Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Research & Innovation Department, Caludon Centre, Coventry and Warwickshire Partnership Trust, Coventry, UK.
Aust N Z J Psychiatry. 2020 Mar;54(3):308-317. doi: 10.1177/0004867419882494. Epub 2019 Oct 24.
Despite considerable morbidity and functional losses associated with adolescent borderline personality disorder, little is known about psychopathological outcomes. This study examined associations between adolescent borderline personality disorder symptoms and subsequent depressive, psychotic and hypomanic symptoms.
We used data from the Avon Longitudinal Study of Parents and Children. Participants were adolescents living in the community who had data for all longitudinal outcomes ( = 1758). We used logistic regression and path analysis to investigate associations between borderline personality disorder (five or more probable/definite symptoms) reported at age 11-12 years and depressive and psychotic symptoms reported at age 12 and 18, and lifetime hypomanic symptoms reported at age 22-23 years.
Adolescent borderline personality disorder symptoms were associated with psychotic symptoms (odds ratio: 2.36, confidence interval: [1.82, 3.06]), diagnosis of depression at age 18 years (odds ratio: 1.30, confidence interval: [1.03, 1.64]) and hypomanic symptoms (odds ratio: 2.89, confidence interval: [2.40, 3.48]) at 22-23 years. Path analysis controlling for associations between all outcomes indicated that borderline personality disorder symptoms were independently associated with depressive symptoms (β = 0.97, < 0.001) at 12 years and hypomanic (β = 0.58, < 0.01) symptoms at 22-23 years. Borderline personality disorder symptoms were also associated with psychotic symptoms at age 12 years (β = 0.58, < 0.01), which were linked (β = 0.34, < 0.01) to psychotic symptoms at age 18 years.
Adolescents with borderline personality disorder symptoms are at future risk of psychotic and hypomanic symptoms, and a diagnosis of depression. Future risk is independent of associations between psychopathological outcomes, indicating that adolescent borderline personality disorder symptoms have multifinal outcomes. Increasing awareness of borderline personality disorder in early adolescence could facilitate timely secondary prevention of these symptoms subsequently, helping to prevent future psychopathology.
尽管青少年边缘型人格障碍与相当大的发病率和功能丧失有关，但对其心理病理学结局知之甚少。本研究探讨了青少年边缘型人格障碍症状与随后的抑郁、精神病和轻躁狂症状之间的关系。
我们使用了阿冯纵向研究父母与子女的数据。参与者为居住在社区的青少年，他们所有的纵向结局数据均可用（ = 1758）。我们使用逻辑回归和路径分析来调查 11-12 岁时报告的边缘型人格障碍（有五个或更多可能/明确的症状）与 12 岁和 18 岁时报告的抑郁和精神病症状，以及 22-23 岁时报告的终生轻躁狂症状之间的关系。
青少年边缘型人格障碍症状与精神病症状相关（优势比：2.36，置信区间：[1.82，3.06]），18 岁时被诊断为抑郁症（优势比：1.30，置信区间：[1.03，1.64]）和 22-23 岁时的轻躁狂症状（优势比：2.89，置信区间：[2.40，3.48]）。控制所有结局之间的关联的路径分析表明，边缘型人格障碍症状与 12 岁时的抑郁症状（β = 0.97， < 0.001）和 22-23 岁时的轻躁狂症状（β = 0.58， < 0.01）独立相关。边缘型人格障碍症状也与 12 岁时的精神病症状相关（β = 0.58， < 0.01），而这些症状与 18 岁时的精神病症状相关（β = 0.34， < 0.01）。
患有边缘型人格障碍症状的青少年未来有患精神病和轻躁狂症状以及抑郁症的风险。未来的风险与心理病理学结局之间的关联无关，表明青少年边缘型人格障碍症状有多种结局。在青少年早期提高对边缘型人格障碍的认识，可以促进随后及时对这些症状进行二级预防，从而预防未来的精神病理学。
