Relationship of age to symptom severity, psychiatric comorbidity and health care utilization in persons with borderline personality disorder

Abstract

AbstractBackground The objective of the study was to test the association of age with symptom severity, frequency and pattern of psychiatric comorbidity, health care utilization and quality of life in subjects with borderline personality disorder (BPD).Methods The analysis is based on a sample of subjects with Diagnostic and Statistical Manual of Mental Disroders, Fourth Edition (DSM‐IV) BPD (n = 163) recruited for participation in a clinical trial at an academic medical center. The subjects were assessed using structured and semi‐structured instruments of known reliability.Results Tests of trend with age showed relationships with important variables assessing symptom severity, comorbidity, quality of life and health care utilization. As expected, younger subjects were less likely to be married, to be employed or to receive disability payments. The frequency of most lifetime comorbid Axis I disorders was not related to age, although posttraumatic stress disorder was more frequent in the 35‐ to 44‐year age group, and younger patients were more likely to have comorbid histrionic and narcissistic personality disorders. Baseline severity variables were mostly unrelated to age, with the exception of impulsivity, which was more common in younger patients, as were acts of deliberate self‐harm. As expected, older patients reported poorer quality of life in categories indicating worse health perception and greater pain levels, and tended to use more health care resources than younger patients.Conclusion Most characteristics of patients with BPD are unrelated to age, yet impulsivity and acts of deliberate self‐harm were less frequent in older patients. Expected age‐related changes, such as reports of worse physical health, greater pain levels and greater health care utilization, were observed in older subjects. Copyright © 2008 John Wiley & Sons, Ltd.