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Prediction of time‐to‐attainment of recovery for borderline patients followed prospectively for 16 years
Author(s) -
Zanarini M. C.,
Frankenburg F. R.,
Reich D. B.,
Wedig M. M.,
Conkey L. C.,
Fitzmaurice G. M.
Publication year - 2014
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12255
Subject(s) - borderline personality disorder , psychology , extraversion and introversion , personality , proportional hazards model , bivariate analysis , psychiatry , neuroticism , clinical psychology , medicine , big five personality traits , social psychology , statistics , mathematics
Objective The purpose of this study was to determine the most clinically relevant baseline predictors of time‐to‐recovery from borderline personality disorder. Method Two hundred and ninety in‐patients meeting rigorous criteria for borderline personality disorder were assessed during their index admission using a series of semistructured interviews and self‐report measures. Recovery status, which was defined as concurrent symptomatic remission and good social and full‐time vocational functioning, was reassessed at eight contiguous 2‐year time periods. Survival analytic methods (Cox regression), which controlled for overall baseline severity, were used to estimate hazard ratios and their confidence intervals. Results All told, 60% of the borderline patients studied achieved a 2‐year recovery. In bivariate analyses, seventeen variables were found to be significant predictors of earlier time‐to‐recovery. Six of these predictors remained significant in multivariate analyses: no prior psychiatric hospitalizations, higher IQ, good full‐time vocational record in 2 years prior to index admission, absence of an anxious cluster personality disorder, high extraversion, and high agreeableness. Conclusion Taken together, the results of this study suggest that prediction of time‐to‐recovery for borderline patients is multifactorial in nature, involving factors related to lack of chronicity, competence, and more adaptive aspects of temperament.