Adolescent borderline symptoms in the community: prognosis for functioning over 20 years.
BACKGROUND
The long-term prognosis associated with adolescent symptoms of borderline personality disorder (BPD) in the general population is virtually unknown. In this study, the relationship of early borderline symptoms to subsequent psychosocial functioning and attainment was investigated based on data from the Children in the Community cohort.


METHODS
Using multilevel linear regression, symptoms of BPD at mean age 14 were employed as predictors of work/school/homemaker role function, social function (social support, relationship quality), and life satisfaction over the subsequent 20 years. Borderline symptoms were also employed as predictors of attainment at 20-year follow-up.


RESULTS
On average, those with higher levels of early adolescent borderline symptoms scored consistently lower in role function, social function, and life satisfaction from mid-adolescence through mid-adulthood. Borderline symptoms predicted lower academic and occupational attainment, less partner involvement, and fewer attained adult developmental milestones. Adolescent borderline symptoms were also associated with adult borderline symptoms, borderline diagnosis, general impairment, and need for services at mean age 33. These effects were evident despite symptom decline with age and were independent of adolescent Axis I disorders.


CONCLUSIONS
Adverse prognosis associated with youth symptoms of BPD appeared early and persisted in important and interrelated life domains. These findings lend support to the utility of DSM-IV BPD symptoms assessed by self-report in early adolescence.
Winograd
Greta
G
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA. winograg@newpaltz.edu
Cohen
Patricia
P
Chen
Henian
H
D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012111:Residence Characteristics; D012720:Severity of Illness Index; D013997:Time Factors