The abuse of prescription medications: borderline personality patients in psychiatric versus non-psychiatric settings.
OBJECTIVE
In this study, the prevalence of prescription substance abuse among those with borderline personality symptomatology was examined in a large cohort of respondents who participated in one of 13 prior research projects.


METHODS
The entire cohort (N = 1039) was divided into 3 subsamples: a psychiatric sample (n = 440), a predominantly primary care sample (n = 599), and an internal medicine sample (n = 332; i.e., a well-defined subset of the predominantly primary care sample that consisted of only internal medicine outpatients seen at one location). The borderline personality scale of the Personality Diagnostic Questionnaire (PDQ), either the revised (PDQ-R) or fourth (PDQ-4) version, was used to diagnose all participants either with or without borderline personality. One item from the Self-Harm Inventory, "Have you ever intentionally, or on purpose, abused prescription medication?," was then used in the subsequent analyses.


RESULTS
Among the psychiatric, predominantly primary care, and internal medicine subsamples, the prevalence rates of prescription medication abuse in those diagnosed with borderline personality according to the PDQ were 46.9%, 46.2%, and 11.5%, respectively. In all subsamples, those with borderline personality were statistically significantly more likely to abuse prescription medication than those without the disorder. For example, borderline patients in the psychiatric sample were twice as likely to abuse prescription medications, in the predominantly primary care sample 4 times as likely, and in the internal medicine only sample nearly 6 times as likely.


CONCLUSIONS
Regardless of setting, patients with BPD are at great risk for the abuse of prescription medications.
Wright State University and Kettering Medical Center, Ohio, USA. Randy.sansone@khnetwork.org
Randy A
RA
Sansone
Michael W
MW
Wiederman
D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010555:Personality Inventory; D055553:Prescription Drugs; D011320:Primary Health Care; D011567:Psychiatric Department, Hospital; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
D055553:Prescription Drugs