Can borderline personalty disorder go away?!

Can borderline personalty disorder go away?

It just doesn't "go away"; it needs to be "cured." However, according to the experts, it can be cured.

* Zanarini MC, Frankenburg FR, Hennen J, ... - Laboratory for the Study for Adult Development, McLean Hospital
2003 Am J Psychiatry. 2003 - The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder.
OBJECTIVE: The syndromal and subsyndromal phenomenology of borderline personality disorder was tracked over 6 years of prospective follow-up. METHOD: The psychopathology of 362 inpatients with personality disorders was assessed. Of these patients, 290 met DIB-R and DSM-III-R criteria for borderline personality disorder and 72 met DSM-III-R criteria for other axis II disorders (and neither criteria set for borderline personality disorder). Most of the borderline patients received multiple treatments before the index admission and during the study. Over 94% of the total surviving subjects were reassessed at 2, 4, and 6 years by interviewers blind to previously collected information. RESULTS: Of the subjects with borderline personality disorder, 34.5% met the criteria for remission at 2 years, 49.4% at 4 years, 68.6% at 6 years, and 73.5% over the entire follow-up. Only 5.9% of those with remissions experienced recurrences. None of the comparison subjects with other axis II disorders developed borderline personality disorder during follow-up. The patients with borderline personality disorder had declining rates of 24 symptom patterns but remained symptomatically distinct from the comparison subjects. Impulsive symptoms resolved the most quickly, affective symptoms were the most chronic, and cognitive and interpersonal symptoms were intermediate. CONCLUSIONS: These results suggest that symptomatic improvement is both common and stable, even among the most disturbed borderline patients, and that the symptomatic prognosis for most, but not all, severely ill borderline patients is better than previously recognized.

* Paris J, Zweig-Frank H. - Department of Psychiatry, McGill University, Montreal, Canada.
2001 Compr Psychiatry. - A 27-year follow-up of patients with borderline personality disorder.
Sixty-four (64) patients with borderline personality disorder (BPD) were followed up for a mean of 27 years. Outcome was assessed using the Diagnostic Interview for Borderlines, Revised (DIB-R), DSM-III-R Diagnosis (SCID), etc. Most patients showed significant improvement... with only five (7.8%) currently meeting criteria for BPD... Fourteen subjects met SCID criteria for dysthymia, and this subgroup had a significantly poorer outcome on all measures. The total percentage of suicides from the original cohort has reached 10.3%, with 18.2% of all patients now deceased.

* Paris J. - Department of Psychiatry, McGill University Montreal, Quebec, Canada.
2002 Harv Rev Psychiatry - Implications of long-term outcome research for the management of patients with borderline personality disorder.
Fifteen- and 27-year follow-up studies of patients with borderline personality disorder show that most of them no longer meet full criteria for the disorder by age 40, and that even more show improvement by age 50. The mechanisms behind remission could include maturation, social learning, and the avoidance of conflictual intimacy. Affective instability is slower to change than impulsivity. Suicide rates in patients with this disorder are close to 10%, with most completions occurring late in the course of illness; early mortality from all causes exceeds 18%. All of these findings have clinical implications. Although treatment effects must be assessed in the context of naturalistic improvement, therapy can hasten remission.