title: The course of substance use disorders in patients with borderline personality disorder and Axis II comparison subjects: a 10-year follow-up study.
abstract: OBJECTIVE
  The purpose of this study is to detail the course of substance use disorders (SUDs) over 10 years of prospective follow-up among patients with borderline personality disorder (BPD) and Axis II comparison subjects.
  
  
  METHODS
  This study uses data from the McLean Study of Adult Development (MSAD), a multi-faceted study of the longitudinal course of BPD using reliable repeated measures administered every 2 years over a decade of prospective follow-up.
  
  
  METHODS
  All subjects were initially in-patients at McLean Hospital in Belmont Massachusetts. PARTICIPANTS; A total of 290 patients with BPD and 72 Axis II comparison subjects were assessed at baseline and five waves of follow-up.
  
  
  METHODS
  The Structured Clinical Interview for DSM-III-R Axis I Disorders (SCID-I), the Revised Diagnostic Interview for Borderlines (DIB-R) and the Diagnostic Interview for DSM-III-R Personality Disorders (DIPD-R) were administered six times. Generalized estimating equations were used to assess longitudinal prevalence of SUDs. Kaplan-Meier analyses were used to assess time-to-remission, recurrence and new onsets of SUDs.
  
  
  RESULTS
  The prevalence of SUDs among borderline patients and Axis II comparison subjects declined significantly over time, while remaining significantly more common among those with BPD. More than 90% of borderline patients meeting criteria for a SUD at baseline experienced a remission by 10-year follow-up. Recurrences and new onsets of SUDs were less common (35-40% and 21-23%).
  
  
  CONCLUSIONS
  Remissions of alcohol and drug abuse/dependence among borderline patients are both common and relatively stable. Results also suggest that new onsets of these disorders are less common than might be expected.
authors.affiliation: McLean Hospital, Belmont, MA 02478, USA. zanarini@mclean.harvard.edu
authors.forename: Mary C
authors.initials: MC
authors.lastname: Zanarini
authors.forename: Frances R
authors.initials: FR
authors.lastname: Frankenburg
authors.forename: Frances R
authors.initials: FR
authors.lastname: Frankenbur
authors.forename: Jolie L
authors.initials: JL
authors.lastname: Weingeroff
authors.forename: D Bradford
authors.initials: DB
authors.lastname: Reich
authors.forename: Garrett M
authors.initials: GM
authors.lastname: Fitzmaurice
authors.forename: Roger D
authors.initials: RD
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D053208:Kaplan-Meier Estimate; D008297:Male; D015995:Prevalence; D012008:Recurrence; D012075:Remission, Spontaneous; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult