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Elevated risk of sexually transmitted infections among adolescents and young adults with borderline personality disorder: a retrospective longitudinal nationwide population-based study

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Abstract

In this study, we examined the risk of sexually transmitted infections (STIs) among adolescents and young adults (AYAs) with borderline personality disorder (BPD). A total of 4649 AYAs with BPD and 46,490 age-, sex-, and socioeconomic-matched controls without BPD were enrolled from the National Health Insurance Research Database of Taiwan from 2001 to 2009 and were followed up until the end of 2011. Participants who contracted any STI during the follow-up period were identified. Cox regression analysis was conducted to examine the risk of contracting any STI among both patients and controls. A total of 4649 AYAs with BPD and 46,490 age-, sex-, and socioeconomic-matched controls without BPD were enrolled from the National Health Insurance Research Database of Taiwan from 2001 to 2009 and were followed up until the end of 2011. Participants who contracted any STI (ICD-9-CM code 042, 091–097, 087.11, 078.8, 078.88, 131, and 054.1) during the follow-up period were identified. Cox regression and sub-analyses stratified by sex, age, psychiatric comorbidity subgroups, and psychotropic medication usage were conducted to assess STI risk. AYAs with BPD were at a higher risk of contracting any STI (hazard ratio [HR] = 50.79, 95% confidence interval [CI] = 33.45–77.11) in comparison with controls, including HIV, syphilis, genital warts, gonorrhea, chlamydia, trichomoniasis, and genital herpes. The association of BPD with an increased risk of any STI was prevalent in both sexes, adolescents, and young adult patients. BPD with or without psychiatric comorbid subgroup were all associated with an elevated risk of contracting any STI relative to the control group. AYAs with BPD are highly susceptible to contracting STIs. Future studies should examine the role of the core symptoms of BPD, sexual orientation, risky sex behaviors, depressive and anxiety symptoms, and substance use before sex in the risk of STIs among AYAs with BPD.

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Acknowledgements

The authors would like to thank Mr. I-Fan Hu for his support. This manuscript was edited by Wallace Academic Editing.

Funding

This study was supported by grants from Taipei Veterans General Hospital (V111C-010, V111C-040, V111C-029, V112C-033, V111D62-003-MY3-1, V111D62-003-MY3-2, and V111D62-003-MY3-3), the Yen Tjing Ling Medical Foundation (CI-109-21, CI-109-22, and CI-110-30), the Ministry of Science and Technology of Taiwan (MOST110-2314-B-075-026, MOST110-2314-B-075-024-MY3, MOST109-2314-B-010-050-MY3, MOST111-2314-B-075-014-MY2, and MOST111-2314-B-075-013), the National Science and Technology Council of Taiwan (NSTC 112-2314-B-075-012), the Taipei, Taichung, and Kaohsiung Veterans General Hospital, Tri-Service General Hospital, Academia Sinica Joint Research Program (VTA112-V1-6-1), and the Veterans General Hospitals and University System of Taiwan Joint Research Program (VGHUST112-G1-8-1). The funding sources had no role in any of the study procedures.

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Author notes

  1. Chao-Cheng Chang and Mu-Hong Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Psychiatry, Yuli Branch, Taipei Veterans General Hospital, Hualien, Taiwan

    Chao-Cheng Chang

  2. Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Beitou District, Taipei, 11217, Taiwan

    Mu-Hong Chen, Ya-Mei Bai, Shih-Jen Tsai & Ying-Jay Liou

  3. Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Mu-Hong Chen, Ya-Mei Bai, Shih-Jen Tsai & Ying-Jay Liou

  4. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Tzeng-Ji Chen

  5. Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan

    Tzeng-Ji Chen

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  1. Chao-Cheng Chang
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Contributions

Chao-Cheng Chang: conceptualization, methodology, writing-original draft and writing-review. Mu-Hong Chen: conceptualization, methodology, formal analysis, writing-review. Ya-Mei Bai: conceptualization, writing-review, funding acquisition. Shih-Jen Tsai: conceptualization, writing-review, funding acquisition. Tzeng-Ji Chen: methodology, writing-review. Ying-Jay Liou: conceptualization, methodology, formal analysis, writing-original draft, writing-review & editing, funding acquisition.

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Correspondence to Ying-Jay Liou.

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Chang, CC., Chen, MH., Bai, YM. et al. Elevated risk of sexually transmitted infections among adolescents and young adults with borderline personality disorder: a retrospective longitudinal nationwide population-based study. Eur Child Adolesc Psychiatry (2024). https://doi.org/10.1007/s00787-024-02464-0

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