Borderline personality disorder: Prevalence and psychiatric comorbidity among male offenders on probation in Sweden.
BACKGROUND
Borderline personality disorder (BPD) is a severely disabling condition, associated with substantially increased risk of deliberate self-harm and, particularly in men, also with interpersonal violence and other criminal behavior. Although BPD might be common among prison inmates, little is known about prevalence and psychiatric comorbidity in probationers and parolees.


METHODS
In 2013, a consecutive sample of 109 newly admitted adult male offenders on probation or parole in all three probation offices of Stockholm, Sweden, completed self-report screening questionnaires for BPD and other psychiatric morbidity. Participants scoring over BPD cut-off participated in a psychiatric diagnostic interview.


RESULTS
We ascertained a final DSM-5 BPD prevalence rate of 19.8% (95% CI: 12.3-27.3%). The most common current comorbid disorders among subjects with BPD were antisocial personality disorder (91%), major depressive disorder (82%), substance dependence (73%), attention deficit hyperactivity disorder (ADHD) (70%), and alcohol dependence (64%). Individuals diagnosed with BPD had significantly more current psychiatric comorbidity (M=6.2 disorders) than interviewed participants not fulfilling BPD criteria (M=3.6). Participants with BPD also reported substantially more symptoms of ADHD, anxiety and depression compared to all subjects without BPD.


CONCLUSIONS
BPD affected one fifth of probationers and was related to serious mental ill-health known to affect recidivism risk. The findings suggest further study of possible benefits of improved identification and treatment of BPD in offender populations.
Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden. Electronic address: dan.wetterborg@ki.se.
Dan
D
Wetterborg
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden; Swedish Prison and Probation Services R&D Unit, 601 80 Norrköping, Sweden. Electronic address: niklas.langstrom@ki.se.
Niklas
N
Långström
Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Behavioural Sciences and Learning, Linköping University, 581 83 Linköping, Sweden. Electronic address: gerhard.andersson@liu.se.
Gerhard
G
Andersson
Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden. Electronic address: pia.enebrink@ki.se.
Pia
P
Enebrink
D000328:Adult; D000987:Antisocial Personality Disorder / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D001883:Borderline Personality Disorder / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D057237:Criminals / Q000523:psychology* / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008297:Male; D015995:Prevalence; D016728:Self-Injurious Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult