Personality disorders tend to overlap more broadly in adolescents than in adults, according to a study in the December 2000 American Journal of Psychiatry. Lead author Daniel F. Becker, M.D., associate clinical professor of psychiatry at the University of California at San Francisco, said researchers found evidence that borderline personality disorder frequently overlaps -- or is comorbid -- with other personality disorders, such as schizotypal and passive-aggressive personality disorders.
In the inpatient study, 138 adolescents and 117 adults were assessed with the Personality Disorder Examination, a diagnostic interview for DSM-III-R disorders. Sixty-eight adolescents and 50 adults met the criteria for borderline personality disorder. Results of the study showed that adults displayed significant diagnostic co-occurrence with borderline personality disorder for antisocial personality disorder only. But for the adolescents, borderline personality disorder showed significant co-occurrence with schizotypal and passive-aggressive disorders.
"Personality disorders are a little different in adolescents than in adults. We need to characterize those differences better through further studies," Becker said, adding that psychiatrists may have mixed feelings about diagnosing personality disorders in adolescents. One reason is the stigma often associated with personality disorders, and another is that therapists may be reluctant to label a teenager with a disorder because they may end up "growing out of it."
But Becker said these diagnoses are not meant to be used as labels; instead, they are descriptors that can be used to guide treatment. "If we shy away from diagnosis, we may be doing patients a disservice," he said.
With treatment, personality disorders may improve over time, Becker said. That may be because personality disorders in teens are less stable than personality disorders in adults, and young people who are treated often do get better.
The study points up the need for more longitudinal research, Becker said; further studies, conducted at multiple points over time, would better help identify the changes adolescents undergo with regard to comorbidity.
"We're trying to determine to what extent are these diagnoses meaningful in adolescents. If they are meaningful, then what do they mean?"
The American Psychiatric Association is a national medical specialty society that represents nearly 40,000 psychiatric physicians specializing in the diagnosis, treatment and prevention of mental illnesses and substance use disorders.
Comorbidity of Borderline Personality Disorder with Other Personality Disorders in Hospitalized Adolescents and Adults," by Daniel F. Becker, M.D., et al., p. 2011, American Journal of Psychiatry, December 2000.
- American Psychiatric Association
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