The Borderline Syndrome

Recent studies question whether the borderline syndrome represents two entities: borderline schizophrenia (or schizotypal personality) as a variant of schizophrenia and borderline personality disorder as a variant of primary affective disorder. Relevant data are presented from the long-term follow-up of patients at the Chestnut Lodge, Rockville, Md, receiving systematic diagnoses by the retrospective application of diagnostic criteria. Studied were (1) diagnostic overlap at index admission, (2) diagnostic change over follow-up period, and (3) comparative long-term functional outcome between borderline samples and other diagnostic groups. Findings supported the hypothesis that schizotypal personality (as defined by DSM-III) is a variant of schizophrenia but borderline personality disorder (as defined by the DSM-III and Gunderson et al criteria) is not. An affiliation of borderline personality disorder with primary affective disorder is suggested although not conclusive.