Borderline personality disorder: health service use and social functioning among a national household population.
BACKGROUND
It is unclear whether Axis II psychopathology or co-morbid clinical syndromes result in the treatment-seeking behaviour and social impairment of patients with borderline personality disorder (BPD). This study examined the independent associations between social functioning and service use and Axis I and Axis II disorders in persons with BPD in the national household population of Britain.


METHODS
The study was a cross-sectional survey of adults aged 16-74 years in households (n=8397). Data included self-reported consultations with health-care professionals and behavioural problems. Diagnosis was determined by computer-assisted interviews. Analyses included logistic regression adjusting for demography, co-morbid Axis I clinical syndromes and other Axis II disorders.


RESULTS
Consultation in the past year was reported by 57.5% of persons with BPD but only 13.4% reported lifetime psychiatric admission. BPD was not independently associated with impaired functioning but was associated with co-morbid psychotic, depressive and anxiety disorders. Only general practitioners (GPs) were consulted for problems independently due to BPD.


CONCLUSIONS
Functional effects of BPD are mediated through co-morbid clinical syndromes, not Axis II psychopathology. A subgroup do not have co-morbid disorders or seek treatment, and are high functioning.
Coid
J
J
University of London, UK. j.w.coid@qmul.ac.uk
Yang
M
M
Bebbington
P
P
Moran
P
P
Brugha
T
T
Jenkins
R
R
Farrell
M
M
Singleton
N
N
Ullrich
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001883:Borderline Personality Disorder / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult