Objective: To study long-term remission of borderline personality disorder (BPD) differentially by age of BPD diagnosis detectio

Bados López, Arturo

Elices, Matilde

Martín-Blanco, Ana

Pascual, Juan Carlos

Soler, Joaquim

Álvarez Tomás, Irene

English

Diposit Digital de la Universitat de Barcelona

EARLY AND DELAYED BPD DIAGNOSISAND ITS RELATIONSHIP TO LONG-TERM REMISSION IN ADULTHOODIrene Alvarez-Tomás 1 2, Joaquim Soler 3, Arturo Bados 2, Ana Martín-Blanco 3, Matilde Elices 3 and Juan C. Pascual 31 Mental Health Service, Institute for Research and Health Innovation Parc Tauli (I3PT). 2      Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, Universitat de Barcelona (UB).3 Department of Psychiatry, Hospital de la Santa Creu i Sant Pau.ObjectivePreventive approaches focus on early detectionto facilitate access to specific interventions andthus reduce potential complications over time.Moreover, previous long-term course studieshave identified younger age as a predictor ofearlier remission (Zanarini et.al. 2006).The present sample was recruited at HospitalSant Pau for a 10-year follow-up study on thelong-term clinical and functional course of BPD(Alvarez-Tomás, I. et al., 2016).Inclusion criteria:  1) Diagnosis of BPD (DSM-IV), assessed by SCID-II and DIB-R (Total Score ≥ 6); 2) Age of 18-45 years; 3) CGI-S score ≥4.  4) No current diagnosis of schizophrenia, drug-induced psychosis, bipolar and major depressive disorders, alcoholism and other substance disorders, mental retardation or organic syndrome with psychiatric symptoms. Participants:An early BPD diagnosis might be relatedto a greater likelihood of remission in thelong term.Subjects with a delayed BPD diagnosisappear more likely to have previouslysuffered lifetime mood disorders.These results should be replicated inlarger samples.IntroductionMethodsResultsConclusionsTo study long-term remission of borderline personality disorder (BPD) differentially by age of BPD diagnosis detection.Initial Sample n= 64 Follow-up Sample n=41Retention Rate = 64%Committed Suicide  n=5   (7.8%)Not localized at follow-up  n=6  (9.4%) Refuse to participate n=12  (18.7%)•There were no significant differences betweendrop-outs and continuers in age, gender, age of1rst BPD diagnosis and BPD severity atbaseline.•Current analyses were run in the follow-upsample (n=41).Clinical characteristics in ED-DD Groups:•Subjects in the ED Group were more likely to havereceived the first mental health intervention beforeage 18 than those in the DD Group ( t= - 4.08,df=39, p<.001).•Mean age of 1th BPD diagnosis was around 20years in the ED Group and 31 years in the DDGroup.•Subjects in the DD Group were more likely topresent a previous mood disorder than those inthe ED Group (X2= 5.66, df=1, p < 0.05).Long-term remission rate in ED-DD Groups:• The ED Group showed a higher remissionrate than the DD Group at 10-year follow-up,although it did not reach statistical significance(2 = 3.37, p =0.06).• The likelihood of long-term BPD remission inthe ED Group was 1.75 times greater than inthe DD Group (RR = 1.75, IC 95% [0.92,3.34]), which represented a moderate effectsize.References[1]M.C. Zanarini, F.R. Frankenburg et al. Prediction of the 10-yearcourse of borderline personality disorder. American Journal ofPsychiatry, 163 (2006) 827-832.[2] I.Alvarez-Tomás, J. Soler et al. Long-term course of borderlinepersonality disorder: A prospective 10-year follow-up study.Journal of Personality Disorders, 30 (2016) 1-16.Contact: mialvarez@tauli.catEarlyBPD DiagnosisED GroupDelayedBPD DiagnosisDD GroupAge 1rtMental Health Intervention14.35yAge1rt BPD Diagnosis20.6yAgeStudyInclusion22.6y21yAge 1rt Mental Health Intervention31.4yAge1rt BPD Diag32.3yAgeStudy Inclusion18 yearsAge of first BPD diagnosis:• Age of first BPD diagnosis and other psychiatricantecedents were retrospectively reported byparticipants in a clinical interview.• According to this variable, two subgroups weredefined: Early BPD Diagnosis Group (ED) ≤ 25 years Delayed BPD Diagnosis Group (DD) >25 yearsRemission:•.Remission was defined as not meeting BPDcriteria by DIB-R and SCID-II in the prior 2-yearperiod.EDGroupDDGroupLIFETIME DIAGNOSES  (2 or +)70 % 61 %Mood Disorders 35% 72%  **Substance Use Disorders 44% 44%Eating Disorders 39% 39%Early Childhood Mental Disorders (< 10y)26% 0%Disruptive Behavior/  ADHD17% 0%ED Group(n=23)DD Group(n=18)REMISSION 1568.2 %738.9 %NO REMISSION 731.8 %1161.1 %

Early and delayed BPD diagnosis and its relationship to long-term remission in adulthood

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Early and delayed BPD diagnosis and its relationship to long-term remission in adulthood

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