The Concept of Personality Organization: A Long-Term Comparative Follow-Up Study With Special Reference to Borderline Personality Organization

Abstract

In a 5-year long-term follow-up study, index and end-point diagnoses were made on 44 psychiatric inpatients according to DSM-III, the Diagnostic Interview for Borderlines according to Gunderson, and the Structural Interview for assessment of personality organization according to Kernberg. Working capacity and psychiatric hospitalization during follow-up were registered. Analyses were made in a comparative design between the three diagnostic categories defined by Otto Kernberg: neurotic, borderline, and psychotic personality organization (NPO, BPO, and PPO). BPO turned out to be a wide concept including patients with a variety of Axis I and Axis II DSM-III disorders: 21% received a diagnosis of major affective disorder, 13% a diagnosis of schizophrenic disorder (residual type), and 46% fulfilled criteria for an Axis II diagnosis of borderline personality disorder. Long-term prognosis was severe. Patients with BPO were hospitalized, on average, during 23% of the follow-up period and only 8% managed without ...