summary
background Borderline personality disorder (bpd) is a severe and frequent disorder. Little is known about its early stages, which can be in childhood or adolescence.
aim To investigate to what extent bpd is stable from childhood through to adulthood.
method The literature was systematically reviewed with the help of Medline, Psycinfo, embase and the Cochrane Library.
results Of children known to have bpd in the primary school age-group, 80% met the criteria for a personality disorder in adulthood and 16% met the criteria for bpd. In a population study of adults with bpd, 30% still met the criteria two years later. In groups of adolescents at risk the criteria were met by 15-30 % after two to three years. These groups also showed a low dimensional stability for bpd. The most stable symptoms were feelings of emptiness, anger, affect-instability and identity problems. Less stable symptoms were suicidality, self-harm, impulsiveness, unstable relationships, derealisation and paranoid thinking.
conclusions Research into the stability of bpd that starts in children of primary school age has been too limited in a methodological sense for us to draw any firm conclusions. Research into bpd that starts in adolescence shows a low categorial and dimensional stability. Research into the onset of bpd in adults shows comparable low stability, but only after six years. In adolescents and adults impulsive and self-harm behaviour are probably the least stable symptoms and affective symptoms the most stable ones.