Time to Attainment of Recovery From Borderline Personality Disorder and Stability of Recovery: A 10-year Prospective Follow-Up Study
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OBJECTIVE: The purposes of this study were to determine time to attainment of recovery from borderline personality disorder and to assess the stability of recovery. METHOD: A total of 290 inpatients who met both DSM-III-R and Revised Diagnostic Interview for Borderlines criteria for borderline personality disorder were assessed during their index admission using a series of semistructured interviews and self-report measures. The same instruments were readministered every 2 years for 10 years. RESULTS: Over the study period, 50% of participants achieved recovery from borderline personality disorder, which was defined as remission of symptoms and having good social and vocational functioning during the previous 2 years. Overall, 93% of participants attained a remission of symptoms lasting at least 2 years, and 86% attained a sustained remission lasting at least 4 years. Of those who achieved recovery, 34% lost their recovery. Of those who achieved a 2-year remission of symptoms, 30% had a symptomatic recurrence, and of those who achieved a sustained remission, only 15% experienced a recurrence. CONCLUSIONS: Taken together, the results of this study suggest that recovery from borderline personality disorder, with both symptomatic remission and good psychosocial functioning, seems difficult for many patients to attain. The results also suggest that once attained, such a recovery is relatively stable over time.
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The proportion of borderline patients attaining a two-year recovery increased from 50% at 10-year follow-up to 60% at 16-year follow-up.
“While 50% of borderline patients attained a two-year recovery after 10 years of prospective follow-up (5), only 60% attained this outcome after an additional six years of prospective follow-up.”
In MSAD, 93% of borderline patients had a remission of at least two years, while only 50% achieved a two-year recovery.
“In the McLean Study of Adult Development, it was found that 93% of the borderline patients achieved a remission that lasted at least two years but only 50% attained a two-year recovery, which was defined as concurrent symptomatic remission and good social and vocational functioning.”
In this study's earlier 10-year follow-up, 30% of borderline patients experienced recurrence after a two-year remission.
“These results are consistent with and extend our findings pertaining to the first 10 years of prospective follow-up in this study where we found that 30% of borderline patients had a recurrence of borderline personality disorder after a two-year long remission (5).”
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- Authors
- Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G.
- Affiliations
- Harvard University (US)
- McLean Hospital (US)
- Venue
- American Journal of Psychiatry
- Published
- 2010-06-01
- Volume
- 167
- Issue
- 6
- Pages
- 663-667
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3203735
- OpenAlex
- W2115471179
- Cited by
- 276
- References
- 21
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 13 · 2023: 11 · 2022: 10 · 2021: 40 · 2020: 14 · 2019: 17 · 2018: 25 · 2017: 10 · 2016: 17 · 2015: 15 · 2014: 18 · 2013: 20 · 2012: 24
- FWCI
- 22.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH-62169, R29MH047588, R01MH062169, MH-47588)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- borderline personality disorder, recovery, remission, relapse, time to recovery, psychosocial functioning, vocational functioning, hospitalized patients, long-term follow-up
- MeSH terms
- Adolescent, Adult, Borderline Personality Disorder, Female, Follow-Up Studies, Hospitalization, Humans, Male, Prospective Studies, Psychiatric Department, Hospital, Remission Induction, Retention, Psychology, Time Factors, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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