The course of eating disorders in patients with borderline personality disorder: a 10-year follow-up study.
OBJECTIVE
The purpose of this study was to describe the longitudinal course of eating disorders in patients with borderline personality disorder.


METHODS
The SCID I was administered to 290 borderline inpatients and 72 participants with other axis II disorders during their index admission and at five contiguous 2-year follow-up periods.


RESULTS
The prevalence of anorexia, bulimia, and eating disorder not otherwise specified (EDNOS) declined significantly over time for those in both study groups but the prevalence of EDNOS remained significantly higher among borderline patients. While over 90% of borderline patients meeting criteria for anorexia, bulimia, or EDNOS at baseline experienced a stable remission by the time of the 10-year follow-up, diagnostic migration was common, particularly for those with anorexia or bulimia. In addition, both recurrences (52%) and new onsets (43%) of EDNOS were more common among borderline patients than recurrences and new onsets of anorexia (28% and 4%) and bulimia (29% and 11%).


CONCLUSIONS
The results of this study suggest that the prognosis for both anorexia and bulimia in borderline patients is complicated, with remissions being stable but migrations to other eating disorders being common. The results also suggest that EDNOS may be the most prevalent and enduring of the eating disorders in these patients.
Zanarini
Mary C
MC
McLean Hospital, Belmont, Massachusetts 02478, USA. zanarini@mclean.harvard.edu
Reichman
Charlotte A
CA
Frankenburg
Frances R
FR
Reich
D Bradford
DB
Fitzmaurice
Garrett
G