The Significance of Borderline Personality Disorder in Older Depressed Patients

Background Borderline personality disorder (BPD) and major depressive disorder (MDD) are often associated with suicidality and psychosocial difficulties. Older depressed adults with BPD are understudied compared to older depressed adults without BPD, which may result in an undertreatment of their psychiatric symptoms. Methods The present study examined differences in suicide risk and functioning between two groups of older depressed adults with BPD and older depressed adults without BPD. Patients were assessed using the Structured Clinical Interview for DSM-IV (SCID). Results Analyses showed that suicide attempts, suicidal ideation, psychiatric hospitalizations were higher in the BPD-MDD group. Similarly, the presence of additional diagnoses, longer depressive episodes, and earlier age of MDD onset was significant in the BPD-MDD group. Conclusions Consistent with our hypothesis, suicide attempts, suicidal ideation, and psychiatric hospitalizations were higher in the BPD-MDD group. These findings highlight the importance of routine assessment and treatment of BPD in older depressed patients.