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Kaila-Vanhatalo M, Tolmunen T, Mattila A, Kaltiala R. Prevalence of Personality Disorder Diagnoses in People Referred to Specialized Gender Identity Clinics in Finland. J Pers Disord 2025; 39:95-112. [PMID: 40293803 DOI: 10.1521/pedi.2025.39.2.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2025]
Abstract
A higher prevalence of personality disorder diagnoses has been found among individuals with gender dysphoria. However, previous studies on this topic have been limited and methodologically inconsistent. The object of this research was to determine the prevalence of personality disorder diagnoses in individuals requesting medical gender reassignment. A registerbased follow-up study tracked individuals who contacted the nationally centralized gender identity services in Finland in 1996-2019 (n = 3,665) and 8:1 age- and sex-matched population controls (n = 29,292). All their specialist-level psychiatric treatment contacts in 1994-2022 were identified in the National Care Register for Health Care. ICD-10 diagnoses and dates of the contacts were extracted. Among the gender dysphoria group, 15.0% (551 out of 3,665) had received a diagnosis in the personality disorder group (F60-69 excluding F64.x), while among the control subjects, 2.1% (625 out of 29,292) had received such a diagnosis.
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Affiliation(s)
- Marja Kaila-Vanhatalo
- From Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Faculty of Medicine and Health Technology, Oulu University Hospital, Oulu, Finland
| | - Tommi Tolmunen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aino Mattila
- Division of Psychiatry, Tampere University Hospital, Tampere, Finland
| | - Riittakerttu Kaltiala
- From Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland; and Vanha Vaasa Hospital, Vaasa, Finland
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Lu Z, Chen M, Yan S, Deng W, Wu T, Liu L, Zhou Y. The relationship between depressive mood and non-suicidal self-injury among secondary vocational school students: the moderating role of borderline personality disorder tendencies. Front Psychiatry 2023; 14:1187800. [PMID: 37867773 PMCID: PMC10585263 DOI: 10.3389/fpsyt.2023.1187800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) has become an important public health issue of global concern, often occurring in adolescents, and depressive mood is closely related to NSSI. In addition, NSSI is considered a symptom of borderline personality disorder. It has been found that adolescents in secondary vocational schools are more vulnerable to behavior and emotional disorders than those in general high schools. This study investigated the risk factors associated with NSSI affecting secondary vocational school students and analyzed the role of borderline personality disorder tendencies in promoting the occurrence of NSSI among students with depressive moods. Methods A total of 1,848 Chinese secondary vocational students completed a self-report questionnaire. The homemade NSSI behavior questionnaire, Patient Health Questionnaire-9 and Personality Diagnostic Questionnaire-4 were used in this survey. Binary logistic regression and PROCESS software analysis were used to explore the influencing factors associated with NSSI and to test for moderating effects. Results Female (OR = 3.412, 95% CI 2.301-5.060), drinking history (OR = 2.007, 95% CI 1.383-2.911), history of suicidal death exposure (OR = 3.161, 95% CI 1.999-4.999), depressive mood (OR = 2.436, 95% CI 1.668-3.558) and borderline personality disorder tendencies (OR = 2.558, 95% CI = 1.764-3.711) were independent risk factors for NSSI. Borderline personality disorder tendencies (B = 0.047, p = 0.000) moderated the relationship between depressive mood and NSSI. The stronger the borderline personality tendencies, the more NSSI behavior occurred when they were depressive. Conclusions Borderline personality disorder tendencies in secondary vocational school adolescents significantly enhance the association of depressive mood with NSSI. There is a moderating role for borderline personality disorder tendencies in depressive mood and NSSI.
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Affiliation(s)
- Zhaoyuan Lu
- School of Medicine, Jianghan University, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Affiliated Wuhan Mental Health Center, Jianghan University, Wuhan, China
| | - Mo Chen
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Shu Yan
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Weixi Deng
- Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Taimin Wu
- Institute of Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Lianzhong Liu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Affiliated Wuhan Mental Health Center, Jianghan University, Wuhan, China
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yang Zhou
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
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Shen JE, Huang YH, Huang HC, Liu HC, Lee TH, Sun FJ, Huang CR, Liu SI. Psychometric properties of the Chinese Mandarin version of the Borderline Symptom List, short form (BSL-23) in suicidal adolescents. Borderline Personal Disord Emot Dysregul 2023; 10:23. [PMID: 37553717 PMCID: PMC10411024 DOI: 10.1186/s40479-023-00230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND The short form of the Borderline Symptom List (BSL-23) is a self-rated instrument developed from the initial 95-item German version of the Borderline Symptom List (BSL-95). It is widely used among Chinese adults, but its applicability, factor structure and validity remain uncertain in adolescents. This study aimed to evaluate the psychometric properties of the Chinese Mandarin version of the BSL-23 in a sample of suicidal adolescents. METHODS The Chinese Mandarin BSL-23 was given to 279 outpatient adolescents with self-injurious thoughts or behaviors. The factor structure, reliability, convergent validity, criterion-related validity and cut-off value were investigated. RESULTS The Chinese Mandarin version of the BSL-23 demonstrated a one-factor structure and replicated the original version. The scale had high reliability and good test-retest stability. The Chinese Mandarin BSL-23 was correlated with depression, hopelessness, impulsivity, emotional dysregulation, self-esteem, loneliness, childhood trauma and parental bonding patterns evaluated with a variety of scales. The measure showed good criterion-related validity and predictive accuracy (AUC = 0.87) for self-injurious and suicidal adolescents with borderline personality disorder (BPD) at a cut-off point of 60/61 (mean score 2.60/2.65), with a sensitivity of 0.76 and specificity of 0.83. CONCLUSIONS The Chinese Mandarin version of the BSL-23 is a reliable and valid self-reported instrument to assess BPD symptomatology among suicidal adolescents.
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Affiliation(s)
- Jui-En Shen
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yu-Hsin Huang
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Hui-Chun Huang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Hui-Ching Liu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tsung-Han Lee
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Chiu-Ron Huang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shen-Ing Liu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan.
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
- MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
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Albermann M, Emery S, Baumgartner N, Strumberger M, Erb S, Wöckel L, Müller-Knapp U, Rhiner B, Contin-Waldvogel B, Bachmann S, Schmeck K, Berger G, Häberling I. Executive functions and borderline personality features in adolescents with major depressive disorder. Front Hum Neurosci 2023; 17:957753. [PMID: 37425294 PMCID: PMC10325791 DOI: 10.3389/fnhum.2023.957753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/26/2023] [Indexed: 07/11/2023] Open
Abstract
Background Executive functions (EF) consolidate during adolescence and are impaired in various emerging psychiatric disorders, such as pediatric Major Depressive Disorder (pMDD) and Borderline Personality Disorder. Previous studies point to a marked heterogeneity of deficits in EF in pMDD. We examined the hypothesis that deficits in EF in adolescents with pMDD might be related to comorbid Borderline Personality features (BPF). Methods We examined a sample of 144 adolescents (15.86 ± 1.32) diagnosed with pMDD. Parents rated their child's EF in everyday life with the Behavior Rating Inventory of Executive Function (BRIEF) and BPF with the Impulsivity and Emotion Dysregulation Scale (IED-27). The adolescents completed equivalent self-rating measures. Self- and parent-ratings of the BRIEF scores were compared with paired t-Tests. Correlation and parallel mediation analyses, ICC, and multiple regression analyses were used to assess symptom overlap, parent-child agreement, and the influence of depression severity. Results Over the whole sample, none of the self- or parent-rated BRIEF scales reached a mean score above T > 65, which would indicate clinically impaired functioning. Adolescents tended to report higher impairment in EF than their parents. Depression severity was the strongest predictor for BPF scores, with Emotional Control predicting parent-rated BPF and Inhibit predicting self-rated BPF. Furthermore, the Behavioral Regulation Index, which includes EF closely related to behavioral control, significantly mediated the relationship between depression severity and IED-27 factors emotional dysregulation and relationship difficulties but not non-suicidal self-injuries. Conclusion On average, adolescents with depression show only subtle deficits in executive functioning. However, increased EF deficits are associated with the occurrence of comorbid borderline personality features, contributing to a more severe overall psychopathology. Therefore, training of executive functioning might have a positive effect on psychosocial functioning in severely depressed adolescents, as it might also improve comorbid BPF. Clinical trial registration www.ClinicalTrials.gov, identifier NCT03167307.
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Affiliation(s)
- Mona Albermann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zürich, Switzerland
| | - Sophie Emery
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zürich, Switzerland
| | | | - Michael Strumberger
- Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, Basel, Switzerland
| | - Suzanne Erb
- Child and Adolescent Psychiatric Services St. Gallen, St. Gallen, Switzerland
| | - Lars Wöckel
- Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, Basel, Switzerland
- Clienia Littenheid AG, Littenheid, Switzerland
| | | | - Bruno Rhiner
- Child and Adolescent Psychiatry Thurgau, Weinfelden, Switzerland
| | | | - Silke Bachmann
- University Clinic of the Martin-Luther University Halle – Wittenberg’s Medical Faculty, Halle, Germany
- Département de Psychiatrie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Klaus Schmeck
- Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, Basel, Switzerland
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zürich, Switzerland
| | - Isabelle Häberling
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zürich, Switzerland
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Petrova N, Charnaia D, Khomenko A, Mamatkhodjaeva T, Chumakov E. Borderline personality disorder in clinical outpatient practice. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:111-116. [DOI: 10.17116/jnevro2022122121111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Artioli M, Bougon E, Mathur A, Salles J. Factors associated with a borderline personality disorder diagnosis in the emergency department. Front Psychiatry 2022; 13:925462. [PMID: 36245874 PMCID: PMC9555017 DOI: 10.3389/fpsyt.2022.925462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/29/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Research on borderline personality disorder (BPD) has shown that less intensive care is especially effective when patients have been told about their condition. However, problems with diagnosing the disorder are also described in the literature. This study thus aims to explore the factors associated with the challenges of identifying and then communicating a BPD diagnosis to patients. METHODS We analyzed a database of 202 patients of Toulouse University Hospital (France) who had a CIM-10 F60.3 diagnosis. This data was used to identify the sociodemographic and clinical benchmarks associated with patients who had received an established BPD diagnosis prior to their attendance at the hospital's emergency department (ED) in the study period. RESULTS Sixty-three percentage of the patients admitted to our psychiatric ED had been given an earlier diagnosis of BPD. Those who had not been diagnosed were more likely to: not have undergone any psychiatric follow-up; not have been hospitalized in the psychiatry department; and not have previously attended at the ED. Patients with BPD and a comorbidity of MDD were also less likely to have received a BPD diagnosis before their ED admission. CONCLUSION This study found that patients without an established BPD diagnosis who present at the ED are more likely to not be known to the psychiatric care system. This suggests that EDs have a specific role to play in making a diagnosis and the subsequent orientation of care.
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Affiliation(s)
- Mariasole Artioli
- Psychiatric Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Emmanuelle Bougon
- Psychiatric Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Anjali Mathur
- Psychiatric Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Juliette Salles
- Psychiatric Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Psychiatric Department, Infinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
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