Attention-deficit hyperactivity disorder as a potentially aggravating factor in borderline personality disorder
Open accessAbstract
Background: Clinical experience suggests that people with borderline personality disorder often meet criteria for attention-deficit hyperactivity disorder (ADHD). However, empirical data are sparse. Aims: To establish the prevalence of childhood and adult ADHD in a group of women with borderline personality disorder and to investigate the psychopathology and childhood experiences of those with and without ADHD. Method: We assessed women seeking treatment for borderline personality disorder (n=118) for childhood and adult ADHD, co-occurring Axis I and Axis II disorders, severity of borderline symptomatology and traumatic childhood experiences. Results: Childhood (41.5%) and adult (16.1%) ADHD prevalence was high. Childhood ADHD was associated with emotional abuse in childhood and greater severity of adult borderline symptoms. Adult ADHD was associated with greater risk for co-occurring Axis I and II disorders. Conclusions: Adults with severe borderline personality disorder frequently show a history of childhood ADHD symptomatology. Persisting ADHD correlates with frequency of co-occurring Axis I and II disorders. Severity of borderline symptomatology in adulthood is associated with emotional abuse in childhood. Further studies are needed to differentiate any potential causal relationship between ADHD and borderline personality disorder.
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The comorbidity between ADHD and the different emotional instability disorders is remarkably large.
“The comorbidity between ADHD and the different emotional instability disorders is remarkably large.”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Philipsen et al., 2008
The ‘History of childhood ADHD and severity of borderline personality disorder’ section (page not available) describes a high association between ADHD and borderline personality disorder. The Results report high childhood and adult ADHD prevalence among participants with borderline personality disorder. The paper does not establish similarly high comorbidity across different emotional instability disorders. (LLM, conf=0.84)
Experimental — accuracy not yet measured42% comorbidity between ADHD and BPD was reported in adolescence and 16% in adulthood in a BPD sample.
“For example, 42% comorbidity between ADHD and BPD was reported in adolescence and 16% in adulthood in a BPD sample (Philipsen et al., 2008)”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Philipsen et al., 2008
The ‘ADHD in people with borderline personality disorder’ section reports childhood ADHD in 41.8% and adult ADHD in 16.1% of women with BPD, supporting the approximate percentages. The source describes the first figure as retrospectively reported childhood ADHD, not ADHD specifically in adolescence; no page number is provided in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEmotional instability disorders (BPD, ASPD, CD) have a high rate of comorbidity with ADHD and ADHD symptoms.
“Although all these disorders have a high rate of comorbidity with ADHD and with ADHD symptoms, they are unquestionably different from classical DSM-5 ADHD.”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Philipsen et al., 2008
The ‘ADHD in people with borderline personality disorder’ section reports high rates of childhood ADHD symptoms and some adult ADHD among women with BPD. The paper does not establish a high rate of ADHD comorbidity for antisocial personality disorder (ASPD) or conduct disorder (CD); its Axis II table lists ASPD only as a co-occurring diagnosis in the BPD sample. (LLM, conf=0.88)
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- Authors
- Philipsen, A., Limberger, M. F., Lieb, K., Feige, B., Kleindienst, N., Ebner-Priemer, U., Barth, J., Schmahl, C., & Bohus, M.
- Affiliations
- University of Freiburg (DE)
- Central Institute of Mental Health (DE)
- Corresponding author
- Bohus, Martin
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2008-02
- Volume
- 192
- Issue
- 2
- Pages
- 118-123
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2154147886
- Cited by
- 220
- References
- 39
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 6 · 2023: 12 · 2022: 3 · 2021: 8 · 2020: 10 · 2019: 8 · 2018: 16 · 2017: 18 · 2016: 16 · 2015: 20 · 2014: 20 · 2013: 12 · 2012: 10
- FWCI
- 16.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Keywords
- attention deficit hyperactivity disorder, borderline personality disorder, ADHD prevalence, childhood emotional abuse, childhood trauma, comorbidities, women
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Borderline Personality Disorder, Female, Humans, Middle Aged, Psychopathology, Severity of Illness Index, Prevalence
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