[Stability of borderline personality disorder from childhood to adulthood: a literature review]

Abstract

Background: Borderline personality disorder (BPD) is a severe and frequent disorder. Little is known about its early stages, which can be in childhood or adolescence.

Aim: To investigate to what extent BPD is stable from childhood through to adulthood.

Method: The literature was systematically reviewed with the help of Medline, Psycinfo, embase and the Cochrane Library.

Results: Of children known to have BPD in the primary school age-group, 80% met the criteria for a personality disorder in adulthood and 16% met the criteria for BPD. In a population study of adults with bpd, 30% still met the criteria two years later. In groups of adolescents at risk the criteria were met by 15-30 % after two to three years. These groups also showed a low dimensional stability for BPD. The most stable symptoms were feelings of emptiness, anger, affect-instability and identity problems. Less stable symptoms were suicidality, self-harm, impulsiveness, unstable relationships, derealisation and paranoid thinking.

Conclusions: Research into the stability of BPD that starts in children of primary school age has been too limited in a methodological sense for us to draw any firm conclusions. Research into BPD that starts in adolescence shows a low categorial and dimensional stability. Research into the onset of BPD in adults shows comparable low stability, but only after six years. In adolescents and adults impulsive and self-harm behaviour are probably the least stable symptoms and affective symptoms the most stable ones.