DSM-III Disorders in the Families of Borderline Outpatients

The family history of 48 outpatients meeting both DIB and DSM-III criteria for borderline personality disorder (BPD), 29 outpatients meeting DSM-III criteria for antisocial personality disorder (APD), and 26 outpatients meeting DSM-III criteria for dysthymic disorder as well as DSM-III criteria for some other form of Axis II disorder (dysthymic OPD) was assessed blind-to-proband-diagnosis using a semistructured interview based on DSM-III criteria. A significantly higher percentage of the first-degree relatives of the borderline probands than the first-degree relatives of either antisocial or dysthymic OPD controls met DSM-III criteria for BPD. However, APD was significantly more common among the psychiatrically disordered first-degree relatives of antisocial subjects than borderline subjects. In addition, a significantly higher percentage of the first-degree relatives of the borderline probands than the first-degree relatives of antisocial controls met DSM-III criteria for an affective disorder and, more specifically, dysthymic disorder. However, these affective differences were largely attributable to the relatives of those borderlines with a personal history of major depression. The authors conclude that these results support the validity of the borderline diagnosis.