Individuals with Borderline Personality Disorder face high risk for premature death
People living with borderline personality disorder (BPD) face a particularly high risk for dying early from a number of causes, including suicide and cardiovascular failure, according to a new study published in the Journal of Clinical Psychiatry.
The results highlight the unique need to screen individuals with BPD for suicidal thoughts, physical health issues, and substance abuse and provide early intervention strategies.
The findings come from a prospective study which followed a group of 290 individuals diagnosed with BPD and 72 control patients with other forms of personality disorders over 24 years.
At the onset of the study, the patients ranged between 18 and 35 years old. They were then evaluated every 2 years as part of the McLean Study of Adult Development.
It should be noted that the participants were overwhelmingly white (87%) and the majority (77%) were women.
By the end of the study, nearly 6% of the participants with bipolar disorder had died by suicide, compared to 1.4% of the other participants. Those with BPD were also at significantly higher risk of dying from other causes compared to the comparison group (14% vs. 5.5%).
The most common non-suicidal causes of death among those with BPD were cardiovascular failure (11 participants), substance abuse complications (5 participants) cancer (4 participants), and accidents (4 participants).
Importantly, the researchers noted that the risk of suicide or non-suicidal death in those with BPD significantly decreased if an individual achieved recovery.
Recovery was defined in this study as at least one 2-year follow-up period during which individuals were in remission, showed good psychosocial functioning, and were engaged in either full-time work or school.
Other risk factors for premature non-suicidal death included gender (males were at higher risk), lower socioeconomic status, receiving government disability funds, history of drug use, number of psychiatric hospitalizations, higher body mass index, and higher use of psychiatric medications.
The researchers do concede there are a number of limitations to this particular study. For instance, all participants were initially psychiatric inpatients. Research into non-inpatient individuals with BPD or those not receiving ongoing treatment may differ.
Nonetheless, the team says the study provides important information for clinicians to consider as “targeting factors found to predict premature death in patients with BPD […] may help prevent or delay this outcome.”
Based on this, the researchers conclude “premature death (not due to suicide) in an adverse outcome that warrants additional clinical attention.”