Child and Adolescent Psychiatry Services, Amiens-Picardie University Medical Centre , Amiens, France.
Psychiatry Residency Program, Department of Psychiatry, University of Picardie-Jules Verne, Amiens, France.
Soc Psychiatry Psychiatr Epidemiol. 2021 Nov;56(11):2053-2062. doi: 10.1007/s00127-021-02067-z. Epub 2021 Mar 21.
The early identification of borderline personality traits (BPT) in adolescents helps to prevent their progression. Data are available for the clinical population, but little has been published on the general population, especially regarding age and sex distribution in adolescence. Even less is known about the comorbidity of BPT with other mental disorders.
We estimated the prevalence of BPT, by sex, age, and comorbidity, in a sample of adolescents aged 12-14 years (n = 799) from the Quebec Mental Health Survey. A complex sampling design was used to ensure representativeness. BPT was assessed with the abbreviated-diagnostic interview for borderlines-revised, with the adolescent as an informant. Reliability coefficients were above 0.80. Several levels of severity were explored using an independent criterion, defined by impairment according to the Columbia impairment scale.
The overall prevalence of BPT was 6.3%. Prevalence estimates for the most impaired were 3.2% for the entire sample and 1.3% for 12-year-olds. Prevalence increased significantly with age for most impairment levels but did not differ significantly between the sexes. In adolescents, BPT displayed moderate-to-strong comorbidity with anxiety (AD) and insomnia disorders, and very strong comorbidity with depressive (DD), attention deficit hyperactivity (ADHD), and oppositional defiant/conduct disorders (ODD/CD).
We, therefore, make two clinical recommendations for child psychiatry practice: (1) with respect to the lower rate of male adolescents attending BPT Health Programs, increase BPT screening in male adolescents; (2) evaluate BPT when children with ADHD or ODD/CD develop AD or DD during adolescence.
早期识别青少年的边缘型人格特质（BPT）有助于防止其发展。临床人群的数据已经可用，但关于普通人群的数据，尤其是青少年的年龄和性别分布，发表的内容很少。关于 BPT 与其他精神障碍的共病性，人们知之甚少。
我们使用魁北克精神健康调查中 12-14 岁的青少年样本（n=799），通过性别、年龄和共病来估计 BPT 的患病率。使用复杂的抽样设计以确保代表性。使用简化的边界线修订诊断访谈，由青少年作为信息提供者来评估 BPT。可靠性系数高于 0.80。使用独立标准（根据哥伦比亚损伤量表确定的损伤）探索了几个严重程度级别。
BPT 的总体患病率为 6.3%。最严重损伤的患病率估计值为整个样本的 3.2%，12 岁儿童为 1.3%。大多数损伤水平的患病率随年龄显著增加，但男女之间没有显著差异。在青少年中，BPT 与焦虑（AD）和失眠障碍有中度至高度的共病性，与抑郁（DD）、注意缺陷多动（ADHD）和对立违抗性/品行障碍（ODD/CD）有很强的共病性。
因此，我们向儿童精神病学实践提出了两条临床建议：（1）鉴于男性青少年参加 BPT 健康计划的比例较低，增加对男性青少年的 BPT 筛查；（2）当患有 ADHD 或 ODD/CD 的儿童在青春期出现 AD 或 DD 时，评估 BPT。
