title: Associations of borderline personality with pain, problems with medications and suicidality in a community sample of chronic non-cancer pain patients prescribed opioids for pain.
abstract: OBJECTIVE
  Borderline personality disorder (BPD) is common in patients with chronic non-cancer pain (CNCP). BPD patients often report worse pain and are more likely to abuse opioid medication. Although the prevalence of suicidality is high in both CNCP patients and those with BPD, no studies have examined the interrelationship of BPD, CNCP and suicidality. This article aims to examine the prevalence and associations of BPD in a large community sample of CNCP patients and the association with medication problems and suicidality.
  
  
  METHODS
  Data from a national sample of 978 CNCP patients prescribed pharmaceutical opioids for CNCP. The screener from the International Classification of Diseases, version 10, International Personality Disorder Examination was used to identify patients with symptoms of BPD.
  
  
  RESULTS
  One in five CNCP patients (19.1%) screened positive for BPD. BPD was associated with a number of demographic and clinical features, such as daily benzodiazepine use, and was independently associated with lifetime pharmaceutical opioid dependence [odds ratio (OR) 2.49, 95% confidence interval (95% CI) 1.42-4.38], past 12-month suicidal thoughts (OR 2.9, 95% CI 1.90-4.39) and lifetime suicide attempts (OR 3.19, 95% CI 2.16-4.72).
  
  
  CONCLUSIONS
  BPD symptoms were prevalent among people prescribed opioids for CNCP and are associated with a number of adverse consequences. Further, those screening positive were at elevated risk of suicidal behaviors. Careful opioid prescription monitoring and appropriate referrals by clinicians are warranted in BPD with CNCP.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW 2052, Australia. Electronic address: g.campbell@unsw.edu.au.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Campbell
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW 2052, Australia; School of Medicine, University of Tasmania, Hobart TAS 7000, Australia.
authors.forename: Raimondo
authors.initials: R
authors.lastname: Bruno
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW 2052, Australia.
authors.forename: Shane
authors.initials: S
authors.lastname: Darke
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW 2052, Australia; School of Population and Global Health, University of Melbourne, Parkville VIC 3010, Australia; Murdoch Children's Research Institute, Parkville VIC 3052, Australia; Department of Global Health, School of Public Health, University of Washington, Seattle, WA 98195, USA.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001883:Borderline Personality Disorder / Q000150:complications*; D059350:Chronic Pain / Q000188:drug therapy / Q000523:psychology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059020:Suicidal Ideation
chemical_list: D000701:Analgesics, Opioid
keywords: Borderline personality disorder; Chronic pain; Dependence; Opioids; Suicidality