Comorbidity and Associated Severity of Borderline Personality Disorder and Physical Health Conditions in a Nationally Representative Sample

Abstract

Objective: To investigate the comorbidity and severity of borderline personality disorder and physical health conditions in a nationally representative sample. Despite the recent trend of examining the relationship between physical and mental health, there has been limited research examining the association of physical health conditions and personality disorders, in particular, borderline personality disorder. Methods: The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Wave 2 (n = 34,653; cumulative response rate, 70.2%; age, ≥20 years) was used in the current study. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition was used to assess mental disorders, and self-reports were used to assess physical health conditions. Multiple logistic regression models examined the comorbidity of physical health conditions with borderline personality disorder and associated suicide attempts. Results: After adjusting for sociodemographic variables, common Axis I mental disorders, and Axis II personality disorders, the presence of borderline personality disorder was significantly associated with arteriosclerosis or hypertension, hepatic disease, cardiovascular disease, gastrointestinal disease, arthritis, venereal disease, and “any assessed medical condition” (adjusted odds ratios, range 1.46–2.80). In the most stringent adjusted model, diabetes, stroke, and obesity were not associated with borderline personality disorder. Furthermore, a greater likelihood of suicide attempts was associated with cardiovascular disease, venereal disease, and “any assessed medical condition” with comorbid borderline personality disorder than borderline personality disorder alone. Conclusion: Careful screening and treatment of physical health conditions among people with borderline personality disorder are warranted. BPD = borderline personality disorder; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; NESARC = National Epidemiological Survey on Alcohol and Related Conditions; AUDADIS-IV = Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version; BMI = body mass index; HRQOL = health-related quality of life; MCS = mental health-related quality of life component score; PCS = physical health-related quality of life component score.