and child abuse. Also, in high-income countries as people enjoy more privileges, they tend to take less responsibility for their actions and expect more and more from the state. We increasingly see more pressure on social services, rather than on parents, to account for the welfare of children. This does not mean that borderline personality disorder is exclusive to the West, but in the social context we do see more reasons for people in the West to have such traits. Given the aetiological factors that we are aware of, and the crucial age factor for borderline personality disorder, it is no surprise that immigration is not a risk factor for borderline personality disorder. This is an interesting study that confirms what was earlier suggested by Tyrer et al 4 and Baleydier et al; 5 however, I am not sure whether a similar study in future would be useful, given that it is unlikely that immigration can be a risk factor for developing borderline personality disorder. I do, however, agree with the authors that future studies in younger immigrants and second generations who will be more influenced by the Western way of life are likely to be interesting and helpful, especially in terms of clinical management.