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Tijdschrift voor Psychiatrie 53 (2011) 1, 27 - 36

Review article

The course of borderline personality disorder within adults. A literature review

S.A.A. Vriend-Bosma, H.J.G.M. van Megen

background Borderline personality disorder (bpd) is a frequent and often severely debilitating disorder. According to the definition, a personality disorder is stable and of long duration. In the last few years, however, more and more research results have demonstrated improvements in patients with bpd and even remission.
aim To investigate to what extent the diagnosis of bpd is stable over time.
method The literature was reviewed systematically with the help of Medline,Psycinfo, embase and the Cochrane Library.
results After 10 years 88% of adults originally diagnosed as having bpd failed to meet the dsm-iv criteria. Of the various symptoms the affective ones seemed to be the most stable and the impulsive ones the least stable. All symptoms were significantly less severe. With regard to psychosocial functioning, improvements occurred more slowly. Dysfunctioning in relationships was the most stable. It is not clear whether impairments in functioning will persist.
conclusion In recent years there has been a considerable amount of prospective research into the stability of the diagnosis of bpd. Results show that the prognosis relating to symptom reduction and psychosocial functioning is much more favourable than previously assumed.

keywords adults, borderline personality disorder, remission, stability