Longitudinal Course of Physical and Psychosocial Impairment in Patients With Borderline Personality Disorder and Personality-Disordered Comparison Subjects: Description and Prediction

This study describes the 8-year course of physical and psychosocial impairment in middle-aged patients with borderline personality disorder (BPD) and other personality disorders (OPD). This study also compares BPD subgroups (recovered vs. nonrecovered) and explores predictors of physical impairment. Patients (N = 282) were assessed as part of the McLean Study of Adult Development. Physical and psychosocial impairments were assessed using the 36-Item Short-Form Health Survey. Patients with BPD reported significantly more impairment than OPD patients across all domains. Nonrecovered BPD patients reported significantly more impairment than their recovered counterparts. Three medical conditions (osteoarthritis, chronic fatigue syndrome, and obesity) and two symptomatic disorders (mood disorder and posttraumatic stress disorder) were significant multivariate predictors of physical impairment in BPD patients. These results suggest that BPD patients experience serious functioning impairment that persists over time and that physical functioning impairments reported by these patients are strongly related to certain physical and psychiatric health conditions.