Developments in Diagnosis and Treatment of People With Borderline Personality Disorder

Sathya Rao; Parvaneh Heidari; Jillian H. Broadbear


Curr Opin Psychiatry. 2020;33(5):441-446. 

In This Article

Recent Developments in the Treatment of Borderline Personality Disorder

Although BPD is more readily diagnosed, treatment referrals remain stymied by barriers to treatment provision. At a population level, most patients with BPD are unable to access evidence-based psychological treatments because of the lack of adequately trained clinicians and resource constraints.[26]

The landmark McLean Study of Adult Development is entering its 24th year, with publication of 10, 14, 16, and 24-year follow-up data.[28] This study, with 290 patients and 79 controls, conducts assessments every two years. All patients had severe BPD at recruitment and continued to receive psychotherapy and medications throughout the follow-up period. After 16 years, 99% of patients had achieved remission lasting at least two years; 78% had a remission lasting eight years.[27,28] A surprising finding was that recurrence of BPD was rare – 6% at 10 years – showing that sustained remission is common. Sixty per cent of patients attained recovery by 16 years; however when the definition of 'recovery' included little or no comorbidity, only 39% of patients attained this outcome. Achieving full functional recovery is the next challenge for the BPD field.