Background: Borderline personality disorder (BPD) usually emerges during adolescence and is associated with severe morbidity. Individuals with BPD are also vulnerable to develop eating disorders as well as mood disorders.
Objective: To study the prevalence of borderline personality and its association with binge-eating and bipolar spectrum disorder in college students.
Methods: A questionnaire based survey was conducted on a convenience sample of 500 college students (> 18 years of age) in medical and engineering campus. Participants were screened on self-report measures including McLean Screening Instrument for BPD (MSI-BPD), Mood Disorder Questionnaire (MDQ) and Binge-Eating Disorder Screener (BEDS-7) for BPD, bipolar spectrum disorder (BSD) and binge-eating disorder (BED), respectively.
Results: The prevalence of BPD was 76 (15.2%, 95% CI 12.3–18.6), BSD was 43 (8.6%, 95% CI 6.4–11.5) and BED was 48 (9.6%, 95% CI 7.2–12.6). There was a significantly higher proportion of BSD (OR 23.6, 95% CI 11.3–49.3) and BED (OR 3.4, 95% CI 1.8–6.5) among those with BPD than those without.
Conclusions: BPD was found in 15% of adolescents and they have higher proportion of BED and BSD. Early identification may help in planning early intervention strategies to reduce associated morbidity.
Borderline personality disorder (BPD) is a complex and serious psychiatric disorder affecting approximately 0.7–5.9% of the general population (Swartz et al., 1990; Lenzenweger et al., 2007). It is a devastating mental illness that centers on the inability to manage emotions effectively. The symptoms include: fear of abandonment, impulsivity, rage, bodily self‐harm, suicide, and chaotic relationships. There is a high rate of attempted suicide and approximately 10% of adults with BPD commit suicide (Skodol et al., 2002). The symptoms lead to impairment in psychosocial functioning and high rates of mental health treatment utilization (Bender et al., 2001). It is known that BPD is underdiagnosed in most clinical settings, which can lead to delay in starting appropriate treatment or sometimes, lead to unnecessary treatment. Personality disorder has its origins in childhood and adolescence, however, diagnosing personality disorder before 18 years is difficult considering evolving nature of the disorder. Recent studies found that borderline personality and mood disorders in youth can be diagnosed with more certainty (Newton-Howes et al., 2015). BPD is recognizable early in life, evolves continuously across the lifespan, and is more plastic than previously believed. BPD or symptoms of borderline personality in young people is associated with high morbidity and potentially poor outcomes. BPD independently predicts current psychopathology, poor general functioning, poor self-care, and poor relationships with family, peers, and significant others (Chanen et al., 2007; Kaess et al., 2012). In a community-based sample of children and adolescents, the prevalence of borderline personality disorder was 11% at age 9–19 years and 22% at 15–25 years (Bernstein et al., 1993). BPD is more common in women than in men (about 70% and 30%, respectively) (Widiger and Weissman, 1991). Individuals with BPD are also vulnerable to develop eating disorders like binge-eating episodes followed by self-harm demonstrated through induced vomiting or other purging behaviors as well as mood disorders. The most common personality disorder in bulimia nervosa was borderline personality disorder, with a prevalence rate of 28% (Sansone and Sansone, 2011).