Screening for borderline personality disorder in outpatient youth.
Young people with borderline personality disorder (BPD) commonly seek help but often go unrecognized. Screening offers a means of identifying individuals for more detailed assessment for early intervention and for research.


OBJECTIVE
This study compared the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Borderline Personality Questionnaire (BPQ), the BPD items from the International Personality Disorder Examination Screening Questionnaire and the BPD items from the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II) Personality Questionnaire.


METHODS
101 outpatient youth (aged 15-25 years) completed the screening measures and were interviewed, blind to screening status, with the SCID-II BPD module. The screening measures were readministered two weeks later to assess test-retest reliability.


RESULTS
All four instruments performed similarly but the BPQ had the best mix of characteristics, with moderate sensitivity (0.68), the highest specificity (0.90), high negative predictive value (0.91) and moderate positive predictive value (0.65). Compared to the other three instruments, the BPQ had the highest overall diagnostic accuracy (0.85), a substantially higher kappa (0.57) with the criterion diagnosis, the highest test-retest reliability (ICC = 0.92) and the highest internal consistency (alpha = 0.92). The only clear difference to emerge in the Receiver Operator Curve (ROC) analysis was that the BPQ significantly outperformed the MSI (p = 0.05).


CONCLUSIONS
Screening for BPD in out-patient youth is feasible but is not a replacement for clinical diagnosis.
Chanen
Andrew M
AM
The ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia. achanen@unimelb.edu.au
Jovev
Martina
M
Djaja
Danica
D
McDougall
Emma
E
Yuen
Hok Pan
HP
Rawlings
David
D
Jackson
Henry J
HJ
D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services / Q000458:organization & administration*; D000328:Adult; D001315:Australia; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D010045:Outpatients / Q000706:statistics & numerical data*; D010552:Personality Assessment / Q000706:statistics & numerical data; D000297:Psychology, Adolescent; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires