Borderline personality features and development of psychosis in an Ultra High Risk (UHR) population: a case control study

Early Intervention in Psychiatry, 06/08/2012

Co–occurring borderline personality disorder (BPD) or BPD features does not appear to strongly influence the risk of short–term transition to psychosis or the risk of developing a non–affective psychotic disorder in this population.


  • This is a case-control study of ‘Ultra High Risk’ (UHR) for psychosis patients treated at the clinic, between 2004 and 2007.
  • ‘Cases’ were UHR individuals who made the ‘transition’ to full threshold psychotic disorder within 24 months; ‘Control’ group was a matched UHR sample who had not developed a psychotic disorder at 24 months.
  • Individuals were matched on time of entry to the clinic, age and gender.
  • Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) BPD features were assessed from clinical assessments using a structured instrument (Structured Clinical Interview for DSM-IV Axis II Disorder for BPD (SCID-II BPD) ).
  • Psychosis diagnosis following transition was rated from the clinical files using the operational criteria in studies of psychotic illness (OPCRIT) computer algorithm.
  • The number of BPD traits and number with full threshold BPD were compared in those who developed psychosis and those who did not.


  • The authors analysed data from 48 cases and 48 controls.
  • There was no statistically significant difference in the rate of transition to psychosis for those with baseline full-threshold BPD, compared with those without BPD.
  • The number of BPD traits or number with full threshold BPD did not differ by psychosis diagnosis grouping.

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