Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study
Open accessAbstract
OBJECTIVE: The purposes of this study were to determine time to attainment of symptom remission and to recovery lasting 2, 4, 6, or 8 years among patients with borderline personality disorder and comparison subjects with other personality disorders and to determine the stability of these outcomes. METHOD: A total of 290 inpatients with borderline personality disorder and 72 comparison subjects with other axis II disorders were assessed during their index admission using a series of semistructured interviews, which were administered again at eight successive 2-year follow-up sessions. For inclusion in the study, patients with borderline personality disorder had to meet criteria for both the Revised Diagnostic Interview for Borderlines and DSM-III-R. RESULTS: Borderline patients were significantly slower to achieve remission or recovery (which involved good social and vocational functioning as well as symptomatic remission) than axis II comparison subjects. However, by the time of the 16-year follow-up assessment, both groups had achieved similarly high rates of remission (range for borderline patients: 78%-99%; range for axis II comparison subjects: 97%-99%) but not recovery (40%-60% compared with 75%-85%). In contrast, symptomatic recurrence and loss of recovery occurred more rapidly and at substantially higher rates among borderline patients than axis II comparison subjects (recurrence: 10%-36% compared with 4%-7%; loss of recovery: 20%-44% compared with 9%-28%). CONCLUSIONS: Our results suggest that sustained symptomatic remission is substantially more common than sustained recovery from borderline personality disorder and that sustained remissions and recoveries are substantially more difficult for individuals with borderline personality disorder to attain and maintain than for individuals with other forms of personality disorder.
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- Findingown data
BPD patients were significantly slower to achieve remission than axis II comparison subjects.
“However, it is also clear that borderline patients remitted at a significantly slower pace than axis II comparison subjects.”
- Also stated in: § Discussion · plain
“However, the results of the current study found that remissions, regardless of length, occurred significantly more rapidly for axis II comparison subjects than for borderline patients.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
Axis II comparison subjects reported even lower rates of recurrence, ranging from 7% after a two-year remission to 4% after an eight-year remission.
“Axis II comparison subjects reported even lower rates of recurrence, ranging from 7% after a two-year remission to 4% after an eight-year remission.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Findingown data
By 16-year follow-up, cumulative remission rates for axis II comparison subjects ranged from 99% to 97%.
“The corresponding rates for those with another personality disorder ranged from 99% to 97%.”
Quote in the paperNot a substantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Findingown data
BPD patients were significantly slower to achieve recovery than axis II comparison subjects.
“In addition, recoveries occurred significantly more slowly for borderline patients than axis II comparison subjects.”
- Also stated in: § Discussion · plain
“The third main finding is that recovery from borderline personality disorder occurred at a lower rate and more slowly than recovery from another personality disorder.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
By 16-year follow-up, cumulative recovery rates for BPD ranged from 60% for a two-year recovery to 40% for an eight-year recovery.
“By the time of the 16-year follow-up, cumulative rates of recovery for borderline patients ranged from 60% for recoveries lasting two years to 40% for recoveries lasting eight years.”
- Also stated in: § Discussion · plain
“In terms of recoveries lasting two years, 60% of borderline patients and 85% of axis II comparison subjects attained this important outcome. In terms of recoveries lasting eight years, these rates dropped to 40% and 75% respectively.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
By 16-year follow-up, cumulative recurrence rates for axis II comparison subjects ranged from 7% to 4%.
“The comparable figures for axis II comparison subjects ranged from 7% to 4%.”
- Also stated in: § Discussion · plain
“Axis II comparison subjects reported even lower rates of recurrence, ranging from 7% after a two-year remission to 4% after an eight-year remission.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
By 16-year follow-up, loss of recovery for BPD ranged from 44% after a two-year recovery to 20% after an eight-year recovery.
“For borderline patients, these losses ranged from a high of 44% after a recovery lasting two years to a low of 20% for a recovery lasting eight years.”
- Also stated in: § Discussion · plain
“Rates of loss of recovery after a two-year recovery were 44% for borderline patients and 28% for axis II comparison subjects. Rates of loss of recovery after an eight-year recovery were 20% and 9% respectively.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
Symptomatic recurrence occurred at substantially higher rates among BPD patients than axis II comparison subjects.
“In contrast, symptomatic recurrence (10–36% vs. 4–7%) and loss of recovery (20–44% vs. 9–28%) occurred more rapidly and at substantially higher rates among borderline patients than axis II comparison subjects.”
- Also stated in: § Results · plain
“As can be seen, by the time of the 16-year follow-up, cumulative rates of recurrence for borderline patients ranged from 36% after a two-year remission to 10% after an eight-year remission. The comparable figures for axis II comparison subjects ranged from 7% to 4%.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Results · plain
- Findingown data
BPD patients and axis II comparison subjects achieved similar high rates of remission by 16-year follow-up.
“However, those in both study groups ultimately achieved about the same high rates of remission (borderline patients: 78–99%; axis II comparison subjects: 97–99%) but not recovery (40–60% vs. 75–85%) by the time of the 16-year follow-up.”
- Also stated in: § Discussion · plain
“The first is that remissions lasting two to eight years are extremely common for borderline patients (and axis II comparison subjects).”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
Symptomatic recurrence occurred more rapidly among BPD patients than axis II comparison subjects.
“Borderline patients also experienced a recurrence significantly more rapidly than axis II comparison subjects experienced a recurrence after a two- to six-year remission.”
- Also stated in: § Discussion · plain
“However, the results of the current study found that recurrences occurred significantly more slowly for axis II comparison subjects than for borderline patients.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
BPD patients achieved lower rates of recovery than axis II comparison subjects by 16-year follow-up.
“However, those in both study groups ultimately achieved about the same high rates of remission (borderline patients: 78–99%; axis II comparison subjects: 97–99%) but not recovery (40–60% vs. 75–85%) by the time of the 16-year follow-up.”
- Also stated in: § Discussion · plain
“The third main finding is that recovery from borderline personality disorder occurred at a lower rate and more slowly than recovery from another personality disorder.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
Remissions lasting two to eight years are extremely common for borderline patients and axis II comparison subjects.
“The first is that remissions lasting two to eight years are extremely common for borderline patients (and axis II comparison subjects).”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Findingown data
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.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] source
Not checked in the free run.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Findingown data
Loss of recovery occurred at substantially higher rates among BPD patients than axis II comparison subjects.
“In contrast, symptomatic recurrence (10–36% vs. 4–7%) and loss of recovery (20–44% vs. 9–28%) occurred more rapidly and at substantially higher rates among borderline patients than axis II comparison subjects.”
- Also stated in: § Results · plain
“For borderline patients, these losses ranged from a high of 44% after a recovery lasting two years to a low of 20% for a recovery lasting eight years. For axis II comparison groups, these losses ranged from a high of 28% after a recovery lasting two years to a low of 9% for a recovery lasting eight years.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Results · plain
- Findingown data
By 16-year follow-up, cumulative remission rates for BPD ranged from 99% for a two-year remission to 78% for an eight-year remission.
“By the time of the 16-year follow-up, the cumulative rates of remission for borderline patients ranged from 99% with a two-year remission to 78% with an eight-year remission.”
- Also stated in: § Discussion · plain
“In fact, cumulative rates at 16-year follow-up for borderline patients ranged from a high of 99% for a two-year remission to 78% for an eight-year remission.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
Recurrences of BPD were relatively rare, ranging from 36% after a two-year remission to 10% after an eight-year remission.
“The second main finding is that recurrences of borderline personality disorder were relatively rare, ranging from 36% after a two-year remission to 10% after an eight-year remission.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Findingown data
Recoveries occurred at lower rates than remissions for those in both study groups.
“The fifth main finding is that recoveries occurred at lower rates than remissions for those in both study groups.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Findingown data
By 16-year follow-up, cumulative recurrence rates for BPD ranged from 36% after a two-year remission to 10% after an eight-year remission.
“As can be seen, by the time of the 16-year follow-up, cumulative rates of recurrence for borderline patients ranged from 36% after a two-year remission to 10% after an eight-year remission.”
- Also stated in: § Discussion · plain
“The second main finding is that recurrences of borderline personality disorder were relatively rare, ranging from 36% after a two-year remission to 10% after an eight-year remission.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
By 16-year follow-up, loss of recovery for axis II comparison subjects ranged from 28% after a two-year recovery to 9% after an eight-year recovery.
“For axis II comparison groups, these losses ranged from a high of 28% after a recovery lasting two years to a low of 9% for a recovery lasting eight years.”
- Also stated in: § Discussion · plain
“Rates of loss of recovery after a two-year recovery were 44% for borderline patients and 28% for axis II comparison subjects. Rates of loss of recovery after an eight-year recovery were 20% and 9% respectively.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Findingown data
Loss of recovery occurred more rapidly among BPD patients than axis II comparison subjects.
“In contrast, symptomatic recurrence (10–36% vs. 4–7%) and loss of recovery (20–44% vs. 9–28%) occurred more rapidly and at substantially higher rates among borderline patients than axis II comparison subjects.”
- Also stated in: § Discussion · hedged
“The fourth main finding is that the loss of recovery was substantially but not significantly more common for borderline patients than axis II comparison subjects, in part due to the relatively small number of events in each group.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · hedged
- Findingown data
By 16-year follow-up, cumulative recovery rates for axis II comparison subjects ranged from 85% for a two-year recovery to 75% for an eight-year recovery.
“In terms of axis II comparison subjects, cumulative rates of recovery ranged from 85% for recoveries lasting two years to 75% for recoveries lasting eight years.”
- Also stated in: § Discussion · plain
“In terms of recoveries lasting two years, 60% of borderline patients and 85% of axis II comparison subjects attained this important outcome. In terms of recoveries lasting eight years, these rates dropped to 40% and 75% respectively.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Interpretationown data
For BPD, lasting symptomatic remission is much more frequent than lasting recovery.
“Taken together, the results of this study suggest that sustained symptomatic remission is substantially more common than sustained recovery from borderline personality disorder.”
- Also stated in: § Discussion · plain
“The fifth main finding is that recoveries occurred at lower rates than remissions for those in both study groups.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
- Interpretationown data
The symptomatic outcome of BPD is better than that of other major mental illnesses like major depression or bipolar I disorder.
“Given these findings pertaining to symptomatic outcome, it seems fair to suggest that borderline personality disorder has a better symptomatic outcome than other major mental illnesses with which it is frequently compared, such as major depression (20,21) or bipolar I disorder (22,23).”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [20] source
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- cites [21] Mueller TI, 1999, Am J Psychiatry source
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- cites [22] source
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- cites [23] source
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- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Interpretationcitation
The findings likely reflect that BPD patients have less stable vocational performance than those with other axis II psychopathology.
“These results too, which are new, probably reflect the unstable vocational performance of borderline patients relative to those with other forms of axis II psychopathology (18).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] source
Not checked in the free run.
- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Premisecitation
In CLPS, roughly 20% of borderline patients had a GAF score of 71 or above for at least two months.
“In terms of overall functioning, about 20% of borderline patients attained a GAF score of 71 or higher for two months or more.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] source
Not checked in the free run.
- Interpretationown data
Longer remissions and recoveries are harder to attain than shorter ones.
“However, when differences in risk periods are taken into account, our results suggest that it is relatively more difficult to achieve longer remissions and recoveries than shorter ones.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Study design and conductcitation
Reliability for axis I and II disorder diagnoses remained good-to-excellent across follow-up and between rater generations.
“Good-excellent follow-up and longitudinal inter-rater reliability was also maintained for both axis I and II disorders (13,14).”
Quote in the paperSubstantial claim0 of 2 sources checked - Study design and conductcitation
Reliability for psychosocial functioning and treatment-use variables remained good-to-excellent across follow-up and between rater generations.
“Good-excellent follow-up (within a generation of raters) and longitudinal (between generations of raters) inter-rater reliability was maintained throughout the course of the study for variables pertaining to psychosocial functioning and treatment use (12).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [12] source
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- Study design and conductcitation
The Background Information Schedule and the three diagnostic interviews have shown good-to-excellent inter-rater and test-retest reliability.
“The inter-rater and test-retest reliability of the Background Information Schedule (12) and of the three diagnostic measures (13,14) have all been found to be good-excellent.”
Quote in the paperNot a substantial claim0 of 3 sources checked - Premisecitation
In CLPS, 85% of borderline patients achieved a remission of 12 months or longer.
“In the Collaborative Longitudinal Personality Disorders Study, it was found that 85% of borderline patients achieved a remission lasting 12 months or more.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] source
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- Premisecitation
In CLPS, patients with another personality disorder had higher recurrence rates than BPD patients (25% vs. 11%).
“However, the opposite pattern was found in the Collaborative Longitudinal Personality Disorders Study where those with another personality disorder (who had as their primary axis II diagnosis either avoidant or obsessive-compulsive personality disorder) had higher rates of recurrence than those with borderline personality disorder (25% vs. 11%).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] source
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- Premisecitation
BPD patients are significantly more likely than axis II comparison subjects to rely on federal disability benefits.
“We have also found that borderline patients are significantly more likely to support themselves through federal disability benefits than axis II comparison subjects (19).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [19] source
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- Premisecitation
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).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] source
Not checked in the free run.
- Premisecitation
Paris and colleagues reported that 75% of 100 traced borderline patients no longer met BPD criteria about 15 years after admission.
“Paris and his colleagues assigned chart review diagnoses of borderline personality disorder to 322 former inpatients and found that 75% of the 100 borderline patients they traced a mean of 15 years after their index admission no longer met criteria for the disorder.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [2] source
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- Interpretationown data
The reduced recurrence and recovery-loss rates are not just due to shorter risk periods; they reflect stable changes in symptoms and psychosocial functioning.
“And that the lower rates of recurrence and loss of recovery are not solely artifacts of shorter risk periods but represent stable changes in symptomatology and psychosocial functioning.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Interpretationcitation
Findings might not apply to untreated individuals, since most participants received non-intensive outpatient care.
“The second is that the majority of those in both study groups were in non-intensive outpatient treatment over time (28) and thus, the results may not generalize to untreated subjects.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] source
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- Premisecitation
Four large follow-back studies reported mean scores of 63-67 for borderline patients on scales preceding the GAF.
“However, all four studies assessed overall outcome and found that the borderline patients received a mean score of 63–67 on scales that were precursors to the Global Assessment of Functioning (1–4).”
Quote in the paperSubstantial claim0 of 4 sources checked
- May combine two claims. 6
- Classified as probably not a substantial claim. 6
May combine two claims.
FindingreasoningRecovery from BPD occurred at a lower rate and more slowly than recovery from another personality disorder.
“The third main finding is that recovery from borderline personality disorder occurred at a lower rate and more slowly than recovery from another personality disorder.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
May combine two claims.
Findingown dataAbout 10% of BPD patients achieved recovery at the first possible time period, compared to about 40% of axis II comparison subjects.
“For each length of recovery, about 10% of borderline patients achieved recovery at the first possible time period, while the comparable figure for axis II comparison subjects was about 40%.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
May combine two claims.
Findingown dataAbout 30% of BPD patients achieved remission at the first possible time period, compared to about 85% of axis II comparison subjects.
“For each length of remission, about 30% of borderline patients achieved remission at the first possible time period, while the comparable figure for axis II comparison subjects was about 85%.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
May combine two claims.
Findingown dataBetween-group differences in loss of recovery were substantial but not statistically significant.
“These between-group differences, while substantial, were not statistically significant.”
- Also stated in: § Discussion · plain
“The fourth main finding is that the loss of recovery was substantially but not significantly more common for borderline patients than axis II comparison subjects, in part due to the relatively small number of events in each group.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Discussion · plain
May combine two claims.
Interpretationown dataBPD patients find it much harder to achieve and keep lasting remissions and recoveries than patients with other personality disorders.
“They also suggest that sustained remissions and recoveries are substantially more difficult for borderline patients to attain and maintain than those with other forms of personality disorder.”
- Also stated in: § Conclusions · hedged
“Taken together, the results of this study suggest that sustained symptomatic remission is substantially more common than sustained recovery from borderline personality disorder. They also suggest that sustained remissions and recoveries are substantially more difficult for borderline patients to attain and maintain than those with other forms of personality disorder.”
Quote in the paperSubstantial claim- Rests on an assumption: The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
- Rests on an assumption: Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
- Also stated in: § Conclusions · hedged
May combine two claims.
PremisecitationIn 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.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [5] source
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Classified as probably not a substantial claim.
Study design and conductown dataFollow-up interviewers did not have access to previously collected data.
“At each of eight follow-up waves, separated by 24 months, psychosocial functioning and treatment utilization as well as axis I and II psychopathology were reassessed via interview methods similar to the baseline procedures by staff members blind to previously collected information.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningFindings might not apply to borderline patients who have never been hospitalized, as all participants began as inpatients.
“The first is that all subjects were initially inpatients. It may well be that borderline patients who have never been hospitalized are less severely ill symptomatically and less impaired psychosocially and thus, more likely to remit more rapidly and attain a good global outcome over time.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationOur group's earlier work found BPD patients have much greater difficulty with consistent, competent vocational functioning than axis II comparison subjects.
“This is so because previous research by our group has found that borderline patients have far more difficulty functioning consistently and competently in the vocational arena than axis II comparison subjects (18).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataBaseline interviewers did not know the patients' clinical diagnoses.
“Each patient then met with a masters-level interviewer blind to the patient's clinical diagnoses for a thorough psychosocial and treatment history as well as diagnostic assessment.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataAmong surviving BPD patients, 87.5% completed interviews at all eight follow-up waves.
“In terms of continuing participation, 87.5% (N=231/264) of surviving borderline patients (13 died by suicide and 13 died of other causes) were reinterviewed at all eight follow-up waves.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataAmong surviving axis II comparison subjects, 82.9% completed interviews at all eight follow-up waves.
“A similar rate of participation was found for axis II comparison subjects, with 82.9% (N=58/70) of surviving patients in this study group (one died by suicide and one died of other causes) being reassessed at all eight follow-up waves.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
The borderline and axis II comparison groups are comparable on baseline characteristics that could affect the outcomes, apart from their diagnoses.
“Borderline patients were significantly slower to achieve remission or recovery (which involved good social and vocational functioning as well as symptomatic remission) than axis II comparison subjects.”
“The corresponding rates for those with another personality disorder ranged from 99% to 97%.”
The paper relies on this without support.
Patients lost to follow-up do not differ systematically from those retained in ways that affect the study's outcome estimates.
“In terms of continuing participation, 87.5% (N=231/264) of surviving borderline patients (13 died by suicide and 13 died of other causes) were reinterviewed at all eight follow-up waves.”
“A similar rate of participation was found for axis II comparison subjects, with 82.9% (N=58/70) of surviving patients in this study group (one died by suicide and one died of other causes) being reassessed at all eight follow-up waves.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Adult BPD typically is a chronic condition, characterized by patterns of remission and relapse at PD symptom level, but with more pervasive and persistent disabilities in psychosocial functioning.
“Longitudinal data suggest that adult BPD typically is a chronic condition, characterized by patterns of remission and relapse at PD symptom level, but with more pervasive and persistent disabilities in psychosocial functioning [4, 5].”
From The (cost-)effectiveness of early intervention (MBT-early) versus standard protocolized treatment (CBT) for emerging borderline personality disorder in adolescents (the EARLY study): a study protocol for a randomized controlled trial (2024) · cites this paper as [5]
The Results report both remission and recurrence of BPD symptoms, while the Discussion shows that sustained recovery—including good social and vocational functioning—was much less common than symptomatic remission. But the paper cautions against calling BPD typically chronic: it says its course is more heterogeneous and, for many patients, more benign than generally thought. Page numbers are not provided in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) have been shown to be effective in addressing identity disturbance and impulsivity in young populations.
“Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) have been shown to be effective in addressing these aspects in young populations (44, 45).”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [45]
The Methods describe a 16-year interview-based follow-up of patients with borderline personality disorder and axis II comparison subjects; the Discussion addresses remission and recovery, not the effectiveness of specific therapies. Searches for DBT, CBT, and their full names found no passage assessing whether they address identity disturbance or impulsivity in young populations. The available passages have no page numbers. (LLM, conf=0.76)
Experimental — accuracy not yet measuredLongitudinal, observational studies suggest that durable functional improvements are much more difficult to achieve than symptomatic improvements.
“Longitudinal, observational studies suggest that durable functional improvements are much more difficult to achieve than symptomatic improvements (47).”
From The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence (2023) · cites this paper as [47]
Substantial data demonstrates similar levels of (in)stability among adults diagnosed with (B)PD, especially regarding the acute symptoms of the disorder, reflecting that the disorder itself is less durable than was previously assumed.
“First, substantial data demonstrates similar levels of (in)stability among adults diagnosed with (B)PD, especially regarding the acute symptoms of the disorder (47), reflecting that the disorder itself is less durable than was previously assumed.”
From The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence (2023) · cites this paper as [47]
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“Large well-designed prospective studies have now shown that although many patients remit, they still remain dysfunctional in relationships, in employment (19, 20), and they experience low quality of life (21, 22).”
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“While there is significant evidence supporting the hypothesis that personality and PD symptoms can improve (Gunderson et al., 2011; Zanarini et al., 2012), this work has not distinguished personality style from severity (Calabrese & Simms, 2014).”
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Hypermentalizing, attachment, and epistemic trust in adolescent BPD: Clinical illustrations.
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“Similar findings have been observed in other studies (Cohen, Crawford, Johnson, & Kasen, 2005; Lenzenweger, 1999; McDavid & Pilkonis, 1996; Zanarini et al., 2012), and the same picture emerges when considering the more fine-grained changes associated with symptom counts as opposed to categorical…”
Pharmacological interventions for people with borderline personality disorder
Stoffers-Winterling, J. M., Storebø, O. J., Ribeiro, J. P., Kongerslev, M., Vӧllm, B., Mattivi, J. T., Faltinsen, E. G., Todorovac, A., Jørgensen, M. S., Edemann-Callesen, H., et al. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012956.pub2 · Cited by 118 · see citing works
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“…physical health, as opposed to stemming solely and directly from active borderline personality symptomatology, particularly as by the time of the 16-year follow-up, 99% had achieved a two-year symptomatic remission and 78% had achieved an eight-year symptomatic remission (Zanarini et al., 2012).”
BackgroundSelf-citationStability and Change in Personality Disorders
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“By the sixteenth year of the study, nearly all patients in the study had experienced a remission, and symptom decline stayed relatively stable, with only a small proportion of the sample experiencing a return to diagnostic status (Zanarini et al. 2012).”
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“At 16 years, the MSAD also reported that 78% of BPD patients had achieved a long-lasting remission of eight consecutive years [7].”
BackgroundPersonality Disorders in DSM-5: Emerging Research on the Alternative Model
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“Subsequently, the same pattern of remitting BPD symptomatology in the face of enduring impairments was found over the course of 10 (Gunderson et al., 2011) and 16 years (Zanarini et al., 2012).”
Zanarini, M. C., Temes, C. M., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. M. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.01.034 · Cited by 78 · see citing works
“It was also found that 84% of axis II comparison subjects achieved this outcome after 10 years of prospective follow-up and 85% achieved this outcome after 16 years of prospective follow-up (Zanarini et al., 2010, 2012).”
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“For example, 99% of the patients with borderline personality disorder reported a two-year remission, 95% reported a four-year remission, and 90% reported a six-year remission (16).”
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Convergence between DSM-IV-TR and DSM-5 Diagnostic Models for Personality Disorder
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“Nevertheless, the high rates of clinical remission shown in more recent long-term follow-up studies (69,70) suggest that such abnormalities may be reversible.”
Martín‐Blanco, A., Soler, J., Villalta, L., Feliu‐Soler, A., Elices, M., Pérez, V., Arranz, M. J., Ferraz, L., Álvarez, E., & Pascual, J. C. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.08.026 · Cited by 71 · see citing works
“Although long-term follow-up studies of subjects with BPD report symptomatic remission rates of about 90%, they also show a permanent impairment in the psychosocial functioning of most of these patients [2–4].”
BackgroundKaess, M., Ghinea, D., Fischer-Waldschmidt, G., & Resch, F. (2017) · Praxis der Kinderpsychologie und Kinderpsychiatrie · doi:10.13109/prkk.2017.66.6.404 · Cited by 68 · see citing works
Morgan, T. A., Chelminski, I., Young, D., Dalrymple, K. L., & Zimmerman, M. A. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.06.009 · Cited by 68 · see citing works
“Similar studies show remission at 99% at sixteen-year (Zanarini et al., 2012) and 94% at 27-year follow-ups (Paris and Zweig-Frank, 2001).”
BackgroundNon-response to psychotherapy for borderline personality disorder: A systematic review
Woodbridge, J., Townsend, M. L., Reis, S. L., Singh, S., & Grenyer, B. F. S. (2021) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674211046893 · Cited by 69 · see citing works
“Remission from BPD is typically defined as no longer meeting Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for BPD for 2 years (Zanarini et al., 2012).”
Miller, C. E., Lewis, K. L., Huxley, E., Townsend, M. L., & Grenyer, B. F. S. (2018) · Personality and Mental Health · doi:10.1002/pmh.1432 · Cited by 61 · see citing works
A Recurrent Question: What Is Borderline?
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Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Harned, A. L., & Fitzmaurice, G. M. (2014) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000232 · Cited by 64 · see citing works
“It may be because the severity of their borderline psychopathology was lessening.(16) It may also be because the rates of co-occurring disorders were declining.”
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Recovery, as Experienced by Women with Borderline Personality Disorder
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The Longitudinal Course of Borderline Personality Disorder
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Self-citation10-Year Outcome of Suicidal Behavior in Borderline Personality Disorder
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Borderline Personality Disorder in the Emergency Department: Good Psychiatric Management
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“Since the long-term prognosis for most BPD patients is good, a sound goal of ED treaters is to minimize excessively intensive interventions and to avoid causing iatrogenic harm while containing intermittent crises.(24)”
BackgroundBorderline Personality Disorder in the Primary Care Setting
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A Focused Systematic Review of Pharmacological Treatment for Borderline Personality Disorder
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“BPD is chronic yet its long-term trajectory is towards remission for the vast majority of patients [4, 5].”
BackgroundNicolini, M. E., Peteet, J. R., Donovan, G. K., & Kim, S. Y. H. (2020) · Psychological Medicine · doi:10.1017/s0033291719000333 · Cited by 52 · see citing works
“Furthermore, although the number of studies are limited (Leichsenring and Leibing, 2003), long-term follow-up shows that the majority of persons with personality disorders achieve sustained remission (Zanarini et al., 2012).”
BackgroundFunctional outcomes in community-based adults with borderline personality disorder
Javaras, K. N., Zanarini, M. C., Hudson, J. I., Greenfield, S. F., & Gunderson, J. G. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.01.010 · Cited by 49 · see citing works
Self-citationThe prevalence, age distribution and comorbidity of personality disorders in Australian women
Quirk, S. E., Berk, M., Pasco, J. A., Brennan-Olsen, S. L., Chanen, A. M., Koivumaa-Honkanen, H. T., Burke, L. M., Jackson, H. J., Hulbert, C. A., Olsson, C. A., et al. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416649032 · Cited by 50 · see citing works
“, 2005) and are a consistent driver of impairments in social and occupational functioning (Gunderson et al., 2011; Zanarini et al., 2012), and a key risk factor for suicide attempts (Ansell et al.”
BackgroundSuicidal Behavior and Psychosocial Outcome in Borderline Personality Disorder at 8-Year Follow-Up
Soloff, P. H., & Chiappetta, L. (2017) · Journal of Personality Disorders · doi:10.1521/pedi_2017_31_280 · Cited by 45 · see citing works
Zanarini, M., Frankenburg, F., & Fitzmaurice, G. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.12020173 · Cited by 47 · see citing works
Self-citationPsychological therapies for people with borderline personality disorder
Storebø, O. J., Stoffers-Winterling, J. M., Vӧllm, B., Kongerslev, M., Mattivi, J. T., Kielsholm, M. L., Nielsen, S. S., Jørgensen, M. S., Faltinsen, E. G., Lieb, K., et al. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012955 · Cited by 48 · see citing works
Keepers, G. A., Fochtmann, L. J., Anzia, J. M., Benjamin, S., Lyness, J. M., Mojtabai, R., Servis, M. E., Choi-Kain, L. W., Nelson, K. J., Oldham, J. M., et al. (2024) · American Journal of Psychiatry · doi:10.1176/appi.ajp.24181010 · Cited by 49 · see citing works
Hutsebaut, J., Willemsen, E., Bachrach, N., & Van, R. (2020) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-020-00133-7 · Cited by 46 · see citing works
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Wedig, M. M., Conkey, L. C., & Fitzmaurice, G. M. (2014) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12255 · Cited by 43 · see citing works
“However, one of these studies also assessed the more complex outcome of recovery—which was defined as symptomatic remission that was concurrent with good social and good full-time vocational functioning (3).”
BackgroundInfluentialSelf-citationMissed diagnosis: The emerging crisis of borderline personality disorder in older people
Beatson, J. A., Broadbear, J. H., Sivakumaran, H., George, K., Kotler, E., Moss, F., & Rao, S. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416640100 · Cited by 47 · see citing works
“Australian & New Zealand Journal of Psychiatry, 50(12) Studies that show decreased levels of impulsivity with ageing (Zanarini et al., 2012) and in the aged (Arens et al.”
BackgroundInfluentialHastrup, L. H., Kongerslev, M. T., & Simonsen, E. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2018_32_344 · Cited by 44 · see citing works
Chung, B. Y., Hensel, S., Schmidinger, I., Bekrater‐Bodmann, R., & Flor, H. (2020) · European Journal of Pain · doi:10.1002/ejp.1567 · Cited by 36 · see citing works
“(2011) did not differentiate between BPD in the current and the remitted stage, other reports of the same cohort suggest very high rates of—at least temporarily stable—symptomatic remission (Zanarini et al., 2012), indicating that the identified predictors of NSSI might also be crucial for rBPD.”
BackgroundRelationship between sleep disturbance and recovery in patients with borderline personality disorder
Plante, D. T., Frankenburg, F. R., Fitzmaurice, G. M., & Zanarini, M. C. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.01.006 · Cited by 41 · see citing works
“As in prior studies from our laboratory, the GAF score was operationalized such that a score of 61 or higher required symptomatic remission from BPD and at least one emotionally sustaining relationship with a close friend, life-partner, or spouse, as well as consistent participation in full-time work or school [27,38].”
BackgroundMethodSelf-citationSocial Factors in the Personality Disorders
Paris, J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108867542 · Cited by 43 · see citing works
Zanarini, M., Frankenburg, F., Wedig, M., & Fitzmaurice, G. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13010055 · Cited by 40 · see citing works
Self-citationA concise guide to personality disorders.
Paris, J. (2015) · American Psychological Association eBooks · doi:10.1037/14642-000 · Cited by 42 · see citing works
A recovery journey for people with personality disorder
Castillo, H., Ramon, S., & Morant, N. (2013) · International Journal of Social Psychiatry · doi:10.1177/0020764013481891 · Cited by 40 · see citing works
Harned, M. S., Wilks, C. R., Schmidt, S. C., & Coyle, T. N. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.02.002 · Cited by 39 · see citing works
“Similarly, in a sample of BPD inpatients followed over 16 years post-discharge, the cumulative rate of a two-year diagnostic remission from BPD was 99%, whereas only 60% achieved a two-year recovery (defined as diagnostic remission from BPD plus a GAF score > 60; Zanarini et al., 2012).”
BackgroundFuture Challenges in Psychotherapy Research for Personality Disorders
Kramer, U., Eubanks, C. F., Bertsch, K., Herpertz, S. C., McMain, S., Mehlum, L. I., Renneberg, B., & Zimmermann, J. (2022) · Current Psychiatry Reports · doi:10.1007/s11920-022-01379-4 · Cited by 41 · see citing works
Hastrup, L. H., Jennum, P., Ibsen, R., Kjellberg, J., & Simonsen, E. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-020-01683-5 · Cited by 37 · see citing works
BATEMAN, A. W., Constantinou, M., Fonagy, P., & Holzer, S. (2020) · Personality Disorders Theory Research and Treatment · doi:10.1037/per0000422 · Cited by 39 · see citing works
Thompson, K. N., Jackson, H. J., Cavelti, M., Betts, J. K., McCutcheon, L., Jovev, M., & Chanen, A. M. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_411 · Cited by 36 · see citing works
Chanen, A. M., McCutcheon, L., & Kerr, I. B. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0591-1_23 · Cited by 39 · see citing works
Zeitler, M.-L., Bohus, M., Kleindienst, N., Knies, R., Ostermann, M., Schmahl, C. G., & Lyssenko, L. (2018) · Journal of Personality Disorders · doi:10.1521/pedi_2018_32_394 · Cited by 33 · see citing works
Collaborative Deprescribing in Borderline Personality Disorder: A Narrative Review
Fineberg, S. K., Gupta, S., & Leavitt, J. (2019) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000200 · Cited by 37 · see citing works
Jørgensen, C. R., Bøye, R., Andersen, D., Blaabjerg, A. H., Freund, C., Jordet, H., & Kjølbye, M. (2014) · Nordic Psychology · doi:10.1080/19012276.2014.963649 · Cited by 35 · see citing works
“At 10-year prospective follow-up, 50% had attained recovery lasting at least 2 years, and 60% of the BPD patients participating had attained this outcome 16 years after their first admission (Zanarini et al., 2012).”
BackgroundA pilot randomized controlled trial of ketamine in Borderline Personality Disorder
Fineberg, S. K., Choi, E. Y., Shapiro-Thompson, R., Dhaliwal, K., Neustadter, E. S., Sakheim, M., Null, K. E., Diaz, D. T., Rondeau, J. A., Pittaro, G. F., et al. (2023) · Neuropsychopharmacology · doi:10.1038/s41386-023-01540-4 · Cited by 41 · see citing works
“The natural history of BPD is to experience decreasing numbers of symptoms over time, but social and occupational recovery are less frequent [50, 51].”
BackgroundImpulsivity and its Therapeutic Management in Borderline Personality Disorder: a Systematic Review
Mungo, A., Hein, M., Hubain, P., Loas, G., & Fontaine, P. (2020) · Psychiatric Quarterly · doi:10.1007/s11126-020-09845-z · Cited by 38 · see citing works
Neue Wege der Klassifikation von Persönlichkeitsstörungen in ICD-11
Herpertz, S. C. (2018) · Fortschritte der Neurologie · Psychiatrie · doi:10.1055/a-0576-7149 · Cited by 36 · see citing works
Pascual, J. C., Palomares, N., Ibáñez, Á., Portella, M. J., Arza, R., Reyes, R., Feliu‐Soler, A., Díaz‐Marsá, M., Sáiz-Ruiz, J., Soler, J., et al. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0640-5 · Cited by 36 · see citing works
“Long-term follow-up studies also show that clinical and general functioning improvements are not always related because high rates of clinical remission are not always associated with better psychosocial functioning [3, 4].”
BackgroundHutsebaut, J., Clarke, S. L., & Chanen, A. M. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1130417 · Cited by 36 · see citing works
“Longitudinal, observational studies suggest that durable functional improvements are much more difficult to achieve than symptomatic improvements (47).”
BackgroundWeekers, L. C., Hutsebaut, J., Rovers, J. M. C., & Kamphuis, J. H. (2023) · Personality Disorders Theory Research and Treatment · doi:10.1037/per0000637 · Cited by 35 · see citing works
Hutsebaut, J., Debbané, M., & Sharp, C. (2020) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-020-0121-4 · Cited by 34 · see citing works
Differential symptomatology and functioning in borderline personality disorder across age groups
Frías, Á., Palma, C., Solves, L., Martínez, B., & Salvador, A. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.081 · Cited by 34 · see citing works
- Authors
- Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G.
- Affiliations
- McLean Hospital (US)
- Venue
- American Journal of Psychiatry
- Published
- 2012-05
- Volume
- 169
- Issue
- 5
- Pages
- 476-483
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3509999
- OpenAlex
- W2002571950
- Cited by
- 484
- References
- 27
- Citations by year
- 2026: 20 · 2025: 29 · 2024: 31 · 2023: 23 · 2022: 30 · 2021: 32 · 2020: 60 · 2019: 44 · 2018: 41 · 2017: 32 · 2016: 30 · 2015: 36 · 2014: 43 · 2013: 25 · 2012: 7
- FWCI
- 40.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH062169)
- 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, personality disorders, symptom remission, recovery, relapse, long-term outcomes, social functioning, vocational functioning, Axis II personality disorders, hospitalized patients
- MeSH terms
- Adolescent, Adult, Antisocial Personality Disorder, Borderline Personality Disorder, Dependent Personality Disorder, Follow-Up Studies, Humans, Interview, Psychological, Paranoid Personality Disorder, Passive-Aggressive Personality Disorder, Personality Disorders, Prospective Studies, Recurrence, Remission Induction, Social Adjustment, Time Factors, Proportional Hazards Models, Case-Control Studies, Treatment Outcome, Kaplan-Meier Estimate, Young Adult
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