The clinical significance of subthreshold borderline personality disorder features in outpatient youth

Poster B57, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Andrew Chanen1,2,3, Henry Jackson4, Marialuisa Cavelti1,2, Jennifer Betts1,2, Louise McCutcheon1,3, Martina Jovev1,2,3, Katherine Thompson1,2; 1Orygen, the National Centre of Excellence in Youth Mental Health, 2Centre for Youth Mental Health, The University of Melbourne, 3Orygen Youth Health, Melbourne Health, 4School of Psychological Sciences, University of Melbourne

The absence of a distinct and scientifically robust threshold for ‘caseness’ for borderline personality disorder (BPD) also means that there is no distinct point of ‘onset’ for the disorder. This is a fundamental issue for ‘indicated prevention’, which includes ‘subthreshold’ forms of the disorder. However, the clinical significance of subthreshold features has not been investigated among real-world patients during the clinical emergence of BPD, which is usually between puberty and emerging adulthood. Studies among adult patients have found that subthreshold BPD features are associated with elevated psychosocial morbidity, compared with patients with no BPD features. This study aimed to replicate and extend this research, by comparing outpatient youth aged 15-25 years with subthreshold BPD features with outpatient youth who had no BPD features. The sample included 499 potential participants, of which 111 had no DSM-IV BPD features, and 155 had between one and four BPD features. Results indicated that the group with subthreshold BPD features had more severe mental illness and poorer social and occupational functioning. These findings suggest that subthreshold BPD features are clinically important and should be the focus of intervention to improve outcome and to reduce longer term disability and cost.

Topic Area: Personality Disorders

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