Longitudinal diagnostic efficiency of DSM-IV criteria for borderline personality disorder: a 2-year prospective study.
OBJECTIVE
To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for borderline personality disorder (BPD).


METHODS
At baseline, we used semistructured diagnostic interviews to determine criteria and diagnoses; blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (specifically, conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, with the independent BPD diagnosis at follow-up used as the standard.


RESULTS
Longitudinal diagnostic efficiencies for the BPD criteria varied, with the criteria of suicidality or self-injury and unstable relationships demonstrating the most predictive utility.


CONCLUSIONS
BPD criteria differ in their predictive utility for the diagnosis of BPD when considered longitudinally. These findings have implications both for clinicians who are considering diagnoses and for researchers concerned with forthcoming revisions of our nosological system.
Grilo
Carlos M
CM
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06520, USA. carlos.grilo@yale.edu
Sanislow
Charles A
CA
Skodol
Andrew E
AE
Gunderson
John G
JG
Stout
Robert L
RL
Bender
Donna S
DS
Yen
Shirley
S
Shea
M Tracie
MT
Morey
Les C
LC
Zanarini
Mary C
MC
McGlashan
Thomas H
TH
D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results