Sustained Symptomatic Remission and Recovery and Their Loss Among Patients With Borderline Personality Disorder and Patients With Other Types of Personality Disorders: A 24-Year Prospective Follow-Up Study

Abstract

Objectives: The first purpose of this study was to determine time to attainment of symptomatic remissions and recoveries of 2–12 years duration for those with borderline personality disorder (BPD) and patients with other personality disorders (OPDs); the second was to determine the stability of these outcomes.

Methods: Two hundred ninety inpatients meeting both Revised Diagnostic Interview for Borderlines (DIB-R) and DSM III-R criteria for BPD and 72 patients with OPDs were assessed during their index admission using a series of semistructured interviews. The same instruments were readministered at 12 contiguous 2-year time periods.

Results: Patients with BPD were significantly slower to achieve remission or recovery (which involved good social and vocational functioning as well as symptomatic remission) than patients with OPD. However, those in both study groups ultimately achieved about the same high rates of remission (BPD patients: 77%–100%; patients with OPD: 97%–100%) but not recovery (37%–60% vs 68%–89%) by the time of the 24-year follow-up. In contrast, symptomatic recurrence (11%–40% vs 5%–10%) and loss of recovery (29%–59% vs 15%–42%) occurred more rapidly and at substantially higher rates among BPD patients than patients with OPD.

Conclusions: Taken together, the results of this study suggest that sustained symptomatic remission is substantially more common than sustained recovery from BPD. They also suggest that loss of sustained recovery is more common than symptomatic recurrences for those with BPD.

J Clin Psychiatry 2024;85(4):24m15457

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