Relationship between borderline personality disorder and axis I diagnosis in severity of depression and anxiety

Background: This study tested the hypothesis that subjects with borderline personality disorder irrespective of the presence or absence of an Axis I m ood or anxiety disorder would exhibit greater severity of depression and an xiety than subjects with either a personality disorder other than borderlin e personality disorder or no personality disorder. Method: Two hundred eighty-three subjects from an outpatient psychiatry cli nic were administered the following assessments: the Structured Clinical In terview for DSM-III-R (SCID) for Axes I and ii, the Hamilton Rating Scales for Depression and Anxiety, the Beck Depression Inventory, and the Spielber ger State-Trait Anxiety Inventory. Subjects were categorized into borderlin e personality disorder, other personality disorder, and no personality diso rder categories and into present versus absent categories on Axis I diagnos is of depression and of anxiety. A 2-factor multiple analysis of variance c ompared personality disorder status and Axis I diagnosis on severity of dep ression by observer rating and self-report. The analysis was repeated for a nxiety. Results: As hypothesized, significant main effects were found for borderlin e personality disorder and for both depression and anxiety. Subjects with b orderline personality disorder showed greater severity on both depression a nd anxiety rating scales than did patients with another personality disorde r, who showed greater severity than did patients with no personality disord er. Axis I diagnosis was also associated with greater severity on depressio n or anxiety rating scales. These differences were found for both observer ratings and self-report. An interaction was also found for depression: Subj ects with borderline personality disorder but without an Axis I diagnosis o f depression rated themselves as more severely depressed on the Beck Depres sion Inventory than did subjects with another or no personality disorder wh o also had an Axis I diagnosis of depression. Conclusion: Implications from the study are discussed including the need to assess for borderline personality disorder in research studies of depressi on and anxiety and to integrate treatments for borderline personality disor der into depression and anxiety treatment to maximize clinical outcomes.