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Correlates, stability and predictors of borderline personality disorder among previously suicidal youth

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Abstract

This article examines a large cohort of previously suicidal adolescents, identifying those that surpassed threshold criteria for borderline personality disorder (BPD), according to the Abbreviated Diagnostic Interview of Borderlines (Ab-DIB), and determining the stability, correlates and predictors of BPD from early-to-late adolescence. Two hundred and eighty-six youth (mean baseline age 14.6 years; SD 1.5), presenting consecutively to a metropolitan pediatric hospital emergency department for evaluation of suicidality, were assessed at initial consultation for Axis I and II disorders and demographic and clinical variables. Two hundred and twenty-nine (80 %) were re-assessed for those variables 4 years later and 204 (70.3 %) had complete data sets at recruitment and follow-up. Previously suicidal youths who met BPD threshold on the Ab-DIB at recruitment were distinguishable at baseline from those who did not in conduct disorder symptoms (p < 0.003), lower levels of functioning (p < 0.001), drug use (p < 0.001), stressful life events (p < 0.003) and family relations (p < 0.001). The BPD diagnosis was consistent, according to this measure, at baseline and follow-up for 76 % of participants. Four groups with respect to borderline pathology (persisting, remitting, emerging and never) were identified (ICC = 0.603, 95 % CI = 0.40–0.78). Persistent BPD status was predictable by older age at presentation (p < 0.01) and level of functioning (p < 0.05). Eight percent were also suicidal at the 4-year follow-up. Using a self-report measure of BPD, we suggest that suicidal youth can indeed be diagnosed with the disorder at 14 years old, supporting the shift from DSM-IV to DSM-5, given what appears to be its temporal stability, differentiation of those suffering with considerable symptomatology or not, and predictors of its status in late adolescence. The low suicidality rate at follow-up indicates a good short-term prognosis.

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Acknowledgements

The Hogg Family Foundation and The Montreal Children’s Hospital Foundation.

Conflict of interest

None.

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Authors and Affiliations

  1. Faculty of Medicine, Montreal Children’s Hospital (MCH), McGill University Health Centre (MUHC), Room D-572, 2300 Tupper St, Montreal, QC, H3H 1P3, Canada

    Brian Greenfield

  2. Department of Psychology and Oncology, Faculty of Medicine, Jewish General Hospital, McGill University, Montreal, QC, Canada

    Melissa Henry

  3. Psychiatry Resident, MCH, MUHC, Montreal, QC, Canada

    Eric Lis

  4. British Columbia Ministry of Children and Family Development, Victoria, BC, Canada

    Josh Slatkoff

  5. Université de Montréal, and Douglas Mental Health Institute, Montreal, QC, Canada

    Jean-Marc Guilé

  6. Faculty of Medicine, MCH, MUHC, and McGill University, Montreal, QC, Canada

    Geoffrey Dougherty

  7. MCH, MUHC, Montreal, QC, Canada

    Xun Zhang & Londa Daniel

  8. Department of Psychiatry, Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada

    Amir Raz

  9. Emeritus of Psychiatry, Ohio State University, Sunbury, OH, USA

    L. Eugene Arnold

  10. Centre for Research and Intervention on Suicide and Euthanasia (CRISE), Université du Québec a Montréal, Montreal, QC, Canada

    Brian L. Mishara

  11. Department of Psychology, Canada Research Chair in the Cognitive Neuroscience of Attention, McGill University and SMBD Jewish General Hospital, Montreal, QC, Canada

    Amir Raz

  12. McGill Ocular Genetics laboratory, Chief Paediatric Ophthalmology, Montreal Children’s Hospital, Montreal, QC, Canada

    Robert K. Koenekoop

  13. National Institute of Public Health, Cuernavaca, Mexico

    Filipa de Castro

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  1. Brian Greenfield
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  2. Melissa Henry
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  8. Amir Raz
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  9. L. Eugene Arnold
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  13. Filipa de Castro
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Correspondence to Brian Greenfield.

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Greenfield, B., Henry, M., Lis, E. et al. Correlates, stability and predictors of borderline personality disorder among previously suicidal youth. Eur Child Adolesc Psychiatry 24, 397–406 (2015). https://doi.org/10.1007/s00787-014-0589-9

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  • DOI: https://doi.org/10.1007/s00787-014-0589-9

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