The abuse of prescription medications: borderline personality patients in psychiatric versus non-psychiatric settings.

OBJECTIVE

In this study, the prevalence of prescription substance abuse among those with borderline personality symptomatology was examined in a large cohort of respondents who participated in one of 13 prior research projects.

METHOD

The entire cohort (N = 1039) was divided into 3 subsamples: a psychiatric sample (n = 440), a predominantly primary care sample (n = 599), and an internal medicine sample (n = 332; i.e., a well-defined subset of the predominantly primary care sample that consisted of only internal medicine outpatients seen at one location). The borderline personality scale of the Personality Diagnostic Questionnaire (PDQ), either the revised (PDQ-R) or fourth (PDQ-4) version, was used to diagnose all participants either with or without borderline personality. One item from the Self-Harm Inventory, "Have you ever intentionally, or on purpose, abused prescription medication?," was then used in the subsequent analyses.

RESULTS

Among the psychiatric, predominantly primary care, and internal medicine subsamples, the prevalence rates of prescription medication abuse in those diagnosed with borderline personality according to the PDQ were 46.9%, 46.2%, and 11.5%, respectively. In all subsamples, those with borderline personality were statistically significantly more likely to abuse prescription medication than those without the disorder. For example, borderline patients in the psychiatric sample were twice as likely to abuse prescription medications, in the predominantly primary care sample 4 times as likely, and in the internal medicine only sample nearly 6 times as likely.

CONCLUSIONS

Regardless of setting, patients with BPD are at great risk for the abuse of prescription medications.