Bordeline personality disorder in primary care: Characteristics and patterns of comorbidity

Background and aims:Borderline personality disorder (BPD) seems to be a prevalent condition in Primary Care (PC) with high rates of comorbidity and health care use. The aim of this study is to describe the characteristics and patterns of comorbidity in patients with suspected BPD.Methods:192 consecutive primary health care patients completed the IPDE screening questionnaire, CAGE and the Prime-MD patient questionnaire, and were interviewed by a general practitioner (GP) using the Prime-MD. Number of visits to the GP (last year), medical illnesses and treatments were also collected. “High Risk” of BPD group (RBPDg) was defined by scoring 4 or higher in the IPDE, and it was compared to patients without psychiatric morbidity and patients with any psychiatric disorder but not BPD's risk.Results:39 (20,3%) patients fulfilled the condition of RBPDg. Compared to the group of patients without psychiatry pathology (n=110) RBPDg had a higher number of visits to their GP (last year) (p<0,001), more somatic complaints (p<0,001), a worse health perception (p<0,001) and higher rates of alcohol abuse or dependence (p=0,016).In the RBPDg we found a high rate of axis I disorders, mainly major depressive disorder (MDD) (40,0%) and generalized anxiety disorder (33,3%). Furthermore, they had a lower level of education (p=0,03) and a higher rate of MDD (p=0,026) than patients with psychiatric pathology but without risk of BPD (n=43).Conclusions:Borderline personality traits or disorder could be present in many depressive patients seen in PC. GP's knowledge about personality disorders needs to be improved