MIDAS Project
Publication Abstracts
Zimmerman, M., Mattia, J.I. Axis I diagnostic comorbidity and
borderline personality disorder. Comprehensive Psychiatry, 2005, 40,
245-252.
Borderline personality disorder (PD) has been the most studied
personality disorder. Research has examined the relationship between
borderline PD and most Axis I diagnostic classes such as eating disorders,
mood disorders, substance use disorders, etc. There is little information,
however, regarding the relationship of borderline PD and overall
comorbidity with all classes of Axis I disorders assessed simultaneously.
In the present study, 409 patients were evaluated with semi-structured
diagnostic interviews for Axis I and Axis II disorders; an expanded
version of the Structured Clinical Interview for DSM-IV (SCID) and the
borderline PD section of the Structured Interview for DSM-IV Personality (SIDP-IV),
respectively. Patients diagnosed with borderline PD, vs. those who did not
received the diagnosis, received significantly more current Axis I
diagnoses (3.4 vs. 2.0). Borderline PD patients were twice as likely to
have been diagnosed with three or more current disorders (69.5% vs. 31.1%)
and four times as likely to have been diagnosed with four or more
disorders (47.5% vs. 13.7%). In comparison to non-borderline PD patients,
borderline PD patients were more frequently diagnosed with major
depressive disorder, bipolar I and II disorder, panic disorder with
agoraphobia, social and specific phobia, posttraumatic stress disorder,
obsessive-compulsive disorder, eating disorder not otherwise specified,
and any somatoform disorder. Similar results were observed for lifetime
diagnoses. Overall, borderline PD patients were more likely to have
multiple Axis I disorders than did non-borderline PD patients. The
difference between the two groups cut across mood, anxiety, substance use,
eating, and somatoform disorder categories. These findings highlight the
importance of conducting thorough evaluations of Axis I pathology in
patients with borderline PD in order not to overlook syndromes that are
potentially treatment responsive.
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