Laboratory for the Study of Adult Development, McLean Hospital, Belmont, MA 02478, USA.
J Psychiatr Res. 2013 Oct;47(10):1499-506. doi: 10.1016/j.jpsychires.2013.06.012. Epub 2013 Jul 12.
The interaction of borderline personality disorder (BPD) with physical health has not been well characterized. In this longitudinal study, we investigated the long-term relationship of chronic medical illnesses, health-related lifestyle choices, and health services utilization to recovery status in borderline patients over a decade of prospective follow-up.
264 borderline patients were interviewed concerning their physical health at 6-year follow-up in a longitudinal study of the course of BPD. This sample was then reinterviewed five times at two-year intervals over the next ten years. We defined recovery from BPD based on a Global Assessment of Functioning score of 61 or higher, which required BPD remission, one close relationship, and full-time competent and consistent work or school attendance. We controlled for potentially confounding effects of time-varying major depressive disorder.
Never-recovered borderline patients were significantly more likely than ever-recovered borderline patients to have a medical syndrome, obesity, osteoarthritis, diabetes, urinary incontinence, or multiple medical conditions (p<0.0063). They were also significantly more likely to report pack-per-day smoking, weekly alcohol use, no regular exercise, daily sleep medication use, or pain medication overuse (p<0.0083). In addition, never-recovered borderline patients were significantly more likely than ever-recovered borderline patients to undergo a medical emergency room visit, medical hospitalization, X-ray, CT scan, or MRI scan (p<0.0063).
Over a decade of prospective follow-up, failure to recover from BPD seems to be associated with a heightened risk of chronic medical illnesses, poor health-related lifestyle choices, and costly health services utilization.
边缘型人格障碍（BPD）与身体健康之间的相互作用尚未得到充分描述。在这项纵向研究中，我们调查了慢性疾病、与健康相关的生活方式选择和卫生服务利用在 10 年的前瞻性随访中与边缘型人格障碍患者康复状况的长期关系。
在一项关于 BPD 病程的纵向研究中，我们在 6 年的随访中对 264 名边缘型患者进行了有关其身体健康的访谈。然后，在接下来的十年中，每隔两年对他们进行了五次重新访谈。我们根据功能总体评估分数为 61 或更高来定义 BPD 的康复，这需要 BPD 缓解、一个亲密关系、全职胜任和持续的工作或上学。我们控制了时间变化的主要抑郁障碍的潜在混杂效应。
从未康复的边缘型患者比从未康复的边缘型患者更有可能患有医学综合征、肥胖、骨关节炎、糖尿病、尿失禁或多种疾病（p<0.0063）。他们也更有可能报告每天吸烟一包、每周饮酒、不规律运动、每天使用睡眠药物或过度使用止痛药（p<0.0083）。此外，从未康复的边缘型患者比从未康复的边缘型患者更有可能接受急诊室就诊、医疗住院、X 光、CT 扫描或 MRI 扫描（p<0.0063）。
在 10 年的前瞻性随访中，未能从 BPD 中康复似乎与慢性疾病、不良健康相关的生活方式选择和昂贵的卫生服务利用风险增加有关。
