regressions) seemed to resolve the most quickly. In contrast, affective symptoms reflecting areas of chronic dysphoria (e.g., anger and loneliness/emptiness) and interpersonal symptoms reflecting abandonment and dependency issues (e.g., intolerance of aloneness and counterdependency problems) seemed to be the most stable.
  
  
  CONCLUSIONS
  The results suggest that borderline personality disorder may consist of both symptoms that are manifestations of acute illness and symptoms that represent more enduring aspects of the disorder.
authors.affiliation: Laboratory for the Study of Adult Development and the Psychiatric Epidemiology Research Program, McLean Hospital, 115 Mill St., Belmont 02478, and the Department of Psychiatry, Harvard Medical School, Boston, 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: D Bradford
authors.initials: DB
authors.lastname: Reich
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Silk
authors.forename: James I
authors.initials: JI
authors.lastname: Hudson
authors.forename: Lauren B
authors.initials: LB
authors.lastname: McSweeney
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000523:psychology; D000367:Age Factors; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000523:psychology; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012652:Self Mutilation / Q000175:diagnosis / Q000523:psychology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D013577:Syndrome