Substance Misuse Is Associated With Increased Psychiatric Severity Among Treatment-Seeking Individuals With Borderline Personality Disorder

Abstract

Despite high prevalence rates of concurrent borderline personality disorder (BPD) and substance use disorders (SUDs), little is known about the impact of substance misuse on the presentation of BPD. Sixty-five individuals with BPD were assessed at intake and at 3- and 6-month follow-up. Assessment included validated instruments such as the Addiction Severity Index and the Revised Symptom Checklist (SCL-90-R). Over half (58.5%) of individuals entering treatment were currently misusing substances. Substance misuse was associated with more legal and employment problems, greater mood disturbance, impulsivity, and psychiatric severity, including almost all SCL-90-R subscales. For the majority of patients (58%), there was little change in substance misuse post-treatment. The high prevalence of substance misuse and its association with psychiatric severity among individuals with BPD suggest that substance misuse should be a targeted behavior during treatment, and further specialized interventions are needed for individuals with comorbid BPD and SUD.