New episodes and new onsets of major depression in borderline and other personality disorders

Abstract

Background: In the context of much literature and conjecture about the relationship of personality disorders (PD) and major depressive disorder (MDD), this paper uses longitudinal data to assess the frequency with which PD patients, and especially those with borderline personality disorder (BPD), have recurrences (for patients with lifetime histories), or new onsets (for patients without lifetime histories) of MDD. Methods: A sample of 478 PD patients received reliable repeated follow-up assessments over a period of 6 years. The rates of new onsets and recurrences of MDD in all PD patients, and in BPD patients compared to OPD patients were analyzed. Whether age, gender, GAF score, or the number and types of BPD criteria predict new onsets or recurrences of MDD was also examined. Results: Eighty-five percent of PD subjects had episodes of MDD during the 6 year follow-up; of those with lifetime MDD, 85% had recurrences. Of the PD subjects without lifetime MDD, 44% had new onsets. BPD subjects were significantly more likely ( p = .0036) to have recurrences of MDD but were about equally likely to have new onsets compared to OPD subjects. The number and types of BPD criteria were predictive of onsets and recurrences for all PDs, but were not more predictive for the BPD than OPD subsamples. Limitations: Longer term follow ups with a more epidemiologically representative sample of PDs would strengthen the generalizability of this study's findings.

The Relationship Between Borderline Personality Disorder and Major Depression in Later Life: Acute Versus Temperamental Symptoms

“…42,43 In addition, older adults manifest maladaptive behaviors and Axis I disorders under acute stress. 35 BPD increases the risk of MDE recurrence, 44 and aging alone does not seem to affect the strength of the relationship between personality disorders and depression. 45 Under stressful situations, temperamental traits might be considered a risk factor for developing episodes of major depression in this age group.…”

Personality Disorders and Traits as Predictors of Incident Cardiovascular Disease: Findings From the 23-Year Follow-Up of The Baltimore ECA Study

“…Recent longitudinal studies have shown that Cluster B PDs are associated with a higher risk of developing depressive and anxiety disorders. [21][22][23] Numerous studies have established that depressive symptoms or episodes increase risk of incident cardiovascular disease in community-dwellers. 24 Anxiety disorders also appear to increase risk for coronary heart disease risk, independently of major depressive disorder.…”

Amygdala Functional Connectivity in Young Women with Borderline Personality Disorder

“…These past comorbidities were included due to high rates of lifetime MDD (Gunderson et al, 2008;Shea et al, 2004) and PTSD (Shea et al, 2004) among individuals with BPD. Similarly, substance use disorders are very common in BPD (Zanarini et al, 2011).…”