BPD + co-existing disorder

On the page we will include resources relating to BPD plus co-existing disorders.

The term “co-existing disorders” (sometimes referred to as co-morbidity) describes the presence of two or more disorders occurring in the same person.  These may be other mental health issues or physical illnesses.

The evidence base around this is fortunately increasing.

Co-existing mental health disorders are extremely common in people with BPD, with the symptoms of other diagnoses often overlaping. So it is important that they are diagnosed correctly and managed actively keeping in mind that the existence of another disorder does not necessarily mean that they should be treated separately. The most common co-existing mental health disorders associated with BPD include the following:

• Major depressive disorder (35-85%)
• Dysthymic disorder (25-65%)
• Bipolar affective disorder (5-15%)
• Generalised anxiety disorder (10-22%)
• Panic disorder (30-50%)
• Agoraphobia (10-35%)
• Social phobia (25-50%)
• Post-traumatic stress disorder (PTSD) (35-55%)
• Obsessive-compulsive disorder (15-25%)
• Eating disorder (30-50%)
• Substance use disorder (20-65%)
• Attention deficit hyperactivity disorder (ADHD) (16-38%) (National Health and Medical Research Council 2012, Bateman and Krawitz 2013, Tomko, Trull et al. 2014)

People with BPD can often meet the criteria for another personality disorder with the most common being:
• Avoidant personality disorder (35-47%)
• Dependent personality disorder (40-50%)
• Paranoid personality disorder (20-30%)
• Antisocial personality disorder (15-25%, likely to be higher in forensic and prison services) (Bateman and Krawitz 2013) (McGlashan, Grilo et al. 2000, Zimmerman, Rothschild et al. 2005, Tomko, Trull et al. 2014).
BPD is less associated with schizoid, histrionic and obsessive-compulsive personality disorders (Zimmerman, Rothschild et al. 2005).
It is usual for people with BPD to meet the criteria for one or more mental health disorders over the course of their life.

Substance Use Disorder

Project Air Strategy Webinar/MHPN: Personality Disorders and Substance Use: Tips on effective treatment approaches